Trade, foreign policy, diplomacy and health

8. International Health Regulations and Epidemic Control

Johan Giesecke


Epidemic control as a global public good

Epidemic control presents collective action problem at global level: ‘Free-riding’ in notification of outbreaks ‘Prisoner's dilemma’ in economic impact of notification of outbreaks ‘Temporal asymmetry’ in imposition vs lifting of sanctions against affected countries

  • ‘Free-riding’ in notification of outbreaks
  • ‘Prisoner's dilemma’ in economic impact of notification of outbreaks
  • ‘Temporal asymmetry’ in imposition vs lifting of sanctions against affected countries

Epidemics are clearly a global public bads: contagious disease has the ability to spread rapidly from country to country. Does this mean that attempts by the international community to stop such spread are always global public goods? Not necessarily. The international situation obviously differs from the national one in that there is no legal structure - such as a public health law - that obliges countries to report outbreaks or to take measures to protect other countries from epidemics. It is, however, a collective action problem at the global level, which has two facets requiring international action to secure its provision.

  • If there were an international agreement to notify all dangerous outbreaks with a potential to spread internationally, it is easy to see that countries could 'free ride'. They would be alerted to all external outbreaks, and thus be able to take counter-measures. However, a failure to notify internal problems would not leave their own populations worse off - at least not in developed countries that have the resources to control an epidemic internally - and it would not have negative consequences for their own export or tourist industry.
  • Countries face a 'prisoner's dilemma'. The strongest disincentive to international notification has little to do with public health, but rather with economics: countries know that if they report outbreaks, their economy will suffer. There is also a 'temporal asymmetry', since other countries will be much quicker to impose trade sanctions against an affected country than to lift them when the problem is over. Ideally, before the international notification system comes into place, each country should be aware of the measures other countries intend to take to protect themselves from importation of disease.
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