Global Health Expertise in the Shadow of Hegemony (Sept 2023)

By Alexandros Kentikelenis (Bocconi) · Leonard Seabrooke (CBS) · Ole Jacob Sending (NUPI)

What enables actors to shape norms in global health governance? Scholarship on
global health has highlighted the role of experts and expertise in operationalizing
norms across a variety of issues. The degree of expert consensus or dissensus and
the negotiation processes between expert communities—for example, in international
organizations, NGOs or academia—are commonly identified as centrally
important for explaining these processes. In this article, we posit that norm-making
in global health governance occurs in the shadow of hegemony; a system of status
and stratification that is centered on economic and security concerns and maintained
by countries at the core of the world system. These countries—notably the USA
and other major economies in the Global North—project their hegemonic position
in the world system across areas of global organizing, including in global health.
We explore the relationship between epistemic consensus and hegemonic interests
as parameters that shape the outcome of norm-making processes. To pursue this
argument, we examine this relationship in the context of the development of policy
norms to counter non-communicable diseases in developing countries and to pursue
the securitization of global health.

Keywords Global health expertise · Hegemony · Global norms · Non-communicable
diseases · Global health security