[Saniya Nasir Javaid] Why study Global Politics of Health?

This essay seeks to argue that an analytical angle that looks at the politics of health can highlight potential conflicts of interest, values and priorities. This will be done by showing that most definitions of global health emphasis health issues with a cross-border nature. It will then be explained that this illustrates the dominant narrative of global health, which is about the increased threat from infectious diseases in an era of travel and trade. Lastly, I introduce a constructivist perspective on global health, which highlights that this narrative is constructed and other perspectives, of which some are conflicting, exist. This constructivist perspective therefore emphasises the policies involved in global health.

It cannot be claimed that there is one definition of global health. Different people and organisations have defined it differently. However, most definitions highlight that global health is about health issues that cross national boundaries. They therefore emphasise that globalisation, and notably increased travel and trade, have made it easier for pathogens to spread rapidly across the globe (McInnes & Lee, 2012). They differ in how they define global health, however and most definitions call to action.

Saniya Nasir Javaid is originally from Pakistan and is currently completing a degree in International Relations and Development at the University of Sussex. Her main research interest is US relations with the world.

Threats of new reality

Globalisation 

Economies, societies and individuals are facing increased risks posed by re-emerging and new diseases. It causes alarmingly high mortality and morbidity rates. By the turn of the millennium new diseases have emerged at unprecedented rates. The SARS outbreak in 2002-3 and the 2009 swine flu is when people became aware of the threat. Moreover, new drug resistant forms of diseases began to emerge. Diseases confined from one part of the world began spreading to other locations, most notably from Africa to the developed world. Ebola and West Nile virus showed up in the US in the 1990s for the first time. Thus these created the impression of the significant risk from these infectious diseases.

This unwelcome and new development was attributed to the globally changing patterns of global behaviour. Previously safe areas were now being affected due to increased human mobility. Those affected by the disease could transfer it to dispersed communities due to increased travel. With increased population density and urbanisation the chance of contact increased as a consequence. Thus enabling diseases to transfer more rapidly.

These diseases pose risk to economies by preventing people from going to work and disrupting trade. The fear of acquiring the disease can cause greater damage o the economy. It is believed that US and Britain governments pressured World Health Organisation (WHO) to not declare swine flu a pandemic due to fear over the economic impact at the time.

Bioterrorism 

It is a growing concern that globalisation makes it easier for terrorists to get hold of pathogens and the technologies to carry out attacks. It has been argued that developing states like Iraq, China and Iran might be tempted to employ bioweapons. These countries may have technological know-how but there is a lack of an organized civil society that is necessary to restrain its utilization. Risk increases with population density. Even a slight exposure to a pathogen can yield catastrophic results especially in places like the United States and Japan. Therefore, due to today’s world of easy travel biological terrorism is a very strong likelihood (Garrett, 1996)

Conflicting Perspectives on ‘Global’ Health

While not contesting that globalisation has changed the reality of health problems (Frenk & Moon, 2013), scholars drawing on constructivist approaches highlight that people construct the world in accordance to their views, values and interests. According to Mclnnes and Lee (2013) the global health understanding emphasizes certain kinds of interests of certain population groups and risks, the way in which the global nature of the problem at hand is defined, and therefore the need for certain high-level political responses. These shape rather than determine what we consider to be important and what we choose to neglect. Also, what solutions we think are suitable and which we think are inappropriate.

This is obvious when we see that the other aspects of globalisation such as non-communicable diseases (NCDs) are less highlighted in the international community. These take 40 million lives annually, which is equal to nearly 70% of all deaths worldwide. More than three quarters of global deaths- 31 million- occur in LMICS. Excessive use of alcohol, unhealthy diets, tobacco use and physical inactivity contribute to the increased risk of dying from a NCD. However, due to international free trade and investment treaties there is a rapid expansion of global food, tobacco and alcohol industries in LMICS.

A political analysis of global health highlights potential conflicts of interests, values and priorities. As seen above most definitions emphasize only on diseases that can cross national boundaries. What we define as global health is not one problem shared by everyone but mostly only by the population of the developed world.

Instead of focusing on the environmental and socioeconomic causes that lead to diseases and preventing them from occurring the downstream treatment of disease and control of its further spread is paid attention to. This can be argued to be a form of a containment policy where diseases are meant to be kept away from the developed world. This reflects on the colonial assumptions that developing countries have insanitary lifestyles and backward customs.

Conclusion

We should study global politics of health because it is necessary to understand that there is no one way of understanding global health, instead there may be conflicts of interest. A political analysis would raise questions about whose interests and concerns prevail and try to understand this in the context of existing power relations. In today’s world various factors come into play, which dominate the narrative understood by all. Powerful states get to influence the understanding adopted by all. It can thus be argued that the official definitions of global health do not take into account all health issues faced by the majority, especially in the developing world.


Saniya Nasir Javaid is originally from Pakistan and is currently completing a degree in International Relations and Development at the University of Sussex. Her main research interest is US relations with the world.


Bibliography

Frenk, J. and Moon, S. (2013). ‘Governance Challenges in Global Health’, New England Journal of Medicine, 368 (10), pp. 936-942.

Garrett, Laurie, ‘The Return of Infectious Disease’, Foreign Affairs. January/February 1996, pp. 66-79.

HM Government. Health Is Global: An outcomes framework for global health 2011-2015. (London: HMSO). Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215656/dh_125671.pdf

McInnes, Colin & Kelley Lee. 2012. Global Health and International Relations        (Cambridge: Polity). Chapter 2: Constructing a New Agenda: International Relations and Global Health.

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