Global Health and Foreign Policy

Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

However, in adopting the revised IHRs, countries gave the WHO a novel ability to intrude upon state interests, ''privileg[ing] global health governance over state sovereignty'' by allowing the use of surveillance reports from nongovernmental organizations and electronic surveillance systems (83, p. 90) . Actions taken by certain countries during the SARS epidemic, especially China's attempts to conceal disease information, precipitated these new WHO powers to overcome selfish state interests. Despite this apparent victory of global health over narrow state interests, a number of countries and commentators have argued that the IHRs actually undervalue ''equity between developed and developing nations'' (86, p. 482 ) and risk fragmentation of poor countries' health systems and ''national health priorities set up by developing countries'' (87, p. 13) . These objections center on the IHRs' primary focus on disease surveillance, which some argue may be of greater importance to wealthy countries seeking protection from new epidemics than for poor countries with large existing disease burdens (87) . Thus, ''the WHO's authority in infectious disease control has been strengthened partly because it suited the interests of Western states to allow this to happen'' (88, p. 308) . Whether the IHRs primarily benefit wealthy states seeking to avoid epidemics or can also address burdens of disease in poorer countries will depend upon the nature of future efforts to build surveillance and response capacity in support of the IHRs.