Health & Geopolitics

In this article about geopolitical dynamics as determinants of future health architectures, I examine observations that understand the success of health and efforts to compensate for diseases and health crises as global events.

Introduction: The Inseparable Interconnection of Health and Power Politics

The COVID-19 pandemic exposed the illusion that health is a neutral, technocratic space beyond geopolitical interests. As the SWP report shows, major powers like the USA and China have long been using global health policy as an arena of systemic rivalry – for example, through targeted supply chain controls or blockades of transparent pandemic agreements 1 3. This instrumentalization not only jeopardizes acute crisis management but also undermines societies' long-term ability to shape future health viability (“Doing Future”).

The World Health Organization (WHO) estimates that 25% of the global disease burden is directly attributable to political-economic factors – evidence of the urgency of geopolitical analyses in the health sector. The USA has announced its intention to leave the WHO. USAID is currently unable to continue its work as usual due to a review.

Geopolitical Conflicts as Health Risk Amplifiers

Pandemic Preparedness in the Shadow of Major Power Rivalry

The currently stalled negotiations on the WHO pandemic agreement illustrate how power claims paralyze global health architectures.

• Transparency clauses fail due to resistance from China and Russia, which see surveillance mechanisms as an infringement on sovereignty 1

• Technological transfer regulations are blocked by the EU to protect pharmaceutical patents 4

• The USA deliberately uses vaccine diplomacy to expand its influence in Southeast Asia 5

These blockades cement a system in which pandemic preparedness becomes a hostage to short-sighted power calculations – with direct consequences: According to the Robert Koch Institute, outbreak phases of new pathogens are extended by an average of 17 days due to politicized data embargoes 1.

Medical Supply Chains as a Geopolitical Weapon

The COVID-19 crisis revealed the vulnerability of globalized production networks.

• In 2020, China deliberately reduced exports of medical protective equipment to cover up domestic supply shortages – an act of "sanitary realpolitik" 3

• India's export stoppage of AstraZeneca vaccines disproportionately affected African states, as 84% of their vaccine imports came from Indian production 5

Such dependencies transform health goods from public to strategic resources, which are subordinated to national interests in the event of a conflict.

Systemic Consequences for Health Cultures

Erosion of Multilateral Trust Structures

The