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• W54630771 abstract "This panel was convened at 10:45 am, Friday, April 5, by its moderator, Benedict Kingsbury of New York University Law School, who introduced the panelists: Gian Luca Burci of the World Health Organization; Jacob Katz Cogan of the University of Cincinnati College of Law; David Gartner of Sandra Day O'Connor College of Law, Arizona State University; and Jennifer Prah Ruger of Yale University's School of Medicine and Law School. COORDINATION IN GLOBAL HEALTH AND ITS COSTS By Jacob Katz Cogan * Just as health problems cross borders, they also range widely across the competences of the organizations that have as their aim the provision of health services and the improvement of health outcomes--whether those organizations are international institutions, governments, private-sector bodies, or civil society groups. For any particular problem, multiple organizations may have separate capabilities that when put together might, more efficiently and effectively, solve or ameliorate health problems. While coordination and cooperation among many public and private, international and national, organizations have always been recognized at some level as important, the challenges and opportunities presented today in global health are unique, and hence the coordination imperative has become even greater. As a consequence, experimentation in the structures of organizational cooperation has been considerable. Here, I very briefly focus on three points pertaining to contemporary coordination and cooperation in global health: why it is that the commitment to coordination is greater now than in the past; the variety of organizational means employed for the achievement of such coordination; and the challenges that stem from coordination. THE IDEA OF COORDINATION Coordination has always been an issue in international organization. It arises from the fact that the international system is a decentralized one operating at three levels. It is decentralized because all states are considered equal, each with sovereign authority and hence sovereign control over and responsibility for their own populations, including their welfare. It is decentralized at the nongovernmental level because private actors mobilize in response to certain perceived needs in their community, whether that community is local or global. And it is decentralized at the intergovernmental level. This is as much by design as by inevitability. At its founding, the idea that the United Nations might act as the central international organization, inclusive of all topics, was purposely rejected and instead what we now know as the family of specialized agencies was adopted. Those the World Health Organization among them, entered into relationship agreements with the UN--but these were weak. For the most part they concerned information exchanges and coordination of administrative and technical services, as well as budgetary consultations. Despite the Charter's provision in Article 58 that the UN shall make recommendations for the coordination of the polices and activities of the specialized agencies, and despite attempts by ECOSOC to implement * this provision over the years, the independence of the specialized agencies--each with its own membership and secretariat, each jealous of its own authorities--typically has limited such coordination. Remarkably, the idea that international coordination is critically important has only arisen within the past two decades. In the area of health, this new understanding stemmed from an increased expectation concerning the right [of individuals] to have [their] basic health needs met, (1) from the realization that health issues (particularly in an age of vast increases in interstate trade and the movement of persons) are matters of transnational scope, and from the increase in the number and diversity of actors seeking to promote their health agendas and priorities. The plethora and variety of programs and actors that fund and implement health initiatives has led to confusion, competition, and duplication of effort. …" @default.
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• W54630771 date "2013-01-01" @default.
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• W54630771 title "21st Century International Institutions: Lessons from Global Health Governance?" @default.
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