Cultural norms
Exotic cuisine sub-culture of South China
High context culture
Chinese New Year (Jan. 24-30 in 2020) coinciding with cold and flu season
Political norms and institutions
Censorship of “political” criticism
Social media monitored
Complex and slow bureaucracy focused on economy
Chinese Center for Disease Control (CCDC) has little political power
*Dr. Zhong Nanshan's visit to Wuhan, Jan. 19
Globalization and China’s economic expansion
Wuhan “Milky Way” 天河 International Airport
Opened for domestic travel, 1995
Inter-Asian flights begin, 2000
✓Flights to Europe (2012) and U.S. (2014) begin
24 million passengers in 2018 (65,000/day)
✓Embodied
International travel
Disembodied
Object-extended
✓Organization-extended
*Precautionary principle
Governments should work together to implement these recommendations
Is it easy to reach an agreement involving bilateral international negotiations between parties with different interests as in the case of Beijing Jeep?
Do governments of the world share equal interest in treating public health as a public good?
Why are the World Health Organization (WHO), International Health Regulations (IHR), and the Bill and Melinda Gates Foundation (BMGF) considered institutions of global health governance? What different roles do they play?
According to Steger, Youde, and Gostin what are the weaknesses of the WHO and IHR when confronted with pandemics of Ebola and COVID-19? Why are the contributions of the Bill and Melinda Gates Foundation (BMGF) controversial?
How can the WHO and IHR be strengthened to guard against future pandemics?
Developed vs. Developing
*United Nations
Organization of member nations
51 in 1945
193 member states + 2 observer states
Agencies with staffs of experts
*WHO (World Health Organization)
Headquarters in Geneva, Switzerland
World Health Organization (WHO)
Executive Board
34 health experts
Secretariat
Director-General
Director-General, Dr. Tedros Ghebreyesus flanked by regional directors in Geneva, Switzerland
6 Regional Health agencies
Africa
Americas
SE Asia
Europe
Eastern Mediterranean
Western Pacific
Médicins Sans Frontières/Doctors Without Borders
*Bill and Melinda Gates Foundation (BMGF)
International Sanitary Regulations (ISR), 1951
Notifiable diseases: Cholera, plague, relapsing fever, smallpox, typhus, yellow fever
International Health Regulations (IHR), 1969
Cholera, plague,
relapsing fever, smallpox, typhus,yellow fever
*International Health Regulations (IHR), 2005
All-risk approach
Non-state reports to WHO
Public Health Emergency of International Concern (PHEIC)
World Health Organization (WHO)
World Health Assembly (WHA)
194 member states
Sovereign & “equal” nation states & interests
Capacity for action
Developed countries
15% of world population
Developing countries
Income less than $2/day
2.8 billion people
3 billion live in countryside
Pay dues
Limited funding Budget, 2018-2019 (Youde, pp. 68-69)
$956.9 million assessed dues
$3.465 billion voluntary contributions
Top-twenty voluntary contributors (nation-states, NGOs, and UN agencies)
Total world health spending, 2012 (WHO data)
$6.5 trillion
Total world military spending, 2019
$1.868 trillion (World Bank data)
2.2% of world GDP (World Bank data)
International Health Regulations (IHR), 2005
Relies on member states for surveillance
WHO only has power to shame