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This chapter examines how the World Health Organization (WHO), under the leadership of Director-General Gro Harlem Brundtland, strategically adapted to the “new policy environment” that was created by the neoliberal reforms in the health sector. In the late 1990s, the WHO underwent programmatic and organizational changes in an attempt to pacify the exogenous forces and to strategically adapt to the logic of neoliberalism. The central component of the WHO leadership's strategic adaptation to the new environment was the replacement of a social logic with economic logic as the foundation for the organization's decisions and policies. This chapter shows how WHO officials justified investment in health by emphasizing the importance of health for economic development rather than as a fundamental part of a nation's social development, while also adopting cost-effective calculations to introduce the concept of the “new universalism,” which rejected primary health care and rigid market-oriented approaches while maintaining the WHO's “central task” of alleviating poverty by improving health.

This chapter examines how the World Health Organization (WHO), under the leadership of Director-General Gro Harlem Brundtland, was able to overcome the most pressing financial difficulties and regain some of its authority over global health programs by strategically adapting to the principles of neoliberalism. It considers the WHO's efforts to accommodate the interests of the private sector and reinvent the organization as a business-friendly venue, in part by avoiding antagonizing an industry even when important health issues were at stake. It also discusses the WHO's strategic resistance in two instances: a global campaign against the tobacco industry as part of its antismoking mission, and the WHO's opposition to the pharmaceutical sector in the dispute over intellectual property protection and access to antiretroviral drugs.

This chapter analyzes the WHO’s second big reform, the One WHO reform undertaken by Gro Harlem Brundtland (1998–2003). This reform tried to reverse, but in the end widened the WHO’s fragmentation. The chapter outlines Brundtland’s economics-based policy approach and shows how her transition team attempted to engineer change and coherence at all organizational levels. Nevertheless, the fragmentation pathway proved irreversible. Both the attempt to integrate the regional budgets into One WHO budget and Brundtland’s plea for more centralized funds were frustrated. Instead, she relied on new organizational layers vested with independent powers, mostly disease-specific programs in the form of public-private partnerships. While the layering strategy ensured the WHO’s continued growth in an increasingly competitive environment, it further undermined its corporate agency. This prevents the WHO from implementing agreed-upon priorities and fuels a quest for reform that continues until today.

In this chapter Helge Ryggvik and Berit Kristoffersen argue that even if Norway avoided the classic symptoms of the oil curse, it nonetheless has been deeply affected, first by the sheer wealth, then by the power of its own national oil company. Political realism in Norway includes fossil fuel dominance—economic and political. Voices are being heard within Norway questioning the net benefit presumption of continued extraction, let alone expansion. They are saying that enough is enough. Fossil fuels, some are beginning to argue, are no longer legitimate nationally or globally as Norway’s well-being is tied to that of the rest of the planet. What is more, if boom conditions have been difficult to moderate, then bust will be as well; it is time to start stopping.