Domestic politics and the WHO's International Health Regulations: Explaining the use of trade and travel barriers during disease outbreaks

Abstract

During the 2009 H1N1 pandemic, the World Health Organization (WHO), acting under the authority of the International Health Regulations (IHR), recommended against the imposition of trade or travel restrictions because, according to WHO, these barriers would not prevent disease spread. Why did 47 states impose barriers anyway? This article argues that states use barriers as political cover to prevent a loss of domestic political support. This logic suggests that governments anticipating high domestic political benefits for imposing barriers during an outbreak will be likely to do so. Logistic regression and duration analysis of an original dataset coding state behavior during H1N1 provide support for this argument: democracies with weak health infrastructure-those that stand to gain the most from imposing barriers during an outbreak because they are particularly vulnerable to a negative public reaction-are more likely than others to impose barriers and to do so quickly.

Keywords: Compliance; Domestic politics; Global health; International organizations; World Health Organization.

Fig. 1

First differences in the simulated predicted probability of imposing barriers moving from strong to weak health infrastructure as democratic institutions strengthen

Fig. 2

First differences in the simulated predicted probability of imposing barriers moving from non-democracy to democracy for states with strong and weak health infrastructure

Fig. 3

Ratios of simulated hazard rates of states with weak health infrastructure to those with strong health infrastructure as democratic institutions strengthen