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In recent years, scholarship on international organisations (IO) has devoted increasing attention to the relations in which IOs are embedded. In this article, we argue that the rationalist-institutionalist core of this scholarship has been marked by agentic, repressive understandings of power and we propose an alternative approach to power as productive in and of relations among IOs. To study productive power in IO relations, we develop a theoretical framework centred on the concept of 'metagovernance norms' as perceptions about the proper 'governance of governance' that are shared among IOs in a governance field. Drawing on discourse theory, we contend that metagovernance norms unfold productive power effects, as dominant notions of how to govern well and effectively (i) fix meanings, excluding alternative understandings and (ii) are inscribed into practices and institutions, hence reshaping inter-organisational relations over time. To illustrate our framework, we trace metagovernance norms in discourses among health IOs since the 1990s. We find a historical transformation from beliefs in the virtues of partnerships, pluralisation, and innovation, towards discursive articulations that emphasise harmonisation, order, and alignment. Moreover, we expose the productive power of metagovernance norms by showing how they were enacted through practices and institutions in the global health field.

In recent years, scholarship on international organisations (IO) has devoted increasing attention to the relations in which IOs are embedded. In this article, we argue that the rationalist-institutionalist core of this scholarship has been marked by agentic, repressive understandings of power and we propose an alternative approach to power as productive in and of relations among IOs. To study productive power in IO relations, we develop a theoretical framework centred on the concept of 'metagovernance norms' as perceptions about the proper 'governance of governance' that are shared among IOs in a governance field. Drawing on discourse theory, we contend that metagovernance norms unfold productive power effects, as dominant notions of how to govern well and effectively (i) fix meanings, excluding alternative understandings and (ii) are inscribed into practices and institutions, hence reshaping inter-organisational relations over time. To illustrate our framework, we trace metagovernance norms in discourses among health IOs since the 1990s. We find a historical transformation from beliefs in the virtues of partnerships, pluralisation, and innovation, towards discursive articulations that emphasise harmonisation, order, and alignment. Moreover, we expose the productive power of metagovernance norms by showing how they were enacted through practices and institutions in the global health field.

This article approaches the field of global health governance from the vantage point of shared discourses and norms on the good governance of governance amongst multiple international organizations (IOs). Conceptually, we introduce metagovernance norms as constitutive, reflexive beliefs concerned with institutional order and IO interactions in a given governance field. We argue that such norms are entangled with causal beliefs and problem perceptions that form part of contingent, contested repertoires of knowledge. Moreover, we illustrate how IO 'expert' groups form an authoritative subject position from which truth claims about governance are advanced. Empirically, we trace metagovernance norms in discourse(s) amongst eight health IOs since the 1970s. We show how metagovernance norms have been constructed around competing beliefs about governance 'effectiveness' and problem perceptions concerned with different forms of 'complexity'. Our research demonstrates that discourses on institutional order in global health are shaped by metagovernance norms drawing on historically-specific knowledge repertoires.

This article approaches the field of global health governance from the vantage point of shared discourses and norms on the good governance of governance amongst multiple international organizations (IOs). Conceptually, we introduce metagovernance norms as constitutive, reflexive beliefs concerned with institutional order and IO interactions in a given governance field. We argue that such norms are entangled with causal beliefs and problem perceptions that form part of contingent, contested repertoires of knowledge. Moreover, we illustrate how IO 'expert' groups form an authoritative subject position from which truth claims about governance are advanced. Empirically, we trace metagovernance norms in discourse(s) amongst eight health IOs since the 1970s. We show how metagovernance norms have been constructed around competing beliefs about governance 'effectiveness' and problem perceptions concerned with different forms of 'complexity'. Our research demonstrates that discourses on institutional order in global health are shaped by metagovernance norms drawing on historically-specific knowledge repertoires.

This paper proposes a theoretical account of institutional transformation and the emergence of order in global inter-organisational relations, which is centred on the concept of "metagovernance". It does so by theorising on the advent of governance architectures in global health governance—relationships between international organisations (IOs) in this field that are stable over time. Global health governance is routinely portrayed as an exceptionally fragmented field of international cooperation with a perceived lack of synergy and choreography between international and transnational organisations. However, our paper starts from the observation that there are also movements of convergence between international organisations. We seek to explain these by looking at the effects of international norms that define good global governance as orderly and harmonised global governance. We conceptualize such norms as "metagovernance norms" that are enacted in reflexive practices which govern and order the relationships between international organisations. Empirically, this paper traces changing interactions and institutional arrangements between IOs (World Health Organization; World Bank; Gavi, the Vaccine Alliance; and the Global Fund to Fight AIDS, Tuberculosis and Malaria) in global health governance since the late 1940s and shows how patterns therein reflect and (re)produce broader discursive perceptions of what "health" is about and how the governance thereof ought to be organised.

This paper proposes a theoretical account of institutional transformation and the emergence of order in global inter-organisational relations, which is centred on the concept of "metagovernance". It does so by theorising on the advent of governance architectures in global health governance—relationships between international organisations (IOs) in this field that are stable over time. Global health governance is routinely portrayed as an exceptionally fragmented field of international cooperation with a perceived lack of synergy and choreography between international and transnational organisations. However, our paper starts from the observation that there are also movements of convergence between international organisations. We seek to explain these by looking at the effects of international norms that define good global governance as orderly and harmonised global governance. We conceptualize such norms as "metagovernance norms" that are enacted in reflexive practices which govern and order the relationships between international organisations. Empirically, this paper traces changing interactions and institutional arrangements between IOs (World Health Organization; World Bank; Gavi, the Vaccine Alliance; and the Global Fund to Fight AIDS, Tuberculosis and Malaria) in global health governance since the late 1940s and shows how patterns therein reflect and (re)produce broader discursive perceptions of what "health" is about and how the governance thereof ought to be organised. ; The publication of this article was funded by the Open Access fund of the Leibniz Association. This article is part of the issue "Supranational Institutions and Governance in an Era of Uncertain Norms", edited by Russell Alan Williams (Memorial University, Canada) and Reeta Tremblay (University of Victoria, Canada).

This paper proposes a theoretical account of institutional transformation and the emergence of order in global inter-organisational relations, which is centred on the concept of "metagovernance". It does so by theorising on the advent of governance architectures in global health governance—relationships between international organisations (IOs) in this field that are stable over time. Global health governance is routinely portrayed as an exceptionally fragmented field of international cooperation with a perceived lack of synergy and choreography between international and transnational organisations. However, our paper starts from the observation that there are also movements of convergence between international organisations. We seek to explain these by looking at the effects of international norms that define good global governance as orderly and harmonised global governance. We conceptualize such norms as "metagovernance norms" that are enacted in reflexive practices which govern and order the relationships between international organisations. Empirically, this paper traces changing interactions and institutional arrangements between IOs (World Health Organization; World Bank; Gavi, the Vaccine Alliance; and the Global Fund to Fight AIDS, Tuberculosis and Malaria) in global health governance since the late 1940s and shows how patterns therein reflect and (re)produce broader discursive perceptions of what "health" is about and how the governance thereof ought to be organised.

Abstract
In this paper, regime complexes are conceptualized as dynamic networks constituted by relations between international organizations (IOs). We introduce "IO positioning" as a conceptual lens for studying patterns and shifts in IO networks resulting from negotiations between IOs over their distinctiveness and social membership in complex organizational fields. We suggest that IO positioning has two constitutive effects. First, on the level of individual IOs, positioning affects IO identities within the field as these are (re)negotiated in relations with other organizations. Secondly, the positioning practices of IOs have constitutive effects on the contours of entire policy fields too; they form and shift the boundaries of regime complexes. Empirically, the paper examines the utility of our approach by analyzing the history, dynamics, and positioning effects of interorganizational relations between eight IOs in global health governance—an area of international cooperation that is commonly portrayed as exceptionally fragmented, complex, and densely populated. Examining relations between our eight IOs, we provide network analytical longitudinal data of in- and out-reporting by IOs derived from IOs' annual reports between 1970 and 2017. We triangulate our network analysis with data derived from semi-structured interviews with health IO professionals.

Background:Timely strategic information is essential for decision makers to mount an effective public health response to infectious disease outbreaks, and public health actors must find an effective way to supply it. The Centre for International Health Protection at the Robert Koch Institute (Germany's national public health institute) developed a three-pronged approach to processing and supplying strategic information on the international state of the COVID-19 pandemic to the German Federal Ministry of Health: monitoring and analysis of international public health and social measures (PHSM); screening, validating, analysing and reporting the global epidemiological situation; and in-depth analyses and syntheses of COVID-19 evidence.
Aims and objectives:We discuss the approach taken by the Centre to provide strategic information and challenges and adaptations during the information provision process. We then distil lessons that will be critical to improve strategic information provision for evidence-informed decision making in future public health emergencies.
Key conclusions:Several lessons can be derived from the Centre's experience. Timeliness of evidence is essential for enabling decision makers to tailor a public health response to an outbreak, and requires sufficient and skilled staff to process evidence. Evidence formats should be adapted to decision makers' information needs; this requires open channels of communication to understand needs. Access to high-quality international data hinges on data sharing across countries and the capacity to collect and process such data in many countries. Heeding the lessons will strengthen pandemic response.

BACKGROUND: During outbreaks, uncertainties experienced by affected communities can influence their compliance to government guidance on public health. Communicators and authorities are, hence, encouraged to acknowledge and address such uncertainties. However, in the midst of public health crises, it can become difficult to define and identify uncertainties that are most relevant to address. We analyzed data on COVID-19-related uncertainties from four socio-economic contexts to explore how uncertainties can influence people's perception of, and response to Risk Communication and Community Engagement (RCCE) strategies. RESULTS: This qualitative study, which adopts an interpretative approach, is based on data from a documentary review, key informant interviews (KII), and focus group discussions (FGD) with members of the general public and people with barriers to information from Germany, Guinea, Nigeria, and Singapore. Transcripts from the KII and FGD were coded and analyzed thematically. We interviewed a total of 155 KIs and conducted 73 FGD. Our analysis uncovered a divergence between uncertainties deemed relevant by stakeholders involved in policy making and uncertainties that people reportedly had to navigate in their everyday lives and which they considered relevant during the pandemic. We identified four types of uncertainties that seemed to have influenced people's assessment of the disease risk and their trust in the pandemic control strategies including RCCE efforts: epidemiological uncertainties (related to the nature and severity of the virus), information uncertainties (related to access to reliable information), social uncertainties (related to social behavior in times of heightened risk), and economic uncertainties (related to financial insecurities). CONCLUSION: We suggest that in future outbreaks, communicators and policy makers could improve the way in which affected communities assess their risk, and increase the trust of these communities in response efforts by addressing non-epidemiological ...