Global Governance Essay 2: Outbreak & Humanitarian Disease Intervention

As the title suggests, Wolfgang Petersens 1995 film Outbreak, depicts a variety of
agency responses to the spread of a deadly contagion in the United States of America.
The film portrays the events leading up to and dealing with an outbreak of a
previously untreatable virus and the correspondence and conflicts between different
organisations.
Despite the film portraying a highly US-centric view of disease control, the events
from the film could be extrapolated to address a more worldwide view through the
films speculation over the lengths military and civilian agencies might go in order to
contain the spread of a deadly contagion.
Many elements of global governance are portrayed, or at least alluded to in the film.
The primary institution in the film is the United States Army Medical Research
Institute of Infectious Diseases (USAMRIID); the main characters are doctors for the
USAMRIID. The film depicts them investigating the initial outbreak of the disease in
Africa, and testing and managing the research team on US soil.
The Centers for Disease Control and Prevention, or CDC is a US Federal Agency and
the governmental body who works with the USMRIID. They had national powers and
the control and ability to send nationwide medical alerts, implement disease control
and provide medical assistance to affected areas.
The World Health Organisation (WHO) is merely mentioned in the film, but would
play a crucial role in the international mitigation of preventative measures and
limiting the spread of the disease. The WHO is an international organisation and a
specialised agency of the United Nations. They are dedicated towards many areas of
world health, but in this scenario, play a large role in public global health and
reducing consequences that the end ay have on world health and its social and
economic implications.
Last, but not least, the Government of the United States of America as a governing
regime is portrayed as having the least involvement, but most power in the situation
including military tasking, control of the area and the planned military bombing as
effective decontamination of the area. The smaller governing bodies had the
responsibility to debriefing the government, so they can evaluate the situation and at
appropriately.
In comparing to theoretical perspectives on global governance, the assumptions made
in the film reflect those of a realist ideology. Whilst Outbreak (1995) is based around
events taking place in the United States of America, there is hardly any influence of
international organisations and there is no international regulation of their
humanitarian and military actions. The decisions made by the state are rational and in
the interest of sovereignty and survival (Mearsheimer 1994, p. 10). These assumptions
are maintained by the state to control the situation, and in decision making where
spreading of the disease would create national chaos and insecurity.

In dealing with the outbreak of Motoba in the film, there are certain governance gaps,
which limit the capabilities of the agencies and institutions. The agencies involved
struggled with the appearance of this new disease because it meant a lack of
knowledge; how it how it infected/travelled/mutated, symptoms, mortality rate and
treatment options. This also meant that there was a lack of norms in the societies and
agencies of ways to combat the spread of infection in the general public.
Gaps in the coordination of policies between the individual agencies presented
conflict in terms of the prioritisation of military, humanitarian and medical demands.
The lack of a single governing or coordinating body meant that the competition
between the institutions, at one point or another, were not fully focused on the
wellbeing of the general public, rather on their own goals. For example, the military
influence on the US government meant that the military were about to withhold facts
about a possible cure, and push their own agenda to bomb the town, to save Motoba
as their own powerful biochemical weapon.
Moreover, the lack of one governing body meant that there was defiance towards the
implementation of policies and lack of compliance because of the variety of orders
and agendas being put forward by each agency.
In the film, there is much conflict over the resolution of the problem consisting of
conflict between governing bodies. Under the influence of the military advice, the
President of the United States orders operation clean sweep a targeted bombing of
the infected town to contain the disease in order to protect the millions of other
Americans from the disease. However at the last minute, two of the main characters
find a cure for the disease and fight against military ruling to stop the bombing.
Dramatic moments in the final scenes see the two main characters on the USAMRIID
defying military orders for the greater good of the infected people in Cedar Creek.
This situation demonstrates the difficulty for organisations and governments between
their responsibility to protect the greater populations from the spreading of disease
and their duty to aid those infected. It highlights the need for a singular governing
body or system in order to effectively deal with opposing agendas and solutions for
global medical epidemics and to monitor and deliver global humanitarian assistance.
In Nickersons (2013) analysis on current global humanitarian health efforts, he
describes that international organisations are not taking and acting upon the windows
of opportunity to mitigate the effects of emergencies. In many models of
international development, humanitarian health responses tend to be reactive, rather
than preventive, with regard to major emergencies (Nickerson 2013) and are more
often than not, in response to late indicators of a populations emergency situation.
Nickerson calls for international development to be reformed, as it will be the
vulnerable populations who will pay the price when effected by natural disaster,
famine or disease outbreak (Nickerson 2013).
The World Health Organisations 2005 International Health Regulations were
prompted by the development of infectious disease threats (WHO, 2005). The
purpose of the IRH (2005) is to prevent, to protect against, control, and provide a
public health response to the international spread of disease in ways that are
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commensurate with and restricted to public health risks, and which avoid unnecessary
interference with international traffic and trade (Article 2). They also appeal for
increased levels of surveillance and control and national levels, and longer-term
responses to international public health emergencies with the aid of global
partnerships and international collaborations, in order to meet their human rights
standards, obligations and accountability (Andrus et al 2010).
In 1950, Andrus et al. (2010) explains that the outbreak of smallpox, cholera, plague,
and yellow fever had been killing thousand of people worldwide, but most notable in
underdeveloped nations, where wealthier countries concerned themselves with the
thread of outbreak in their own country. This lead to the first version of the
International Health Regulations in 1951, and future revisions in 1969, 1995 and
2005. The emerging threat of Ebola during the 1990s and 2000s, which is the disease
which the Motaba virus from Outbreak is loosely based on, called for the organisation
of the Global Outbreak Alert and Response Network (GOARN), a global mechanism
which was challenged to address major health outbreaks. The Network and Response
teams would also assist to respond to national threats in developing countries.
Whilst the IHR represented a positive step in the right direction of strengthening
international responses to public health emergencies, efforts to increase national
capacities are essential for the future. The IRH (WHO, 2005) has proven to be vital in
maintaining accountability and providing developmental response to emergencies
(Andrus et al., 2010)
The securitisation of public health has places infectious disease emergencies under the
heading of threats to national and global security, of which man are becoming. Global
health challenges and global institutions' current responses are contemporary aspects
of dealing with and finding the best solutions for each individual health epidemic our
world faces (Cooper, Kirton & Schrechker 2007), however the progress wince the
contributions of the World Health Organisations, World Trade Organisation and UN
agencies will hopefully see us into a more positive future.
Piot et al. (2004) explains that programs have developed over the years through
coordination between well-intentioned donors, UN agencies, and non-governmental
organizations, however the focus on international responses and organization has
taken the toll on struggling counties, and havent successfully strengthened systems
on the national level.
Public health systems are essential for not only surveillance and mitigation of
humanitarian assistance, but also to guide the consignment, treatment and quarantine
measures in the early stages of a potential health disaster (Adrias 2004, p. 16).
Many different agencies were represented in the film, and the issues between
communication and conflict of ideas took away from the overall mission to control
and treat the Motaba outbreak. Despite the film being based in an American society
with USU agencies, the ideas and organizations can be extrapolated to suit a more
global outlook.
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Bilateral and multilateral institutions and organisations play a vital role in

implementing new initiatives to deal with health crises (Leke 2010). These include,
but are not limited to health advocacy, multiple actors responding to the increasing
disease threats and actors whom endeavour to provide health care to populations and
communities, a humanitarian act from which developing countries benefit
tremendously (Leke 2010).
However, from a perspective of global governance, several issues still need to be
addressed to increase overall impact. The focus, plans, and policies need to be better
aligned with all counties, developed and developing in order to provide a more
effective response mechanism (Leke 2010). Leke (2010) also argues that
responsiveness to a countries needs is sometimes on a short-term basis, where instead
long-term initiatives need to be in place to ensure sustainability and maintenance of a
countrys sovereignty.
Lastly, Leke (2010) argues that there is urgent need for a mechanism that will enable
coordination of aid for health at country, regional, and global levels, and coordination
among partners and funders within a specific sector. Coordination between countries
and organisations should be strengthened at all levels of government in order to
improve efficiency and effectively. The results would end up having an increase in
global harmonisation, transparency, accountability, better implementation of
programmes, and a fair and even attribution of resources within a country, which
would be a positive move in order to combat diseases and emergency health outbreaks
and increase the effectiveness of preventative measures for the future.

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