Complexity as a Policy Problem: Governance Effects in Global (Health) Governance

This paper puts forward a critical-constructivist approach to how international organizations (IOs) socially construct “complexity” as a policy problem in international politics and the power effects that result from complexity as a ‘truth claim’. The default perspective on international politics equates the proliferation of actors, rules and institutions with historically unprecedented complexity of the social structures surrounding issues and actors. As a consequence, much of contemporary scholarship on global governance assumes that policy problems, knowledge about these problems and the structures and actors through which policy problems are governed are indefinitely more complex than they were before. This diagnosis of complexity, we argue, does not merely serve descriptive purposes. Rather, we use health governance as a case to show how complexity is a powerful metanarrative with productive effects. The claim of complexity emerges as a cross-cutting policy problem that simultaneously shapes its accompanying policy solutions. In this paper, we show how complexity operates according to a number of historically variable logics within health governance. Our results show four such logics: 1) Invoking the diagnosis of complexity provides a source of legitimacy for IOs: Complexity can empower individual IOs when it allows them to present themselves as particularly capable of problem-solving by virtue of their expertise, at the expense of other IOs or actors. 2) Complexity as a problem that is ‘too big for anyone alone to resolve’: IOs use the truth claim of complexity as ‘naturally unsolvable’ to avoid being accused of underperforming. 3) Complexity as a policy problem creates demand for expert knowledge, which depoliticizes debates: When a problem or issue is constituted as too complex to be resolved through bargaining or negotiation and too technical for political debate, this creates the perception that only people in command of specialized knowledge can say anything true about such problems. 4) Complexity is connected with changing beliefs regarding effective governance: In the 1990s, the dominant discourse in health governance was concerned with the complexity and lacking effectiveness of “centralized”, “traditional” governance through the state and hierarchical inter-governmental IOs. In this context, privatization and partnerships with the private sector were positively associated with effectiveness. However, in the 2000s, the governance discourse typically included diverse actor constellations, complicated relations, and rule systems in negative narratives about complexity. Here, the fragmentation of rule systems, the increase in the number of actors and actor types and the proliferation of diverse institutional arrangements were drawn upon to portray the health governance field itself as ineffective and in need of institutional reform. Complexity as a policy problem thus signals the need for a response from governance actors; it opens up a discursive space where expertise and strategies need to be found and applied to the issues or objects complexity has afflicted. Overall, we show the effects of complexity as a policy problem, as it endows specific actors with expert authority, permits others to shirk responsibility, depoliticizes debates by excluding certain kinds of knowledge, and unfolds productive effects by shaping the institutional order of policy fields.