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Thursday, 2 July 2020

Eyal Benvenisti is Whewell Professor of International Law, University of Cambridge, Director of the Lauterpacht Centre for International Law, C C Ng Fellow, Jesus College, Cambridge, Visiting Professor, The Hebrew University of Jerusalem.

This blog contains the abstract and introduction of Professor Benvenisti’s recent research paper The WHO-Destined to Fail?: Political Cooperation and the COVID-19 Pandemic published on the University of Cambridge Faculty of Law Legal Studies, Research Paper Series.

 

 


Abstract

In this essay, I argue that the World Health Organization (WHO) has not been equipped with the necessary authority to adequately fulfill its mission. The WHO was built on the mistaken assumption that attaining adequate global health is a matter of high-level coordination. However, the challenge of global health governance is, crucially, also one of complex political cooperation. I distinguish between different types of cooperation problems faced by the WHO and explain why achieving global health calls for intrusive powers by a governing authority—powers that the WHO does not enjoy. 

Introduction

The criticisms leveled at the World Health Organization (WHO) since the onset of the Covid-19 global pandemic in early 2020 are fundamentally misguided. Undoubtedly, in this instance, the organization failed to meet its overarching objective - “the attainment by all peoples of the highest possible level of health.”1 It not only reacted slowly to information about an outbreak of coronavirus in China but also offered imprudent advice—exhorting states to avoid travel bans, even after China had imposed a lockdown in Wuhan.2 But these errors of judgment, betray a more fundamental flaw: the very design of the WHO is not fit for purpose in relation to the challenges it faces. The organization was designed on an assumption that the improvement of global health was the shared goal of all nations, that fighting disease was an effort to which all are committed, and that more affluent countries would help those with limited resources in this complex endeavor. 

Given this assumption, the underlying premise of the visionaries behind the WHO was that the primary challenge in the pursuit of global health was how to coordinate nations’ efforts effectively. A coordination problem requires a collective decision on which course to take, which expert theory to follow, or which standard to adopt. Once agreed, everybody shares the incentive to follow that standard. Hence, the founding fathers of the WHO Constitution perceived it as a body that could represent humanity by taking a science-based approach—one that transcended politics.3

But the Covid-19 pandemic has vividly demonstrated that the underlying challenge of improving global health is not one of poor coordination among scientists, nor even one of lack of scientific cooperation. Rather, the WHO’s efforts to combat the pandemic have been plagued by competing economic, political, and social demands—in short, a lack of political cooperation.4 And, just as we have witnessed in other global-scale cooperation problems—such as climate change—even if everybody knows what needs to be done, at least some have the incentive to “cheat”. Fighting pandemics poses collective risks to human society, but some are more vulnerable than others, and the associated costs—of prevention and treatment, for instance—are not shared equally. Seeking to protect their citizens or outdo competitors, states are primed during pandemics to take defensive action, such as underreporting outbreaks or closing their borders pre-emptively,5 while powerful lobbies also weigh in to steer national and global policies in their favor.6 

This paper analyses the type of challenges that global health management poses and to demonstrate that the WHO was not designed to wield the tools necessary to meet them. To substantiate this claim, I survey the functions of international organizations (IOs), distinguishing between the two fundamental types of challenge they address: coordination and cooperation (Part I). I explain why each of these two challenges requires distinct organizational tools, and then apply these insights to the challenges posed by global health management. In Part II, I examine the design of the WHO and argue that it was never conceived to fulfill the crucial role of ensuring international political cooperation in times of crisis. The opportunity to endow it with tools to effectively manage pandemics, and thereby to endorse the creative approach adopted successfully during the 2003 SARS pandemic, was passed-on in 2005: the WHO’s member states refused to commit to cooperation and submitted the International Health Regulations (IHR) to extensive revisions. It is as a result of this refusal that the WHO now has such limited capacity to guarantee inter-state coordination, let alone to attempt to secure political cooperation. Part III concludes.


1 The World Health Organization Constitution (1948), Art.1.

2“Wuhan lockdown 'unprecedented', shows commitment to contain virus: WHO representative in China” Reuters, January 23, 2020. The WHO’s updated advice did not include restrictions on international traffic (“Updated WHO advice for international traffic")

3See infra, notes 8, 24-25 and accompanying text.

4 On the distinction between coordination and cooperation, see Duncan Snidal, Coordination Versus Prisoners' Dilemma: Implications for international Cooperation and Regimes, 79 AMERICAN POLITICAL SCIENCE REVIEW, 923 (1985).

5 Patrick Zylberman, Civilizing the State: Borders, Weak States and International Health in Modern Europe, in MEDICINE AT THE BORDER: DISEASE, GLOBALIZATION AND SECURITY (Alison Bashford ed., 2007); ALISON BASHFORD, IMPERIAL HYGIENE, 115–36 (2004). (on disease as a motivation for states to enhance control of borders).

6 Rob Davis & Jasper Jolly, Aviation Bosses Raise 'Serious Concern' Over UK Quarantine Plans', THE GUARDIAN, May 11, 2020


Professor Benvenisti would like to thank Shai Dothan, Doreen Lustig, and the participants in the Lauterpacht Centre’s Authors' Workshops for their excellent comments, and Michal Roitman for her careful research assistance.

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