By /The Conversation/ – The pandemic has made us painfully aware of our common vulnerability to disease outbreaks. New communicable diseases originating in one part of the world can spread quickly and widely, underlining that health is a global concern. But this is old news.
The advent of the concept of “global health” is well established in both the academic literature and policy discussions, reflecting the consensus that we have seen a fundamental change in the nature of the causes and outcomes of ill-health in recent decades.
This change is rooted in the effects of globalisation and seen not only in the spread of communicable diseases, but in other developments – the globalised pharmaceutical market, the emergence of global civil society, new international health actors with a global perspective (such as the Bill and Melinda Gates Foundation), and the migration of health professionals. These developments combined to create a powerful sense of change, such that as long ago as 2008, the UK government declared that “health is global”.
COVID-19 appears to reinforce this narrative. Most striking, of course, is the spread of the disease. It has touched almost everyone. Within 18 months of its appearance, the WHO has identified only 14 countries reporting zero cases, 12 of which were Pacific Islands which had implemented strict travel restrictions, reinforcing sea borders.
The pandemic has also demonstrated the global nature of the marketplace for health products. From the often desperate search for PPE in the early months of the pandemic to the development, production and supply of vaccines in 2021, it is clear that states cannot rely on national suppliers alone.
The liberal vision
But the global health narrative was always more than simply an analysis of a new reality. It was also a call for new ways of working to address both new diseases, like COVID-19, and existing health inequalities. Underpinning this was the argument that if health was global, then responses needed to be global too, and that a consequence of globalisation was that the health of one state or population group was linked to the health of all.
This liberal vision of global health – one which held that the rich had responsibilities to the rest of the world, and progress was possible through cooperation – was already in trouble prior to COVID.
For all of the stated concerns about inequalities from the G7 and others, the global health agenda originated in high-income countries and reflected their concerns (especially over the spread of disease from other countries).
As a result, proposed responses prioritised their interests, including an emphasis upon dealing with the effects of disease – through pharmacological solutions – rather than addressing the causes, which might have been disruptive to their economic interests. That is why there were so many calls to decolonise global health before COVID emerged.
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