| Course | PU335 Global Health |
|---|---|
| Unit | Unit 5 |
| Paper type | Global health governance analysis |
| Length | About 1,090 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Health Science |
| Updated | October 2026 |
Free sample paper for PU335 Unit 5
Who Is in Charge When Cholera Crosses a Border: A Unit 5 Governance Analysis of Haiti, the Dominican Republic and the Global Health System
[Student Name]
Purdue University Global
PU335: Global Health
Unit 5 Governance Analysis
[Instructor Name]
[Date]
The analysis is the student's; the institutions, regulations and studies cited are real.
What Governance Means in Global Health
Global health governance refers to the institutions, rules and processes through which countries and other actors coordinate action on health problems that cross borders. It includes the World Health Organization and its regional offices, binding agreements such as the International Health Regulations, financing bodies, nongovernmental organizations and, most important, each country's own health ministry and public health agencies. Governance determines who decides, who pays and who is accountable.
Binding Rules for Outbreak Reporting
The International Health Regulations, last revised in 2005, are a legally binding instrument under which countries agree to build core capacities for spotting, investigating, notifying and responding to health events that could spread across borders, and to notify the World Health Organization of such events (World Health Organization, 2016). Both Haiti and the Dominican Republic are bound by them. In 2010, the Regulations provided the framework for reporting the cholera outbreak and for coordinating the response, but they could not supply the capacity Haiti lacked.
National Governance Compared
Haiti. Haiti's Ministry of Public Health and Population had limited budget, staff and reach even before the 2010 earthquake, which destroyed government buildings and killed many civil servants. Much of Haiti's health care is delivered by nongovernmental organizations and faith-based groups, often funded by foreign donors with their own priorities. This fragmentation made coordination difficult: when cholera arrived, the ministry was one actor among hundreds of organizations, many working independently.
Dominican Republic. The Dominican Ministry of Public Health has a more established national structure, provincial health services and a national epidemiological surveillance system. Its response to cholera, though imperfect, could rely on government-run facilities and a functioning chain of command, and the outbreak there remained much smaller.
In Haiti, the question in 2010 was not what the plan was but whose plan it was.
The Role of Nongovernmental Organizations
After the earthquake, Haiti was sometimes called a republic of NGOs, a phrase that captured how much of the health system was run outside government. Organizations such as Partners In Health, Doctors Without Borders and many smaller groups ran hospitals, cholera treatment centers and community programs. Their work saved many lives, and some, notably Partners In Health, deliberately worked through public facilities and paid government staff. But the overall pattern created three governance problems. Each organization reported to its own donors, so the ministry did not know who was treating whom. Salaries at international organizations drew trained Haitian staff away from public posts. And when funding ended, programs closed without a plan for the ministry to take them over, leaving patients and trained community workers with nowhere to turn.
What the Dominican Response Shows
The Dominican Republic's response also had limits. Surveillance identified cases quickly in most provinces, but outreach to bateyes and to undocumented migrants was weaker, and some migrants avoided clinics for fear of being reported to immigration authorities. Governance therefore depends on more than institutional strength: a strong ministry that excludes part of its population still leaves gaps that a disease can travel through.
Why National Public Health Agencies Matter
Sasie et al. (2026), in global scoping studies of institutional governance and national public health agencies, describe how countries with dedicated national public health institutes, clear mandates and legal authority are better positioned to coordinate surveillance, laboratories and emergency response. On Hispaniola, the contrast supports that view: the country with the stronger national institution contained the outbreak more effectively. External support can fill gaps temporarily, but sustained preparedness depends on national institutions with staff, funding and authority.
The Global Layer
Beyond regulations, the global layer includes agencies such as the World Health Organization and its regional office for the Americas, the Pan American Health Organization, and financing from bilateral donors and global funds. In Haiti, the volume of international aid after the earthquake was large, but much of it flowed through international organizations rather than the government, which may have weakened national institutions further. Pledges made at donor conferences after the earthquake were large, but disbursements were slower and smaller, and only a small fraction went to Haitian government agencies. The United Nations' own role in the cholera epidemic, traced by investigators to a peacekeeping camp (Piarroux et al., 2011) and examined in Unit 2, added a governance problem of its own: the actor responsible for the outbreak's origin was part of the system meant to respond to it.
Cross-Border Cooperation
Cholera, like other diseases, does not respect the border. The two countries cooperated in surveillance and response with regional support, but cooperation is shaped by tense relations over migration and history. In practice, the two ministries exchanged information through the regional office and held technical meetings, but there was no standing joint body, so cooperation depended on individual officials and rose and fell with political relations. Border markets, where thousands of people cross each week to trade, were a known route for spread, yet joint water and sanitation work there was limited. Effective governance on a shared island requires joint surveillance, shared laboratory capacity and agreed procedures for people moving across the border, including migrants without documents, who are least likely to seek care if they fear deportation.
Recommendations
National, Haiti. Strengthen the ministry's coordinating role by requiring that international organizations align with a national health plan and report through national systems, and direct a larger share of donor funding through government channels as capacity grows.
National, Dominican Republic. Extend surveillance and care explicitly to migrants and residents of bateyes, with protections that separate health services from immigration enforcement.
Binational. Establish a standing binational health committee for surveillance and emergency response, with a shared data agreement.
Global. Donors should fund national public health institutions directly and over the long term, not only emergency programs, consistent with the evidence that national agencies drive preparedness.
Conclusion
Cholera's spread across Hispaniola tested national ministries, the International Health Regulations and the global system together. The Regulations set rules but could not create capacity; Haiti's fragmented, donor-dependent system struggled to coordinate, while the Dominican Republic's stronger national institutions contained a smaller outbreak. Preparedness on the island depends most on national public health institutions, supported rather than bypassed by global actors, and on cooperation across a border that disease ignores.
References
Piarroux, R., Barrais, R., Faucher, B., Haus, R., Piarroux, M., Gaudart, J., Magloire, R., & Raoult, D. (2011). Understanding the cholera epidemic, Haiti. Emerging Infectious Diseases, 17(7), 1161-1168. https://doi.org/10.3201/eid1707.110059
Sasie, S. D., Aragaw, F. M., Gebeyehu, T. A., Shikur, S. A., Fekadu, L., Ali, N. Z., & Argaw, Z. M. (2026). Building systems for preparedness: Global scoping studies on institutional governance and national public health agencies. PLOS Global Public Health, 6(2), e0005427. https://doi.org/10.1371/journal.pgph.0005427
World Health Organization. (2016). International Health Regulations (2005) (3rd ed.). https://www.who.int/publications/i/item/9789241580496
What the PU335 Unit 5 assignment asks for
In Unit 5 students analyze how global health governance works in a specific case. The paper should explain the main institutions and rules involved, such as the World Health Organization and the International Health Regulations, and how national governments fit within them. Comparing two countries or two responses is common. Instructors look for analysis of coordination, financing and accountability, not only a description of agencies. Students are often asked to explain why national institutions matter and to cite evidence. The role of nongovernmental organizations and donors should be considered. Recommendations are expected for national, regional and global actors, each tied to a weakness identified in the analysis, and stated specifically enough to be acted on.
How this PU335 Unit 5 example is built
The sample defines global health governance and explains the Regulations with the World Health Organization's text. Haiti's fragmented system is compared with the Dominican ministry under a highlighted line that the question in 2010 was whose plan it was. A section on nongovernmental organizations describes reporting to donors, staff drawn from public posts and programs closing without handover. The Dominican response is shown to have its own gaps among migrants. Sasie and colleagues support the importance of national agencies. The global layer covers aid flows and the United Nations' role in the outbreak, citing Piarroux and colleagues. Cross-border cooperation is examined, and recommendations are made for each government, a binational committee and donors.
Reading the PU335 Unit 5 grading rubric
Governance analyses are usually graded on understanding of institutions, quality of analysis, use of evidence and recommendations. Graders look for accurate description of the Regulations and the roles of global agencies. The analysis should explain how power and money flow, not only list actors. Comparison between countries should identify why outcomes differed. Attention to nongovernmental organizations and donors shows a realistic view of governance in low-income settings. Recommendations should be specific and assigned to the right level. Evidence from peer-reviewed research and official documents should be cited in APA 7. Acknowledging the limits of strong institutions, such as excluded groups, shows balance. A clear structure moving from national to global levels helps the reader follow.
PU335 Unit 5 help: mistakes that cost points
Governance papers often describe the World Health Organization at length and say little about national ministries, where most capacity lies. Another common gap is treating nongovernmental organizations as wholly positive or wholly negative rather than weighing their effects. Some students recommend that countries simply comply with the Regulations without explaining how capacity would be built. Recommendations frequently lack a responsible actor. Before drafting, sketch who did what in your case, which agency, which ministry, which donor, and who paid. Then mark where coordination failed. Share that map with the prompt, and the governance paper can grow out of it.
Get a PU335 Unit 5 example written to your instructions
Send the countries and the instructions with the rubric. A custom analysis compares governance structures and their effects. The first one costs nothing, back within 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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PU335 Unit 5 questions, answered
What is global health governance?
The institutions, rules and processes that coordinate action on health across countries.
What are the International Health Regulations?
A binding framework requiring countries to detect, report and respond to public health emergencies.
Do national agencies matter?
Yes. Strong national public health institutions are central to preparedness.
Where can I find a free PU335 Unit 5 sample paper?
The complete PU335 Unit 5 governance analysis is available here, using cholera on Hispaniola to compare national and global governance.
Why does the PU335 Unit 5 sample stress national agencies?
Because the country with the stronger national institution contained a smaller outbreak, and evidence links national public health agencies to preparedness.