Reforming global health governance in the face of pandemics and war

When Russian tanks rolled into Ukraine in late February 2022, two years after the identification of SARS-CoV-2, the ensuing humanitarian crisis and upending of international law fractured the already fragile system of global health governance.Many have elaborated on the immediate health effects of Russia’s invasion of Ukraine in the face of an ongoing pandemic. The long term effects on global health governance are, however, underappreciated. These unprecedented challenges to global health infrastructure highlight an urgent need for systemwide reforms.The short term consequences of the war include more than 12 000 civilian casualties, 6.9 million refugees, the levelling of Ukrainian healthcare facilities, widespread food insecurity, and higher risks of cholera, polio, tuberculosis, and covid-19.1 Less noticeable and possibly more profound are the tectonic geopolitical shifts that threaten the foundations of global governance and, by extension, the international health system.The invasion of Ukraine and the increasingly belligerent rhetoric between the US, Russia,…
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