On border crossings: COVID-19 as a test to global health’s architecture

By Fiona Gedeon Achi (McGill University)

As we hear about how the world – especially Europe – is currently experiencing the “second wave” of the coronavirus pandemic, many countries are enacting new lockdowns as well as border closures and restrictions. Public announcements exhort travelers to carefully follow local restrictions, including to submit themselves to thorough quarantine and testing. In various countries, government agencies have devised strategies to incentivize compliance including the threat of fines, the need to produce sworn statements to attest of being COVID-19 free, and making testing obligatory for passengers from risk areas upon entry.

At first glance, it seems only logical that international borders have become sites of intense control to prevent the propagation of the COVID-19 virus. The current intensification of disease control at the site of border crossing constitutes an opportune time to reflect more broadly on the geographic imagination that animates efforts to battle a global pandemic. Besides its spread, what exactly is “global” about the COVID-19 pandemic? How do the ways in which the COVID-19 spread has been managed at a world scale illuminate how “global crises” starkly re-entrench old political logics and their exclusionary practices?

Last winter, the spread of COVID-19 cases in every corner of the world and concurrent warnings and guidelines issued by the World Health Organization (WHO) reiterated the notion that the globalized world is increasingly interconnected and that global efforts were needed to battle the spread of the virus at a planetary scale. After declaring on January 30 the COVID-19 outbreak as a “Public Health Emergency of International Concern”, in late April, the WHO led a virtual event to launch the ACT Accelerator, a “groundbreaking global collaboration”  which brings together governments, international organizations, philanthropies, and corporations  “to accelerate development, production, and equitable access to COVID-19 tests, treatment and vaccines”.

However, as demonstrated by the closure of international borders and national responses to the pandemic, which varied greatly even among neighboring countries, many of the early and present sanitary responses to contain the COVID-19 re-entrench the persistence of a “national geographic” world (Malkki 1992). Here, states are endowed with a natural responsibility to “protect” their respective populations through a level of governmental intervention unusual for our (neo)liberal era. Justified in the name of health, extreme governmental measures to control threats to society, such as quarantine and isolation and the reinstatement of European and other borders, seem to reemerge from a bygone past. Some speak of 2020 and the COVID-19 pandemic as the birth of “radical” or “caricatured” biopolitics wherein biological life has become a supreme value governed through warlike rhetoric and interventions to govern fearful publics, such as curfews.

Through a focus on travel and borders as an object of state control, this essay problematizes the political architecture of global efforts to control a pandemic, whereby national contexts are coated with excessive epidemiological and legal importance. What do the closures of borders tell us about human capacity to tackle other global (and multispecies) crises?

Coordinated recommendations

In mid-May 2020, as countries around the world were lifting – or easing –  their first round of lockdowns, the WHO reported that over one hundred of its member states had adopted a “landmark resolution to bring the world together to fight the COVID-19 pandemic” during the 73rd WHO Assembly. To battle a “shared threat” to humanity, the resolution exhorted the “intensification of cooperation and collaboration at all levels” to control the pandemic and posited massive immunization against COVID-19 as a global public good that would help end the pandemic. In light of the severe material and psychological consequences of lockdowns and other exceptional measures taken up by governments on low-income groups, including migrants, the resolution recognized the “disproportionately heavy impact of the pandemic on the poor and most vulnerable”. It therefore called on member states to implement national action plans to mitigate the huge economic and social consequences of the pandemic and its management. As examples, it advised member states to promote social protection programs and to ensure that the restrictions on the movement of people were temporary and targeted.

To meet these aims, late last June, the European Council presented a coordinated approach for the lifting of travel restrictions on residents of non EU countries into the EU. The Council recommendation was based on an evaluation of the countries’ epidemiological situation and containment measures. But that “Council recommendation is not a legally binding instrument” because EU member states individually have the authority to decide whether or not to implement the recommendation.  On October 13, in the midst of the second wave, EU member states adopted a new Council Recommendation on a common approach to travel measures within the EU after the successive spring border closures curtailed EU citizens’ rights to move freely within the Schengen area, including for those people who cross borders every day to go to work. Organized around a common epidemiological map detailing risk levels by regions, the goal is to promote a predictable approach to the restriction of movements within the EU. The recommendation stipulates that member states should not restrict the movements of people travelling to and from green areas. It also specifies that member states should in principle not refuse entry to people travelling from other member states, even from orange or red regions, but instead when deemed necessary consider implementing restrictions such as quarantine and testing. To quote the press release, “the decision on whether to introduce restrictions to free movement to protect public health remains the responsibility of member states; however, coordination on this topic is essential”.

The concerted approaches of the European Council might prove valuable toward alleviating the exclusionary implications of state emergency protocols designed to protect health as much as perhaps public opinion. Ultimately however, the management of the COVID-19 pandemic remains entirely subordinated to decision-making processes at national levels. What does it mean to think of the global as a political space made of recommendations for coordinated practices? What figure of the state emerge when transnational responses to a global crisis take the shape of repeated calls for action and advices to intensify cooperation between countries, such as those issued by the WHO, and yet which have no legal underpinnings? What kind of future can we imagine when confronted with a model of global governance premised on the one hand by exhortations to act in the “spirit of unity” and “global solidarity” and on the other hand on the re-entrenchment of national policies as the (almost) only legitimate forces to govern?

To answer these questions, we need to recall the term used by the WHO to qualify the COVID-19 pandemic, namely a Public Health Emergency of International Concern (PHEIC). Who, exactly, is the public whose health is endangered: a global public or multiple national publics? Where precisely is this emergency located – at the global scale or at recurring national scales? Are there several public health emergencies which are of international concern? An examination of these linguistic notions offers a useful window to reflect on the political rationalities that are currently deployed and solidified in the worldwide fight against COVID-19 (Brown, et al. 2006).

Old style international health?

Medical historian George Rosen opened the preface of his classic History of Public Health with the claim that “the protection and promotion of the health and welfare of its citizens is considered to be one of the most important functions of the modern state” (1958: lxxxix). Public health, as is well known, is about the governmental responsibility to safeguard the wellbeing of its national population. Among others, Michel Foucault (1978) has extensively discussed how the enhancement of a population’s life constitutes the main objective of the biopolitical state. It is on the notion of protection in Rosen’s definition that I want to zoom in because it can help us appreciate how ad-hoc efforts to manage the COVID-19 pandemic are re-inscribing a world map in which geopolitical frontiers intersect with epidemiological fears in ways that that should at least make us worry about whether we have really moved beyond colonial and racist administration of hygiene.

As defined by the WHO, a PHEIC is an extraordinary event which is determined to “constitute a public health risk to other States through the international spread of disease” and therefore to “potentially require a coordinated international response”. In other words, the spread of COVID-19 is framed as an epidemiological threat to other nation states, rather than an issue for the planet as a whole. In this framing, what is at stake is the protection of national populations against the imperceptible trajectories of a virus which crosses borders when it shouldn’t and without asking permission. By enacting border closures and restrictions, even in line with recommendations to do so in harmonized fashion, it is not always clear whether states are protecting their populations only from the disease, or from threatening outsider bodies – often the foreigner or the migrant – which are seen as carrying the virus and infecting others. Both Qatar’s early imposition of sanitary cordons on migrant workers, leaving them without access to food supplies or decent healthcare, and the fact that  the Trump administration and the Hungarian government have used the COVID-19 situation to deny entry to asylum seekers, are sobering examples of how public health rhetoric can be harnessed toward more insidious political goals to segregate along national lines. 

Of course, at a moment when no vaccine exists to immunize people against COVID-19, efforts should be directed at stopping and breaking chains of transmission in ways that also account for shadow pandemics – for instance the documented rise of domestic violence worldwide due to prolonged lockdown. Yet, why is it that countries would prevent international entry and exit into their territory, but allow their citizens to travel thousands of kilometers within state borders, potentially bringing the virus along with them? Such epidemiological control at the sites of international border crossing suggest that, imaginatively, there might be “multiple” viruses, more dangerous and weaker ones, and that some might be more dangerous when transmitted by a foreign body.

In this context, the very notion of a coordinated international response that would concretize concern for human rights above the separate preoccupations of nations seems oxymoronic. Instead, this concerted global response is left to exist only in the form of recommendations and calls for action, aware despite themselves of their own limited purview. We seem to be stuck in an era of old-style “international health” wherein intergovernmental action is focused “on the control of epidemics across the boundaries between nations” (Brown, et al 2006).

The last two decades had made us believe in the consolidation of global health as a field of practice centered on “the health needs of the people of the whole planet above the concerns of particular nations” (Brown et al 2006). The COVID-19 pandemic is telling us that if global health is to exist at all, it cannot remain confined to global alliances for vaccine development, public-private partnerships, or NGO programs across the global South. If it is to be more than postcolonial interference and patchwork intervention, global health must mobilize states – their concerns and their resources – as “instruments of scale” to successfully reach people (Fadaak 2019; Gedeon Achi 2019). But global issues – in the form of health or climate change – need more than the old biopolitical states which prescribe to their population ways to protect themselves from the virus and from others, by washing their hands and closing down borders. We need states that are capable of challenging corporate logics which destroy human and earthly life. Can we envision a global that wouldn’t bring us back to imperial logics, and yet which might destabilize the immutable sovereign power of the nation state border? To deal with the multidimensional consequences of the COVID-19 pandemic – sanitary, economic, societal, and ecological, we need a global action space that is not merely about national publics, but that accounts for shifting publics – human and otherwise – through concerted plans that have binding, rather than only advisory, properties.

Fiona Gedeon Achi, PhD has recently completed her doctoral degree in Anthropology at McGill University. Her work uses ethnography to understand the many forms, logics, and labors of infrastructure that sustain collective living and orient its future, especially in the margins of the state. She has conducted an ethnography of evidence-based, anti-poverty policy-making and is starting a new project about political landscapes of waste in the megacity of Istanbul.

References:

Brown, T. M., Cueto, M., & Fee, E. (2006). The World Health Organization and the transition from “international” to “global” public health. American Journal of Public Health, 96(1), 62-72.

Foucault, Michel. (1978). The History of Sexuality, Volume 1. New York: Pantheon Books.

Fadaak, Raad. (2018) Prevent, Detect, Respond: An Ethnography of Global Health Security. Department of Anthropology, McGill University: Canada, PhD thesis.

Gedeon Achi, Fiona. (2019) Evidence in action: An anthropology of global poverty alleviation efforts. McGill University: Canada, PhD thesis.

Malkki, Liisa H. (1992) National Geographic: The Rooting of Peoples and the Territorialization of National Identity among Scholars and Refugees. Cultural Anthropology 7(1):24-44.

Rosen, George. (1993). A history of public health. The Johns Hopkins University Press: Baltimore and London.

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