Trade, foreign policy, diplomacy and health

7. International Law

David P Fidler

1. The role of power in global public health

  • Realism posits that GPGs produced only when powerful states want/need cooperation
  • Power politics determines the agenda and the outcome of international cooperation
  • Thus, if US & EU not engaged then GPGH unlikely to be produced
  • e.g. HIV/AIDS in Southern Africa & Kyoto Protocol on climate change

The emphasis of Realism on power in international politics means that it has no robust concept of GPGs or international law. Realism posits that GPGs only come into being when powerful states want or need cooperation on a given issue. Power politics determines the agenda and the outcome of international cooperation. Those familiar with the world politics of public health know that power still matters in shaping the global public health agenda and the nature of international cooperation. If the great powers of public health, such as the United States and the European Union, are not engaged in the production of specific GPGH, then the chances for producing such goods are diminished

One need look no further than the HIV/AIDS debacle in sub-Saharan Africa to see the consequences of great power indifference toward a global public health problem. Further, great power opposition to certain international legal regimes can place the production of certain GPGH in jeopardy, as illustrated by the United States' refusal to participate in the Kyoto Protocol on climate change and the proposed compliance protocol to the Biological Weapons Convention.