Reforming the World Health Organization: What influence do the BRICS wield?

The World Health Organization (WHO) is currently undergoing fundamental reform that is intended to impact its programmes and priority setting and its financial and governing structures. Within the reform debates, new relations of powers are emerging among traditional donors and emerging economies such as the 'BRICS': Brazil, Russia, India, China and South Africa. These five emerging economies have formally committed 'to strengthen and legitimise the WHO as the coordinating authority in global health' through the principle of multilateralism. In this paper, the results of a qualitative study - based on 21 key informant interviews - that seeks to better understand BRICS' engagement in this organisation and the extent to which their action enables these countries to influence the reform process were presented. The results show that individual BRICS countries found natural pairings with each other on both particular elements of the reform, notably governance and WHO financing, and specific health issues. While numerous examples of individual BRICS countries seeking to raise the profile of specific health issues were found, some evidence of a coordinated effort to influence reform as a bloc was also found. Although this was largely limited to rhetorical announcements of support in formal Declarations and Communiqués, it nevertheless articulates a vision of the WHO as an organisation with a broad mandate delivered with sufficient, predictable funding.