Pandemic shifts? The Covid-19 pandemic and the geopolitics of disease

This chapter begins by discussing the role of the WHO in the politics of global health, its mandate, authority and funding, with particular emphasis on the governance of emerging infectious diseases. As an intergovernmental organisation, the WHO derives its legitimacy and authority from its member base, and this has influenced its ability to act in the field of global health insofar as individual state interests often forestalled an international cooperative response. On the other hand, since the end of the Cold War, emerging infectious diseases have increasingly been identified as posing a serious global risk, which triggered a discourse of global (public) health security, promoted especially by some Western WHO members and the organisation itself. This discourse has motivated new institutional developments in the WHO and in global health governance more generally. Specifically, it elevated the WHO to be the main actor in coordinating global disease surveillance and containment in global health emergencies. The chapter then shows how the governance of emerging infectious diseases over the past two decades has been plagued by the ceaseless discursive struggles between state sovereignty and global health security, and this despite the WHO’s new central role and relative autonomy. The chapter traces this tension in the global response to three consecutive international infectious disease outbreaks preceding the Covid-19 pandemic. The conclusion discusses the dynamics of international collaboration in response to the current, still unfolding, pandemic as well as the challenges faced by the multilateral WHO moving forward.