Global Health Governance in the Sustainable Development Goals: is it grounded in the Right to Health?

This paper explores the extent to which global health governance - in the context of the early implementation of the Sustainable Development Goals is grounded in the right to health. The essential components of the right to health in relation to global health are unpacked. Four essential functions of the global health system are assessed from a normative, rights-based, analysis on how each of these governance functions should operate. These essential functions are: the production of global public goods, the management of externalities across countries, the mobilization of global solidarity, and stewardship. The paper maps the current reality of global health governance now that the post-2015 Sustainable Development Goals are beginning to be implemented. In theory, the existing human rights legislation would enable the principles and basis for the global governance of health beyond the premise of the state. In practice, there is a governance gap between the human rights framework and practices in global health and development policies. This gap can be explained by the political determinants of health that shape the governance of these global policies. Current representations of the right to health in the Sustainable Development Goals are insufficient and superficial, because they do not explicitly link commitments or right to health discourse to binding treaty obligations for duty-bearing nation states or entitlements by people. If global health policy is to meaningfully contribute to the realization of the right to health and to rights based global health governance then future iterations of global health policy must bridge this gap. This includes scholarship and policy debate on the structure, politics, and agency to overcome existing global health injustices

Co-production and self-care: new approaches to managing community care services for older people

A lack of management theory which is relevant to human service agencies, combined with a failure to recognise the very large contribution which older people make to their own care makes it difficult to deliver supportive services. Self care by elders is divided, in this preliminary classification, into new strategies for everyday living, the reallocation of time and the avoidance of risk. Managers who understand that service users are co-producers of care and recognise the need to manage the users, as well as their own staff and relations with other agencies, are more likely to be able to deliver good services. However the management of co-production is at present only theorised for the private sector where ethical issues are less pressing and users are customers. In future a greater understanding of co-production and the development of theory and practice which will combine the management of co-production with the empowerment of users will be essential