Global Health Governance at a Crossroads.

Area of Science:

• Public Health
• International Relations
• Health Policy

Background:

• The evolution from international health governance (IHG) to global health governance (GHG) involves diverse actors and complex dynamics.
• Understanding the multifaceted framing of health—as national security, human security, human rights, or a global public good—is crucial for effective GHG.
• Decades-old challenges in GHG persist, necessitating novel approaches.

Purpose of the Study:

• To review and synthesize the existing literature on global health governance (GHG).
• To identify major actors, challenges, successes, and key themes within GHG.
• To explore potential new frameworks for advancing global health governance.

Main Methods:

• Systematic literature review of global health governance (GHG).
• Analysis of the transition from international health governance (IHG) to GHG.
• Examination of major themes including persistent problems, approaches, multisectoral connections, economic influences, health framing, inequalities, ownership, international law, and research gaps.

Main Results:

• Persistent challenges in GHG remain despite various approaches (vertical, horizontal, diagonal).
• The framing of health significantly impacts governance strategies and outcomes.
• Global health inequalities, issues of local ownership, and the role of international law are critical components of GHG.
• Existing GHG frameworks are insufficient, highlighting the need for new directions.

Conclusions:

• Decades-old challenges in global health governance persist, indicating a need for innovative solutions.
• The concept of shared health governance presents a promising framework for addressing contemporary global health challenges.
• Further research is needed to address identified gaps in the GHG literature.