The Exercise of Public Health
Sovereignty:
Trends and Trajectories
IHR Workshop
Ottawa
September 21, 2006
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
4
Public Health Sovereignty and
Governance: Transformations
Globalization
Centralization
Intensification
Harmonization
Public health’s
“new world order”
5
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 nonfederal 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 Trajectories:
Driving 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
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