The Power of Procedures. the Managerialization and Bureaucratization of Global Health Policies: The Example of the Global Fund in West and Central Africa[Le pouvoir des procédures. Les politiques de santé mondiale entre managérialisation et bureaucratisation : l’exemple du Fonds mondial en Afrique de l’Ouest et du centre]

This article analyzes contemporary transformations in international public action through the case of the Global Fund to Fight AIDS, Tuberculosis and Malaria in West and Central Africa. It focuses in particular on the effects of four core principles promoted by the Global Fund: partnership, country ownership, results-based financing, and transparency. Although these mechanisms are presented as instruments of decentralization, accountability, and greater openness in public action, they also contribute to the standardization of practices, the formalization of procedures, and tighter control over national actors. The article shows that mechanisms associated with New Public Management do not lead to a reduction in bureaucracy, but rather to its reconfiguration. Evaluation procedures, performance indicators, contractual arrangements, and reporting requirements strongly structure the design and implementation of funded policies. At the same time, the institutionalization of participatory mechanisms reshapes relations among public administrations, international donors, and civil society actors. The case of the Global Fund thus highlights the emergence of a form of transnational bureaucracy based on managerial instruments, standardized procedures, and new forms of governing at a distance.