Coincident polio and Ebola crises expose similar fault lines in the current global health regimeReport as inadecuate

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Conflict and Health

, 9:29

First Online: 16 September 2015Received: 10 March 2015Accepted: 11 September 2015DOI: 10.1186-s13031-015-0058-1

Cite this article as: Calain, P. & Abu Sa’Da, C. Confl Health 2015 9: 29. doi:10.1186-s13031-015-0058-1


BackgroundIn 2014, the World Health Organization WHO declared two -public health emergencies of international concern-, in response to the worldwide polio situation and the Ebola epidemic in West Africa respectively. Both emergencies can be seen as testing moments, challenging the current model of epidemic governance, where two worldviews co-exist: global health security and humanitarian biomedicine.

DiscussionThe resurgence of polio and the spread of Ebola in 2014 have not only exposed the weaknesses of national health systems, but also the shortcomings of the current global health regime in dealing with transnational epidemic threats. These shortcomings are of three sorts. Firstly, the global health regime is fragmented and dominated by the domestic security priorities of industrialised nations. Secondly, the WHO has been constrained by constitutional country allegiances, crippling reforms and the limited impact of the 2005 International Health Regulations IHR framework. Thirdly, the securitization of infectious diseases and the militarization of humanitarian aid undermine the establishment of credible public health surveillance networks and the capacity to control epidemic threats.

SummaryThe securitization of communicable diseases has so far led foreign aid policies to sideline health systems. It has also been the source of ongoing misperceptions over the aims of global health initiatives. With its strict allegiance to Member States, the WHO mandate is problematic, particularly when it comes to controlling epidemic diseases. In this context, humanitarian medical organizations are expected to palliate the absence of public health services in the most destitute areas, particularly in conflict zones. The militarization of humanitarian aid itself threatens this fragile and imperfect equilibrium. None of the reforms announced by the WHO in the wake of the 68 World Health Assembly address these fundamental issues.

KeywordsGlobal health World Health Organization Polio eradication Ebola Security Militarization Epidemic response Humanitarian action Disasters International Health Regulations AbbreviationsBWCBiological Weapons Convention

CIAUS Central Intelligence Agency

COTPERCoordination Office for Terrorism Preparedness and Emergency Response

IHRInternational Health Regulations

UNUnited Nations

UNMEERUN Mission for Ebola Emergency Response

USAUnited States of America

WHOWorld Health Organization

Electronic supplementary materialThe online version of this article doi:10.1186-s13031-015-0058-1 contains supplementary material, which is available to authorized users.

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Author: Philippe Calain - Caroline Abu Sa’Da


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