International Health, the WHO and Planning for the Next Pandemic. Medical Citizenship in a Global Context in the 1990s and Early 2000s

In 2005 the American president George W. Bush made quite clear that not only the USA, but the world in total faced difficult times: Scientists and doctors cannot tell us where or when the next pandemic will strike, or how severe it will be, but most agree: at some point, we are likely to face another pandemic“. The expectation that the next pandemic lay just around the corner forced not only national governments but also the World Health Organisation (WHO) to readjust their preparedness measures. The WHO used the momentum of the bird flu of the early 2000s to reformulate the International Health Regulations, giving much more power to the international organisation. The WHO reinvented itself; instead of being just a clearing house of epidemiological information the organisation tried to become the spearhead of spreading the idea of health as a basic human right (Brundtland). Therefore, at the same time the notion of the political aims of the WHO changed. For most of the time of the 20th century since its founding after the Second World War, WHO’s main focus lay on “international health” – which means that national states were the main actors in international health policy and the WHO only played a coordinating role. From the 1990s onwards, the new slogan was “global health”. Health in this conception was not something only national states should take care of but a right the global society gave the WHO the power to guarantee (or at least protect). That was not only a new conception of the WHO as institution but also of medical citizenship in general which should develop into some kind of ‘medical global citizenship’. Pandemic preparedness was the testcase for the WHO to prove what that kind of global medical citizenship could mean in practice.