Global Governance and the WHO’s Mandate Post-COVID-19 Crisis

Abstract

The COVID-19 has renovated the debate about global health governance. A number of scholars have proposed that the World Health Organization should assume the position of a central coordinator with hierarchical powers, demanding nation-states to “share their sovereignty”. This article presents four main objections to this project. First, when international institutions receive leverage, they use to impose “one-size-fits-all” policies, which conflicts with the characteristic heterogeny across countries. Second, geopolitical questions and the distribution of power in multilateral institutions put developing countries in a position of vulnerability within a hierarchical order. Third, the risk of crowding out parallel initiatives, especially from non-state actors. Fourth, decisions about health can have a major impact on countries, which may thwart the internal democratic principle. A Pareto improvement would be possible by strengthening the WHO’s operational capacity and its ability to issue technical guidance and coordinate with countries. To test this hypothesis, this study analyses the possible influence of the WHO’s guidance in the first year of the coronavirus health crisis, from January 2020 to January 2021, in 37 countries reported in the World Values Survey Wave 7 (2017-2020). The OLS regression performed shows a statistically significant negative relationship between the trust in the WHO, assumed as a proxy for the level of the organization's penetration, and the number of cases of COVID-19 (per million people) in the countries of the sample. These findings reinforce the hypothesis that there is a valid case for the countries to strengthen the WHO’s mandate post-COVID-19, but they should enhance the operations of provision of reliable information and support. Nation-states, in particular the developing ones, should eschew the temptation to create a hierarchical global health structure, which may not only fail due to countries’ asymmetries but is likely to create losers in the process.