Global actors in health policy

Many institutions exist in global health, with different governance mechanisms and funding, powers and mandates. This brief explores the range and influence of global health actors and the implications for health diplomacy within east and southern Africa. The challenge of representation of east and southern African (ESA) countries interests in health would also appear to demand co-ordination in negotiations across different global multilateral actors that influence health issues, to avoid policy incoherence or policy conflict and to draw synergies across the different areas; full disclosure of actual or potential conflicts of interest in any forums where public health decisions are under negotiation. This means being clear about the governance structures and interests of those around the table, including disclosing corporate affiliations (directorships, advisory panels, funding receipt) and investment holdings of individuals and institutions; and a mechanism for tracking and building accountability for the global resources dedicated to public health, particularly given the high concentration of global health needs within the regionThe proliferation of actors at the global level and national level has stretched the capacity of the Region to meaningfully participate in the discourse on global public health. It is crucial that the African Region draws strength from its numbers, and strengthen its collective capacities, mechanisms and dialogue given the scope and breadth of the global health agenda While new south-south alliances and interactions are emerging in the engagement with this diversity of global health actors, this does not detract from the need to safeguard the leadership of WHO in global health. According to one Geneva based African diplomat it has equally become a matter of global health diplomacy to safeguard the WHO, in line with its constitutional mandate, and in consultation with other stakeholders, coordinate global efforts in health. This includes ensuring that the norms, standards and policy guidance of the organisation are rooted in its constitutional norms and are evidence based.