Constructing and contesting industry’s role in multistakeholder governance: a qualitative analysis of responses to WHO consultations

Background
Multistakeholderism as a norm stating that global public issues should be addressed by all those who affect or are affected by this issue, has become increasingly institutionalised in global governance, including the United Nations (UN) system. Despite an increasing body of evidence showing the risks of corporate capture of multistakeholder governance (MSG) and its related inability to deliver effective public health outcomes, this approach is increasingly common. While research shows that industry actors have pushed for MSG, and others have questioned its legitimacy, how MSG is constructed, legitimised and contested by different actors has not been systematically studied. Analysing responses to World Health Organization (WHO) consultations related to non-communicable diseases (NCDs) and associated risk factors, this study examines how actors construct or contest the legitimacy of MSG to address these public health issues.

Results
Our analysis of 135 responses to 10 consultations revealed significant differences in how actors justified or contested MSG. Proponents of MSG, primarily industry-affiliated organisations, often cited industry expertise and resources as key justifications for a multistakeholder approach, in which they invariably included industry as a key stakeholder. Conversely, non-profit and academic respondents often argued against industry inclusion in MSG, referring to conflicts of interest, corporate capture of the policy process and the associated risks that MSG with industry actors poses to democratic and effective policymaking. While actors commonly invoked the same values (e.g., participation, effectiveness, fairness), they interpreted these differently, to argue for or against the inclusion of industry in MSG.

Conclusion
Our findings underscore the contested nature of MSG, with actors calling on similar values and terminology to support fundamentally opposing positions. The ambiguity of concepts like participation, accountability and conflicts of interest may risk creating an opportunity for private sector interests to promote MSG as an ambiguous governance concept to fit their agenda. Given the normative role of WHO and other UN agencies in shaping what is considered ‘good governance’, it is essential for the WHO and other UN agencies to critically examine the evidence on multistakeholder approaches before deciding on its appropriateness and use unambiguous terminology when discussing their interpretation of the approach.