January 7, 2016

The quid pro quo at the heart of the international health regulations

Disease Diplomacy. International Norms and Global Health Security

The implementation of international health regulations has its pluses and minuses. Some countries show reluctance to accept a new landscape of global health security. All these issues are reflected in an interesting recent book.
We have seen dramatic changes in the past decade. The engagement of high-level political and security communities with an area that had previously been primarily treated as a technical concern has been a major cause of that change, but it has also meant that the new system is taking time to settle. Prior to 2005, the IHR had not been substantially revised since 1969.

International norms are by their very nature collective ideas, and they rely on that collectivity—the notion of states as forming a cohesive international society—in order to function effectively. When a number of states cannot meet the IHR core capacity requirements and cannot attract the help they need to do so, the entire ethos of the global health security regime is undermined. This, for us, is the challenge facing norm leaders: how to maintain the regime’s political purchase when the security discourse used to establish it is increasingly met with antipathy post-H1N1 and with a lack of financial support to institutionalize the necessary capacities in the domestic structures of the poorest states. Thus, one of the key lessons we draw from the norm-building process examined in this book is that recognizing appropriate behavioral standards and “wanting to do the right thing” are not the same as having the ability to conform to those standards.