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Grant No.

18－G28

Research Report
Name :
Lana Bauab Brito
Organization (at the start of the grant period):
Kobe University, Graduate School of International Cooperation Studies (GSICS)
Title of Research:
Private Philanthropic Foundations as Orchestrators in Global Health GovernancePurpose of Research:（200 words）
My main purpose is to expand the Orchestration Theory, created by Professors Duncan Snidal and Kenneth
Abbott (2009), by shifting the focus from intergovernmental organizations towards private philanthropic foundations asorchestrators. Unlike delegation, which is hard and indirect, orchestration is defined as a soft and indirect governancemode in which a lead organization enlists or creates intermediaries to influence the behavior of other actors. When arefoundations, such as the Rockefeller Foundation and the Bill and Melinda Gates Foundation (BMGF), more likely toorchestrate? How does foundations’ orchestration differ from other governance actors?
My paper presented at the 2018 ISA Convention established the basis of my research by reviewing theliterature and testing the applicability of existing orchestration hypotheses to foundations. This initial research showedthat foundations usually orchestrate to create a new intermediary rather than enlisting existing ones. When creatingsuch an intermediary, public-private partnerships were the preferred institutional model (Brito, 2018). Evolving fromthis initial research, I seek to create an abstract model of orchestration by foundations through the analysis of casestudies within Global Health Governance (GHG). My goal is twofold: to contribute to the orchestration theory and to
inform the debate over foundations’ power in GHG.
Content/Methodology of Research:（400 words）
Orchestration is often advocated as a mechanism that can help manage regime complexes. Abbott (2012)
argues that it is possible to minimize the costs of fragmentation and enhance the benefits of decentralization throughorchestration, in which governance actors, in particular IGOs, support and steer other international or transnational
institutions that pursue shared governance goals. As a ‘light coordination mechanism,’ orchestration does not solve theproblem of global governance ineffectiveness, but it enhances the benefits of regime complexes.
Orchestration also allows for a more nuanced analysis of IGOs’ independent contributions to global
governance, showing how IGOs can act autonomously, circumventing member-states’ control, as well as the limits of
their actions due to its soft character (Abbott, et al., 2015). Similarly to IGOs, foundations’ contributions to global
governance are also misrepresented; being often reduced to their financial contributions. Orchestration, in this context,
showcases how IGOs and foundations can autonomously influence global governance outside their expected roles.
While the Orchestration Theory is the main theoretical framework, this thesis also speaks to a range oftheoretical conversations focusing on debates over non-state actors’ power and influence in global governance,philanthrocapitalism, and private authority.
Based on the Grounded Theory approach, this research utilizes case studies to draw on the theoretical
implications of privative foundations orchestration in GHG. The Children’s Vaccine Initiative (CVI), Gavi, the Vaccine
Alliance, and the Affordable Medicines Facility for Malaria (AMFm) hosted by the Global Fund to Fight AIDS,

Tuberculosis and Malaria (Global Fund) are my main case studies, due to the active involvement of the Rockefeller
Foundation and/or BMGF in their creation and later consolidation. Three other subcases, namely the International
AIDS Vaccine Initiative (IAVI), the Global Polio Elimination Initiative (GPEI), and the Clinton Health Access
Initiative (CHAI) are considered to provide counterbalancing examples in order to better determine when and whyorchestration is being chosen and when delegation and/or cooptation are seem as the preferred option.
Following a qualitative research design, semi-structured interviews are used to complement other forms ofdata, such as official documents and academic books and papers. The data collection was divided into fieldwork in
New York and Geneva as well as Skype interviews (ongoing). The fieldwork included not only interviews withrelevant personnel from UN agencies, health related public-private partnerships, private foundations, NGOs,
pharmaceutical companies, etc. but also discussions with experts, and review of relevant documents from theRockefeller Archive Center and WHO Archives.
Conclusion/Observation（200 words）
Although all gathered material hasn’t been fully analyzed, some preliminary findings can be drawn. Theinterviews were able to fill gaps in my initial paper. Interviewees, for example, confirmed my initial suspicion that
there was no coordination between the Rockefeller Foundation and the BMGF in the creation process of Gavi. This
piece of information directly affects the characterization of the collaborative orchestration between the World Bank, theRockefeller Foundation, and the BMGF as a case of multi-orchestration.
In general, the interviews show a change in the engagement of the BMGF with Gavi due to its consolidation
as an organization and due to the institutional reform of Gavi in 2008. During the eighteen years of Gavi, the BMGF
transitioned from being perceived solely as a donor to being also perceived as a technical expert in the area of global
health. The merger of the Vaccine Fund with Gavi Alliance in 2008 and its transformation into a Swiss Foundation alsochanged the relationship between Gavi and the BMGF. Despite the end of its initial hard control over the Vaccine Fund,the BMGF continues to use its financial autonomy to not only support Gavi, but also to test new mechanisms within
the partnership.

References
Abbott, K., 2012. The transnational regime complex for climate change. Environment and Planning C: Governmentand Policy, 30(4): 571-590. doi:10.1068/c11127.
Abbott, K., et al., eds., 2015. International Organizations as Orchestrators. Cambridge: Cambridge University Press.
Abbott, Kenneth W. and Snidal, Duncan (2009). Strengthening International Regulation through Transnational
Governance: Overcoming the Orchestration Deficit. Vanderbilt Journal of Transnational Law, 42:501–578.
Brito, L. B., 2018. Private Philanthropic Foundations as Orchestrators in Global Health Governance: An Analysis of
the Rockefeller Foundation. Paper presented at the ISA 59th Annual Convention, San Francisco, CA, USA, April
2018.