Research page
Global Health Centre

How to break the gridlock in global health governance

  • Coordinators:  Ilona Kickbusch, Michaela Told
  • Principal Members: David Held, Gian Luca Burci, Stefan Germann
  • Associated Members: Lelio Marmora, David Evans, Jonathan Patz, Albrecht Schnabel, Peter White, Eleanor Hutchinson
  • Project owners: The Global Health Centre at the Graduate Institute of International and Development Studies
  • Project status: Concluded March 2018
  • Key Words: diplomacy, development, environment, global health, global governance, global health governance, global policy, gridlock, health diplomacy, health financing, health sciences, international negotiations, international relations, multilateralism, multipolarity, political science, security, social policy, WHO

This project seeks to understand pathways that lead to gridlock in global health governance in order to conceptualise how this gridlock can be overcome. Gridlock is the tendency to stall in pressing international negotiations and describes the breakdown of the major tools of global policy making when there is increased need for collection action. The research will analyse how the four pathways to gridlock (i.e. growing multipolarity, institutional inertia, hard problems, and fragmentation) developed by Hale et al. (2013) apply to global health while drawing on studies conducted on gridlock in other areas of global governance, including security, environment, and the economy.

It will also explore case studies on HIV/AIDS, Ebola, and Antimicrobial Resistance (AMR) which illustrate three types of health threats (protracted, acute, and future/latent respectively) in order to understand the manifestations of gridlock in these cases and how the positioning of these issues transitions from low to high politics. Taken together, this analysis will consider the institutional gridlock that occurs in the space between sovereignty and collective action as well as the frameworks and processes used to gain political momentum and make breakthroughs for action on global health challenges and crises.

Working with a number of different partners across academia, international organisations, civil society, and the private sector, this interdisciplinary project aims to bridge the literature gap as well as to promote dialogue on these issues through publications, workshops and events.  It will further strive to take discussions on global health governance out of a ‘health silo’ and relate them to larger governance issues at stake in the global risk society. The findings will be considered in light of the current WHO reform process, the consequences it may have for Geneva as the global health capital, and the options that may emerge from this for the formation of new organisations or changes in the current global health architecture. Accordingly, the project will contribute not only to the academic debate on global governance and global health governance, but will also have direct policy relevance and impact.

Further reading


Policy Dialogue Workshop, "How to Break the Gridlock in Global Health Governance"

On 16 September 2016, the Global Health Centre, in collaboration with the Global Policy Institute of Durham University, held the first Policy Dialogue Workshop on the SNIS-funded research project on “How to Break the Gridlock in Global Health Governance” to discuss whether a failure in global health governance exists or not; and if mechanisms can be identified which lead to successful governance solutions and therefore can inform future reform strategies. 26 participants representing UN agencies, governments, academia and NGOs discussed the gridlock theory and its relevance to health.


Policy Dialogue Workshop, "Gridlock and Beyond: How Does Global Health Compare with Other Sectors of Governance?"

On 21 September 2017, the Global Health Centre, in collaboration with the Global Policy Institute of Durham University, held the second Policy Dialogue Workshop on the SNIS-funded research project on “How to Break the Gridlock in Global Health Governance”. The objective of the Dialogue was to receive feedback from selected experts and practitioners on the preliminary findings of the project, as well as to compare potential trends that can be identified in global health with other sectors of governance, including the environment, economy, and security. The dialogue was attended by 39 participants representing UN agencies, governments, academia and NGOs, who provided their inputs to the research team as it approaches the final months of research.


Symposium, "Innovation and Pathways in Global Health Governance"

Global health governance has seen significant innovations, an "explosion" of actors and funding streams, and a growing importance of political leadership. At the same time, multilateral cooperation on health issues has become increasingly difficult, and progress in the fight against specific diseases has not necessarily translated into sustainable health systems or effective governance processes. How can we make sense of these - apparently conflicting - trends?


This Symposium (13 March 2018) aimed at:

  • Exploring the opportunities and challenges associated with the growing politicisation of health, and its implications for global health governance;
  • Discussing the multiple ways in which global health governance has transformed to respond to an increasingly interconnected, multipolar world;
  • Learning from the past to the future, to ensure that global health governance remains "fit for purpose" in the 21st century.


Event materials and videos