Rituals of global health: Negotiating the World Health Assembly

The World Health Assembly is the WHO's supreme decision-making body and consists of representatives from the 194 WHO Member States who take formal decisions on the WHO's policies, workplan and budget. The event is also attended by representatives of non-governmental organisations, the private sector, the press and even members of the public. Based on participant observation at six World Health Assemblies, in-depth interviews with 53 delegates to the WHA, and an analysis of WHA Official Records, this article examines the ritualistic aspects of WHA negotiations. We argue that analysing the WHA as a ritual provides an insight into power and legitimacy within global health. Not only are certain understandings of health issues and courses of actions decided by the Assembly, but also the very boundaries of global health community are set. The rules of the ritual place limits on different categories of actors, while both formal and informal rules of behaviour further serve to include or exclude actors from the rituals. Success in negotiation is measured by through the inclusion of certain ideas, norms and values in the wording of resolutions and is achieved through the repetition of language in speeches and by adhering to the rules of behaviour.