This thesis examines the changes in health governance at both global and country levels brought by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), a self-described public/private partnership intended as a financing mechanism to achieve Millennium Development Goal (MDG) 6. Since the G8 announced the Global Fund's creation in 2001, it has succeeded in mobilising over US$30 bn in commitments, primarily from donor governments. This thesis is rooted in the 'high politics' of International Relations (IR), and in particular its literature on globalisation, governance and international institutions. Where this literature has failures or gaps, it draws from the Development Studies and International Political Economy (IPE) literatures. It also relies on key informant interviews undertaken in Geneva, Lilongwe and Zomba with executives of international institutions, and those involved in Malawi's HIV/AIDS response including government representatives and staff from the National AIDS Commission, donors, NGOs and those working on the front line. This thesis relies on a descriptive, single case study to create a 'thick' narrative. Rather than deriving generalisations, it provides a basis for further research into the nature and effects of systemic change in how health is governed that the Global Fund signals. This thesis makes three contributions to knowledge: 1) It provides a basis to evolve the IR literature on globalisation, governance and international institutions to consider the nature, significance and effects of the Global Fund as a form of institutional innovation which is disrupting the traditional multilateral order, particularly for international institutions working in health; 2) It challenges the use of the term 'country ownership' to mean 'putting the country in the driver's seat', and instead notes the double deficit in external accountability that arises when global politics and country evidence collide in a Global Fund convened elite, mediated space for country ownership; and 3) It synthesises observations from field work in Malawi on the exercise of the Global Fund's authority and its dislocation from external accountability when failures occur. The IR literature is silent on the rise of the Global Fund's authority. It fails to contend with the notion that country ownership is as much about the burden of responsibility as it is about agenda setting. This highlights the dislocation between the loci for authority and accountability despite the Global Fund's growing authoritative territorial claims.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:560438 |
| Date | January 2012 |
| Creators | Walker, Louise |
| Publisher | University of Warwick |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://wrap.warwick.ac.uk/51668/ |
Page generated in 0.0108 seconds