Global Governance in Public Health

The lecture yesterday focused on how the institutions and mechanisms of global governance are ill equipped to address many of the global problems with which we are confronted. The deadlocks on trade (the Doha Round) and climate change are examples of how achieving global solutions is difficult in a multipolar world. This report by Indiana University School of Law Professor David Fidler, which was published in the Bulletin of the World Health Organization in 2001, looks at global governance in public health since the 19th Century and what lessons can be drawn from that period.

In this 2006 YaleGlobal article, David Heymann, now an Assistant Director-General of the World Health Organization, discusses the global cooperation that was needed to combat the SARS virus in 2003 and the extent to which that collaboration has continued.

You might also be interested in this YaleGlobal essay published in September, in which Huang Yanzhong of Seton Hall University examines the responses to the global spread of the H1N1 swine flu virus. “Pandemics are global but political calculation to confront them are decidedly local,” he writes.

Finally, in 2003, in the aftermath of the SARS virus outbreak, YaleGlobal published this piece by Michael Merson, then the dean of the Yale School of Public Health (he is now director of the Duke Global Health Institute), which argued that SARS proved that health is a global public good. It is important for the international community to harness the forces of globalization to shape collaborative responses to future public health threats, Merson wrote.

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2 Responses to “Global Governance in Public Health”


  1. 1 Lau Chi Ling, Stef 17/11/2009 at 9:07 pm

    “Pandemics are global but political calculation to confront them are decidedly local.” What a statement, I cannot agree more to it. Especially in contemporary world when globalization in taking place, and there are much more contacts between people from different continents, there is surely a higher chance to diseases and pandemics to spread all over the world. The widespread of Swine Flu is a good piece of evidence, in which why the virus spreaded to Asia and Europe so quickly from Mexico and US is simply because people travel around. For instance, the first reported case in HK is brought by a Mexican tourist. However, in terms of decisions made by governments to combat the pandemics, they’re always local decisions. The lack of power of WHO could be a reason to explain. This body is of course useful in giving guidelines on the prevention and treatments of diseases, as well as setting standards of how much calories and sugar an adult need for a day, but in terms of making decisions to fight against pandemics, its power is limited. It can of course report the number of casualties and people got infected, but it does not have the real power to coordinate any programmes in accordance of the outbreak of pandemics, and does not really have the power to co-ordinate member states to follow all its instructions. For example, during the outbreak of SARS, it could encourage countries to take various preventive measures and suggest the appropriate treatment, but it could not do anything if some countries, like China, tried to hide the actual situation within their own territories. In this sense, all decisions are in fact locally made because of various political calculations. What should be done with WHO, so more international decisions can be made? It comes back to the fundamental question: to what extent countries can willing to give up part of their sovereignty and let the international body unite all nations, to carry out some international policies that can benefit everyone?

  2. 2 Edward Andrew Ross 06/12/2009 at 5:33 pm

    In the event of a global epidemic or virus outbreak, the ones to respond to the situation are the governments and they, as evidently in the case in SARS initially responded alone and only to the problems of their own country. Border controls were reinforced and preventative measures were taken. Each country had their own method of managing the outbreak and it seemed that international order failed to suppress the situation. China’s lack of media transparency failed to ameliorate the situation and the social panic aroused from such an outbreak had been uncontrollable. The WHO had failed to implement its sovereignty and found the situation itself hard to control. The problems that lie with global health governance as with international bodies such as the WHO lie in the lack of sovereignty that they withhold. The WHO has not developed beyond the embryonic stage as a world instutition and has not been able to surmount the barrier of state-centered decision making. It’s powers and finances remain inadquate to perform its tasks to the maximum. The broad consensus of agreement among nations, which must be attained for fully effective health work is vulnerable to the deep political and ideological cleavages, as evident in China’s management of controlling SARS and other African nations in events of a humanitarian crisis, and remains a problem for almost all international institutions.


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