Path departure or path dependency at a critical juncture? OECD between resilience and efficiency in the health policy field

Crisis opens up opportunities for international organisations (IOs) to change institutional settings, providing a moment for them to make choices to take on a new path or reinforce their original path. This article proposes a new framework for analysing crisis-induced change in IOs’ policy outputs, elaborating on path-departing and path-dependent changes through six sub-types based on the unit of alterations (idea vs policy) and the scope of alterations (moderate vs radical). Deriving from these two dimensions, the framework yields six analytically distinct sub-types: absolute, consistent, and inconsistent variations of path departure and path dependency. Applying this framework, the article evaluates the extent to which the Organisation for Economic Co-operation and Development’s (OECD) health policy outputs changed during the COVID-19 crisis. The main finding highlights that, despite the surprising focus shift from the long-lasting call for maximising efficiency to the novel agenda of building resilience, the OECD exhibits consistent path dependency, pointing to moderate changes at both ideational and policy levels. This case study demonstrates that IOs may appear to engage in a path-departing transformation, while substantively maintaining existing paths. By offering a more nuanced typology of crisis-induced variations in IOs’ policy outputs, this article advances the scholarly understanding of institutional continuity and change in global governance.