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The article analyzes the contested concept of global health through the lens of orders of worth. Drawing on pragmatist political and social theory, especially the work of Boltanski and Thévenot, I conceptualize orders of worth as moral narratives that connect visions of universal humankind to ideas about moral worth and deficiency. They thereby differ from the self/other narrative of political identity that is emphasized in International Relations scholarship. Orders of worth do not pitch a particularistic identity against foreign identities, but tie collective identity to a higher common good. They provide tools for moral evaluation and the justification of hierarchy. I use this heuristic to reconstruct four main conceptions of health in global politics: The order of survival, the order of fairness, the order of production, and the order of spirit. Each of them articulates a distinct political identity, as 'we species', 'we liberals', 'we bodies' and 'we souls', and implies different notions of virtuous and selfish conduct in the global community. These orders are derived from scholarly writings and the policies of global health institutions. Finally, I discuss the nature of compromises between the four orders regarding contested issues such as health emergencies or digital medicine.

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich. / This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively. ; The article analyzes the contested concept of global health through the lens of orders of worth. Drawing on pragmatist political and social theory, especially the work of Boltanski and Thévenot, I conceptualize orders of worth as moral narratives that connect visions of universal humankind to ideas about moral worth and deficiency. They thereby differ from the self/other narrative of political identity that is emphasized in International Relations scholarship. Orders of worth do not pitch a particularistic identity against foreign identities, but tie collective identity to a higher common good. They provide tools for moral evaluation and the justification of hierarchy. I use this heuristic to reconstruct four main conceptions of health in global politics: The order of survival, the order of fairness, the order of production, and the order of spirit. Each of them articulates a distinct political identity, as 'we species', 'we liberals', 'we bodies' and 'we souls', and implies different notions of virtuous and selfish conduct in the global community. These orders are derived from scholarly writings and the policies of global health institutions. Finally, I discuss the nature of compromises between the four orders regarding contested issues such as health emergencies or digital medicine.

The article puts forward a historical institutionalist account of how international organizations are 'designed.' I argue that deliberate institutional design is circumscribed by path-dependent power dynamics within international organizations. Power-driven path dependence is used to explain that organizations lock in and reinforce historical privileges of international organization subunits. Early winners in the international organization lock in their privileges with the support of member-state allies, and reap increasing returns from their positions over rounds of reform. They thereby amplify features of international organization design that reformers would otherwise change later on. The argument is illustrated with a historical case study of the World Health Organization's unique federal design, which grants the regional offices near autonomy from headquarter oversight. Vocal criticisms of the World Health Organization's regionalization and repeated centralization attempts notwithstanding, the powers of the regions have increased over time. The case study retraces the path-dependent struggles over the World Health Organization's federal design since its creation in the 1940s. While the literature on international organizations tends to reserve inertia and path dependence for constructivist analysis, this article offers a rationalist account of inertia in international institutions. ; Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich / This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation).

"Gesundheitssicherheit ist keineswegs ein globales öffentliches Gut, sondern sehr ungleich verteilt. Globale Seuchenkontrolle leidet unter notorischer Ressourcenknappheit, vor allem angesichts schwacher Gesundheitssysteme in Entwicklungsländern, und ist geprägt von Verteilungskonflikten zwischen armen und reichen Ländern." (Autorenreferat)