Diplomatic roles of regional coordinators for WHO Member States.

Objective: To examine the coordination functions, decision-making processes and consensus-building strategies of World Health Organization (WHO) regional coordinators of Member States in Geneva within the WHO's federal governance structure. Methods: In this qualitative study, we interviewed 12 current and former regional coordinators from five WHO regions (African, the Americas, South-East Asia, European and Eastern Mediterranean) using a semi-structured questionnaire. A regional coordinator from the Western Pacific Region later provided a written response to the questionnaire which we report separately due to methodological and time differences. We analysed the data using a hybrid thematic approach combining initial coding assisted by artificial intelligence with our rigorous interpretive validation. Findings: We identified eight main coordination functions. Core liaison and information-sharing were functions undertaken by regional coordinators in all the regions, while position development and meeting organization were undertaken by regional coordinators in most regions. Coordination complexity and consensus-building strategies, such as bilateral mediation and issue reframing, varied depending on regional political dynamics and institutional capacities. A formal job description and procedural handbooks were lacking, and therefore the regional coordinator role was a negotiated practice dependent on informal knowledge transfer. Conclusion: Regional coordinators serve as boundary-spanners linking regional autonomous governance with global health governance. To address the absence of documented institutional knowledge, we propose developing formal induction curricula, cross-regional mentorship pairing and harmonized procedural handbooks. These measures will strengthen regional voices and ensure more inclusive participation in global health diplomacy.