SeriesInternational collective action in health: objectives, functions, and rationale
Section snippets
International organisations and nation states
International health is characterised by different types of institution. However, we focus in this paper on WHO, which is the primary organisation in international health cooperation. We do not analyse the work that WHO is carrying out, but provide a framework to derive a definition of the functions of any effective world health organisation. Such a process can help efforts to bridge the gap between current performance and desired improvements.
Many attempts have been made to specify the
Core functions
The first type of essential function transcends the sovereignty of any one nation state, and therefore makes up the core of international health cooperation. These functions address problems of the “global commons”,9 in which individual decisions based on property rights are made ineffective by the fact that use of resources cannot be contained within boundaries. This is the case with both international public goods—when use by any one country producing them does not preclude use by other
Supportive functions
The second type of essential function deals with problems within individual countries that may warrant collective action at an international level owing to the shortcomings of national health systems; because they supplement activities that are primarily the responsibility of nation states, these functions are supportive.
In view of human-rights arguments and an ethical imperative to protect the health of people, irrespective of their nationality, the international community can become an “agent
Conclusions
The distinction between core and supportive functions has important implications. Core functions are an attempt to solve the global analogue of “market failures”—ie, situations in which costs and benefits of an action are not reaped exclusively by the individual agent, in this case, the nation state. Supportive functions, by contrast, are intended to compensate for “government failures”—ie, scenarios in which a government cannot fulfil its responsibilities independently. The ultimate goal of
References (19)
America's vital interest in global health: protecting our people, enhancing our economy, and advancing our international interests
(1997)Enhancing the performance of international health institutions
(1996)The future of international health: report on the regional follow-up for the Americas of the Pocantico Retreat
(1997)Basic documents: 39th edition
(1992)- et al.
The future of world health: the new world order and international health
BMJ
(1997) Jihad vs McWorld
(1996)World Development Report 1997: the state in a changing world
(1997)The United Nations revisited
Foreign Affairs
(1995)The tragedy of the commons
Science
(1968)
Cited by (64)
Punt Politics as Failure of Health System Stewardship: Evidence from the COVID-19 Pandemic Response in Brazil and Mexico
2021, The Lancet Regional Health - AmericasLeveraging health diplomacy to end the tuberculosis epidemic
2019, The Lancet Global HealthAlleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report
2018, The LancetCitation Excerpt :Universal access to palliative care requires global collective action through the participation of actors whose primary purpose is to improve health—WHO and its regional offices, multilateral development banks, multinational corporations, and international civil society groups—guided by rules and norms governing their interactions.330 The scope of action for the global health system should include recommendations, health products, and health-focused activities that can be provided most effectively by global institutions.41,331 The four core functions of the global health system are stewardship, production of global public goods, management of externalities, and mobilisation of global solidarity (table 8).294,332
The costs of reaching the health-related SDGs
2017, The Lancet Global Health