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This chapter outlines how the international community tries to address cross-border health concerns through its system of global health governance. It looks at the historical evolution and contemporary context of the global health governance system. In order to delve more deeply into the strengths and weaknesses of the current system, the chapter looks at the COVID-19 pandemic to assess how various national and international actors responded and where they ran into problems fomenting cooperation in the face of a global microbial threat.

This chapter looks at public health on a global scale and examines how crucial this topic has become since the recent Covid-19 pandemic. Global political interest in pandemics, the chapter argues, is about much more than just the threat to health and lives. It is also about the knock-on impact health emergencies, such as the recent pandemic, have on economics and society including social welfare and education, but also socio-economic, gender, and racial equality. The chapter starts with an examination of how health became a global issue with reference in particular to the relationship between war and disease. In addition to this, health became a global issues as a result of the growth in world trade and the resultant economic globalization. Two case studies are presented in this chapter. The first consider the United Nations Security Council Resolution 1308 and the second delves into the relationship between Covid-19 vaccinations and intellectual property rights.

What threat can diseases pose to security? The sheer breadth of possible answers to this question has become increasingly evident during the recent COVID-19 pandemic, which was caused by the SARS-CoV-2 virus. This chapter explores three such links between health and security. First, some diseases are identified as threats to human security. The human security framework draws particular attention to diseases—such as HIV/AIDS, malaria, and tuberculosis—that remain endemic in many low-income countries, that continue to cause millions of deaths annually, and that also pose substantial challenges to the survival and well-being of individuals and communities. Second, some emerging infectious diseases—such as SARS, pandemic flu, Ebola, and COVID-19—are identified as threats to national security because their rapid spread can cause high death tolls and trigger significant economic disruption. Finally, some diseases are also identified as narrower threats to bio-security within the context of international efforts to combat terrorism. Here concerns have focused on the spectre of a terrorist attack using a disease-causing biological agent such as anthrax, smallpox, or plague. The chapter concludes by contrasting two different ways of understanding this health–security nexus: as an instance of securitization or medicalization.