Trade, foreign policy, diplomacy and health

8. International Health Regulations and Epidemic Control

Johan Giesecke

3. IHR and national politics

  • Building a functioning global surveillance system and strengthening national capacity requires resources
  • For developing countries, these activities may be of low priority
  • Lobbying for the impact of ‘globalisation’ and need for investment in other countries’ surveillance and control is critical

The greatest cost of building a functioning global surveillance system lies with strengthening national capacity in a large number of countries. There is also a need for a considerably stronger technical co-ordination team centrally at the WHO, but this cost is many orders of magnitude lower.

It may not be easy to secure funds of the size required from national budgets in developed countries: the need to improve surveillance and control in developing countries on the other side of the globe will probably come low on the priority list. Also, the notion of the world as one single arena for epidemics is still not intuitive. Instead, the reflex to return to the closing of borders lies deep within us, however inefficient this may be. Therefore this consequence of globalisation needs to be stressed repeatedly to policy makers.

Another aspect from the country perspective concerns the relations between public health and trade. An adoption of a more efficient IHR will lead to a stronger position for public health in matters of trade and trade sanctions. This may not be an easy shift of balance in several countries.