The Global Politics of Health
Polity Press, Cambridge
This book describes the current global health crisis and the political dilemmas. It provides an insightful contribution to intensify the debates over contemporary human health and government systems. The book is divided into three sections: (a) the International Relations (IR) student approach to public health issues; (b) issues that deserve more attention and deliberation, and (c) directions for further study. It consists of seven chapters which mainly focus on seeking to understand the interconnection between health and world politics. Because of my particular interest in population health, I have reviewed four chapters in depth to provide an essence on politics and health preferences in the global level.
The first chapter 'Understanding the Global Politics of Health' is particularly important, as it sets out a framework to guide the remaining sections of the book. The author has introduced two key perspectives in this chapter, e.g. 'statist' focussing on the state as the primary referent, and 'globalist' suggesting individuals as a referent. The main difference is that 'statist' uses the language of security to promote health, while 'globalist' considers individuals as important. The current global politics of health are concerned with either security of the state or the security of the individual. The author concludes that, if at all possible, both initiatives should be considered at the same time.
The second chapter 'Global Health Actors' describes the range of different players, to some extent, diluting the primary responsibility of the state in the area of public health. It has led to the state losing its' identification as a sole player, since the global players come up with their own agendas in specific areas of public health policy. It is becoming harder to know the patterns of influence in which these players relate to and impact on each other. However, it is very important to know this complex combination to observe the state becoming more or less significant in the health improvement.
The third chapter 'Health as a Human Right' argues that health should be considered as a human right, and describes the challenges it faces from an IR perspective. Many of the powerful governments still do not consider health as a human right, which has led to only limited progress in areas such as women's' rights in the area of reproductive and sexual health, and individuals infected with HIV. Globalists and statists both declare that the state bears the responsibility to respect, protect and fulfil these rights, and that it should provide economic, social and political support to claim them. However, there still remains a considerable area of ambiguity from rights-based claims to understand and identify the positive duties such as what the outcome is meant to look like and which different players are responsible for claiming it.
Chapter six discusses how infectious disease has become a matter of 'high politics' in the Western states and the way they pursue the disease through the language and logic of 'securitisation'. As a consequence, many diseases that exact the highest morbidity and mortality in the world's poorest places have been de-emphasised. The author argues that the poor people are ignored to protect the rich people from the spread of infectious disease, and the wealthy governments have failed to tackle its root cause. Nevertheless, the World Health Organization (WHO) is able to set up a mechanism to inform the international community of a disease outbreak and to highlight the wider threat of communicable disease, which is distressful to the poorest part of the world, and this is admirable.
Finally, this book examines the relationship between health and IR which is still to be studied systematically. The author suggests that IR more closely examines the interdependence between health and politics, and to establish relations between states and non-state players. The book concludes with mainly three concerns: the variety of players operating at a global level has a greater influence on an individual's health; understanding the dynamics of global health politics allows us to better understand the preference at the global level; and comprehending how relationships between the growing numbers of political players affect health outcomes. In particular, this book would be appropriate to students of health studies, global politics and related disciplines, scholars and researchers, to gain an innovative and comprehensive introduction to health and IR.
Dev R Acharya