Today we're going to talk about Global Health Governance. So what do I mean when I say global health governance? The term governance refers to how an entity is run. For example, who is on the board and how are they selected? What decisions can a CEO make without board approval? And what are the policies and principles that define metrics of success? So the term global health governance refers to how global health organizations and entities are run, and how the various stakeholders who participated in that group are supposed to work together. And ideally, an organization applies strong governance principles including clarity of roles and decision making, transparency and accountability. Governance has become a more important issue with the proliferation over the past decade of global health entities, including financing mechanisms, partnerships, and other organizations. And governance is a central issue to global health diplomacy. The conversations about who holds leadership roles, how decisions are made, and the adoption of policies, is often highly political and is informed by a wide range of interests. For the major global health entities, there are often significant negotiations on these various points. The issue of global health governance is one that I believe is critically important. But one which hasn't receive enough attention. There's several challenges around global health governance. First, every organization is governed differently. And while each organization need some degree of variability to ensure the governance structures is set up for that specific situation, too often, organizations are not learning from what has worked in successfully governed organizations and they reinvent the wheel. Second, some organizations are not very transparent about their governance. I'm a strong believer that transparency and clear accountability are critical to success in reaching challenging global health goals. If an organization isn't transparent about their decision making process, they may not be getting the benefit of the full set of available knowledge. Finally, some global health efforts are not structured to take full advantage of the range of stakeholders who want to contribute to solving a problem. Now let's take a moment to review what we've learned so far. Over the course of this module, we'll discuss several existing entities and examine their governance mechanisms. But for now, I'll briefly mention an interesting case study that I saw around the West Africa Ebola outbreak. Until the 2014 outbreak, Ebola was a very rare disease. Therefore, there was no global infrastructure surrounding work on Ebola. When Ebola hit the global headlines, there was a surge of attention and interests, from a wide variety of new actors who wanted to help fight Ebola. This resulted in some promising outcomes. New dollars dedicated towards getting West Africa to zero Ebola cases. New thinking and innovations. And new voices shaping the response efforts. However, there is no natural place for these new stakeholders to dock in. And a lot of people felt frustrated that they couldn't contribute to solving the problem. For example, a leading Silicon Valley software firm was really eager to help and spent a lot of time and money creating software to support the response efforts. Unfortunately, the final product could not be used because it was created without adequate understanding of what was really happening on the ground, and was therefore not useful. The United Nations eventually set up a Global Ebola Response Coalition weekly conference call, that was very effective at sharing information across the many interested parties. Well there are many unique things about the Ebola situation. This example did highlight a problem that I see too often in global health governance which is the challenge of embracing new and different partners and the resources they bring to global health. Too often global health governance mechanisms have been defined in terms of 20th century partners. Donor and recipient countries plus multilateral institutions. But the Ebola epidemic crystallized that we have to evolve to an expanded set of 21st century partners. Imagine the improved impact in global health, if we included these new actors more intentionally in global health governance moving forward. This will directly re-enforce the entry of more new actors, and retain existing ones while also strengthening and synergizing overall response time and efficiency. Now let's move on to the next lesson and discuss some specific examples of how global health organisations are governed.
