From Imperialism to the “Golden Age” to the Great Lockdown: The Politics of Global Health Governance

Abstract

This article reviews the state of the literature on the politics of global health governance and associated political dynamics of actors involved in this issue space. We identify seven eras in the field, beginning with the period of empire and colonialism and ending with the COVID-19 outbreak. The field of global health has long had a focus on infectious disease, often rooted within a state-centered approach to transnational global health problems with recurrent debates about whether and how restrictions on trade and travel should be imposed in the wake of disease outbreaks. This statist focus is in tension with more cosmopolitan visions of global health, which require broader health system strengthening. In the mid-2000s, a golden age emerged with the influx of new financing and political attention to addressing HIV/AIDS and malaria, as well as reducing the risk posed by infectious disease outbreaks to economies of the Global North. Despite increased awareness of noncommunicable diseases and the importance of health systems, events of recent years (including but not limited to the COVID-19 outbreak) reinforced the centrality of states to global health efforts and the primacy of infectious diseases.