The recent Ebola virus outbreak resulted in widespread international attention. The essence of the epidemic outbreak for political observers is that it vividly demonstrates the important problems in global health governance and cooperation in international affairs as a whole. Four important problems or aspects could be distinguished at present stage.
To start with, the rapid escalation of the disease across the African continent illustrates the lack of sufficient safeguards, which could have protected the regional population. Some level of responsibility should be attributed to the African nations themselves, but it also reveals a general lack of attention to the issue of disease at an international level. This fault is understandable: while the West is engaged in resolving important security issues, notably the Ukrainian conflict, developing nations are focused on their internal economic development. As a result, such important issues of international concern are left largely unnoticed. However, this is a dangerous mistake: in the current age of global interconnectedness, we should understand that issues such as health governance are as important as violence and military conflict. Similarly, we cannot pretend that existing problems in Africa will have only limited local consequences. Instead, the problems in Africa today can become truly global dangers tomorrow. Thus, the international community should move beyond the simplistic logic of national interest towards a wider concept of a “global responsibility for all”.
Furthermore, this crisis also reveals the inadequacy of the current form of cooperation in combating violent diseases. While attention to the issue of disease has certainly increased since the end of the Cold War, the cooperation in this area still remains international, rather than global. The central assumption of this approach is that states, which are likely to suffer from the outbreak of the disease are expected to cooperate the most in order to prevent the emergence of the disease. The logic of this approach is understandable, yet it no longer applies in practice. In the case of the African continent, the achievement of such cooperation remains problematic not only due to limited resources of the African states, but also because of their important cultural, historic and ethnic differences, which serve as the obstacles even to a minimal form of cooperation. The achievement of global cooperation in health governance requires the participation of every member state, alongside important nonstate actors, such as NGOs, medical associations, human rights activists and philanthropic organizations, which could provide their important input in the area.
However, the issue of input raises another important question: Which actor should regulate and coordinate this input for disease prevention? The answer is WHO, which has multiple problems, such as limited resources and lack of attention from the member states and fails even beyond the minimal expectation. Thus, the organizational role had weakened considerably in the post-Cold War era. Yet changes are still possible. The ability to reform organizations depends on the will of the member state, who should commit themselves more seriously to organization, but fundamentally it starts with WHO itself. The organizational bureaucracy have to understand that the institution has a completely new role in the current global age. It should act as a global coordination centre, which not only sets certain objectives and principles, but also brings on a wide number of participants to the decision-making process. Unless such an objective is fulfilled by the WHO, global health governance is likely to be characterized by a power vacuum, where the outbreak of a certain disease becomes an issue of no one’s concern.
Finally, we need to acknowledge the need of utilizing multidimensional solutions to the existing problems of global health governance. In other words, the problem of the epidemic escalation should not be tackled simply by addressing the problems in the medical area or even the causes of a specific disease, but instead the international community should focus on the factors, which might serve as the preconditions for the epidemic emergence. In case of Ebola infection in Africa, the escalation and outbreak could possibly be prevented or at least minimised by addressing such long-term problems as poverty, inequality, lack of basic hospital infrastructure or medical equipment. Yet the ability of African nations themselves to tackle such issues is limited due to lack of sufficient resources and they need the Western assistance for any progress in this area.
The importance of these aspects is twofold. On the one hand, they demonstrate that the current form of health governance is imperfect and when problems emerge, such as the recent Ebola outbreak in West Africa, these problems can affect a significant number of innocent people. On the other hand, these aspects suggest the need for reform in specific areas, which once enacted carefully, could provide a strong foundation for tackling problems in global health governance in the near future.