The path-dependent design of international organizations: Federalism in the World Health Organization

• Published in: European journal of international relations Vol. 21; no. 1; pp. 215–239 - 239
• Main Author: Hanrieder, Tine
• Format: Journal Article
• Language: English
• Published: Thousand Oaks, CA Sage Publications 01.03.2015; SAGE Publications; Sage Publications Ltd
• Subjects: Case studies; Constructivism; Federalism; Governance; Government grants; historical sociology; Institutions; intergovernmental organization; Intergovernmental organizations; International organizations; International Relations; Organization theory; Organizational structure; Regionalization; Studies; World Health Organization; institutions; International Relations; historical sociology; Governance; intergovernmental organization; regionalization
• ISSN: 1460-3713; 1354-0661; 1460-3713
• DOI: 10.1177/1354066114530011

The article puts forward a historical institutionalist account of how international organizations are ‘designed.’ I argue that deliberate institutional design is circumscribed by path-dependent power dynamics within international organizations. Power-driven path dependence is used to explain that organizations lock in and reinforce historical privileges of international organization subunits. Early winners in the international organization lock in their privileges with the support of member-state allies, and reap increasing returns from their positions over rounds of reform. They thereby amplify features of international organization design that reformers would otherwise change later on. The argument is illustrated with a historical case study of the World Health Organization’s unique federal design, which grants the regional offices near autonomy from headquarter oversight. Vocal criticisms of the World Health Organization’s regionalization and repeated centralization attempts notwithstanding, the powers of the regions have increased over time. The case study retraces the path-dependent struggles over the World Health Organization’s federal design since its creation in the 1940s. While the literature on international organizations tends to reserve inertia and path dependence for constructivist analysis, this article offers a rationalist account of inertia in international institutions.