WHO: Past, Present and FutureLeveraging non-binding instruments for global health governance: reflections from the Global AIDS Reporting Mechanism for WHO reform☆
Section snippets
Global health lawmaking: the emergence of international law as a tool of global health governance
As globalization increasingly restricts the capacity of sovereign states to protect health through unilateral action alone, innovative mechanisms to promote global cooperation and coordination have become essential components of public health governance.1, 2, 3 One such mechanism – international lawmaking – has drawn unprecedented attention in recent debates surrounding World Health Organization (WHO) reform as a future priority functiona
Reforming WHO in the context of the evolving global lawmaking environment
Growing recognition of the complexity of the global health landscape, increasing concern over the predictability and sustainability of funding and an emerging consensus on the need to strengthen WHO has led WHO Member States to embark upon the most extensive reform process in the Organization's history.8 Strengthening WHO's leadership and effectiveness in health governance is a strategic priority of its reform programme.9 In light of an increasingly complex architecture and a lessening role of
The AIDS movement delivers the UN Declaration of Commitment on HIV/AIDS
In 2001, 189 UN Member States endorsed the Declaration of Commitment on HIV/AIDS (DoC). Today, the DoC, with its reporting mechanism, is considered among the most effective models of a non-binding instrument in global health policy. The reporting mechanism has evolved and come to have a substantial impact on domestic AIDS legal and policy environments and has significantly improved accountability at both national and global levels.
The AIDS response is largely regarded as one of the most
Role and evolution of the Global AIDS Reporting Mechanism
The first round of UNGASS reporting, based on UNAIDS-designed indicators, was completed in 2004 and the process has been repeated biennially until 2012, and since 2013, annually (See Fig. 1 for milestones of the Global AIDS Reporting Mechanism).33, 34, 35 At the heart of the DoC reporting system lies a series of indicators which track a range of financial, policy (including human rights, civil society involvement, gender, etc.), programmatic, behavioural and impact measures.32 Despite their
Potential power of a non-binding instrument: from reporting to national action and results
While the system UNGASS reporting has evolved over the last decade, the effective reporting instrument has remained an essential implementation mechanism that has transformed the non-binding political declaration from a purely rhetorical device to one that promotes real and sustained national action. Critically, civil society, with the backing of UNAIDS, has been central to the implementation machinery.
The Global AIDS Reporting Mechanism: a non-binding instrument as an effective accountability tool
The overall effectiveness of the Global AIDS Reporting Mechanism provides striking evidence of the functional utility of cogently drafted and effectively implemented non-binding mechanisms in promoting commitment and compliance with international health commitments. Undoubtedly, the experience of the global response to AIDS is unique in the annals of global health governance. Despite the singular aspects of the history of AIDS and its response, effective non-binding instruments have been
Challenges to WHO in exercising leadership on international lawmaking
As argued above, an increasingly globalizing world calls for more legal approaches to governing some aspects of global health. In this challenging global financial, institutional and policy landscape, WHO is struggling to reclaim its leadership and global health governance role. The WHO reform process has highlighted the evolving significance of international law in global governance for health. As global integration progresses, states and other global health actors will increasingly turn to
Conclusion
With calls for new WHO health treaties in the last few years, the perceived success of the FCTC has appeared to make treaties negotiated under WHO auspices the gold standard of global health governance. Despite new found interest in international legal tools, it is essential to recognize that not all global health problems have an international legal solution. Nonetheless, when legal strategies are employed, policymakers should think more innovatively and strategically about legal form,
Ethical approval
None sought.
Funding
None declared.
Competing interests
T Alfven, S Tanaka and K Buse are currently employed by UNAIDS, which administers the Global AIDS Reporting Mechanism. The authors have no other competing interests.
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This article is abridged and adapted from the article, Taylor AL, Alfven T, Hougendobler D, Buse K. Nonbinding Legal Instruments in Governance for Global Health: Lessons from the Global AIDS Reporting Mechanism (forthcoming).