Engaging global health governance
Over the past two or three decades, both China and India have expanded their engagement in global health governance (GHG). An examination of their history in global health norm development, their use of non-health governance arrangements to promote global health, and their visions of GHG all suggest their ability to play a distinctive, important, even inspiring role in GHG. The analysis nevertheless has not led us to conclude with confidence that both countries represent a transformative force in GHG. Their contributions to GHG remain limited and constrained by domestic health challenges and institutional shortfalls. In developing institutions for global disease prevention and control, their approach to global health agenda setting and rule making remains selective and individualistic. Moreover, their record of compliance with global health rules is mixed, mitigated by limited health-system capacities and ongoing governance challenges. A look at the ideational foundations of their involvement in GHG suggests that while both contribute to an alternative model for GHG, most components of the model are neither novel nor innovative, and their effectiveness remains in question.