Globalization and Global Public Health

Abstract

In providing a social scientific account of the WHO’s reaction to H1N1, the organization’s self-proclaimed role as a coordinator of ‘global health’ is key to explaining its decision-making process. The global health paradigm, which replaced earlier conceptualizations of ‘international health’, was fundamental to the WHO’s management of H1N1. This is both because pandemics are essentially globalized diseases and because the organization strongly subscribes to the new global health perspective. It characterized H1N1 as particularly ‘global’ in nature. This characterization led the WHO to emphasize global cooperation and interdependence in the management of the pandemic. In respect to this global management strategy, it presented its own role as one of coordination and facilitation rather than one of action. In fact, using the lens of the global health paradigm, the WHO characterized the reaction to H1N1 as the responsibility of state governments and not its own. This distancing of responsibility was key to the WHO’s narrative of H1N1. It reflects the institutional attempts to adapt to the new structuring of global health. However, the organization’s positioning was somewhat ambiguous as it was perceived to be a directive body by outside actors (exemplified by the Council of Europe’s narrative), where the WHO’s recommendations were understood as explicit instructions.