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Gridlock, Innovation and Resilience in Global Health Governance

Held, David; Kickbusch, Ilona; McNally, Kyle; Piselli, Dario; Told, Michaela

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David Held

Ilona Kickbusch

Kyle McNally

Dario Piselli

Michaela Told


Global health governance is in many ways proving more innovative and resilient than other sectors in global governance. In order to understand the mechanisms that have made these developments possible, this article draws on the concept of gridlock, as well as on the additional theoretical strands of metagovernance and adaptive governance, to conceptualize how global health governance has been able to adapt despite increasingly difficult conditions in the multilateral order. The remarkable degree of innovation that characterizes global health governance is the result of two interrelated conditions. First, developments that are normally associated with gridlock in multilateral cooperation, such as institutional fragmentation and growing multipolarity, have transformed, rather than gridlocked, global health governance. Second, global health actors have often been able to harness the opportunities offered by three important pathways of change, namely: (1) a significant degree of organizational learning and active feedback loops between epistemic and practice communities; (2) a highly polycentric system of governance; and (3) the increased role of political leadership as a catalyst for governance innovation. These trends are discussed in the context of three case studies of significant political, social and health relevance, namely HIV/AIDS, the 2014 Ebola outbreak and antimicrobial resistance.


Held, D., Kickbusch, I., McNally, K., Piselli, D., & Told, M. (2019). Gridlock, Innovation and Resilience in Global Health Governance. Global Policy, 10(2), 161-177.

Journal Article Type Article
Online Publication Date Feb 14, 2019
Publication Date May 31, 2019
Deposit Date Feb 19, 2019
Publicly Available Date Feb 19, 2019
Journal Global Policy
Print ISSN 1758-5880
Publisher Durham University
Peer Reviewed Peer Reviewed
Volume 10
Issue 2
Pages 161-177


Published Journal Article (Advance online version) (853 Kb)

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Copyright Statement
Advance online version © 2019 The Authors. Global Policy published by Durham University and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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