International Organization and Health/Disease

Abstract

Patterns of health and disease have been relevant to international studies for as long as human populations have migrated across large territorial spaces. After World War II, international health cooperation was accepted as a key function of the newly established United Nations system, with the creation of the World Health Organization (WHO) as the UN specialized agency for health alongside other UN bodies. However, social science scholarship paid little attention to the perceived technical field of health, and thus international health organizations, until the 1970s. The limited scholarship produced during the postwar period was largely by those engaged with international health organizations and was primarily descriptive of technical and legal issues. It was not until debates emerged about the role and effectiveness of WHO, beginning in the 1980s, that scholars began considering the politics of international health cooperation. The adoption of the Declaration of Alma Ata, List of Essential Drugs, and International Code of Marketing of Breast-Milk Substitutes spurred debates about the “politicization” of WHO’s technical mandate. Public health practitioners and social historians contributed reflections on how structural inequalities shape health outcomes, and international organization scholarship introduced critical theoretical approaches to the study of health institutions. Scholars began to locate patterns of health and disease within the broader international political economy. The subsequent proliferation of new institutional arrangements for collective action on health issues, involving both state and non-state actors, generated studies of the distribution of power and responsibilities in an increasingly complex institutional landscape. This led to the concept of global health governance (GHG), with health becoming located within globalization processes, encouraging scholarly links across international relations, social policy, law, and anthropology. A wider range of international organizations, with health-related impacts, were incorporated into GHG scholarship. Concurrently, new theoretical approaches to understanding collective action for global health emerge, notably realist notions of global health security and critical approaches to the construction of GHG. The study of international organization and health since the mid-2000s has focused intense attention on the reform or creation of new institutional arrangements amid major global health crises, acute health inequities, and shared risks. This increasingly rich literature has been informed by diverse normative perspectives.

The multiple meanings of global health governance: a call for conceptual clarity

“…It is within the above context that fuller understanding of the conceptualisation of GHG to date can be located. Emerging from a longstanding literature on international health cooperation [ 45 ], a series of discussion papers, commissioned by WHO in the late 1990s, set out the parameters of the emerging subject of GHG [ 1 , 46 - 49 ]. In the substantial literature published over the past decade and a half, three core ontological variations can be observed.…”