The study of global governance has accelerated in recent years in part because the very concept embraces so many facets of contemporary international relations. Indeed, two senior scholars suggest that it may even “rescue” the field (Thomas G. Weiss and Rorden Wilkinson, “Global Governance to the Rescue: Saving International Relations?” Global Governance 20(1) [2014]: 19–36). Whether or not that is the case, there is a burgeoning literature on the subject, including studies of specific areas such as health and climate.

As James Rosenau put it two decades ago, “Governance…is a more encompassing phenomenon than government” (James N. Rosenau and E.O. Czempiel, eds., Governance Without Government: Order and Change in World Politics, 1992). More recently, Thomas Weiss has suggested that “a deeper investigation of contemporary global governance has the potential to capture more accurately how power is exercised across the globe, how a multiplicity of actors relate to one another generally as well as on specific issues, make better sense of global complexity, and account for alterations in the way that the world is and has been organized (or governed) over time” (“Rethinking Global Governance? Complexity, Authority, Power, Change,” International Studies Quarterly 58(2) [2014]).

Jeremy Youde’s book, Global Health Governance, is one of three books on this subject published in 2012. It provides an accessible introduction to the subject aimed largely at an undergraduate audience. His central argument is that with the growing importance of cross-border health issues, “the questions of who should respond and how these responses should best be organized become increasingly complicated ” (p. 1). In charting the evolution of global health governance, he therefore looks beyond the World Health Organization (WHO) to various other actors, to how funding of health initiatives has changed significantly, and at how the range of health issues has expanded from infectious diseases to non-communicable diseases and the practices of the pharmaceutical industry.

The book is organized into three parts, the first of which provides a brief history of early international health governance, including a nice section on the role of the Rockefeller Foundation’s International Health Division between 1913 and 1945. Part II focuses on actors, specifically, the WHO, the World Bank, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, private actors (notably the Clinton and Gates Foundations), and civil society organizations (CSOs). As Youde notes, WHO “does not lead the global health governance regime, and it is not the totality of global health governance” (p. 30). Part III looks at three issues to illustrate evolving health governance: the creation of the Global Infectious Disease Surveillance Regime, the framing of “health security,” and access to pharmaceuticals. The concluding chapter reviews the pattern of health governance evolution and suggests where research should go in the future, for example, exploring the implications of increased attention to non-communicable diseases for sustaining attention to infectious diseases.

The book does an excellent job of laying out the parameters of evolving global health governance. It highlights the absence of a single motivating rationale as the scope of issues has expanded (i.e. from economic concerns to health as a human right and to human security). Its organization emphasizes the expanding range of actors, emphasizing the most visible and recognized. And, it charts the shift of health from low to high politics at the end of the 1990s with the recognition of the HIV/AIDS epidemic in particular as a major threat to human security.

In my view, the author’s effort to provide a comprehensive overview falls short in three main areas: first, in not situating global health governance within the broader literatures on global governance, international organizations, nonstate actors, and human security; secondly, in not tracing more of the dynamics of actors’ interactions, their agency, and the nitty-gritty of politics and processes; and thirdly, in not doing more with the effects of changing health governance on people, efforts to contain communicable diseases, and access to drugs.

In explaining why focus on global versus international health governance, it would be good to talk more about global governance generally. The chapters on the WHO and World Bank would have benefitted, for example, from the research on IOs as bureaucracies (e.g., see Michael Barnett and Martha Finnemore, Rules for the World: International Organizations in Global Politics, 2004) and how organizational cultures and staff backgrounds have shaped both. Drawing on literature on networks, partnerships, and coalitions would have strengthened the chapter on CSOs and subsequent issue chapters (e.g., see Miles Kahler, ed., Networked Politics: Agency, Power, and Governance, 2009). Likewise, the chapter on “Framing Human Security” would have benefitted from using literature on the concept’s emergence (e.g., see S. Neil MacFarlane and Yuen Foong Khong, Human Security and the UN: A Critical History, 2006).

The range of actors, including networks and coalitions, creates challenges in researching global governance. Political scientists will want to know more about the dynamics of politics and processes that have yielded changes in health governance. How do public and private actors interact and who influences what happens and how? How much, for example, do donor states dominate the Global Fund versus other actors (pp. 77–78)? How much did they versus bureaucratic politics within the UN system and NGO activism lead to the creation of UNAIDs in 1994 (p. 66)? Who drove the campaign for universal ARV access? The book would have benefitted from more attention to these questions of power, influence, and dynamics of interaction.

Likewise, some readers will wish the author had provided more on what difference changes in health governance have made. Did they improve responses to the Avian flu outbreak (pp. 133–36), for example? What has been achieved by the World Bank’s greatly increased funding for health or by the Global Fund? In short, more data on funding and impact would be helpful.

Finally, some sections of the book would benefit from more background information. The chapter on the WHO, for example, slides over its campaigns to eradicate smallpox and polio and the 1980s Code on Marketing Breast-Milk that laid a foundation for the tobacco control initiative. The treatment of HIV/AIDS lacks a short history of its emergence, initial WHO responses, and gradual recognition that it was more than a health problem. Data on the scope of the HIV/AIDS problem by the late 1990s would show why it was seen as a threat to security worthy of UN Security Council, General Assembly, and G-8 attention. In Chapter 9 on Access to Pharmaceuticals, background on how the effort to widen access originated in the WHO in the 1960s and how the AIDS epidemic sharpened the access issues in the 1990s would be helpful to understanding the campaign for anti-retroviral drug access, and the politics of getting action.

Despite the concerns I have outlined, Youde’s book provides an excellent overall conceptualization of evolving global health governance and a useful examination of key actors and selected cases for delving more deeply into this important area. Its accessibility makes it a good choice for courses specifically on the topic of global health or more generally on global governance.