DR Congo

Humanitarian governance and the consequences of the state fragility discourse in DRC’s health sector

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This working paper examines how the discourse on state fragility affects the preferences of key actors in humanitarian governance for different types of health sector interventions in the Democratic Republic of Congo (DRC).

Based on fieldwork in South Kivu and Kinshasa, we argue that, in addition to focusing on the actual meaning of state fragility, practitioners and scholars should give attention to the interactive processes around the state fragility discourse among stakeholders in the health sector. The lack of consensus on state fragility influences humanitarian governance, especially mutual perceptions of and interactions among the host-government, donors and international non-governmental organisations (INGOs). Donors and INGOs have legitimised the persistence of vertical, emergency based interventions by emphasising state fragility, whereas state officials have preferred to assert political statehood and a higher degree of state control.

Nevertheless, state, INGOs and donor organisations agree that donors’ financial contributions ensure the survival of the public health sector. Looking forward, it is important to build a policy coalition based on harmonised views on addressing fragility. This will be necessary for effective engagement and the sustainability of interventions but, given the current political situation, this harmonisation is not likely to happen any time soon.