Strengthening Global Health Governance: Defending the Public Interest and Holding Powerful Private Actors Accountable

The last four decades have seen a set of powerful private actors (PPAs) have ever greater impacts on health outcomes. Although private actors make positive contributions to society, there are concerns about their negative impacts on health and health inequalities. A growing body of literature on the commercial determinants of health, for example, points to the harms of aggressive marketing and supply of unhealthy commodities, the externalisation of environmental and social costs from commercial activities, and the ability of large oligopolistic trans-national corporations (TNCs) to gouge excessive profits at the expense of equitable access to medicines, vaccines and other technologies. 

The increasing financialisation of society has also seen private equity, hedge funds, investment banks, and private asset managers make incursions into the health sector in ways that are exploitative or harmful. Meanwhile, efforts to reverse the trend of widening inequalities and to prevent further damage to the planet are being hindered by PPAs who have vested interests in maintaining the status quo. 

At the same time, PPAs now assume ever greater levels of influence over policy-making and systems of governance through public-private partnerships and multi-stakeholder forums. In parallel, in viewing private finance capital as a solution to the problem of declining public budgets, private actors are also increasingly being invited to provide important public goods and services. Finally, the past few decades have also seen individuals with extreme wealth and large private foundations become powerful global actors in their own right. 

In November 2023, an expert group meeting convened by UNU-IIGH (see report here) acknowledged an important role for markets and private actors in society, but noted a lack of effective mechanisms by which to hold PPAs accountable, especially given the corresponding weakening of governmental agencies, inter-governmental organisations (IGOs), and other public institutions. The withdrawal of the United States from the World Health Organisation (WHO) and other multilateral institutions, as well as cuts made by the United States and other countries to their aid budgets, raises further new and urgent questions about the influence of PPAs in global health governance. 

With these developments in mind, UNU-IIGH and Third World Network have organised a one-day symposium to examine the influence, behaviour, and impact of PPAs across the global health system and to discuss what efforts are needed to mitigate their power and hold them more accountable.

J𝗼𝗶𝗻 𝘁𝗵𝗲 𝗹𝗶𝘃𝗲𝘀𝘁𝗿𝗲𝗮𝗺 on the day: https://go.unu.edu/ElCNL