Global Health Governance: International Law and Public Health in a Divided World.

• Author: Shackelford, Scott
• Position: Book review

Global Health Governance: International Law and Public Health in a Divided World. By Obijiofor Aginam, Toronto: University of Toronto Press, 2005. Pp. xv, 202. $60.00 (cloth).

History is replete with epidemics that have decimated ever larger populations, from the Plague of Athens in 430 BC, to the global swine flu of 1918-19, to AIDS and the dire modern predictions surrounding H-5N1. Due to the rapid pace of globalization, the world is fast becoming a global germ pool. Diseases such as tuberculosis, which used to be restricted geographically, are now striking regions once thought to be safe; an outbreak anywhere is now a threat everywhere. In Global Health Governance: International Law and Public Health in a Divided World, Dr. Obijiofor Aginam analyzes the root causes of public health failures throughout the world. These include underdevelopment, the legacy of colonialism, and poverty, which according to the WHO is the world's leading cause of ill health and suffering. This perspective is shared by Kofi Annan, who argues that the best cure for disease is economic growth and broad-based development. Dr. Aginam approaches these international public health topics through the lens of international law combining critical, analytical and qualitative approaches to explore global health challenges in a divided world.

Never before has humanity been so closely-bound together, and at the same time so sharply polarized. Over eighty percent of the world's population lives in nations that collectively have less than twenty percent of the world's wealth and productive capacity. According to UNICEF, 30,000 children die each day due to poverty, 1.1 billion people in developing countries have inadequate access to water, and 2.6 billion lack basic sanitation. (1) These statistics underscore the deeply unbalanced state of the world. They also highlight the basic failings of international public health and international law to limit the spread of disease by neglecting the underlying conditions that allow pathogens to proliferate and kill the unprotected.

Dr. Aginam's subject is the international legal response to the globalization of public health from a third world perspective, focusing on the failings of global health governance in contemporary international relations. Aginam examines, through the rubric of international law, the global health paradox of why so many health problems such as infectious diseases go untreated when it is in the self-interest of...