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Globalising dynamics have had wide-ranging and pervasive impacts on nearly every form of human relatedness, which now include the bases upon which states calculate and express their political responsibilities. As the ‘reach’ of practical and normative pressures extends and their demands intensify, the compass of state responsibility is becoming a key pressure point for facing the challenges and mediating the tensions of our globalised and still globalising world. This theme is examined from a global health perspective. The general disposition of states toward their acknowledged political responsibilities is unlikely to change, but the combination of legal, normative, political and practical dynamics impinging on them have already begun to register, as both states and the international system adjust to a politics that now have global dimensions.

The prospect for the MDGs cannot be reduced to the sum of the eight goals, divorced from international dynamics, the hard interests of states and the global dynamics that impact on both, or from the complexities and intractability of widespread poverty and its consequences. The legacies and controversies of previous international development initiatives also beset perceptions of, and support for, the MDGs. However, the wholly inclusive nature of the goals give them a unique normative standing and momentum; and the quantitative measures of progress ensure that there is more to the goals than lofty ideals. In addition, the thematic linkages between each of the goals is mutually reinforcing. While not discounting either structural difficulties or the lack of adequate progress in some specifics, it is important not to overlook the political consensus, abundant goodwill and normative momentum that have already been generated in the ten years to date. The answer to the question, `How promising is the p...

Five years from the end of the 15-year span of the Millennium Development Goals (MDGs) it is already plain that progress has been patchy and that the larger goals will not be met. The scale and profile of the MDGs will make them subject to eventual success or failure judgments and ‘lessons learned’ analyses, but the evidence of the past decade and current trajectories are sufficient to reveal our conceptual and operational shortcomings and the kinds of reorientation needed to ensure that the last five years of the MDGs will exhibit positive momentum rather than winding-down inertia. Such reorientations would include prioritising actors over systems; disaggregated targets over global benchmarks; qualitative aspects of complex forms of human relatedness over technical ‘solutions’; and the painstaking work of developing country enablement over quick outcome indicators, not least for the purpose of sustainability. Thinking and planning beyond 2015 must be made integral to the last five years of the M...

The Global Fund to Fight AIDS offers great promise as an instrument of global action to address the devastating effects of the disease. Yet the enormity of its promise also speaks to the scope of its mission: to facilitate the financing by governments, corporations, philanthropical bodies and individuals of a massive effort to address the epidemic that has to date outpaced previous efforts at effective control. A key challenge is to devise a governance structure that makes effective action likely, satisfies donors, responds efficiently, and produces observable results. By examining recent developments, this paper seeks to outline facets of the governance challenge facing the Global AIDS Fund.

(2002). Global health and the politics of governance: An introduction. Third World Quarterly: Vol. 23, No. 2, pp. 191-195.

The 13th International Conference on AIDS held in Durban, South Africa, highlighted the social catastrophe unfolding on the African continent. The meeting took place in the country with the largest number of people infected by HIV - the virus that causes AIDS - on the continent that is home to 70% of the world's HIV-infected population. The cruel irony of the unfolding human tragedy is that Africa is also the least equipped region in the world to deal with the multiplicity of challenges posed by the HIV virus. Drawn from ongoing research in southern Africa, this article charts the relationship between poverty, HIV prevalence and the politics of global response.