Exploring Institutional Competition In Global Public Health Governance

Since the end of World War Ⅱ,especially after the end of the Cold War,the international institutions has grown at an alarming rate,and intergovernmental international organizations,non-governmental international organizations,public-private partnerships,and regional organizations have developed rapidly.The proliferation of international institutions has promoted the vigorous development of global public health governance.Health has evolved from a single governance model centered on the World Health Organization to a complex composed of many stakeholders including state and non-state actors.While the new type of governance subject brings vitality to global public health governance,it may also compete and conflict with existing regimes in terms of governance rules,principles and norms.What are the forms of international institutional competition in global public health governance?What factors lead to competition among international institutions?What is the impact of international institutional competition on global public health governance?This is the question this paper attempts to answer.In order to answer this series of questions,this paper constructs a framework for analyzing international institutional competition.In terms of manifestations,this paper ’believes that international institutional competition has two forms,which are regime shifting and competitive regime creation.Regime shifting refers to actors transferring rule-specified activities from existing institutions to other multilateral institutions,thereby weakening the authority of existing institutions.Competitive regime creation means that actors implement rules that are more beneficial to themselves by creating a multilateral system that is more in line with their own interests.The competition among international institutions is mainly affected by three aspects.First,institutional overlap in related issue areas,institutional competition is the objective result of institutional overlap;Second,the dispute over the legitimacy of the international system.When the leading mechanism in the subject area lacks absolute authority and advantages,the degree of institutional competition will intensify;Third,driven by the dominant state,institutional competition is one of the strategic choices and important forms of competition between major powers,with the purpose of gaining power and interests.The competition of international institutions has become increasingly inevitable,and its impact on global public health governance is significant.On the positive side,competition can stimulate vitality,alleviate the inertia brought about by institutional monopoly,give full play to the advantages of different governance regimes,and improve the effectiveness of global public health governance through positive feedback effects on multilateral institutional governance.On the negative side,competition for decentralized health governance resources has exacerbated the fragmentation of the health governance regime,resulting in a decline in governance efficiency and coordination capabilities,making it difficult to deal with frequent global public health crises.In addition,once the international institutional competition moves towards the extreme form of exclusive multilateralism,it may trigger confrontation between the two alliances and eventually tear the international community apart.Facing the situation of institutional competition in global public health governance,this paper argues that China should promote the reform of the governance system on the basis of maintaining the global public health system led by the WHO,and at the same time enhance the ability to create and design international institutions.