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I. The Anatomy of Global Cooperation for Infectious Diseases
II. COVID-19 and Global Cooperation
III. Policy Considerations
Since the World Health Organization(WHO) was first notified on Dec. 31, 2019 of a novel Coronavirus (COVID-19) outbreak in China, it took just three months for the virus to spread around the entire world and plunged the world into confusion and depression. Since infectious diseases do not respect international borders, efforts by individual nations are not sufficient enough to confront the outbreaks of infectious diseases; the world needs a globally coordinated response.
And COVID-19 is no exception. Nevertheless, the scale of worldwide COVID-19 infections and deaths seen over the past seven months since its first report tells us that the world has failed miserably in forging global cooperation for COVID-19 despite the world’s previous experience in fighting infectious diseases together and the extant global governance for it.
And what is worse is that such failure to build global cooperation in the face of COVID-19 has its origins in non-medical factors rather than medical ones, that is, international and domestic politics and institutions.
I. The Anatomy of Global Cooperation for Infectious Diseases
Global cooperation to fight infectious diseases has two dimensions, medical and non-medical. The medical dimension of global cooperation to fight infectious diseases relates to stemming and treatinginfectious diseases, while the non-medical dimension includes cooperation aimed at addressing various problems in the aftermath of infectious diseases such as an economic crisis.
Global cooperation to combat infectious diseases takes concrete shape when the countries where infectious diseases originated in and their neighboring countries take measures in a responsible manner and international mechanisms function effectively in tandem to coordinate them. Since 1945, the WHO and the International Health Regulations (IHR) have been the most effective international disease response mechanisms.
The tripartite global cooperation for infectious diseases became visible when Severe Acute Respiratory Syndrome (SARS) broke out in 2003 soon after the turn of the century. SARS was a turning point for the IHR to morph into a global regime for infectious diseases from an international one. Through revisions of the IHR in 2005, the WHO has acquired authority to restrict state sovereignty over infectious diseases. And the 2014 Ebola Outbreak in Western Africa demonstrated that global response to infectious diseases is not confined to the WHO and healthcare; it requires coordination beyond the WHO on the non-medical dimension as well.
II. COVID-19 and Global Cooperation
The failure to forge a coherent international response to the coronavirus, despite the presence of global governance in charge of infectious diseases, can be explained with the following factors.
1. Politicization of Infectious Diseases
The COVID-19 outbreak began in China, a great power, and the United States, another great power, appears to be its biggest victim. As the world’s great powers are deeply mired in the pandemic, leadership anticipated in the face of global crises is yet to emerge. Although COVID-19 is certainly a transnational matter, China, the originating country of COVID-19, handled it as a very sovereign matter. On the other hand, to the world’s dismay, the United States, despite its most advanced healthcare system, was unable not only to save itself from COVID-19 while having the biggest number of infections and deaths in the world but also to take the lead in global response to COVID-19, putting itself ahead of others. And the hegemonic competition between the US and China further fueled the politicization of COVID-19 and constrained global cooperation.
2. The Collapse of Implicit Dual Structure in Infectious Diseases
COVID-19 proved that implicit assumptions about infectious diseases were flawed. For instance, it was previously thought that there is a dual structure, where infectious diseases would break out in developing countries and developed countries secure from infectious diseases provide remedies and relief. COVID-19 revealed, however, that developed countries, which used to intervene in infectious outbreaks in developing countries by offering financial assistance, were utterly unprepared to tackle infectious diseases spreading within their national borders.
3. Complex Crisis
COVID-19 is not just a public health crisis. It has prompted a chain reaction of economic and social crises and paralyzed countries, exposing their vulnerabilities. The economic crisis in the wake of COVID-19 was artificially induced as countries enforced social distancing in order to slow down the spread of the virus. Also, the scale and severity of the economic crisis triggered by COVID-19 is much larger than those of the 2008 financial crisis as both demand and supply in the economy faced trouble.
And the economic recession in the developed world spilling over to the developing world would put an additional burden of dealing with economic crises on developing countries which are already grappling with the public health crisis sparked by COVID-19.
4. State Unilateralism
Countries did not meet their obligations under the IHR for the sake of protecting their nationals from COVID-19, but that only accelerated the global spread of the virus. It is not to say that countries’ intention to protect their nationals was a problem but to point out that their actions, in the absence of a competent leadership, were not coordinated and thus created a problem. Over 70 countries placed travel restrictions on countries affected by COVID-19, and over 80 countries controlled exports of medical goods and equipment and hoarded them within their national borders.
5. WHO’s Poor Performance
The WHO showed incoherent responses to COVID-19 and failed to provide countries with incentives to trust and comply with the WHO. First and foremost, the WHO hesitated to declare COVID-19 as a Public Health Emergency of International Concern (PHEIC) and was unable to inform the world of the true severity of COVID-19.
The WHO’s poor performance in the face of COVID-19 could be rooted in its finance. The WHO’s finance is structured such that it becomes attentive to the requests of the member states who pay or have potential to make large financial contributions. This explains why the WHO’s stance on COVID-19 has been similar to that of China. China made the third-largest assessed contribution in 2018-19 and the second-largest behind the US in 2020-21. Rapidly growing Chinese influence in the WHO gives less credence to the WHO’s claim that its decisions regarding COVID-19 were made independently.
III. Policy Considerations
1. Implications Cooperation of Failed Global Cooperation for COVID-19
First, the absence of global cooperation for COVID-19 indicates the decline of multilateralism in global health and return to state unilateralism prior to 2005. This is in line with general trends unfolding in international relations and reflects the decline of the US-led international order. Second, the US-China rivalry makes the WHO susceptible to political pressure and marginalized. Countries might be interested in establishing new health governance in place of the WHO. And lastly, COVID-19 reminds countries of the risks globalization accompanies and the need to address them. Countries would attempt to reduce the risks of globalization by re-shoring some selected sectors and/or diversifying global supply chains.
2. Policy Considerations for Korea
COVID-19 has frayed the fabric of global leadership not only in public health but also in international relations. While traditional leadership in international relations has retreated to some extent, South Korea has newly risen to leadership thanks to its successful COVID-19 response. Korea can translate this into diplomatic assets that will help advance the country’s health security and trade interests.
Korea can consider forming a network of cooperation with like-minded countries to detect, share information, and supply medical goods in case of an outbreak of infectious diseases. This would be a way to address uncertainties in multilateral response to cross-border infectious diseases. Second, Korea should come up with a stance to navigate its way forward in the face of a possible WHO reform and establishment of trade rules related to infectious diseases. And lastly, Korea can increase health ODA to promote public health in Southeast Asian countries – its New Southern Policy partners - and cooperate with the International Vaccine Institute to develop vaccines as quasi-public goods.
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