Domestic politics and the WHO’sInternationalHealth
Regulations: Explaining the use of trade and travel
barriers during disease outbreaks
Catherine Z. Worsnop
Published online: 26 November 2016
Springer Science+Business Media New York 2016
Abstract During the 2009 H1N1 pandemic, the World Health Organization (WHO),
acting under the authority of the International Health Regulations (IHR), recommended
against the imposition of trade or travel restrictions because, according to WHO, these
barriers would not prevent disease spread. Why did 47 states impose barriers anyway?
This article argues that states use barriers as political cover to prevent a loss of domestic
political support. This logic suggests that governments anticipating high domestic
political benefits for imposing barriers during an outbreak will be likely to do so.
Logistic regression and duration analysis of an original dataset coding state behavior
during H1N1 provide support for this argument: democracies with weak health infra-
structure—those that stand to gain the most from imposing barriers during an outbreak
because they are particularly vulnerable to a negative public reaction—are more likely
than others to impose barriers and to do so quickly.
Keywords International organizations
World Health Organization
On March 18, 2009, authorities in Mexico discovered the first cases of H1N1 influenza
(originally referred to as Swine Flu). Cases steadily rose in Mexico in the following
Rev Int Organ (2017) 12:365–395
Electronic supplementary material The online version of this article (doi:10.1007/s11558-016-9260-1)
contains supplementary material, which is available to authorized users.
* Catherine Z. Worsnop
Health Sciences Department, Worcester State University, Worcester, MA, USA