India and the Philippines in Global Health Governance

This chapter explores the consequences of institutional reforms in global health governance. Specifically, it investigates and compares changes in the voice and influence of Indian and Philippine stakeholders—and assesses whether and to what extent these changes are attributable to recent institutional reforms undertaken by the World Health Organization (WHO), the Codex Alimentarius Commission, the International Council for Harmonisation (ICH), and the Global Fund to Fight AIDS, Tuberculosis, Malaria. For both India and the Philippines, the reforms have resulted in increased voice opportunities in global health governance; both also have increased their actual engagement and experienced real gains in influence. Increases in voice opportunities, engagement, and influence have been remarkably similar for the two countries (and almost entirely governmental), though often for different reasons. The chapter also highlights numerous differences in the consequences of institutional reforms across the four health governance institutions. It shows that understanding improvements in—and remaining impediments to—stakeholder participation for previously marginalized stakeholders in global health governance requires the analysis of domestic institutions and the domestic politics of health governance in interaction with institutional change and persistence at the global level.