The Global Health Working Group held an online event on the 12th of May 2022 entitled ‘The Future Of (Post)-Pandemic Health Security – A Global Perspective’. This popular event sought to expand the health section’s focus beyond local questions of pandemic governance. We had three great speakers reflecting on farther-reaching developments in different parts of the world, including Anne Roemer-Mahler (Associate Professor in International Relations at the University of Sussex), Adam Kamradt-Scott (Professor in International Relations at the European University Institute) and Nick Thomas (Associate Professor in International Relations at City University of Hong Kong).
Anne Roemer-Mahler shared insights from her recent work on the formation of 'health security' in Africa and, in particular, the emergence of the Africa Centers for Disease Control and Prevention (Africa CDC). Analyzing the future of global health security from the perspective of this regional organization set up to promote public health in Africa, she detailed how it coordinated approaches to the COVID-19 pandemic across this continent and the particular challenges it faced in this context. Drawing from the study of this institution since 2018, she elaborated on how the fact that it was run according to African health priorities contributed to a diversity of perspectives on what health security means and how it should be implemented. Some of these points focused on the emergence of tensions between African and global health priorities resulting in a questioning of the possibility of a truly ‘global’ health security agenda.
Two strategies emerged within the African CDC to address this tension that included the downplaying of the security angle and the prioritization of public health. In this way, in an African context, health security changes to focus on new priorities including the creation of a new public health order for Africa. A core part of this is an ambition to establish self-sufficient manufacturing capabilities for pharmaceuticals and diagnostics.
Adam Kamradt-Scott drew on his extensive scholarly and practical experience in the field of health security and governance, his ongoing work on the adoption of international legal instruments for health, and discussed recent moves towards the creation and adoption of a new pandemic treaty at the World Health Organization (WHO). This ambitious undertaking seeks to move existing mechanisms such as the International Health Regulations (IHRs) on to a new footing, and has been a focal point for lobbying and negotiations. Arguably, the current COVID-19 pandemic has sparked more intense efforts in this direction, showing the need for more coherent approaches and simplified structures. Developments thus far focused on ways of reshaping the existing structures contained in the International Health Regulations (IHRs) and of setting out the types of questions of that should go into such a treaty.
In the light of recent experience with the formulation and implementation of pandemic health security responses at a global level, especially with regards to challenges to the WHO’s role as a global leader in this field, questions were raised as to whether an expanded treaty could ever be truly effective. Further doubt regarding the feasibility of this undertaking stemmed from the fact that the WHO has only adopted one such treaty in the past, an instrument with a specialist focus on tobacco control. This experience showed that it can often take 8-13 years to agree and implement a treaty, and is thus anything but a rapid fix to a question that may need to provide quick and reliable responses in a crisis. Further lessons in the field of treaty negotiation were derived from other truly ‘global’ policy areas, including treaties on outer space and landmines.
Nick Thomas again drew attention to the urgency and implications of these high-level debates in case of an ongoing pandemic situation, and shared findings from his current work on the response to the COVID-19 pandemic in Asia. This included the political and social effects of policies such as the zero COVID-19 strategy in China and Taiwan, which has given rise to much criticism in the later stages of the global pandemic. While these policies were considered to be particularly effective in the early days of the outbreak, this perception changed several years down the line, with a growing availability of effective countermeasures and vaccines and resultant demands for the loosening of restrictions. Political debate around these issues can be seen to drive both the science and medical advice in the case of zero COVID-19 policies, which reinforce state control and authoritarian state structures. Nationalist rhetoric over the provision and quality of vaccines further contributed to a sharpening of debates within Asia as a region. China for example supplied vaccines to Bangladesh and other areas in an overt act of global solidarity that however also increased diplomatic leverage in several geopolitical arenas.
This diplomatic effort contrasts with an increasing pushback against harsh lockdown measures within some Asian countries. Here, authoritarian states are increasingly being criticized for not having lived up to the social contract of protecting their populations effectively, as restrictions cause widespread disruption and food shortages. Trust and democracy are thus key concerns in a wider debate to come out of the COVID-19 pandemic, needing further analysis of whether democratic or more authoritarian regimes are more effective in dealing with infectious disease outbreaks. In the case of the more recent restrictive responses, democratic regimes were seen to play a more effective role in the later stages of the pandemic.
This event was very well-received across the BISA global health working group, and the individual contributions generated much discussion amongst attendees and presenters. Overall, this shows that there is a need to draw on existing expertise in different empirical and regional fields of health governance, and that overarching discussion can highlight commonalities that go beyond the remit of an individual case or region. In this vein, the Global Health Working Group will seek to organize further events that explore the current implications and likely futures of global health governance.