The Exercise of Public Health Sovereignty: Trends and Trajectories

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The Exercise of Public Health SovereigntyTrends
and Trajectories

• IHR Workshop
• Ottawa
• September 21, 2006

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Public Health Sovereignty

• The implementation of the IHR 2005 raises many
  questions concerning changes in how nation-states
  exercise their sovereignty in terms of public
  health (public health sovereignty).
• Public health sovereignty in two senses
• In the international context (international law)
• Within states (constitutional, domestic law)

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Four Trends from the Workshop

• From intergovernmental cooperation to the
  globalization of governance
• From decentralized government towards the
  centralization of governance
• From complacency in government towards
  intensification of governance
• From heterogeneity of approaches toward
  harmonization of strategies and operations

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Interdependent Trends
Globalization
Harmonization
Centralization
Intensification
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Public Health Sovereignty and Governance
Transformations
Globalization
Centralization
Intensification
Harmonization
Public healths new world order
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Examples from the Workshop

• Globalization of governance IHR 2005
• More authority for WHO
• Involvement of non-state actors
• More demanding obligations on WHO member states
• Centralization of governance the growing role of
  federal/national governments in public health,
  esp. infectious diseases
• Intensification of governance the scaled-up
  activities of non-federal governments (e.g.,
  China, India, France, Russia)
• Harmonization of governance the importance of
  the IHR 2005, the changed nature of
  federal/sub-federal cooperation

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The Trends as TrajectoriesDriving Factors

• The heightened public health importance of new
  information and communication technologies
• The design of new public health strategies for
  globalized problems
• Conceptual changes in thinking about public
  health challenges (e.g., global health security,
  national health security)
• Involvement of non-governmental actors in
  governance activities
• The demand for and supply of new legislation/
  norms/SOPs/MOUs