faculty & experts
09 May 2023

The World Health Assembly and the Imagined Citizens of the World

As the World Health Assembly celebrates its 76th anniversary this year, Amitabha Sarkar, Swiss Government Excellence Fellow at the Institute's Global Health Centre, looks at how the Assembly has contributed to internationalism and the challenges it faces ahead. 

The World Health Assembly (WHA) has been the reason for celebration of internationalism in cosmopolitan Geneva for the past 75 years. No other health-related event in International Geneva matches the scale of the WHA, which attracts national delegations and civil society representations from all over the world. Thus this year’s congregation is an opportune moment to deliberate on the ideals of health internationalism. 

Historically, public health has always been a matter of concern in international affairs. The fading of mercantilism (a policy of self-sufficiency and trade protectionism) and the growing acceptance of free trade as economic policies (surprisingly initiated by Physiocrats and not economists at first) from late eighteenth century Europe marked the beginning of formal cross-border communications and commodity exchanges among nations.

Incidentally, that was a period of pandemics and frequent epidemics, in which infectious diseases were first identified/understood as capable of escaping the physical boundaries of territorial governance and ravaging societies.

That period led to the first
international sanitary conference in 1851 in Paris where 14 European nations came together to develop common international quarantine regulations to combat cholera, plague and yellow fever. In the same way, the present-day World Health Assembly has become the convening place for Member States (currently 194) to debate, discuss and adopt health policies that are of international importance, such as the transition from International Health Regulations (2005) to the so-called Pandemic Treaty.

While this ‘transition’ is illuminating the academic, political and diplomatic spaces for obvious reasons, the role of internationalism in crafting such global policies seems to be missing. It is well-debated that the
geo-economic fragmentation of the world order and private foundations expanding roles have been eroding the values of internationalism in the United Nations global affairs system. But this is not new, at least, for the World Health Organization (WHO). The lofty ideals of promoting universalist health policies and facilitating social security institutions around the globe, as imagined by some of the visionaries of WHO at the time of the organisation’s inception in 1948, never really took off as Cold War politics were set in motion from the early 1950s. While WHO, as an institution, should be credited with resisting the exogenous factors obstructing international cooperation and development for decades, its role in institutionally devising an endogenous strategy fostering internationalism is still warranted. 

One way to address this challenge is by nurturing the organisation as a
socio-technological space, where social values – based on the principles of equality and non-discrimination – correspond to the technological realities of global health policies and programmes. Such delicate yet balanced designs primarily need the worldview of ‘politics of solidarity’.

To this end, WHO needs to embrace once again Brock Chisholm’s (the Organization’s first ever Director General, 1948 - 1953), short-lived
‘world citizenship project’ to endorse internationalism in global health policies. Throughout history, pandemics have changed the course of international cooperation in health governance. In the same way, the COVID-19 pandemic brought the task of Pandemic Treaty negotiation to the international community. WHO should seize this opportunity by using the WHA forum to unite the globe in solidarity and not disease.

The real comeback of internationalism in global health governance would be possible if the Assembly could re-envision the pandemic treaty as an accord of international solidarity instead of global security.