Global health networks, webs of individuals and organizations with a shared concern for a particular condition, have proliferated over the past quarter century. They differ in their effectiveness, a factor that may help explain why resource allocations vary across health conditions and do not correspond closely with disease burden. Drawing on findings from recently concluded studies of eight global health networks—addressing alcohol harm, early childhood development (ECD), maternal mortality, neonatal mortality, pneumonia, surgically-treatable conditions, tobacco use, and tuberculosis—I identify four challenges that networks face in generating attention and resources for the conditions that concern them. The first is problem definition: generating consensus on what the problem is and how it should be addressed. The second is positioning: portraying the issue in ways that inspire external audiences to act. The third is coalition-building: forging alliances with these external actors, particularly ones outside the health sector. The fourth is governance: establishing institutions to facilitate collective action. Research indicates that global health networks that effectively tackle these challenges are more likely to garner support to address the conditions that concern them. In addition to the effectiveness of networks, I also consider their legitimacy, identifying reasons both to affirm and to question their right to exert power.
Commentaries Published on this Paper
Polycentrism in Global Health Governance Scholarship; Comment on “Four Challenges That Global Health Networks Face”
Shiffman J, Quissell K, Schmitz HP, et al. A framework on the emergence and effectiveness of global health networks. Health Policy Plan 2016; 31(suppl 1): 3–16.
2Shiffman J. Networks and global health governance. Health Policy Plan. 2016; 31(suppl 1): i1-i2.
Shiffman J, Schmitz HP, Berlan D, Smith SL, Quissell K, Gneiting U, Pelletier D. The emergence and effectiveness of global health networks: findings and future research. Health Policy Plan. 2016; 31(suppl 1): i110-i123.
Quissell K, Walt G. The challenge of sustaining effectiveness over time: the case of the global network to stop tuberculosis. Health Policy Plan. 2016; 31(suppl 1): 17–32.
Berlan D. Pneumonia’s second wind? A case study of the global health network for childhood pneumonia. Health Policy Plan. 2016; 31(suppl 1): 33–47.
Smith SL, Rodriguez MA. Agenda setting for maternal survival: the power of global health networks and norms. Health Policy Plan. 2016; 31(suppl 1): 48–59.
Shiffman J. Network advocacy and the emergence of global attention to newborn survival. Health Policy Plan. 2016a; 31(suppl 1): 60–73.
Gneiting U. From global agenda-setting to domestic implementation: successes and challenges of the global health network on tobacco control. Health Policy Plan. 2016; 31(suppl 1): 74–86.
Schmitz HP. The global health network on alcohol control: successes and limits of evidence-based advocacy. Health Policy Plan. 2016; 31(suppl 1): 87–97.
Gneiting U, Schmitz HP. Comparing global alcohol and tobacco control efforts: network formation and evolution in international health governance. Health Policy Plan. 2016; 31(suppl 1): 98–109.
Smith SL, Shiffman J. Setting the global health agenda: the influence of advocates and ideas on political priority for maternal and newborn survival. Soc Sci Med 2016; 166: 86–93.
Shawar YR, Shiffman J. Generation of global political priority for early childhood development: the challenges of framing and governance. Lancet. 2017; 389: 119–124.
Shawar YR, Shiffman J, Spiegel DA. Generation of political priority for global surgery: a qualitative policy analysis. Lancet Global Health. 2015; 3: e487-e495.
Goffman E. Frame Analysis: An Essay on the Organization of the Experience. New York: Harper Colophon; 1974.
Benford RD, Snow DA. Framing processes and social movements: an overview and assessment. Ann Rev Soc. 2000; 26: 611–639.
Stone DA. Causal stories and the formation of policy agendas. Polit Sci Q. 1989; 104: 281-300.
Hodgson D, Watkins SC. Feminists and neo-Malthusians: past and present alliances. Popul Dev Rev. 1997; 23: 469-523.
Harris PG, Siplon PD. The Global Politics of AIDS. Boulder, CO: Lynne Rienner Publishers; 2007.
Prins G. AIDS and global security. International Affairs 2004; 80: 931-952.
Shiffman J, Smith S. Generation of political priority for global health initiatives: a framework and case study of maternal mortality. Lancet. 2007; 370: 1370-1379.
Hilgartner S, Bosk CL. The rise and fall of social problems: a public arenas model. Am J Soc. 1988; 94: 53-78.
Koon AD, Hawkins B, Mayhew SH. Framing and the health policy process: a scoping review. Health Policy Plan. 2016; 31: 801-816.
McInnes C, Lee K. Framing and global health governance: key findings. Global Public Health. 2012; 7: S191-S198.
Provan KG, Kenis P. Modes of network governance: structure, management, and effectiveness. Journal of Public Administration Research and Theory 2008; 18: 229-252.
Institute for Health Metrics and Evaluation. Financing global health 2014: shifts in funding as the MDG era closes. Seattle, WA: IHME; 2015.
Darmstadt GL, Kinney MV, Chopra M, et al. Who has been caring for the baby? Lancet. 2014; 384: 174-188.
World Health Organization, UNICEF. Global Immunization Data. Geneva, Switzerland: World Health Organization; 2015.
World Health Organization. Global Tuberculosis Report 2013. Geneva, Switzerland: World Health Organization; 2013.
World Health Organization. Global Tuberculosis Report 2014. Geneva, Switzerland: World Health Organization; 2014.
Eriksen M, Mackay J, Ross H. The Tobacco Atlas. 4th ed. Atlanta, GA: American Cancer Society; 2012.
World Health Organization. Global Status Report on Alcohol and Health 2014. Geneva, Switzerland: WHO; 2014.
Dahl R. Polyarchy: participation and opposition. New Haven, CT: Yale University Press; 1971.
Daniels N. Accountability for reasonableness in private and public health insurance. In: Coulter A, Ham C, eds. The global challenge of health care rationing. Buckingham: Open University Press; 2000: 89-106.
Schmidt VA. Democracy and legitimacy in the European Union revisited: input, output and ‘throughput.’ Polit Stud. 2013; 61: 2-22.