title: Coincident polio and Ebola crises expose similar fault lines in the current global health regime.
abstract: BACKGROUND
  In 2014, the World Health Organization (WHO) declared two "public health emergencies of international concern", in response to the worldwide polio situation and the Ebola epidemic in West Africa respectively. Both emergencies can be seen as testing moments, challenging the current model of epidemic governance, where two worldviews co-exist: global health security and humanitarian biomedicine.
  
  
  CONCLUSIONS
  The resurgence of polio and the spread of Ebola in 2014 have not only exposed the weaknesses of national health systems, but also the shortcomings of the current global health regime in dealing with transnational epidemic threats. These shortcomings are of three sorts. Firstly, the global health regime is fragmented and dominated by the domestic security priorities of industrialised nations. Secondly, the WHO has been constrained by constitutional country allegiances, crippling reforms and the limited impact of the (2005) International Health Regulations (IHR) framework. Thirdly, the securitization of infectious diseases and the militarization of humanitarian aid undermine the establishment of credible public health surveillance networks and the capacity to control epidemic threats.
  
  
  CONCLUSIONS
  The securitization of communicable diseases has so far led foreign aid policies to sideline health systems. It has also been the source of ongoing misperceptions over the aims of global health initiatives. With its strict allegiance to Member States, the WHO mandate is problematic, particularly when it comes to controlling epidemic diseases. In this context, humanitarian medical organizations are expected to palliate the absence of public health services in the most destitute areas, particularly in conflict zones. The militarization of humanitarian aid itself threatens this fragile and imperfect equilibrium. None of the reforms announced by the WHO in the wake of the 68(th) World Health Assembly address these fundamental issues.
authors.affiliation: Research Unit on Humanitarian Stakes and Practices (UREPH), Médecins Sans Frontières, Rue de Lausanne 78, Geneva, 1211 Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Calain
authors.affiliation: Research Unit on Humanitarian Stakes and Practices (UREPH), Médecins Sans Frontières, Rue de Lausanne 78, Geneva, 1211 Switzerland.
authors.forename: Caroline
authors.initials: C
authors.lastname: Abu Sa'Da
keywords: Disasters; Ebola; Epidemic response; Global health; Humanitarian action; International Health Regulations; Militarization; Polio eradication; Security; World Health Organization