Evolution and Impact of the Global Partnership to Stop TB

In this study, we examine the evolution of the global TB (tuberculosis) policy network, with the Stop TB Partnership and the World Health Organization TB Department at its core, and the influence it has had on policy adoption, implementation, and scale-up in low-income countries. In particular, we examine the appropriateness of governance arrangements as well as how the structure of this network shapes both what strategies are used and the effectiveness of these strategies on the ground. We use a process-tracing methodology with data from interviews of approximately two-dozen key informants within the global TB policy network as well as several hundred reports and published documents. Findings indicate that the governance structure has changed little over the past decade, to the frustration of many in the activist community. While the Partnership has welcomed the participation of an ever-increasing number of organizations, many do not see it as a partnership of equals, but as a coalition dominated by the WHO. The governance arrangements have emphasized information sharing between the Partnership, WHO, and Ministries of Health, facilitating the development of clear norms and policies. However, they have not been as strong in engaging civil society organizations and creating national-level partnerships to increase grassroots pressure on governments. Moving forward, the Partnership must balance the tension between efficiency and inclusiveness, paying particular attention to the management of disagreement, the creation of trust, the facilitation of cooperative behavior, and the strengthening of grassroots-level advocacy in order to make continued progress in mortality reduction.