Informality in global health governance

This thesis focuses on changing dynamics within the global health governance (GHG), especially one regarding the position of the World Health Organization (WHO) within the existing system. Informal practices within the global health governance, and how this informality impacts the functioning of the global health system is examined in this thesis. For a long time, global health governance has been dominated by the WHO as the primary actor responsible for systematical functioning of the global health system. In the light of diminishing influence of the WHO in global health governance and increased presence of new actors in this field, this thesis project focuses on the puzzle of informality within global health governance, while examining the diminishing role of the formal practices undertaken by the WHO authority within this framework. This study aims to answer the questions of "How informality impacts global health governance?", "How has the WHO lost its function over time?", and "What kind of implications the competition WHO faces will have on global health governance in a post- pandemic world?". In this thesis, three illustrative cases of China, Bill and Melinda Gates Foundation and the Global Fund were analyzed through the three-way typology of informality (Westerwinter et al. 2021) to examine the changing dynamics in global health governance. In GHG, the existence of more than one influential actor may cause conflict in the negotiation of many important health issues, however, this variety may also contribute to a positive multilateral approach. It is certain that informality plays an important role in global health governance. In some cases, informal practices bring a new approach to common issues within the global health system and help improve the condition of the global health and individuals who are primarily affected by the policies of the global health community. In my analysis, informality within the WHO has negative impact on global health governance. Informality around, and of institutions have positive impact in global health governance to a certain degree. However, this outcome is heavily dependent on the fact that the two institutions I have examined are willingly abide to the rules and norms of global health governance set by the WHO. Therefore, in different cases focusing on different actors, which aim to create an alternative governance structure, informality around and informality of institutions may also have negative impact on global health governance. If informal practices abide by the rules and norms of global health governance, which prioritize individuals' right to health and wellbeing and principle of human security, informal practices have higher chance to have a positive impact on global health governance.