International Organization and Health/Disease

Abstract

Human history has been shaped by shifting patterns of health and disease. Many of the factors influencing those patterns have spanned national borders, such as human and animal migration, armed conflict, colonization, trade and investment, globalization, and environmental change. International studies scholars’ interest in health and disease has slowly evolved over time. After World War II, international health cooperation was accepted as a key function of the United Nations system, with the creation of the World Health Organization (WHO). However, health was deemed a largely technical field, alongside the activities of international health organizations. The limited scholarship produced during the postwar period was largely descriptive of technical and legal issues. It was not until the 1970s, when debates emerged about the appropriate forms of health development assistance, concerns about large commercial interests, and the role of WHO, that scholars began considering the politics of international health cooperation. The Declaration of Alma Ata on Health for All, Essential Drugs List, and International Code of Marketing of Breast Milk Substitutes were expressions of discontent in international health with a status quo perpetuating inequality among states. These initiatives then spurred accusations of “politicization” of WHO’s technical mandate, accompanied by the freezing of the organization’s budget. The study of international organizations and health began to apply critical theoretical approaches, locating health and disease within the liberal world order. From the 1990s onward, the proliferation of new institutional arrangements for international health cooperation prompted studies of this increasingly complex landscape. The term “global health” was coined to reflect the interplay of state and nonstate actors amid globalization, alongside the concept of global health governance (GHG). This encouraged scholarly exchange across international studies, social policy, law, and anthropology. International organizations with health-related impacts, such as the World Trade Organization, and powerful nonstate actors, such as foundations and commercial interests, were incorporated into GHG scholarship. Concurrently, new theoretical approaches to understanding collective action for global health emerged, notably realist notions of global health security, and social constructivist approaches to the framing of problems and solutions. Major disease outbreaks since the early 2000s, including SARS in 2003–2004, Ebola virus in West Africa in 2014–2015, and COVID-19 since 2020, have intensified scrutiny of GHG. The sharp rise in noncommunicable diseases alongside the globalization of market capitalism also drew growing attention. Amid renewed debate about WHO reform, analyses have focused on the lack of coherence among global health actors, weakness of legal and ethical frameworks for collective action, and inadequacy of resources.