China Engages Global Health Governance: Processes and Dilemmas

Using HIV/AIDS, Severe Acute Respiratory Syndrome (SARS), and avian influenza as case studies, this paper discusses the processes and dilemmas of China's participation in health governance, both at the domestic level and the global level. Globalization has eroded the boundary between public and private health and between domestic and global health governance. In addition, the SARS outbreak of 2002-2003 focused global attention on China's public health. As a rising power with the largest population on earth, China is expected by the international community to play a better and more active role in health management. Since the turn of this century, China has increasingly embraced multilateralism in health governance. This paper argues that China's multilateral cooperation is driven by both necessity and conscious design. International concerns about good governance and its aspiration to become a 'responsible' state have exerted a normative effect on China to change tack. Its interactions with United Nations agencies have triggered a learning process for China to securitize the spread of infectious diseases as a security threat. Conversely, China has utilized multilateralism to gain access to international resources and technical assistance. It is still a matter of debate whether China's cooperative engagement with global health governance can endure, because of the persistent problems of withholding information on disease outbreaks and because of its insistence on the Westphalian notion of sovereignty

State Supremacy in Decline

This paper discusses the dynamics of the international pharmaceutical industry, and how these are creating problems for the Australian government in its efforts to manage change within the regulated domestic industry. The paper argues that regulatory reform and industry development policy have eroded the capacity of the federal government to maintain the pricing regime associated with the Pharmaceutical Benefits Scheme (PBS) since 1950. The bargaining strength of the transnational firms which dominate the pharmaceutical industry in Australia is increasing; current global rationalisation of manufacturing and of R&D make threats to relocate more credible than in the past.