Description
The academic and policy debates of global health governance normatively assert states as the protectors and providers of health, with the ‘monopoly on legitimate violence’ over its recognised territories. However, when states are ‘unable or unwilling’ to address external threats within their borders, what happens to their populations during global health crises? This paper outlines and critically examines the limits of state-centrism in global health governance during contemporary conflicts. Through a comparative case analysis of the COVID-19 response in Syria and Yemen, this paper analyses the impact of policies and actions deriving from states and actors involved in each of these conflicts – from the targeted violence against health and humanitarian workers, to the criminalisation of aid in opposition-controlled territories. The challenges of health security in conflict-affected contexts have been attributed to state failure, mistrust between communities and actors, as well as communities being ‘hard to reach’. However, these narrow and ahistorical claims overlook the socio-political and colonial dynamics of state-society relations in conflict-affected contexts, particularly where states are recognised as a source of insecurity than a source of protection. By remaining beholden to states as a central actor in global health governance, it undermines the health and well-being for populations living under state violence and conflict.
