Conflicts over capacity to pay in the health regime

This chapter analyses two key moments during which capacity to pay (C2P) is contested. The analysis shows that the norm as such is broadly supported. However, reviewing the scale methodology (operationalization of the norm) and updating data (practical consequences of the methodology) turn out to be contentious. In the first case study, the G-77 and China are opposed to any changes that would redistribute financial obligations from developed to developing countries. At the World Health Organization (WHO), the contestations result in implementation flexibilities. In the second case study, the idea has been accepted that such change is a legitimate consequence of the global economic shift – as long as it is only induced by updated data. This altered understanding is noteworthy since the assessment rates of Brazil, China, and India have risen considerably at the time of the second case study. At the same time, China and India in particular remain beneficiaries of differential treatment.