In mid March 2003 the small bush airport of Maun, Botswana, the entrance to the
magnificent Okawango Delta, transformed overnight from a calm African airstrip into a
possible entry point for a major health threat. Airport staff in masks handed health
warnings of a novel and unknown disease called Severe Acute Respiratory Syndrome
(SARS) to passengers wearing khaki adventure clothing. Ministry of Health officials
questioned incoming passengers predominantly from Europe and Northern America,
about their latest travels and in return received anxious and concerned inquiries from
leaving passengers ready to board their flights back home. A feeling of vulnerability lay heavily in the air. Meanwhile, on the other side of town, in the local hospital Batswana children, women and men stood patiently in a long line, under the scorching sun to await their routine medical checkups. Every person in this line had tested positive for the Human Immunodeficiency Virus (HIV), and many are also latent or open carriers of the bacterium Mycobacterium tuberculosis (TB). No questions were asked here; overworked doctors and nurses were too busy providing basic support to the never-ending line of patients. The feeling here could be best described as accepting ones fate to die, with little hope to become eligible for a place on the antiretroviral therapy (ARV) program initiated by the government, which had commenced a year earlier.1 What remained was the perception that something profoundly different happened in the same place, at the same time. But what was it?
Table of Contents
I. Introduction
II. Conceptualizing global communicable diseases and its governance
III. HIV/AIDS and SARS: 25 years of stigma to 7 months of fear or an ideational shift in the governance of global diseases?
HIV/AIDS - from ‘gay plaque’ to crippling disease of the third world
SARS - from ‘Chinese whispers’ to exemplary global response
Intermediate Summary: Two diseases, two ideologies, an inevitability?
IV. Constructing the becoming of global diseases: from status quo to tabula novelis
V. Conclusion
Research Objectives and Core Themes
This paper investigates the governance of global health by contrasting the responses to HIV/AIDS and SARS to understand how certain diseases are constructed as global threats while others are marginalized. It explores the interplay between state-centric interests, global authorities, and the ideational shifts necessary to address health as a universal public good.
- The physical and ideational "becoming" of global diseases.
- Disparities in global health governance responses between SARS and HIV/AIDS.
- The role of powerful actors and international institutions like the WHO.
- The potential for a new "global collective" approach to health security.
- The ethical tension between individual human rights and collective public health responses.
Excerpt from the Book
SARS - from ‘Chinese whispers’ to exemplary global response
The first known cases of ‘atypical pneumonia’, which were later coined SARS, emerged in mid-November 2002 in Foshan city, Guandgdong Province, China. Yet, Chinese health officials did not report these cases to the WHO until the 11th of February 2003. Thus three month went by; during which the new disease was able to spread without being noticed by the WHO. Only ten days later, after China revealed its cases, an infected medial doctor from Guangdong Province checks into a four star hotel in Hong Kong. From here, he infects guests and workers alike and ‘seeded outbreaks of cases’ in the Hong Kong, Viet Nam and Singapore hospital systems. Simultaneously, the disease further spread ‘along international air travel routes’ as hotel guests flew to Toronto, Canada and elsewhere. These initial geographic ‘hot zones’ of the disease, affected primarily medical staff that treated patients seeking medical care. All subsequent transmissions could be traced back to these ‘hot zones’.
Dr. Carlo Urbani, a WHO official, who assisted in Viet Nam with these cases of atypical pneumonia is alarmed and concerned ‘it might be avian influenza’ and notifies the WHO Regional Office for the Western Pacific on the 28th of February, 2003. The WHO headquarters immediately declares, after Dr. Urbani’s warning, a heightened state of alert. Whilst coincidently, the organization already was ‘at a time of heightened surveillance for atypical diseases’, when these first warnings of SARS accumulated.
Summary of Chapters
I. Introduction: This chapter introduces the differing global perceptions of the SARS outbreak versus the HIV/AIDS pandemic, establishing the central research question regarding how diseases become "global."
II. Conceptualizing global communicable diseases and its governance: This section establishes the theoretical framework, defining globalization and health governance while arguing for a social constructivist approach to understanding power dynamics in global health.
III. HIV/AIDS and SARS: 25 years of stigma to 7 months of fear or an ideational shift in the governance of global diseases?: This core chapter provides historical timelines for both diseases, contrasting the disorganized response to HIV/AIDS with the rapid, coordinated international response to SARS.
IV. Constructing the becoming of global diseases: from status quo to tabula novelis: The chapter explores how geo-political factors and national security interests shape global health agendas and advocates for reordering health as a global public good.
V. Conclusion: The conclusion synthesizes the findings, asserting that while physical borders have diminished, ideational obstacles remain, and calls for a collective, moral approach to global health governance.
Keywords
Global Health, Governance, HIV/AIDS, SARS, Globalization, World Health Organization, Public Health, Securitization, Ideational Shift, Collective Consciousness, Communicable Diseases, Health Security, Global Public Goods, Stigmatization, International Relations
Frequently Asked Questions
What is the central focus of this research?
The research examines the mechanisms of global health governance by contrasting the divergent international responses to the SARS outbreak and the HIV/AIDS pandemic.
What are the primary themes discussed?
The work explores themes of political agency, the role of international organizations, the "securitization" of health, and the impact of ideational norms on how societies respond to pandemics.
What is the core research question?
The author asks why some diseases are constructed as urgent global priorities (like SARS) while others, such as HIV/AIDS, faced significant delays in achieving a coordinated global response.
Which scientific methodology is applied?
The paper utilizes a social constructivist framework to analyze how norms, rules, and institutions inform the formation of ideas and identities in global health governance.
What is covered in the main body of the text?
The main body contrasts the historical timelines and governance responses of HIV/AIDS and SARS, ultimately critiquing the current state-centric and profit-driven models of international health.
Which keywords best characterize this work?
Key terms include Global Governance, Public Health, Globalization, Securitization, and the distinction between physical and ideational "becoming" of diseases.
How does the author characterize the response to SARS compared to HIV/AIDS?
The author frames the SARS response as an "exemplary success" involving rapid network mobilization by the WHO, whereas the HIV/AIDS response is depicted as a "devastating failure" characterized by initial ignorance and stigma.
What role does the "Global Fund" play in the author's analysis?
The author identifies the Global Fund as an aspirational model that could potentially create a more unified "global collective" for health governance beyond traditional state boundaries.
Does the author suggest that human rights must be compromised?
The author discusses this as a difficult moral dilemma, noting that while human rights are essential, some nations (like Cuba) have historically employed drastic measures for the sake of the collective, which raises questions about the balance between individual freedom and public security.
- Quote paper
- Jan Lüdert (Author), 2006, Governing Global Health: whose diseases become global diseases?, Munich, GRIN Verlag, https://www.grin.com/document/90020
