Using air travel, virtually every country in the world is accessible within a few days’ journey. Before the Industrial Revolution, these trips took years to complete. With the remarkable and rapid advancement of transportation and communication technologies, the world has been rapidly globalized ‘into one’. This has allowed a growing number of remote geopolitical regions to become interconnected with the ability to trade and interface. As a result, nations have been becoming increasingly dependent on each other both economically and politically, reaching towards a more globalized world. After the global financial crisis of 2007/08, however, the growth of globalization plateaued. The increase of world trade reached its peak in 2008 and began to decline in 2011. Along with the decline of economic globalization, we have also observed political movements towards nationalism and protectionism during the last decade. These include the victory of Donald Trump in the 2016 US Presidential election, BREXIT, and rising nationalist parties in Europe. Altogether, these events suggest a recent trend of emerging economic and political deglobalization. In December 2019, a novel coronavirus causing COVID-19 emerged in Wuhan and quickly spread to other countries, creating a global pandemic. As of July 2020, more than 12.4 million cases and 559,000 deaths have been confirmed worldwide. Amidst the recent emergence of deglobalization, it remains a question as to whether we can respond to this global threat in an internationally collaborative manner.
Historically, an increase of connections between distant geographical regions had tight associations with the emergence and spread of infectious diseases. The Athenian plague (430 B.C.) and the Black Death (14th century) are examples of how infectious diseases spread to remote regions by way of international trade and military campaigns. Technological advances have remarkably accelerated this process. Cholera, which originated in India, spread to various parts of the world via steam ship travel in the early 19th century. Likewise, international air travel significantly accelerated the spread of the H5N1 influenza outbreak in 1997, severe acute respiratory syndrome (SARS) pandemic in 2002, and today’s COVID-19 pandemic. The emergence and rapid spread of global pandemics is a by-product of today’s hyper-interconnected world.
To face these problems in a global manner, various platforms for global collaboration have been formed. After the devastating cholera pandemics in the 19th century, France initiated the International Sanitary Conference (ISC) in 1851 with the participation of twelve countries to discuss quarantine regulations. Later, the Constitution of the World Health Organization (WHO) was created and adopted in 1946 by the United Nations (UN). In 2007, member and non-member states of the WHO agreed to comply with the 2005 International Health Regulations (IHR 2005), which call on member states to notify the WHO upon “the identification within a State Party’s territory” of an “event that may constitute a public health emergency of international concern”. In the 21st century, the importance of such collaborative networks has been emphasized during the preparedness and response to pandemics. The SARS outbreak in 2002 showed an unprecedented level of international cooperation. The WHO led collaborative efforts of eleven laboratories worldwide for the identification of SARS’ causative agent, which facilitated the development of clinical diagnostic tools. Later, public health guidelines were shared between different countries for improved disease control. The importance of international cooperation on public health upon world health emergencies was also highlighted in 2009 with the H1N1 influenza pandemic, where detection and response in early stages of the virus outbreak was key. Early on, Mexico detected and announced the potential influenza threat, and therefore Canada and the US were able to collaborate with Mexico under the North American Plan for Avian and Pandemic Influenza for the exchange of data and biological samples, enabling rapid identification of the influenza strain. Together, lessons from previous pandemics suggest the importance of international collaboration to fight emerging and ongoing outbreaks.
A key difference between COVID-19 and previous modern pandemics, such as 2009 H1N1 or SARS, is that COVID-19 occurred amidst an already emerging trend of economic and political deglobalization. Donald Trump’s victory in the 2016 US Presidential election and BREXIT are two representative events of emerging nationalism and trade protectionism. Likewise, the US-China tariff tension has been driving a sharp increase in the world trade uncertainty index since 2016, and European right-wing parties in 2010 showed a trend toward an increase in nationalist movements.
During the present pandemic, we have already observed signs of declining international collaboration. For example, the US-China relationship has worsened after political disputes between Chinese and US officials. A Chinese foreign ministry spokesperson prompted conspiracy theories, suggesting that the COVID-19 outbreak originated in the US or by the US Army. Later, the US President Donald Trump blamed the “incompetence of China” for “mass worldwide killing”, referring to China’s response to COVID-19. Soon after the Chinese Foreign Minister Wang Yi accused the US of having a “political virus” and pushing the US-China relations to “a new Cold War”. The escalating tension of the two Great Powers seems to be followed by a surge in pandemic nationalism. In April, President Trump declared a halt to US governmental funding to the WHO. The US government had contributed 15% of the WHO’s 2018-2019 budget, approximating 400 million USD, and was the largest single funder. Furthermore, the US, Russia, and India refused to join international efforts for the development and distribution of a COVID-19 vaccine.
Historically, disease outbreaks have often been interwoven with increased sociopolitical conflicts. Human behavioural studies demonstrate an increase in in-group and out-group barrier during historical pandemics, which often results in the dehumanization of marginalized groups. Persecution against Jewish communities in Europe during the Black Death, and the association of the prevalence of the Nazi party during 1932 to 1933 in German regions with higher mortalities from the 1918 flu outbreak are examples of increased sociopolitical conflicts during pandemics in the past. Increased conflicts and nationalist movements, as shown from past disease outbreaks, may hinder the generation of international collaborative responses. Already, survey results in Spain before and after the COVID-19 outbreak reveal an increase in preference for national over global efforts against the outbreak crisis, and a growing demand for strong leadership.
Together, the emergence of pandemics is an inevitable by-product of the globalized world due to increased travel, trade, and connectedness. Studies report more disease candidates with the potential to develop into global pandemics than ever before. Examples of historical pandemics show tight association of arising political and social conflicts with disease outbreak, but lessons from modern pandemics, such as SARS and influenza, strongly urge for collaborative responses to global outbreaks of infectious diseases. Today, the world faces COVID-19 in an era of deglobalization, marked by growing nationalism and trade protectionism. Augmentation of international collaboration is needed now more than ever before to fight this unprecedented threat of “the whole of humanity”.
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