Health Governance and ‘Wicked Problems’: Facing Complex Developmental Transitions Using a Rights-Based Approach* Su-ming Khoo School of Political Science and Sociology, National Universityof Ireland, Galway ABSTRACT This article discusses the question of ‘good governance’ in relation to the current debates about global development and health. It aims to clarify some of the conceptual confusion and problems surrounding the ‘governance’ idea, addressing governance issues in a direct and substantive way through a discussion of current global health reforms. The article responds to the theme of this issue of Irish Studies in International Affairs , ‘The changing face of Africa’, by taking the changing face of global health as the focal space and asking how this shapes the way we understand ‘governance’. The discussion suggests that it is not the particular or exceptional situation of Africa per se that needs to be addressed but the complexity of development transitions, raising fundamental questions about equity, power, ideology, values and democratic choice. The article discusses the promises and shortfalls of the ‘shared health governance’ approach in Africa and suggests that a rights-based approach provides an alternative capable of addressing the ‘wicked problems’ of governance. INTRODUCTION All problems of governance and development are, to some extent, ‘wicked problems’. A ‘wicked problem’ can be defined as a problem that cannot be definitively solved because there are competing ideas about it, leading to different and competing solutions. 1 ‘Wickedness’, a combination of incommen- surability and intractability, is heightened as complexity increases, an observed Irish Studies in International Affairs , Vol. 24 (2013), 259–273. doi: 10.3318/ISIA.2013.24.8 *This article has been developed from a previous article by the author, ‘Putting the “public” back into public health’, Commonwealth Health Partnerships 2013 (London, 2013), 27–31. 1 H.W.J. Rittel and M.M. Webber, ‘Dilemmas of ageneral theoryof planning’, Policy Sciences 4 (2) (1973), 155–69; Jeffrey Conklin, Dialogue mapping: building shared understanding of wicked problems (Chichester, West Sussex, 2006). Author’s e-mail: suming.khoo@nuigalway.ie