Redefining Global Health in the 21st Century, Chapter 3: Governing Global Health in a Multipolar World

In this episode of “Redefining Global Health in the 21st Century,” Ben speaks with authors Dr. mike Reed and Professor Eric Goosby about how COVID exposed the geopolitical ramifications of Global Health, using Serbia’s vaccine deals with China, Russia, Pfizer, and AstraZeneca as a case study. They argue the era of a single global health superpower is fading and discuss a multipolar future shaped by “middle powers,” alongside the consequences of the US stepping back from traditional global health commitments, including leaving the WHO. The conversation critiques bureaucratic, duplicative governance and vaccine inequity, examines China’s largely transactional health role and the limited donor potential of the BRICS nations, and warns that the US defunding of South Africa’s HIV program harms HIV research more broadly. They call for stronger WHO implementation and decentralized rapid-response capacity, greater accountability, and less credit-seeking, while condemning tying lifesaving aid to transactional commercial arrangements, for example access to minerals and other commodities. 00:00 Serbia Vaccine Surprise 01:45 Multipolar Health Governance 05:04 US Retreat and Local Ownership 08:33 Why WHO Faces Critique 11:08 China Steps Into the Gap 17:04 BRICS Limits and Leverage 22:15 South Africa Research Stakes 24:54 WHO Reform and Decentralization 34:36 WHO Beyond Guidelines 36:29 Pandemic Governance Gaps 38:36 Climate Zoonoses Preparedness 39:45 Trust And Fragmentation 42:01 Rapid Response Blueprint 45:38 Inclusive Accountable Governance 49:36 Post Aid Future Financing 52:53 Hard Power Moral Costs 58:54 New Compact Conclusion 59:48 Humble Leadership Lessons 01:03:01 Thanks And Where To Listen Learn more about the book: https://bit.ly/redefining-global-health More from UCSF Institute for Global Health Sciences: https://globalhealthsciences.ucsf.edu Check out mike Reid’s Substack: https://substack.com/@reimaginingglobalhealth Check out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! What would it take for global health to avoid decline? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health — and look out for a dedicated sub channel for Redefining Global Health in the 21st Century under A Shot in the Arm’s YouTube home. Redefining Global Health in the 21st Century: The Podcast (Playlist on Youtube) https://bit.ly/rgh-podcast A Shot in the Arm Podcast Youtube (Main Channel) https://youtube.com/@shotarmpodcast