The emerging field of global governance has produced a number of breakthroughs, as well as failures, aimed at managing global problems through the voluntary and ad hoc cooperation of a diverse range of international actors. The essays in this series represent the assessment of advanced students and young scholars from around the world, and document the key achievements, obstacles and challenges animating the field.
On May 8, 1980, the World Health Organization (WHO) officially declared the world rid of smallpox, which thus became the first disease eradicated by human effort. Of all achievements in global governance and cooperation, this one stands unquestionably head and shoulders above the rest.
In the 20th century alone, smallpox killed between 300 and 500 million people, leaving most survivors scarred or blinded (Bailey 2006; Koplow 2004, 1). By contrast, Zbigniew Brzezinski estimates that in the 20th century, between 167 and 175 million deaths were caused by “politically motivated carnage,” which includes all deaths caused by war, genocide, and human-caused famines (as in the case of failed agricultural collectivization) (Brzezinski 1996, 17). Bassiouni (1997) estimates 203 million such deaths. Considering that the last naturally occurring case of smallpox was diagnosed in 1977, the contrast becomes even more staggering: In three-quarters of the past century, smallpox killed perhaps twice as many people as did war, genocide and famines combined over the course of the entire century.
This success of global governance and cooperation becomes even more staggering when we look at how low the costs were relative to the gains. Overall, international donors provided $98 million, while $200 million came from countries where smallpox was endemic. (Barrett 2007, 186) The U.S., the single largest international donor, recovers its investment every 26 days, considering the funds saved from vaccination programs and health care (Fenner et al 1988, 1365). By way of contrast in terms of cost-effectiveness, the U.S. Treasury has spent more than $845 billion directly on the war in Iraq, and estimates of the war’s total cost to the U.S. economy have surpassed the $3 trillion mark (Trotta 2008).
The bottom line is this: For a tiny fraction of government expenditures, WHO and its member states were able to accomplish a feat that, in terms of the human costs, was greater than the elimination of war, genocide and famine combined.
What is truly mystifying is that this successful cooperative effort to eradicate smallpox, which incontestably achieved so much good at such a minimal cost, almost failed due to a lack of funding and political initiative. In the words of the WHO team that led the effort, the “lack of resources constituted a serious, continuing problem and, even in the concluding years of the program, those that were made available barely sufficed to maintain momentum. . . . Success was never a certainty, even during the years immediately preceding the last-known cases” (Fenner et al 1988, 423).
If cooperation toward such a positive, achievable public good proved this difficult, how much more difficult must it be when there is less convergence of international interests? The difficulties that this landmark achievement faced lead us inevitably to the question of what could possibly have stood in its way.
In researching this question, a Columbia University professor, Scott Barrett (2007), took a game-theoretical approach, and he concludes that the problem facing the international community was twofold. First, although smallpox eradication was indubitably in the interests of the developed countries that were called upon as international donors, the problem of free-riding led each of them to expect that it could withhold resources while another developed country would cover the cost. Second, the absence of any strong lobbying groups campaigning for smallpox eradication meant that governments did not have a domestic political reason to prioritize extra foreign aid to accomplish the task.
Both these aspects of the smallpox eradication problem point to one broad conception of the key obstacle to global solidarity overall: the absence of an institutional structure that encourages international cooperation. On the one hand, no global institution has the power to sanction selfish behavior such as that typified by the free-rider situation. On the other hand, the basic accountability of democratic governments to the electorates within their own territories means that they are incentivized to follow a course of action that is at variance with the global good if it will enhance their chances for reelection.
Critiques of this sort usually highlight the lack of a global sovereign with coercive powers. But this is not central to addressing the problem. It is true that a globally sovereign institution could enforce the provision of global public goods, but much the same function could be served by strong global and national public opinion. If the general public of a democratic state manifests sufficient support for prioritizing the interests of people within other states, then individual states would be incentivized to do so. This is particularly relevant for humanitarian concerns, which typically entail a much greater benefit for those in need than it would cost those who could provide aid, and as such have the capacity to elicit sympathetic and moral sentiments in the publics of developed countries.
Now, global governance is not entirely about the provision of public goods; there is a whole normative and cultural dimension to the concept, with problems such as global solidarity, justice, and tolerance. But most concrete policy problems can be usefully conceived of as problems of global public goods.
At any rate, these problems are most easily mitigated when there is a clear convergence of global interests, and when the costs to those who will benefit least are minimized. As such, in keeping with the lessons learned from the successful global campaign to eradicate smallpox, I believe that it is reasonable to hope for similar breakthroughs in the following areas:
Nuclear nonproliferation: The nature of modern warfare means that the risk of conventional wars against a nuclear-capable state is probably less of a danger than the risk of nuclear terrorism, particularly when existing stockpiles of nuclear arms more than suffice to function as a deterrent. As such, nuclear-capable states should hopefully recognize their common interest in reducing and securing existing stockpiles.
Infectious diseases: As was the case with smallpox, there can be no question that the eradication of infectious diseases serves the interests of everyone. As such, there should hopefully be the possibility for renewed WHO and regional programs to eradicate the seven diseases that the Carter Center’s International Task Force for Disease Eradication has identified as potentially eradicable: measles, mumps, rubella, poliomyelitis, lymphatic filariasis, pork tapeworm and guinea worm disease. In particular, the project to eradicate guinea worm disease was halted several years ago because of the insecure situation in Southern Sudan; hopefully, its forthcoming secession will allow the program to be restarted.
Global Institutions to incentivize the provision of global public goods: The main problem facing global governance, in my view, is that the current institutional framework is simply not constructed to encourage the tackling of worldwide problems. A concrete example of how this situation could change is the proposed Health Impact Fund. As has been highlighted by the economist Joseph Stiglitz (2006) and the philosopher Thomas Pogge (Pogge & Hollis 2008), pharmaceutical companies have no market incentives to develop cures for diseases that affect the global poor, and the strict enforcement of intellectual property rights means that a medicine that has already been developed cannot be distributed unless the owners of the rights to it opt to produce it themselves for no market gain. Instead, the proposed fund would incentivize previously unprofitable research by providing remuneration commensurate with particular needed medicines’ impact on the global poor to those pharmaceutical companies that provide these medicines at cost to those who need them. The fund thus would serve as a model for the kind of framework necessary to encourage continuing significant achievements in global cooperation and solidarity.
References
Bailey, Pat. 2006. “The Top 10: Epidemic Hall of Infamy.” UC Davis Magazine 23, no. 4.
Barrett, Scott. 2007. “The Smallpox Eradication Game.” Public Choice 130, nos. 1–2: 179–207.
Bassiouni, M. 1997. “Searching for Peace and Achieving Justice: The Need for Accountability.” Law and Contemporary Problems 59, no. 4.
Brzezinski, Zbigniew. 1996. Out of Control: Global Turmoil on the Eve of the Twenty-First Century. New York: Simon & Schuster. Fenner,
F., D. A. Henderson, I. Arita, Z. Jezek and I. D. Ladnyi. 1988. Smallpox and Its Eradication. Geneva: World Health Organization.
Koplow, David. 2004. Smallpox: The Fight to Eradicate a Global Scourge. Berkeley: University of California Press.
Pogge, Thomas & Aidan Hollis. 2008. The Health Impact Fund: Making Medicines Available for All. New Haven, CT: Incentives for Global Health.
Stiglitz, Joseph. 2006. "Scrooge and Intellectual Property Rights." British Medical Journal 333, no. 7582: 1279.
Trotta, Daniel. 2008. “Iraq War Hits U.S. Economy: Nobel Winner.” Reuters.com
David Leon, MPhil International Relations, University of Oxford