International Regimes in Global Health Governance; by Jiyong Jin, Routledge, 2021, 242 pages, $170.00 (Hardback).
Global health issues and global health governance have attracted great concern during the ongoing COVID-19 pandemic. Jiyong Jin’s new book surveys relevant international regimes and presents a distinctive Chinese perspective on relevant issues.
After the introductory chapter, Chapter 2 lays the book’s theoretical groundwork. It outlines a framework consisting of (1) the Copenhagen School’s securitization theory, which is used to emphasize the need for global health governance; (2) public goods theory, which is used to explain the approach used in global health governance; and (3) international regime theory, which is used to assess key international regimes currently involved in global health governance. Jin first highlights the urgency of global health security and the necessity of global cooperation. He then emphasizes the global “externality” of public health security, illustrating the “non-rivalry” and “non-excludability” characteristics of health security as a global public good. He also gives a brief overview of international regimes covered by the book and outlines his explanation of the root causes for their current insufficiencies.
The next four chapters examine some key international regimes in global health governance. Chapter 3 deals with the World Health Organization (WHO), the most prominent actor in global health governance, starting with an overview of the history of international public health cooperation. The chapter then surveys the WHO’s institutional structure and its three regulatory functions and provides an in-depth examination of the newly revised International Health Regulations (IHR) and their weaknesses. The rest of the chapter discusses factors restraining the WHO’s role in global health governance and the root causes for such limitations. The chapter also evaluates the WHO’s past reforms. Chapter 4 examines the relationship between trade and global health with a focus on the conflict between the World Trade Organization’s (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the accessibility of medicines in developing countries. It highlights TRIPS’ negative impact on global health governance—i.e., its broadening of the divide between developed and developing countries—and the limitations of measures taken by the WTO to handle the tension between intellectual property protection and public health security. Jin suggests power politics and double standards in the WTO and the privatization of health governance are the root cause of the WTO’s incompetence. Chapter 5 assesses the connections between international human rights regimes and public health. It surveys the development of these international human rights regimes and their links with public health, detailing how human rights protections have contributed to global health governance. Jin emphasizes that global health governance can be achieved only if human rights are well promoted and protected. The chapter also discusses the concept of the right to health, examining its definition, scope, evolution, and goals. Chapter 6 studies the relationship between the Biological Weapons Convention (BWC) and public health, with a focus on the danger of biological terrorism. It reveals the lack of confidence-building measures and absence of organizational support for the BWC. The chapter also examines the three dilemmas that lead to the BWC’s dysfunction, namely problems of collective action, the biosecurity dilemma between member states, and the dual-use dilemma of biotechnology.
Chapter 7 assesses China’s contributions to current global health governance, particularly its recent public health diplomacy at the global and regional levels. It also presents a timely case study on China’s response to the COVID-19 pandemic. Jin suggests that in recent months, China has become a champion in building a global community of health for all and a pillar of strength for countries with weak public health systems. It has carried out multidimensional cooperation to battle the pandemic, and a wide range of actors in China has pitched in. Beijing is now a provider of global norms and technologies in the global COVID-19 response.
Chapter 8 summarizes the main arguments of the book. To explain why each of the previously analyzed international regimes has failed to provide enough global public goods for health, it emphasizes that all of those regimes lack publicness in both decision-making and distribution of benefits. Their insufficiency has to do with problems of collective action in global health governance, the North–South Divide in public health, and power asymmetry in international regimes. To achieve better global health governance, Jin argues, the international regimes must work to democratize, add publicness to global health policymaking, and narrow the North–South Divide.
In summary, Jin’s new book adds a timely Chinese perspective on the role of international regimes in global health governance, the root causes of the often insufficient supply of global public goods for health, and deficiencies in current global health governance. This is a welcome contribution to the literature on global governance.
Social Closure and International Society: Status Groups from the Family of Civilised Nations to the G20, by Tristen Naylor, Routledge, 2019, 224 pages, $48.95 (Paperback).
Exclusion and stratification are aspects of international order that international relations scholars have previously overlooked. Tristen Naylor’s latest book develops a theory of “international social closure” to examine how groups secure advantages for themselves at the exclusion of others in international society and how exclusion, entrance, and inclusion strategies have shaped the stratification of social groups and the evolution of international order.
The scope and goals of the book are ambitious, covering issues such as the exclusion of outsiders (chapter 4), outsiders’ efforts to overcome exclusion and gain entry into groups (chapter 5), and insiders’ incorporation of others into groups (chapter 6). The book also investigates and compares closure strategies and closure systems across various status groups and temporal periods and within different institutional and normative contexts. A broad historical survey ranging from the “Family of Civilised Nations” and the “Great Powers’ club” to the G7 and G20 today reveals how exclusion games have changed over time and what this means for international politics today.
Naylor’s main arguments are as follows: closure rules and barriers in international society are predominantly functional-individualist in nature, and barriers to entry and mobility for state actors are relatively few and relatively open. Nonetheless, this does not mean international society is an open system. Some membership requirements are set so high that they are largely impossible for most actors in a system to meet. As a result, groups might appear to be open but are substantively closed. Various forms of clubs thus survive. Even if a status contest seems to be fair, it might be structurally unfair. Further, the moves of outsiders and insiders are not necessarily conflictual; aside from the exclusion strategies of insiders, the entry strategies of outsiders can also cause closure and stratification in the international system. Intra-group closure further promotes stratification.
Naylor additionally suggests that collectivistic exclusion endures in contemporary international society and that social mobility has reduced over time. The main reason is that the legal requirement of sovereignty divides the international domain into two categories of state and non-state actors: sovereign states maintain their primacy while any incorporation of non-sovereign actors is secondary and subordinate. Indeed, in most cases, possession of sovereignty is now a necessary condition and an absolute barrier to membership in global governance. While networked governance is emerging, networks have not supplanted clubs. They are the clubs’ bulwarks, not their challengers. While the actors may have changed, the closure game remains.
A key theoretical contribution of the book is its new taxonomy of exclusion and inclusion strategies available to actors in the closure game. In particular, Naylor introduces the concept of “mobility dampeners.” Mobility dampeners rely on the ideational and institutional underpinning of a club to prevent status changes. As more covert ways of exclusion, they help insiders prevent or slow a loss of their status and a rise of others through subtle means. This new concept helps us further explain how a system can be stratified even without closure barriers.
This book’s most innovative empirical findings are those on international summits. In extant scholarship, summits are treated merely as contexts in which politics takes place. In contrast, Naylor suggests that we can examine the broader dimensions of a summit. Based on archival research, elite interviews of summit organizers and participants, and ethnographic participant observation at summits, Naylor offers a vivid account of how membership and inclusion in G-summitry actually work, highlighting how state and international institutions constrain the participation of non-state actors in G-summitry. With its sociologically grounded insights, this book has the potential to transform the study of contemporary summitry.
To conclude, Naylor presents a novel perspective on global governance, emphasizing that incorporation in status groups and participation in the management of global affairs is fundamentally a “closure game” played by state and non-state actors. It shows that while international society seems to be less hierarchical than before, that is substantively not the case, particularly for non-state actors. The book captures many otherwise overlooked dynamics and deserves scholars’ close attention.
Ideology and International Institutions, by Erik Voeten, Princeton University Press, 2021, 224 pages, $95.00 (Hardcover).
Discussion on global governance cannot escape the problem of ideology. In his latest book, Erik Voeten tries to bring ideology “back in[to]” the study of international institutions (19), arguing that the politics of multilateralism has always been built on ideological differences among states.
Voeten begins his book by illustrating the case of the difficult choice Ukraine faced in 2014—i.e., whether to pursue closer cooperation with the European Union or with Russia—before elaborating on how the book is inspired by the ideological challenges and contestation that the liberal international institutional order currently faces. The book’s first four chapters are largely theoretical. Voeten develops a new theoretical framework that highlights how disputes over principled interests have shaped the international institutions that regulate global governance. Chapter 1 defines ideology “as a collection of more or less coherent views about how and who should handle a set of problems” (5) and highlights the distributional consequences it brings. The chapter also deals with (although a bit too roughly) the essential methodological issue of measuring state ideologies through their voting records at the United Nations General Assembly. Chapter 2 discusses how four “families” of theories of international institutions—namely functionalism, rational institutionalism, liberal institutionalism, and constructivism—fail to explicitly deal with ideologies. To illustrate ideological contentions, chapter 3 develops a “spatial modeling framework” which demonstrates the way cooperative arrangements between states can adversely affect the welfare of other states. Governments try to sway other countries’ policies toward their chosen ideological stances, and institutions are essential tools for them. If some states coordinate their policies, other states may incur policy losses. Thus, interdependence creates incentives for cooperation but also creates pressure to bring about harmonization. International institutions can be viewed as platforms where states struggle to move the status quo closer to their respective ideal points [(Voeten confesses later in the volume that this framework is a bit “underdeveloped” (177)]. Chapter 4 challenges the notion of neoliberal intuitionalism that informational asymmetries lead states to delegate authority to international institutions. Instead, he treats institutions as trustees (not agents) of their member states and suggests that trustee-principal relationships in situations of ideological conflict are important to understanding international institutions.
After conceptual and theoretical discussion, the next four chapters illustrate Voeten’s theoretical argument empirically in different domains (though the author’s spatial framework is not substantively referred to in later chapters.) While many studies argue that democracy leads to membership in international organizations (IO), Voeten in chapter 5 argues that ideology is a more important factor. According to him, up to the 2000s, states joined international institutions according to their respective ideological positions and less so on the basis of their level of democracy. Ideological distances also appear to be an important element in states’ choices of alliances. Chapter 6 deals with militarized disputes. Voeten suggests that shared IO membership has visible effects on great powers’ behavior, as they are less likely to have militarized disputes with other states that share their ideology. However, shared IO membership has no significant effect on territorial disputes amongst neighbors, as the unideological nature of those conflicts mutes the effects of IOs. Chapter 7 focuses on bilateral investment treaties (BITs), arguing that these treaties are more frequently introduced based on ideological factors, not economic concerns. For instance, ideological distance has a negative effect on the likelihood of signing a BIT. Chapter 8 explains backlashes against international courts through the lens of populism, suggesting that populist leaders are often linked to such critiques of international courts.
In summary, Voeten presents an innovative framework that puts ideological disputes at the center of an analysis of global governance arrangements. His emphasis on distributive ideological contests distinguishes this book from existing literature, and this volume is a welcome contribution to the literature on global governance. Nonetheless, as Voeten himself says in the conclusion, his book only “offers a way to think about institutionalization rather than a theory of any specific institution” (176). This book is a good starting point for future research on the relationship between ideological shifts and institutional changes in global governance.
Funding
This research is supported by the National Social Science Fund of China, Project No.21AZD093.
Declarations
Conflict of interest
The author declares that there is no competing interests.