Environmental Engineering Reference
In-Depth Information
a caveat is in order. First, this revolution in global health governance may have
occurred with SarS precisely because the novel coronavirus was perceived as highly
lethal and extraordinarily contagious. The inexorable spread of avian influenza has
generated significant concern and a desire for international cooperation in capitals
around the world. In the case of H5n1, the wHo remains very involved in directing
the international efforts to contain the spread of the pathogen throughout southeast
asia, and regional governments appear to be conceding authority to the organisation.
However, it is increasingly apparent that the power to contain an influenza outbreak
remains in the hands of sovereign states. Furthermore, one might ask whether the
international community will respond in a similar manner to other pathogens that are
less lethal and less communicable (e.g., malaria and HIv). In fact, such a response
has not materialised, because these latter pathogens do not generate similar levels
of fear as does SARS or avian influenza. This lack of concern may also result from
the relatively high certainty about their epidemiology and pathology; also these
pathogens do not pose an immediate danger to the material interests of industrialised
states. Furthermore, HIv/aIDS, malaria, and tb do not threaten the global 'jet set',
and are therefore perceived as diseases of the poor by global elites, which in turn
results in the continuing lack of effective response (see Farmer 2003; Poku 2002).
Moreover, examination of the success of various countries in controlling the
epidemic demonstrates that a state with high capacity (such as canada) had a much
more difficult time in containing the infection than did states with lower capacity,
particularly vietnam. recent epidemiological evidence suggests that SarS appears
to thrive under conditions that promote nosocomial transmission (SarS commission
2006).
therefore, the sealed hospitals of developed societies appeared to facilitate
SarS transmission through internalised ventilation systems. conversely, vietnamese
hospitals are often open air, diminishing the probability of nosocomial transmission.
In other words, the SarS coronavirus appears to be more transmissible in the sealed
hospital and urban environments of high-capacity nations. Ironically, then, SarS
would seem to pose a greater threat to states of higher capacity.
In early 2006 the consolidation of global public goods, such as improved
pathogen surveillance systems, and pathogenic containment regimes resulted from
two central factors, namely fear and the attendant economic loss generated by
contagion. A significant amount of leadership to provide such public goods has, in
fact, been provided by hegemonic pressures (i.e., the U.S.), with the assistance of
many other developed countries in order to shore up surveillance and containment
capacity within the developing world. this issue of regional and national capacity
will continue to affect the dynamics of global health governance (Price-Smith 2002a).
SarS emerged in the Pacific Rim states, which exhibit moderate to high capacity,
wherein NGOs and private citizens (e.g., physicians) possessed the technical means
both to acquire public health data and then to disseminate it on a global scale via
high-tech communications. However, in the poorer regions of the developing world
where endogenous human capital levels are rather limited, where the communications
infrastructure is meagre or non-existent, and where NGOs may have a difficult time
in gaining access to certain areas, collaborative public health governance will remain
