From Responsive to Deep Solidarity: Reframing Global Health Governance in an Interdependent World

Abstract

Solidarity is widely invoked as vital for overcoming present and future public health emergencies, as well as bridging global health disparities and inequities. However, despite its rhetorical prominence, appeals to solidarity have repeatedly failed to produce equitable outcomes in global health due to profound disagreements about the concept and how to institutionalize it in global health practice. Negotiations over the recently-adopted Pandemic Agreement revealed two key contrasting notions of solidarity: as redistributive and enforceable, grounded in demands for equity and historical redress; or voluntary, emphasising intellectual property protections and national discretion. We offer an account of solidarity that can function as a framework for integrating these rival views. Specifically, we theorise two understandings of solidarity that we have termed Deep and Responsive solidarity. While Deep solidarity refers to a normative principle of solidarity that is grounded on a profound understanding of being as fundamentally and intrinsically relational, Responsive solidarity is motivated as a response to crises. Our central intervention in this paper, drawing from the two accounts of solidarity, is to reorient solidarity from a crisis language towards a more foundational account of global health governance that can sustain justice both in ordinary times and in moments of rupture.