How to Break the Gridlock in Global Health Governance

To what extent does the concept of gridlock apply to the global health governance and account for its deficiencies?  What is the potential for reform?


Over the last twenty years, available funding for global health and the number of global health actors have both increased exponentially, making it one of the most dynamic and innovative arenas of global governance. This being said, the Millennium Development Goals related to health have largely gone unmet (UN 2013) and health crises such as the recent Ebola outbreak have powerfully underscored the fact that increased number of institutions and funding streams have not translated into sustainable health systems, effective governance, or decisive global health leadership. Indeed, this proliferation of actors and institutions has led to fragmentation, competition, and – in a word – “gridlock” in global health governance.

Gridlock is the tendency to stall in pressing international negotiations and describes the breakdown of the major tools of global policy making. Gridlock decreases the ability of international actors to coordinate effectively at a time when there is increased interdependence and need for collective action to protect global public goods.

This project seeks to operationalise the concept of gridlock to account for the deficiencies in global health governance and to illuminate the potential for reform. It will explore if, and how, the four pathways to gridlock (i.e. growing multipolarity, institutional inertia, harder problems, and fragmentation) can be applied to global health. The research will bridge existing literature gaps and draw on studies conducted on gridlock in other areas of global governance (including security, environment, and the economy). The research team will conduct a comparative analysis to understand not only the pathways to gridlock in global health governance, but more importantly, how to break the gridlock.


  • Development
  • Environment
  • Global health governance
  • Global policy
  • Gridlock
  • Health diplomacy
  • International negotiations
  • International relations
  • Multilateralism
  • Social policy


  • Development
  • Diplomacy
  • Environment
  • Health / Medicine
  • International relations
  • Law
  • Political science
  • Security
  • Sociology


International Organisations

  • World Health Organisation (WHO)

NGOs, state- and other institutions

  • World Vision International
  • Geneva Centre for the Democratic Control of Armed Forces
  • World Business Council for Sustainable Development
  • University of Durham
  • Swiss Tropical and Public Health Institute
  • University of Wisconsin

Relevant Countries

  • All countries


This project, started in 2015, is completed.

Contact the project team

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Research team

Ilona Kickbusch
Graduate Institute Geneva

Michaela Told
Graduate Institute Geneva

Gian Luca Burci
Principal Member
World Health Organisation (WHO)

Stefan Germann
Principal Member
World Vision International

David Held
Principal Member
University of Durham

Kyle McNally
Principal Member
University of Durham

Dario Piselli
Principal Member
Graduate Institute Geneva

Srikanth Reddy
Principal Member
Graduate Institute Geneva

David Evans
Associated Member
Swiss Tropical and Public Health Institute

Eleanor Hutchinson
Associated Member

Lelio Hernan Marmora
Associated Member
UNITAID International drug purchase facility

Jonathan Patz
Associated Member
University of Wisconsin-Madison

Albrecht Schnabel
Associated Member
DCAF Geneva Centre for the Democratic Control of Armed Forces

Peter White
Associated Member
World Business Council for Sustainable Development