Saturday, June 03, 2006

WHO, part I: 300 years old at birth

[This is the first of several posts giving some background to the place of WHO in the international system. I am trying to explain some things about WHO behavior and positions I think might be useful to interpreting their actions and statements. It is not meant as a defense of either.]

The World Health Organization (WHO) came into this world with a congenital deformity. Since then it has struggled, against the odds, to walk normally and do things that might seem difficult or impossible, given its disabilities. It hasn't stayed static, however, but is trying to perform reconstructive surgery on itself. To understand what is wrong and appreciate its achievements given the circumstances, we need to consult some textbook history.

WHO was established as the health agency in the United Nations system by an international charter in 1948. This is exactly 300 years from the year the modern system of international relations was crystalized in the Peace of Westphalia, ending the disastrous conflicts known as The Thirty Years War. This may seem a strange place to start an explanation of WHO's predicament, but we will try to show why it is important.

The Thirty Years War was a complex, chaotic and catastrophic convulsion that devastated continental Europe between 1618 and 1648. The causes were on many levels: Princes versus The Holy Roman Emperor; Protestants versus The Church in Rome; and internecine warfare between states and princes and everyone else. It was a War of All Against All and it decimated the continent and killed almost half the population of Europe, a three decade pandemic of violence more deadly than 1918 flu. The Peace of Westphalia, the Treaty that ended it (at least most of it), was known to contemporaries as The Peace of Exhaustion.

The Peace of Westphalia also gave rise to what political scientists call the Westphalian System of international relations, identified with the idea of sovereign national states subject to no higher authority. Each state actor could determine whith what other states and under what conditions they would have legal relations. The Westphalian system is "anarchic" in the sense there is no authority above a nationally sovereign state -- except such authority as the state agrees to in advance. Power is divided, and no "world government" is possible except to the extent a state agrees to be subject to some extra-national conditions.

Anarchy in this case doesn't mean confusion and disorder. On the contrary. There is a definite structure to Westphalian relations and its core is sovereignty -- states have sole power within their borders -- and its corollary is non-intervention: states do not interfere in the internal affairs of other states (I have used international legal scholar David Fidler's monograph SARS, Governance and the Globalization of Disease as a source for some of this exposition).

These principles are enunciated in the UN Charter (art. 2.7) which states that
"[n]othiing contained in the present Charter shall authorize the United Nations to intervene in matters which are essentially within the domestic jurisdiction of any State or shall require the Members to submit such matters to settlement under the present Charter." (quoted in Fidler).
This idea, the sovereignty and equality of nations, is the linchpin of the international system within which the UN, and hence WHO, operate. Again, from Fidler:
The Declaration on Principles of International Law Concerning Friendly Relations and cooperation Among States (1970, p. 42) states, for example, that "[e]very state has an inalienable right to choose its political, economic, social, and cultural systems, without interference in any form by another State." The principle of non-intervention excludes a great deal of sovereign behavior from being the subject matter of state interaction. (Fidler, p. 23)
Westphalian relations have a politics as well as a structure, however, and the politics are largely (but not exclusively) the politics of the Big Powers. Individual state actors are the units, but with no power acting over them, material resources, military power and strategic alliances affect how states relate to each other, just as they do in a democracy where the individual is the theoretical unit but some individuals are more equal than others.

In Part II we will examine how WHO's birth as a Westphalian institution has affected its functioning in public health, with particular emphasis on infectious diseases. Sovereign states are demarcated by borders, but viruses don't recognize those borders. The Westphalian System recognized this early on and developed ways to handle it. It is those ways WHO inherited at its birth in 1948.