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Looking for alternatives in global governance

why multi-level health governance is not the answer for poverty reduction

Sophie Harman


Concern about reaching the targets set by the UN Millennium Development Goals (MDGs) has galvanised questions surrounding the need for alternative models of global governance that respond more effectively to the challenge of poverty reduction. One response to such questions has been the suggestion of more inclusive, multi-level governance. Multi-level governance refers to a disaggregation of power at the global, national, and community level, that involves new structures of co-ordination and planning drawn up between the private and public sector. Its emphasis is on inclusion of multiple actors and ideas that provide the space for ‘innovative’ solutions to the complex issue of poverty reduction. This paper explores the limitations of multi-level governance as a mechanism of governing poverty reduction. It does so by considering the experiences and lessons from global health governance and what multi-level governance is in practice. The paper argues that despite presenting the opportunity for more inclusive, innovative and participatory forms of governance, multi-level governance embeds wider problems of governing poverty. As global health interventions show, multi-level health governance is highly centralised and organised around a distorted separation of power that reduces the conceptual and practical space for different actors to operate. In this sense, it presents a form of bad governance that rests on confusion and hidden decision-making.

The paper develops this argument in the following way. First it outlines the problem of governing poverty reduction and why multi-level governance presents a possible solution. Second, the paper outlines what multi-level governance is and how it is understood in the context of the European Union (EU) and debates on deliberative democracy. Second, the paper traces the emergence of multi-level governance within global health strategies. Third, the practical ramifications of multi-level governance are explored to suggest that in practice, this form of governance does not offer a change towards inclusive models of poverty reduction. The paper then considers the implications of multi-level governance for sustained poverty reduction, before offering several conclusions as to the nature and role of multi-level governance in providing an alternative to current understandings and practice of global governance.

Publication Type(s)

Conference Paper

Ten Years of War Against Poverty Conference Papers

Conference: Ten Years of War Against Poverty


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