A paper on the Coronavirus outbreak which examines a back to the future return to a realist version of international relations and why a more cosmopolitan view of inter-state relations stressing the expertise of medical decision-makers is to be preferred founded on the institutional structure of the WHO - World Health Organisation.

1. The Back to the Future Virus: Coronavirus and it’s
implications for International Relations and Domestic
Security
How is the rise of global health security transforming our understanding of
international relations? To date the literature on global health security has sought to
trace how the securitisation of global health is affecting the governance of diseases
in the international system; yet no-one has analysed – conversely – how the
practices of security also begin subtly to change when they become concerned with
a growing number of contemporary health issues. Health is a security risk, not least
because of its effects on state stability. There are very few threats that can compare
with infectious diseases in terms of their potential to result in catastrophic loss of
life. Health is global. In the era of globalization, health problems are increasingly
global in their effect and consequently require global responses (what is frequently
termed ‘global health governance’). Debates about health security should therefore
encompass a medical dimension. The fact that they don’t is a very serious omission
when it comes to the formulation of international and by implication also domestic
security.
The rise of global health security therefore should surely enable a range of medical
and public health experts to play a greater role in the formulation and analysis of
contemporary security policy thereby moving national interests into an area
traditionally dominated by scientific rationality. By emphasizing the potentially
catastrophic impact of global health risks, it will make it difficult to oppose
measures that could help mitigate or prepare for medical catastrophes.
The field of global health and global health governance is dominated by policy-
makers and experts with a background in public health, epidemiology and medicine,
long permeated by an ethos of positivism and scientific rationality. In this tradition,
rigorous observation, high-quality data and the application of reason can identify
both the likelihood of infection and the best response to a given problem: an
approach seen across health policy and practice, from the treatment of disease to
the allocation of resources. The idea is that there is an optimal solution to a given
problem, which can be arrived at through the use of a robust empirical
methodology. Depoliticizing global health governance will limit the scope for
contestation between different deliberately political interests by erecting a screen of
scientific neutrality outside the realm of politics.
Current health security debates have encouraged attempts to secure populations
through recourse to a growing array of pharmacological interventions and new
medical countermeasures. The question is why this hasn’t happened before? Are
we witnessing a new phenomenon: the ‘medicalisation of security’.
From this perspective, the future risk of disasters depends on decisions that
someone has made—or not made. One can demand that such dangers be obviated.
Hence, with the perception that risks depend, at least partly, on human decisions
comes the expectation that decisions be made that minimize future risks. Increased
knowledge will lead to progress.
That is the optimistic cosmopolitan view. The unfolding reality is very different and
hugely more pessimistic.

2. There are however very real limitations inherent in the emerging health–security
interface in particular the role of the WHO - the World Health Organisation part of the
institutional structure of the UN - the United Nations.
The reason is the impact of globalization. The impact of globalization has had
enormous repercussions not only because the risk of the spread of disease is so
large scale, but also because the risk is inherently global. Globalization plays a key
role in global health risks not only in terms of accelerated mobility which makes it
easier for pathogens to spread widely and rapidly, but in the interconnectedness of
critical systems for economics, finance, communication, trade and travel. In this
fundamentally interconnected world, the potentially catastrophic impact of
pandemics on critical systems is having global repercussions.Previously evidence
showed that people from the Global South are more likely to experience insecurities
in their day to day lives than people in the Global North. The Coronavirus outbreak
has “initially” turned this trend on its head.
The global and catastrophic impact appears unavoidable: new pathogens with
pandemic potential emerge all the time through natural evolution, and their
transmission is facilitated through global systems of travel and trade, which cannot
be disrupted, because they are of vital importance for the functioning of modern
society and economies. Hence it is the combination of natural evolution and a social
order based on global infrastructures that makes infectious disease outbreaks
appear potentially catastrophic, yet unpredictable and unavoidable. Outbreaks of
infectious disease in particular were newly identified as being a global risk, given
their potentially rapid spread between states and across continents through
accelerated travel and trade. In 2002–2003, for example, the SARS outbreak
demonstrated how novel viruses could spread across continents within weeks.
The potential of infectious diseases to spread quickly across the globe has also
meant that, for the first time in several generations, high-income states are
vulnerable to outbreaks of infectious disease. The World Bank's World Development
Report 2014 states that pandemics are one of the key risks facing the world today
and the World Economic Forum's Global Risks Report 2016 discusses pandemics
as one of the global risks ‘in focus’.
A vision of the world as it was during the First World War is opening up in front of
us. Some call this “back to the future”. This isn’t about imagining an alternative
future. There is a common perception that ‘the future depends on decisions made in
the present’. The impact of Coronavirus is very real. It’s here and now. A vision of a
billiard board view of world politics with state to state relations has attained a new
and potent primacy with hard borders reintroduced and closed with the
governments of states reclaiming or should that be enhancing domestic decision-
making authority imposing authoritarian regimes restricting the movement of
citizens within the borders of states and preventing travel without hermetically
sealing borders to citizens of other states by air, land and sea. The billiard ball view
of states as hard entities so redolent of the realist view of international relations has
made a powerful return. Some say it never went away. When the very foundations of
the state - it’s borders and people are threatened by forces beyond its control
threatening in turn its security by challenging its very existence - then it returns to
type. Or should that be in the face of an invisible and highly infectious enemy which
expose the permeable nature of borders in the most profound sense states act

3. independently of each other to protect their security and thus their very survival?
International co-operation is less about co-operation and coordinated policies and
is instead a recognition that states will do whatever it takes to minimise their
exposure any impression of convergence is a lucky accident more a consequence
of fortuitous overlapping priorities than deliberate shared objectives. It raises the
question of whether genuine integration can be restored in the short to medium
term or whether the European Union project can ultimately be restored? Imagine if
the European Union was a reality and had been responsible for responding to the
pandemic across continental Europe when the Commission President expresses
her deepest concerns about preserving a full functioning Single Market based on
open borders. This is surely the ultimate dystopian novel of nightmares.
The same is true of co-operation under the medical security dilemma - the threat of
disease which the World Health Organisation (WHO) defines as “caused by
pathogenic microorganisms, such as bacteria, viruses, parasites or fungi; the
diseases can be spread, directly or indirectly, from one person to another”
The threat of disease in the context of the Coronavirus outbreak is so potent I would
suggest because of its very apolitical nature. The apolitical aspect of infectious
disease is because diseases function under normal pathogenesis and spread
through a population.
Another concept that needs to be discussed in order to understand the security
dimension of disease is the Copenhagen School’s securitisation theory. The
Copenhagen School first conceptualised securitisation in the 1990s and attempted
to understand how previously benign issues become security threats. There are
three steps involved in securitising an issue. The first is an actor declaring an
existential threat against their survival or existence. Second, the audience - civil
society, accepts that there is a threat working against their survival or existence.
Finally, extraordinary action, effort, and allocation of resources are dedicated to
combating the new security threat.
Securitisation theory places stress on the fact that security issues are perceived
and created through actions, rather than being part of the functioning of the
international state system in the absence of world government (or in the face of so-
called international anarchy as characterised by structuralist leaning international
relations theorists).
A broader and much more all-encompassing definition of security raises
fundamental questions about the degree to which international co-operation is
genuinely possible and ultimately the limits to that co-operation. One states sector
specific specialisation in the production of goods and services is another’s
perception of protective markets in ventilators. States will ultimately seek to utilise
their advantage to protect and benefit their home population rather than make
available such technology when there is an existential threat to their home
population. Ventilators May become the 21st Century equivalent of pre-First World
War Dreadnaught.
Because Disease causes a decline in human well-being it now effectively
constitutes a ‘security’ threat. The United Nations Development Programme (UNDP)
created the term human security in the 1994 Human Development Report. The report
focussed on the experiences of individuals and how they feel insecure in their
everyday lives. The UNDP’s human security agenda, which included health security,
arose at the same point as the idea that infectious disease, most notably HIV/AIDS,
could be a threat to national security. It is clear that infectious diseases are both
seen as and are in actuality an existential threat to the survival and integrity of

4. states. While opinion is still divided on an exact definition the concept of human
security is generally believed to encompass freedom from fear.
In July of 2000, Security Council Resolution 1308 was unanimously passed which
noted that HIV/AIDS would be a threat to stability and security if action was not
taken to combat the disease. A similar resolution should be passed in relation to the
Coronavirus outbreak. The unanimous passing of Resolution 1308 shows that the
threat of infectious disease was a priority for many countries’ security agendas. The
securitisation move made in the UNSC was then followed by other United Nations
agencies in combating the threat of HIV/AIDS. Similar actions should take place with
regard to the Coronavirus.
Resolution 1308 which codified HIV/AIDS as a genuine international security
concern, prompted the WHO to take on a more authoritative role in managing
infectious diseases and the security concerns that they presented.
The WHO was established in 1948 in order to medically and scientifically assist
states dealing with health issues, and has acted as a humanitarian entity
representing the health concerns of international civil society. The securitisation of
infectious disease, particularly HIV/AIDS, has encouraged the WHO to take on a
different role in recent years. It now states that, “[i]n the 21st century, health is a
shared responsibility, involving equitable access to essential care and collective
defence against transnational threats.” This highlights the changing role of the
WHO in a securitised world. The WHO needs to up its role in global health advocacy,
additionally in developed states, spearheading initiatives to securitise disease as an
existential threat for Western states. The WHO needs to further turn its
responsibility toward being a surveillance agent for Western security interests
thereby consolidating its role as the ultimate authority on global health.
When the World Health Assembly allowed the WHO to reform the International
Health Regulations (IHR), the WHO created the Global Public Health Information
Network to scan the World Wide Web and identify disease outbreaks in order to
reduce economic and political damage, as well as humanitarian costs.
The WHO has worked outside its own jurisdiction in the past in order to prevent the
spread of disease; for example, it issued global alerts on travel to China and Canada
during the Severe Acute Respiratory Syndrome (SARS) pandemic in 2003 for not
being transparent in their cooperation with the WHO to manage the situation.
It is estimated that the world lost US$100 billion during the SARS pandemic due to
insecurity surrounding social, economic, and political activity showing links
between economic security and infectious disease. Given this vulnerability to
economic insecurity, let alone social and political insecurity in times of uncertainty
from disease, states began to fully acknowledge the link between disease and
security and allowed the WHO to increase surveillance of disease around the world.
The number of people who succumbed to SARS during the 2003 pandemic was
quite large but no finite figure has thus far been established.
Traditional measurements of morbidity and mortality with infectious disease are
almost ignored; they suggest that dread of a disease compounds the social,
political, and economic disruptions in society.
States and individuals are left feeling insecure because they dread the impacts of
infectious disease to such an extent that they view it as an existential threat. It is
this sense of vulnerability, that is driving responses.

5. This tension between feeling ‘at risk’ and the low likelihood of infection was, we
suggest, not a case of misperception of the level of risk, which had it been better
communicated would have reduced society's fear,but rather reflected a broader shift
in society's understanding of risk, of which health threats form part.
Communicable diseases are considered ‘threats’, requiring extraordinary responses
which move them outside the realm of normal politics - from the closing of borders,
restrictions on travel and imposition of curfews to the deployment of militaries and
other security personnel, all of which occurred during the west African Ebola
outbreak of 2014–15.
The emphasis is now being placed on social vulnerability with a concern over the
potentially catastrophic impact of health issues such as Coronavirus. Such an
emphasis draws on a detailed technical understanding of risk prevalent in the public
health arena, using advanced epidemiological methodologies and modelling
techniques to assess the likelihood of the spread of disease and infection. Risk
assessment is seen as a tool as scientific rather than political. We need to be aware
however that that risk analysis is not interest or value-free indeed, on the contrary,
politics is intrinsic to the way in which the discourse around medical risk is being
constructed. News of global health risks is certainly mobilizing public attention and
political action, because it places global health firmly within the wider sense of
society being at risk.
What this has done is to reveal stark differences in how vulnerable populations are
becoming infected and in their ability to access treatment. Different interests,
perspectives and values have also become apparent with regard to which interest
groups and communities to prioritize
So what is to be done?
Societies and Governments have thus far found ways to cope with emergent risks,
such as accidents in factories or traffic but large-scale risks like Coronavirus is now
calling into question the capacity of modern societies to deal with them
Nor do current analyses address the socio-cultural aspects spreading infectious
disease. We need to start stressing the experience of the individual and how the
Coronavirus nexus has made them feel insecure and how it should be viewed as the
cause for economic, social, and political disruption of society.
We should not ignore the concept of dread risk. Under the new security agenda
there is a real dread of infectious disease disrupting the functioning of society and
causing human suffering. The perception of vulnerability is both a defining feature
of modern society. the concept of ‘dread risk’ is useful. It refers to a combination of
lack of control and extreme potential, This fear may be prompted by the symptoms
involved, the lack of a vaccine or cure, or the stigma associated with the disease.
Ebola accordingly represented a ‘dread risk’ because, although the chances of
infection outside west Africa were vanishingly low, the lack of an effective vaccine
or cure, coupled with the gruesome symptoms, created the unprecedented levels of
‘fear and terror’
The perception of infectious disease outbreaks as global risks therefore feeds into a
general sense of vulnerability to disaster in modern societies.

6. The new security agenda and increasing incidences of infectious disease arose
during the post-Cold War period when states were readdressing their values in a
relatively peaceful world. Infectious disease has now become part of the new
security discourse. Infectious disease has the power to seriously disrupt the
functioning of society, and cause real human suffering. The challenge now for the
international community is to engage with infectious disease dynamics within a
human security framework in order to secure the international realm against
apolitical disease threats.
Responding to global health security threats demands better preparedness both in
the near future. The enormous costs of pandemics can be averted with strategic
investment in capacity building mitigating the impact of such events by becoming
more prepared for their occurrence.
The Global Health Security Agenda, a US-led international initiative of more than 50
countries, argues in a recent report that ‘the enormous costs of pandemics can be
averted with strategic investment in capacity building and preparedness’.The
background paper on pandemics for the World Bank's World Development Report
2014 states: ‘Active promotion of whole-of-society resilience and pandemic
preparedness can benefit countries by reducing not only pandemic impact, but also
the costs of other disasters and major crises.’ The language of preparedness has
also featured in the names of newly created institutions, such as the Coalition on
Epidemic Preparedness Innovations (CEPI), established in the aftermath of the
Ebola outbreak, the WHO's 2011 Pandemic Influenza Preparedness Framework and
the European Commission's 2013 Global Research Collaboration for Infectious
Disease Preparedness (GloPID-R). In an article in The Lancet, the founders of CEPI
underscored the rationale behind the preparedness response: ‘Although no-one
knows what the next outbreak will be we must develop the required arsenal now.’62
Faced with potentially enormous losses, not only in human lives but also in
economic terms, it is difficult to argue that resources should be spent elsewhere.
Hence, preparedness emerges as the key rationale for how to respond to the
incalculable risk of unavoidable and potentially disastrous events. The basis for
acting on risks framed as unpredictable, yet unavoidable and potentially
catastrophic, is not to calculate what is more or less likely to happen, but to be
prepared for whatever happens
The new security agenda must stress an institutional response to infectious
disease. Under the new security agenda the WHO ought to play an essential role in
monitoring infectious disease epidemiology in order to assess the international
security situation.
Cllr Dr. Ged Mirfin
Deputy Chairman (Political) Ribble Valley Conservative Association
07841 729 146
ged.mirfin@gmail.com
Ged Mirfin is a former academic who Lectured in Political Science and International
Relations at the Universities of Hull, Wolverhampton and Coventry. He is widely
published in the field of Political Science Theory. Recently Ged was Chief Data
Officer for Business Link North West the Business Support Arm of the North West
Development Agency – the NWDA. Ged led a Team which built the Rapid Response

7. Framework initiated by the North West Development Agency to deliver Support and
Funding to Businesses struggling as a consequence of the economic downturn in
2008-2010. As Chief Data Officer at Business Link Northwest - a data driven
evidence-based business information economics role he was the Architect of the
Business Performance Index (BPI) and its contribution to the development of the
Northwest Development Agency's (NWDA) "Rapid Response Framework". His Paper
on White Van Man Voters published by the Think Tank Political Voice was one of the
most widely downloaded papers written by a Conservative in the world 2013. His
most recent papers on Political Hypocrisy was written in 2019 and that on Political