The 2005 revision of the International Health Regulation (IHRs) created a new set of obligations on member states, namely, to put in place a range of ‘core capacities’ (surveillance, laboratories, border inspection, etc) which, once implemented globally, would enhance ‘global health security’.
From 2008 when the IHRs (2005) came into effect, there was a rising tide of criticism directed at countries – largely low-income countries – who had not implemented the required core capacities. From 2014 the criticism was superseded by moves to put in place external inspections, initially voluntary, as part of holding delinquents accountable. The Joint External Evaluation was the first iteration, which was then subsumed into the Universal Health Preparedness Review.
In the first half of this paper we review the chronology of these events. In the second half we explore the power relations behind these events from a coloniality of global health perspective.
The accountability of countries to the ‘international community’ matters, in relation to global health security as in many other respects. However, assessing this history of finger-pointing and diplomatic pressure in relation to core capacities needs to take account of some wider issues. We discuss the opportunity costs of the core capacities, the lack of accountability of the global North for the rising threats to global health security, and the coloniality of global health.
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Posted 26 Jan 2025