Yet, the architecture of global health governance often produces outcomes that diverge from its lofty ideals. The World Health Organization (WHO), its treaties, and its many partnerships embody both the promise and the peril of global cooperation: institutions that begin as vehicles for public good can evolve into complex bureaucracies driven by competing incentives.

A useful way to understand this paradox is through the old "Bootleggers and Baptists" framework — coined to explain how moral crusaders ("Baptists") and opportunists ("Bootleggers") find common cause in supporting regulation. 

In global health, this coalition reappears in modern form: moral entrepreneurs who campaign for universal virtue and institutional purity, joined by actors who benefit materially or reputationally from the resulting rules. But there is a third, often overlooked participant — the bureaucrat. Bureaucrats, whether within WHO secretariats or international treaty bodies, become the custodians of regulation and its moral aura. Over time, their incentives can subtly shift from serving the public interest to preserving and enlarging their institutional mandate.

This essay explores how these three forces — the Baptists, the Bootleggers, and the Bureaucrats — interact within global health governance. It looks at the WHO's Framework Convention on Tobacco Control (FCTC) as a revealing case, and then considers how similar patterns are emerging in the proposed Pandemic Treaty. The analysis argues that moral certainty, donor dependency, and bureaucratic self-preservation often combine to produce rigid, exclusionary, and sometimes counterproductive global health regimes. The challenge is not to reject global cooperation, but to design it in ways that resist these incentives and remain responsive to evidence and accountability.