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: Starting October 2015 for two years
  • 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:

Hale, T., Held, D. and Young, K. (2013). Gridlock: From Self‐reinforcing Interdependence to Second‐order Cooperation Problems. Global Policy, 4 (3): 223‐235.

Kickbusch, I., and Reddy, K.S. (2015). Global health governance- The next political revolution. Public Health: 1-5.