An Essay about Governance and Globalization

Social Institutionalism in the Global Health Governance of Infectious Diseases

By Genevieve M. Nangit
November 10, 2014

1. Introduction
The situation in West Africa about the cases of Ebola made its way in the news on the
third quarter of this year. The outbreak began in the countries of West Africa (Towers, PattersonLomba, & Castillo-Chavez, 2014) - Guinea, Sierra Leone, and Liberia - and entered Spain and
U.S.A. through infected individuals who came from the endemic areas. The cases of Ebola in the
two countries outside Africa was very small compared to those in West Africa but this kind of
numbers should not keep us from ignoring the reality of the disease and its effect in global scale.
Rather in some degree and with a different perspective, the cases of Ebola in USA and Spain
implies that in a matter of days the infectious agent was able to transfer from a country outside
the endemic area. The good thing of this present time is that epidemic in one country can be
reported and be monitored. The globalization of news in this event was helpful in promoting
awareness, empathy and support for our fellow individuals in Africa. However, it was the
globalization of travel that led Ebola to USA and Spain. It is this acts of globalization and its
relationship to infectious diseases, such as Ebola, that inspire me to write this essay.
I have been contemplating the idea that if news and travel are the two factors that are
related to globalization and at the same time affect the spreading of infectious diseases then it
only implies that international relations is very important in reducing the spread of infectious
agents. Now, I wonder what kind of international relations paradigm can promote the principle of
good health in international level.
Controlling infectious diseases beyond the border of ones nation requires a different
mechanism of relationship. Unlike governance of infectious disease within the territory of ones
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nation, infectious diseases in a transnational level has to weight the sovereignty of the different
nations, the right of individuals, and at the same time the disastrous effect of infectious diseases
when it moves from one country to another without causing much damage on economic and
trading activities. All these factors have to be addressed while controlling the spread of the
infectious agent in transnational level. The steps of action requires both the power of scientific
reasoning and the art of diplomacy. It is in this context that made me favor sociological
institutionalism as the best paradigm for international relations for global health.
This essay will begin by defining important terms, followed by an overview of infectious
diseases in global scale, and finally the sociological institutionalism paradigm of controlling
infectious diseases in global health.

2. Definition of terms
Globalization
When globalization is interpreted as internationalization, the term refers to a growth of
transactions and interdependence between countries. From this perspective, a more global
world is one where more messages, ideas, merchandise, money, investments, pollutants and
people cross borders between national-state-territorial unitsGlobal relations of this kind can
be examined on the same ontological and methodological grounds as international relations.
(Scholte, 2007)
Global health
We use the term "global health" to refer to the health of all populations in the world,
regardless of nation-state, geographical position or stage of development. It
includes an interdisciplinary set of challenges that transcend national boundaries
involving health determinants (social, political, economic), collections of health
problems, and the organized social response to these conditions (structured both
within and outside of health systems). The defining characteristic that makes global
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health "global" is its central concern with the impacts of globalization on health, the
transfer of health threats and opportunities across national borders, and the
resulting state of interconnection and interdependence among populations.
(Harvard Global Health Institute, 2014)
Global health governance
Global health governance as a mechanism for collective problem-solving for
improved health through the interplay of different institutional forms and actors at
different levels. (Kickbusch, 2009, pp. 320-321)
Sociological Institutionalism
I was able to extract six definitions of social institutionalism, and to summarize here is my
preferred definition of sociological institutionalism
The sociological institutionalists in the sociology of organizations (Powell and
DiMaggio 1991) and those examining the influence of the "world society" (Meyer
et al, 1997) focus on cultural and ideational causes. These are posited to exert
influence either at the supra-societal or supra-state level for states and their
policies, or at the societal level for organizations. (Amenta & Ramsey, 2010, p.
15)

3. Globalization and infectious diseases

The mobility of people in this present time made it fast to move from one country to
another, and the same goes with infectious agents.

Infectious diseases can no longer be

contained in one country without meddling on the international activities such as air travel,
importing and exporting. Obviously, urbanization and modernization did not exactly eliminate
infectious diseases and the capacity of infectious agents to be transmissible (Woolhouse & Grant,
2009). Neither the changing climate can prevent it from spreading, as a matter of fact, the change
in climate made it possible for some infectious agents to re-emerge. (Morse, 2009). Infectious
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diseases are here to stay and we have to live with them. Like any social system, infectious
pathogens have their own system of existence and so are we as humans. If it is possible for a
country where this infectious pathogens exists are able to be controlled by its human inhabitants,
then maybe there is something in their practices that kept this pathogens from entering them.
With this context in my mind, a globalizing activities such as mobility that is fast and with the need
to interact with other individuals from other countries, we have to work in the transnational level
to protect our constituents from the effect of infectious agents. We are to keep in mind that even
though infectious agent is transmissible and has disastrous effect in a population, it is not a
sufficient and valid reason to impose actions to people living on the endemic areas without formal
negotiations and disregarding the sovereignty of each affected countries. What is the best
paradigm of international relations can we use in interacting with countries in transnational level
so that together we promote and protect the health of our own nations by promoting and protecting
the health of others?

4. Sociological Institutionalism of Global Health Governance of Infectious Diseases

Sociological institutionalism does not impose actions but influence them. It makes use of
existing formal structures and policies of organizations and dwell much on the use of symbolic
practices, moral models and cognitive schemes to generate collective actions (Powell & Bromley,
2013; Thoenig, 2011). It is this way that sociological institutionalism gained its legitimacy because
it respects the sovereignty of different actors (Amenta & Ramsey, 2010) in the relationships and
made it the best method of promoting and protecting the health of people. It create the necessary
actions by bringing all actors together and collectively decide the best processes.
The sociological institutionalism is a favorable mechanism for the governance of infectious
disease in global scale as reflected in the three major documents - United Nations Charter,
Constitution of World Health Organization and Second Edition of International Health Regulations.

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References
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