Glocal Health Governance: Organizational Innovations in the Era of COVID-19

Wen-Hua Kuo () and Kayo Takuma
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Wen-Hua Kuo: National Yang Ming Chiao Tung University
Kayo Takuma: Keio University

Chapter 6 in Capitalism, Innovations, and Health after Covid-19, 2026, pp 215-242 from Springer

Abstract: Abstract The COVID-19 Pandemic offers a critical opportunity to reassess global health governance. This chapter examines the vulnerabilities of existing governance frameworks during the initial outbreak and early responses, and analyzes how local and regional networks joined the global efforts and generated novel organizational innovations. Moving beyond narratives that focus primarily on the World Health Organization’s (WHO) shortcomings or geopolitical failure, the chapter introduces the concept of “glocal health governance” to capture the dynamic, multilayered interactions among global, regional, national, and non-state actors during the pandemic. Drawing on global health security scholarship and institutional analysis, the authors argue that COVID-19 revealed both the limits of centralized global coordination and the growing importance of regional and local capacities. The chapter conceptualizes the pandemic as a governance “tabletop exercise” unfolding across three stages: initial outbreak and early responses; vaccine development and distribution; and post-crisis institutional stabilization. In the first stage, delayed WHO action—constrained by political pressures and the International Health Regulations (IHR)—coincided with more proactive responses by regions and individual states, signaling a shift away from a single global gatekeeper model. The second stage examines vaccine governance as a central arena of health diplomacy, where initiatives such as COVAX demonstrated both unprecedented collaboration and deep inequities shaped by vaccine nationalism and geopolitical rivalry. The third stage analyzes efforts to stabilize pandemic governance through institutional reforms, including the revision of the IHR, negotiations over the Pandemic Agreement, and the strengthening of regional health infrastructures in Europe, Africa, and Asia. Through comparative regional analysis, the chapter shows that organizational innovations—such as the European Health Union, Africa CDC–led procurement mechanisms, vaccine manufacturing partnerships, and biomanufacturing training hubs in Asia—played a critical role in addressing governance gaps at the global level. The chapter concludes that glocal health governance provides a more realistic and flexible framework for understanding pandemic response and for building more resilient health governance systems in an increasingly unstable world.

Date: 2026
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DOI: 10.1007/978-3-032-24479-6_6

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