The Politics of Outbreak Response: The Evolution and Effectiveness of WHO's International Health Regulations (in-progress book manuscript)
The COVID-19 pandemic reveals longstanding gaps in the system for governing the global response to major disease outbreaks. Advancements in medical science and technology to prepare for and fight outbreaks continue apace. Yet, in confronting the sixth global health emergency in just over ten years, country responses have been uncoordinated, inconsistent with World Health Organization (WHO) guidance, and based on limited scientific evidence. For its part, WHO’s authority and capacity appear outmatched by the pandemic.
Many of the shortcomings of the global response to COVID-19 are part of a pattern of states contravening their commitments to WHO’s International Health Regulations (IHR)—the binding international agreement governing the response to major outbreaks like COVID-19, Ebola, Zika Virus, and H1N1. In responding to each major outbreak since revising the IHR in 2005, states have withheld information, ignored WHO guidance, and underinvested in domestic outbreak response and preparedness in “peacetime.”
Using extensive archival materials and original quantitative data collected over the past several years, The Politics of Outbreak Response examines the enduring political dynamics shaping—and hindering—international cooperation during major outbreaks. The book asks two questions: 1) what explains changes in the design of the IHR over time and 2) what explains variation across states in compliance with key IHR commitments to share information, follow WHO guidance on border policies, and build domestic capacity? In answering these questions, the book highlights the central role of internal politics within both WHO and states. By exploring fundamental questions about state cooperation and the role of IOs in a novel context, the project not only provides insight into the design and performance of IOs, but also sheds light on whether and how these organizations can help to solve real world problems like the challenge of outbreak response.