Table 2 Blending processes and mechanisms for a blended integrated knowledge translation (IKT) – global health governance (GHG) approach

Identify problem and identify, review, select knowledge

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Adapt knowledge to local context

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Governance bodies that work together to identify problems and knowledge

Consideration of the composition of non-traditional actors, such as civil society and private sector, in governance bodies

Guidance for meaningful engagement between actors, particularly in shared governance models

Promising example: GAVI mitigates known global power imbalances through the composition of their Board, which includes 9 neutral individuals who speak to public interests, 5 government representatives each from donor and recipient countries, 1 expert in research and technology, 1 industry representative each from the global South and global North, 1 civil society representative, and 1 representative each from WHO, UNICEF, World Bank and Bill & Melinda Gates Foundation

Taking steps to balance power between global North and global South

Promoting transparency and accountability in decision-making about the composition of governance bodies

Attentiveness to how particular ways of framing health and governance influences how a ‘problem’ is being understood

Attentiveness to how historical conditions and power dynamics privilege particular assumptions

Assess barriers to knowledge use

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Select, tailor, implement interventions

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Guidance on how to resolve discrepant norms and values between engaged actors

Guidance on how to ensure legitimacy of leadership

Guidance on how political will and power influence this process

Platforms for coordinating global-level responses to wicked problems

Promising example: The Lancet Commission on GHG offered specific recommendations for governance mechanisms and processes, with detailed calls to make the examination of issues of power an explicit responsibility of GHG. They called for attention to democratic deficit, institutional and structural inflexibility, strengthened accountability, identification and involvement of missing institutions and voices, and to create a policy space for health. Their report offers specific guidance on how to do so. Among the Commission’s recommendations were specific mechanisms, including a proposed UN Multi-stakeholder Platform on Global Governance for Health

Attentiveness to how historical conditions and power dynamics give rise to inequities in inclusion and voice

Exploration of how processes of historical exclusion (e.g. due to race, class, gender, Indigeneity, etc.) can be mitigated

Monitor knowledge use

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Evaluate outcomes

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Sustain knowledge use

Generation and maintenance of mechanisms provide infrastructure for monitoring and evaluation

Norms and expectations for transparency in decision-making

Promising example: Two advisory bodies, the Technical Review Panel and a Technical Evaluation Reference Group, provide independent audit and monitoring of programmes funded by the GFATM. Their reports highlight lessons learned from funding requests and reviews, including perspectives of applicants, technical partners, the Secretariat and the Board. They consist of external experts in HIV, TB and malaria as well as experts in human rights, gender, health systems and sustainable financing. Their reports are made publicly available through the GFATM website

Attentiveness to who decides what knowledge count as legitimate

Attentiveness to who decides what outcomes count as legitimate

Consideration of who owns knowledge, with efforts to promote publicly owned and accessible data

Attentiveness to equitable distribution of resources and benefits