151. Buse K. (2004), ‘Governing Public-Private Infectious Disease Partnerships’, Brown Journal of World Affairs’, X (2): 225-242.

Globalization has far-reaching implications for health and for the manner in which health threats arise and are addressed. Previous papers have focused on the manner in which increased global integration creates fertile ground for the rapid spread of infectious diseases and the considerable challenges it poses to their appropriate management. Indeed, some countries may be facing life-expectancy levels as low as those in the medieval era as a consequence of infectious diseases. Globalization has also contributed to increasing global awareness of the growing burden of communicable diseases and has heightened concerns over the potential and actual threat of contagion to populations that had previously thought of themselves as largely immune. The SARS outbreak has widely confirmed such vulnerability by traveling “more widely, swiftly, and lethally than any other recent new disease so far.” Growing awareness has galvanized renewed interest, political commitment, and new resources for infectious disease control. It has also been argued that globalization has spawned a rash of public-private partnerships (PPP) at global, regional, and country levels, to mobilize and coordinate resources and institutions on specific health targets, particularly infectious diseases. The number of health partnerships is unprecedented, the vast number of institutions party to some of the large Alliances is remarkable, and the amount of resources they have mobilized is impressive. The most radical aspect of these initiatives might lie in their governance. After all, they are heralded for bringing together public, commercial, and civil society sectors through innovative organizational arrangements to achieve shared goals. In particular, in their governance, market-based authority, or the discipline of the market, meets hierarchical command and control mechanisms of state bureaucracies, creating hybrid organizations. Good governance promotes justice and is associated with positive outcomes.