i4C-4 Institutions

The world is becoming increasingly interconnected and interdependent. As a result, many of today’s greatest challenges to global health can only be properly addressed through global collective action. The knowledge about global collective action for health, however, is sparse relative to the range and magnitude of the problems for which such action is required. Our current knowledge is also meager when compared to what we know about global governance for many issues other than health and when compared with all we know about effective interventions at the clinical level.

The goal of this project is to start closing these gaps by addressing three game-changing questions:

  1. What strategies for global collective action for health are available?

  2. How do they relate and differ?

  3. To what extent, and under what conditions, are they legitimate, effective, fair, and feasible?


Working toward answers to the three questions will help generate systematic knowledge about the strategies decision-makers have at their disposal and help create a science of global health strategy that is helpful across sectors.

The project will consist of four streams of research:

Stream A: Identifying and classifying strategies for global collective action for health

Research in this stream will identify and classify strategies for global collective action, with a view to helping global decision-makers by providing a menu of options from which to look for feasible and desirable alternatives in any given situation.

Stream B: Developing a standard for the assessment of strategies and reforms

Today, there is no established, comprehensive standard for the assessment of strategies for global collective action for health or associated reforms. This stream will seek to improve the quality and the impact of assessments through the development of a state-of-the-art standard with criteria pertaining to legitimacy, effectiveness, fairness, and feasibility.

Stream C: Assessing strategies and reforms

Research in this stream will seek to assess a set of strategies and reforms, and will do so partly on the basis of the standard developed in stream B. Accordingly, strategies and reforms will be assessed in terms of legitimacy, effectiveness, fairness, and feasibility related to the outputs, outcomes, and impact of each strategy.

Stream D: Cross-cutting analyses

Research in this stream will build on the other streams, provide input and context for other streams, or some combination. This research will include comparative analyses of global health governance and global environmental governance, and an assessment of strategies in the context of the UN Sustainable Development Goals (SDGs).

i4C-4 Project Team

Steven J. Hoffman

Steven J. Hoffman

Director, Global Strategy Lab
Professor, Faculty of Health and Osgoode Hall Law School, York University
Scientific Director, CIHR Institute of Population & Public Health
Trygve Ottersen

Trygve Ottersen

Faculty Associate, Global Strategy Lab
Adjunct Professor of Law, University of Ottawa
Associate Professor of Medicine, University of Oslo