No / This article explores options to strengthen environmental law to maximize its health impact in the developing world. A review of environmental treaties, including their domestic implementation, reveals the weak synergies between health and environmental objectives. The article advances adaptive governance as a framework for rethinking international environmental law to improve health in Africa, but argues that it has its limits. It analyses these strengths and limits in the context of evolving regional environmental health governance in Africa, and proposes four principles – environmental justice, multi-sectoral collaboration, evaluation and environmental ethics – to reinforce its potential to improve health and the environment in Africa.

Through the lens of public health, in particular HIV/AIDS, this research first scrutinises China’s compliance with and resistance to the norms and rules embedded in the global health regime, and second, illustrates China’s evolving global role and its intentions for global governance. China’s response to its HIV/AIDS epidemic and its active engagement with the multilateral institutions of global health governance are attributable to both necessity and conscious design. While calling for and welcoming the involvement of multiple actors, a sine qua non for China’s continued engagement with global governance and global health governance is that they should be conducted in accordance with the principles of national sovereignty, non-intervention and territorial integrity. Overall, while China does not seek any radical transformation of the prevailing world order, its vision for the global order is not compatible with that espoused by the West which attaches much weight to liberal democratic values thereby justifying the notion and practice of humanitarian intervention. With a preference for a Westphalian model of governance, China is not a ‘responsible stakeholder’ in the liberal democratic order. Beijing advocates multilateral cooperation in a pluralist ‘harmonious world’ and argues that there is no fixed universal blueprint for development. China adopts a twin strategy in its relations with the outside world. On the one hand, it seeks to defend itself from the encroachment of liberal values while maintaining friendly relations with the leading powers of the West; and on the other, to shore up the principles of national sovereignty and non-intervention as well as strengthen ties with Third World countries so as to consolidate a normative and political bulwark against liberal democratic values on the world stage.

<p>The purpose of this dissertation is to discuss and evaluate processes and institutional structures that influence relationships between Aboriginal communities and government in the development, implementation, and evaluation of health policy. It explores the changing nature of Aboriginal health policy and politics in Canada and examines the shift to self-determination that has transpired in Canada’s Aboriginal health policies focusing on their application to Aboriginal peoples. This dissertation examines two Aboriginal health policies in Canada: the federal health transfer policy and Ontario’s Aboriginal Healing and Wellness Strategy. Both policies are intended to improve health at the community level by supporting the development of community-based and culturally appropriate health programs. Thus, using community-based research methods, this dissertation maps some of the key political stakeholders in Aboriginal health policy, from local level community members and health representatives to peak provincial and federal Aboriginal organizations, to the offices of ministers in Canadian parliament. I reflect upon the processes and institutional structures that shape relationships between the Aboriginal community-controlled health sector and government.</p> <p>I examine several First Nations communities in northern Ontario involving both federal and provincially supported initiatives to illustrate the strengths, weaknesses and paradoxes that surface from the implementation of locally controlled health programs. I contrast these efforts with a second First Nations community in Manitoba that operates solely under the federal health transfer policy. I juxtapose these two communities to assess whether additional layers of community-controlled initiatives make tangible differences to community wellness; particularly for Aboriginal peoples living off reserve. This dissertation is being written under the theoretical assumption that governance and community wellness are intrinsically linked. Arguably, there is a definitive correlation between self-determination and community well-being; self-determination may be a determining factor in improving conditions for Aboriginal peoples and understanding resiliency.</p> <p>This dissertation is about a long lasting colonial legacy of social inequalities in Aboriginal health but also about the incredible successes in Aboriginal health. It is also about the many challenges of Aboriginal representation and self-determination in the context of contemporary Canadian society.</p> / Doctor of Philosophy (PhD)

<p>The World Health Organization (WHO) states that working intersectorally and internationally with health issues is crucial in creating a change towards healthy public policy at a local level. Healthy Cities is one of the programmes where WHO uses a health governance approach (governing through networks) to try to reach this objective. The aim of this bachelor thesis is to identify the factors that make member cities of the WHO European Healthy Cities Network successful in reorienting local public policy towards healthy public policy. An analysis of nine documents corresponding to the selection criteria set up by the authors was conducted. These documents consisted of reports published by WHO on the Healthy Cities programme, but also of independent research articles and one thesis published on other networks similar to Healthy Cities. Also, further data was collected through telephone interviews with contact persons in four member cities. The interviews were transcribed word by word. Both data (documents and interviews) were analysed using a qualitative content analysis.</p><p> </p><p>The results show that the four key “elements for action” (political commitment, leadership, readiness for institutional change and intersectoral collaboration) crystallized by WHO for creating healthy public policy were mainly confirmed in this research study. Therefore, the authors draw the conclusion that WHO has succeeded in making the member cities commit to the Healthy Cities philosophy and in spreading the idea of health governance in Europe. However, additional factors were found both in the document analysis and in the interviews. When looking at the top four frequently occurring factors in the documents, community participation and status were highlighted. The two additional factors found in the interview data was holistic thinking and systematic, goal-oriented work. Also, the importance of political commitment was questioned by a minority of the respondents. This might indicate that the four key “elements for action” crystallized by WHO might not have as big of an effect in creating change at a local level as has been made out by WHO. Furthermore, respondents stated that difficulties existed in translating theory into practice at a local level. This might indicate that potential changes made in the member cities after joining the Healthy Cities programme are mainly ideological. Despite this, the attitudes among the respondents towards membership in the WHO European Healthy Cities Network were overall positive, and even though difficulties still exist, the respondents maintained that Healthy Cities enables them in taking the next step towards healthy public policy at a local level.<strong></strong></p>

The World Health Organization (WHO) states that working intersectorally and internationally with health issues is crucial in creating a change towards healthy public policy at a local level. Healthy Cities is one of the programmes where WHO uses a health governance approach (governing through networks) to try to reach this objective. The aim of this bachelor thesis is to identify the factors that make member cities of the WHO European Healthy Cities Network successful in reorienting local public policy towards healthy public policy. An analysis of nine documents corresponding to the selection criteria set up by the authors was conducted. These documents consisted of reports published by WHO on the Healthy Cities programme, but also of independent research articles and one thesis published on other networks similar to Healthy Cities. Also, further data was collected through telephone interviews with contact persons in four member cities. The interviews were transcribed word by word. Both data (documents and interviews) were analysed using a qualitative content analysis.   The results show that the four key “elements for action” (political commitment, leadership, readiness for institutional change and intersectoral collaboration) crystallized by WHO for creating healthy public policy were mainly confirmed in this research study. Therefore, the authors draw the conclusion that WHO has succeeded in making the member cities commit to the Healthy Cities philosophy and in spreading the idea of health governance in Europe. However, additional factors were found both in the document analysis and in the interviews. When looking at the top four frequently occurring factors in the documents, community participation and status were highlighted. The two additional factors found in the interview data was holistic thinking and systematic, goal-oriented work. Also, the importance of political commitment was questioned by a minority of the respondents. This might indicate that the four key “elements for action” crystallized by WHO might not have as big of an effect in creating change at a local level as has been made out by WHO. Furthermore, respondents stated that difficulties existed in translating theory into practice at a local level. This might indicate that potential changes made in the member cities after joining the Healthy Cities programme are mainly ideological. Despite this, the attitudes among the respondents towards membership in the WHO European Healthy Cities Network were overall positive, and even though difficulties still exist, the respondents maintained that Healthy Cities enables them in taking the next step towards healthy public policy at a local level.

The central argument that I advance in this dissertation is that the influence of the Rockefeller Foundation (RF) and the Bill and Melinda Gates Foundation (BMGF) in the governance of global health and agricultural development has been derived from their ability to advance knowledge structures crafted to accommodate the preferences of the dominant states operating within the contexts where they have sought to catalyze change. Consequently, this dissertation provides a new way of conceptualizing knowledge power broadly conceived as well as private governance as it relates to the provision of public goods. In the first half of the twentieth-century, RF funds drove scientific research that produced tangible solutions, such as vaccines and high-yielding seed varieties, to longstanding problems undermining the health and wealth of developing countries emerging from the clutches of colonialism. At the country-level, the Foundation provided advanced training to a generation of agricultural scientists and health practitioners, and RF expertise was also pivotal to the creation of specialized International Organizations (IOs) for health (e.g. the League of Nations Health Organization) and agriculture (e.g. the Consultative Group on International Agricultural Research) as well as many informal international networks of experts working to solve common problems. Finally in the neo-liberal era, RF effectively demonstrated how the public-private partnership paradigm could provide public goods in the face of externally imposed austerity constraining public sector capacity and the failure of the free-market to meet the needs of populations with limited purchasing power. Since its inception, the BMGF has demonstrated a similar commitment to underwriting innovation through science oriented towards reducing global health disparities and increasing agricultural productivity in poor countries, and has greatly expanded the application of the Public-Private Partnership (PPP) approach in both health and agriculture. Unlike its intellectual forebear, BMGF has been far more focused on end-points and silver bullets than investing directly in the training of human resources. Moreover whereas RF has for most of its history decentralized its staff, those of BMGF have been concentrated mainly at its headquarters in Seattle. With no operational programs of its own, BMGF has instead relied heavily on external consultants to inform its programs and remains dependent on intermediary organizations to implement its grants. Despite these and other differences, both RF and BMGF have exhibited a common capacity to catalyse institutional innovation that has benefited historically marginalized populations in the absence of structural changes to the dominant global power structure. A preference for compromise over contestation, coupled with a capacity for enabling innovation in science and governance, has resulted in broad acceptance for RF and BMGF knowledge structures within both state and international policy arenas. This acceptance has translated into both Foundations having direct influence over (i) how major challenges related to disease and agriculture facing the global south are understood (i.e. the determinants and viable solutions); (ii) what types of knowledge matters for solving said problems (i.e. who leads); and (iii) how collective action focused on addressing these problems is structured (i.e. the institutional frameworks).

After looking at the existing research and considering the devastating effects of the present COVID-19 pandemic, the problem at the core of this thesis is found in the fact that the world is rather unprepared (Lakoff, 2017) for this type of crisis. While conducting an extensive review of the available resources, the lack of data and attention given to city networks concerning the topic of health was identified. The purpose of this thesis is to fill in the knowledge gap by exploring the potential of transnational city networks as actors in global health governance at times of global health emergencies, such as the present pandemic crisis. I find that the ongoing pandemic presents an opportunity to test the ability of cities and city networks to quickly re-orient their policy focus and collectively mobilize in reaction to a problem that impacts the whole world (Acuto et al., 2021, p.146). As the pandemic evolves, transnational city networks have taken it upon themselves to deal collectively with the public health challenges and economic recovery (Pipa and Bouchet, 2020a, p.606), and in this process, they have without a doubt proven their potential as global health actors, particularly in the initial phase of the pandemic response.

Abstract Developing countries are net importers of intellectual property products and open source software (OSS) production is one way in which local socio-economic development can take place. The public goods characteristics of OSS are contested and this study investigates whether in a developing country context OSS is a pure public good that can be locally appropriated and not exclude any users or producers from doing so. This case study of an OSS public good finds that it does not have all the characteristics of a pure good, that there is a role for a sponsor, and in particular the importance of copyright protection of derivatives in order to ensure that the source code does not fall out of fashion and use. Having explored that, however, there is further evidence that OSS collaborative learning is both publically and personally beneficial for developing country computer programmers. Furthermore, the state benefits from the improved benefits of health information systems made possible through the appropriation of this model of learning.

<p>In South Africa, governance structures in the form of clinic committees, hospital boards and district health councils are intended to provide expression to the principle of community participation at a local and district level. They are meant to act as a link between communities and health services and to provide a conduit for the health needs and aspirations of the community to be represented at various local, districts, provincial and national levels. This study aimed to assess the functioning of health governance structures in the form of clinic committees. Specifically, the study sought to ascertain the number of clinic committees associated with public health facilities in three provinces in South Africa namely the Eastern Cape, Free State and KwaZulu Natal and to identify the factors that are perceived by clinic committee members to either facilitate or impede the effective functioning of clinic committees.</p>

Purpose: The study focused on investigating the uses of the term “public participation” to clarify an important public policy concept for health governance as a firm foundation for theory building, policy and practice. Key questions concerned: What counts as participation? Who counts as a participant? And, is there legitimated space for dissent within this concept? Method: A combined methodology (Rodrigues, 2006) for the concept analysis of public participation use was adopted after three methods were extensively studied. Procedures were detailed for a systematic, random sampling of the professional, academic, theoretical and empirical literature from 1990 to 2012. Four disciplinary literatures (social work, sociology, political studies, and nursing) relevant to the field of health were surveyed. The databases furnished 336 documents, out of which 120 were randomly selected for study. Each document was read for construct definitions to ascertain the essential features and the contextual basis of the concept. Two distinct analysis phases were performed. Documents were divided by content into either theoretical or empirical studies, then, sorted into use areas. Findings: Analysis found three typical uses (intended, borderline, and contrary) characterized as prudent, spurious, and pernicious types of public participation. Pernicious types account for 40% of the literature surveyed, spurious types account for 37%, followed by prudent types at 23% (though most were failed examples). Normalized inconsistencies between purported ideals and their application were found across all the disciplines. A suggested polarization between theory and practice was strongest in the social work literature, while the nursing literature was striking for its consolidation of spurious and pernicious types. In short, a probability sampling of the literature suggests marginal and contrary uses of the concept predominate in the field. A Trichotomy of Public Participation Use is presented based on the determining criteria found, indicating the need to: affirm constituency interest in participant constructions for open negotiation, not just discussion; admit conflict and dissent as indicators of a healthy functioning democracy; privilege the interests of the poor in public participation designs and practice; and secure commitment from authorities to tie public participation mechanisms to the policy process in representative systems. Implications: The scope of this concept has contracted and continues narrowing by way of normalized contradictions that are well circulated within major discourses. Unless we are prudent with our thinking and theory building, the conceptual architecture for public participation is merely repackaging the master narrative to more effectively disseminate the logics of neoliberalism.