African Participation and Partnership in Performance-Based Financing: A Case Study in Global Health Policy

Participation is a key policy concept in global health, and relates to the ability of stakeholders to engage with and shape health policy at four intersecting levels: local, national, regional and global. Such engagement remains the key normative aim behind debates about furthering more equitable health diplomacy and has, as a result, been increasingly integrated into the agenda of global agencies, including the Global Fund to Fight AIDS, TB and Malaria and the World Bank.

This report forms part of a research programme led by the Regional Network for Equity in Health in East and Southern Africa (EQUINET) through Training and Research Support Centre (TARSC) and University of Carleton focusing on the participation of African actors in global health diplomacy. This specific case study focuses on the participation of African actors in global health governance. In an attempt to better understand the spaces and places within which participation can occur, and particularly the ways in which global actors such as the Global Fund and the World Bank provide such opportunities, the research sought to explore the following questions:

• How do the Global Fund and World Bank provide spaces for participation in global health governance processes?
• To what extent can African actors nationally and regionally extend their agency within these participatory spaces?
• What role does the World Health Organisation (WHO) and its own governance play in the interface between African actors and the Global Fund and World Bank?