Covid-19 didn't just strain hospitals and supply chains. It exposed something structural: international organizations built to manage global health security, the WHO chief among them, don't actually have the authority to make states act. They can set standards, issue alerts, and coordinate information. They can't compel a single government to do anything. That gap between mandate and authority is the starting point for a broader argument about how the world should organize itself against transnational health threats: not around global institutions alone, but around regional security complexes.

The problem with managing security at the global level

States exist, at minimum, to secure their populations. To do that, they draw on two overlapping tools: defending against external threats and managing internal ones. Historically, this settles into the concept of "international security", generally built on twin pillars of peace and defense. But peace and security aren't the same kind of concept. Peace is comparatively easy to define and measure: the absence of war. Security is subjective, a state of confidence that one is safe from danger, and far harder to assess.

There are, broadly, three institutional approaches to organizing that security. Common security treats it as inherently collective, since no state can really secure itself alone. Collective security goes further, resting on the idea that every state should enjoy security equal to every other, backed by shared mechanisms. Regional security is different again: it grows out of the older, more concrete practice of military alliance, which stabilizes relations between neighboring states through arrangements that look more like collective defense than the more abstract collective security ideal.

The trouble is that the global system, as currently structured, tends to prioritize the concerns of major powers by default. International bodies with real legitimacy, the UN, the WHO, aren't supranational. States haven't ceded sovereignty to them. So the priorities these institutions pursue are ultimately dictated by what the most powerful member states are willing to support, which skews the handling of urgent challenges that may matter enormously to a given region but barely register at the global level.

The academic case for thinking regionally

This isn't a new idea in international relations theory, and it's worth being precise about where it comes from.

Barry Buzan and Ole Wæver, working out of the Copenhagen School of security studies, developed the concept of the "regional security complex": a group of states whose major security concerns are so interlinked that their national security problems cannot reasonably be analyzed or resolved separately. Security interdependence, in this view, is a function of geographic and historical proximity, not global power politics.

Karl Deutsch got there earlier, in 1957, with the idea of the "security community", a group of people integrated enough, through shared institutions and a genuine sense of belonging, that large scale violence between them becomes almost unthinkable. Joseph Nye later added "islands of peace": pockets of regionally integrated states where economic and political cooperation actively defuses conflict, epidemic, and crisis before they escalate.

Put together, these three frameworks describe the same underlying intuition from different angles: security interdependence is strongest between neighbors, and the institutions best positioned to manage a threat are often regional ones, not global ones.

Why health security fits this model

Health security is a useful test case precisely because it looks global (a virus doesn't respect borders) but behaves regionally (outbreaks spread fastest to the countries next door). The WHO defines health security as the proactive and reactive activity needed to minimize the danger of acute public health events that cross geographic regions and international borders. Since 1948, it has built the institutional architecture for that: 194 member states, over 150 offices, six regional bureaus, and the International Health Regulations, a binding legal framework requiring states to report outbreaks with epidemic potential within 24 hours.

But the WHO cannot act alone, and was never designed to. Its own budget structure makes the point: for 2020 to 2021, roughly 80% of its funding came from voluntary contributions rather than fixed member state dues, meaning its actual capacity depends heavily on which priorities donor states choose to fund. Real health security delivery runs through a wider ecosystem: UNICEF on maternal and child health, UNAIDS, national bodies like the US CDC, and multilateral initiatives like the Global Health Security Initiative, a G7-plus-Mexico partnership formed in 2001 and expanded significantly after the 2014 Ebola outbreak, organized around five working groups covering laboratory cooperation, risk communication, pandemic influenza, chemical threats, and radiological and nuclear threats.

Every one of these mechanisms, notably, clusters around regional or bilateral cooperation rather than a single global chain of command. That's the pattern regional security complex theory predicts, and it's also, functionally, how the response to recent outbreaks has actually worked.

What this means in practice

The practical argument follows directly: a regional security complex approach to pandemic response would formalize what's already happening informally. It means encouraging genuine multiscalar interaction, military, economic, political, social, environmental, and health, between geographically proximate states, so that information flows both ways between local and international actors, and interregional solidarity gets built before the next crisis rather than improvised during it.

For Africa specifically, this raises a concrete design question, since the continent can be mapped two different ways: geographically, the OECD's five regions plus the diaspora, or by economic affinity, the African Union's eight recognized regional economic communities (UMA, COMESA, CEN-SAD, EAC, ECCAS, ECOWAS, IGAD, and SADC). An effective regional security complex probably needs to draw on both: geographic proximity to define who genuinely shares a threat environment, and existing economic and political community structures to sustain the interactions once they start.

There's already a live example of this logic in action, even if it postdates the original research behind this argument: Africa CDC, established by the African Union in 2017 and modeled in part on the US CDC, became the continent's central coordinating body for the Covid-19 response and has since taken on an expanded continental health security mandate. It's arguably the clearest real world instance of a regionally anchored health security institution operating exactly the way this framework describes, evidence that the theory isn't just academically appealing, it's already being built.

The takeaway

None of this argues that global institutions are pointless. The WHO's standard setting role and its coordination function still matter enormously. But the Covid-19 experience suggests that resilience against the next pandemic, or the next hybrid epidemic, won't come primarily from strengthening global governance. It will come from investing seriously in the regional layer sitting between the nation state and the United Nations: reinforced regional economic communities with real health mandates, WHO regional offices empowered to act with more autonomy, and health ministries within a given region treating each other as first responders rather than distant peers.