Restructuring neoliberalism at the World Health Organization

Most descriptions of the spread of neoliberal economic policies since the 1980s overlook the significant contribution of international organizations not only to the dissemination of these policies, but also to their making. The scholarship often regards international organizations as passive transmission belts that merely comply with the demands of their member-states. Scholars who do identify the constitutive role of international organizations consider them to be enthusiastic supporters of the neoliberal project. There were cases, however, when international organizations were opposed to neoliberal reforms imposed from above. This paper draws on the experience of the World Health Organization (WHO) to show that in the process of adapting to the emerging neoliberal regime, international bureaucracies actively restructured this regime in accordance with their own institutional cultures. Some neoliberal prescriptions were successfully transmitted, but others were transformed, with the result that the global regime was hardly monolithic and included elements that were introduced by the international bureaucracies themselves. In developing this argument, the paper identifies the adaptive strategies that allow international bureaucracies, in spite of their vulnerability to external forces, to incorporate their own organizational agendas into what has consequently become a more heterogeneous global neoliberal regime.