The race for Ebola drugs: pharmaceuticals, security and global health governance

Abstract

The international Ebola response mirrors two broader trends in global health governance: (1) the framing of infectious disease outbreaks as a security threat; and (2) a tendency to respond by providing medicines and vaccines. This article identifies three mechanisms that interlink these trends. First, securitisation encourages technological policy responses. Second, it creates an exceptional political space in which pharmaceutical development can be freed from constraints. Third, it creates an institutional architecture that facilitates pharmaceutical policy responses. The ways in which the securitisation of health reinforces pharmaceutical policy strategies must, the article concludes, be included in ongoing efforts to evaluate them normatively and politically.

Military crisis responses to COVID‐19

“…Earlier disease outbreaks have been coined in security terms by employing wartime discourse. This happened during outbreaks of Ebola (Roemer‐Mahler & Elbe, 2016; Walsh & Johnson, 2018), Asian influenza (Curley & Herington, 2011), Zika (Wenham & Farias, 2019), pandemic influenza (Kamradt‐Scott & McInness, 2012; Watterson & Kamradt‐Scott, 2016) and in response to the spread of HIV/AIDS (Sjöstedt, 2008). And if there is an “enemy” to be “fought” in “battle” or “war,” which organization would be better suited to take the lead than the military?…”

“…And if there is an “enemy” to be “fought” in “battle” or “war,” which organization would be better suited to take the lead than the military? During the Ebola crisis, Liberia and Sierra Leone activated their armed forces, while Western governments likewise deployed thousands of military units (Roemer‐Mahler & Elbe, 2016). In response to the Zika crisis, the Brazilian military was also sent onto the streets to “combat” the “enemy,” while simultaneously signalling the gravity of the situation to the population (Wenham & Farias, 2019).…”

Conditions of Global Health Crisis Decision-Making—An Ethical Analysis

“…Political concern with health security often also goes hand in hand with the pharmaceuticalization of public health threats, where pursuit of “magic bullet” interventions can eclipse political engagement with the underlying socioeconomic issues that contribute to the causes of the crisis (Davies 2008 ). A pharmaceutical intervention focusing on “a precise target in a circumscribed event with direct security relevance for domestic populations” will be an easier sell politically than a long-term commitment to addressing “complex socioeconomic problems whose domestic relevance is uncertain” (Roemer-Mahler and Elbe 2016 , 493). Moreover, where a health security threat has been identified, an “exceptional policy space” opens up in which key norms and rules governing the development and approval of pharmaceutical interventions can be modified to expedite an effective and politically acceptable response to the threat (Roemer-Mahler and Elbe 2016 , 495; Edwards 2013 ).…”

Pharmaceuticals and the Global South: A Healthy Challenge for Development Theory?

“…Yet this does not mean old Pharmaceuticals and the Global South 371 debates have disappeared. Echoes of the earlier dependency debate have re-emerged with renewed emphasis on local production, and as growing discourses of health security and insecurity (Nunes 2014, Roemer-Mahler andElbe 2016), and on interdependence (Frenk et al 2014), are mobilised in a more globalised world. The pharmaceutical industry has now become more differentiated.…”

“…Moon et al () have suggested the need to delink the financing from the pricing of products and have proposed an international R&D treaty in this regard. Health crises, for example that posed by the Ebola outbreak, have also raised questions for global governance, including response to infectious diseases and questions of new medicines development (Roemer‐Mahler and Elbe ).…”