SOCIAL COHESION, GLOBAL GOVERNANCE
AND THE FUTURE OF POLITICS

Multilateralism with Multiple
Layers and Strengthening theBase of National Capacity
Hideaki SHIROYAMA (The University of Tokyo)
Submitted on March 15, 2019
Revised on June 6, 2019

Abstract
The field of management of risks caused by globalization has been thefields where multilateral frameworks have been extensively used. But
multilateralism also has its critics, while there are also challenges based on
unilateralism. This paper clarifies what types of criticism and challenges
are active concerning multilateralism so far on the issues of global healthand climate change policies. The facts shown indicate a certain level ofresilience of multilateralism in these particular fields. At the same time,measures for Strengthening multilateralism with multiple layers and thecapacity of each country are necessary in order to further strengthen
multilateralism.

Social Cohesion, Global Governanceand the Future of Politics
Challenge
Globalization has increased the movement of people, things, and information
while also encouraging the progress of science and technology. Yet at the sametime this has brought about various risks. This field of risk management andcrisis management has seen the fields where multilateral frameworks havebeen extensively used. But multilateralism also has its critics, while there arealso challenges based on unilateralism. This paper seeks to clarify what typesof criticism and challenges are active with the accumulation of multilateralism
so far on the issues of global health and climate change policies. Having doneso, it will also consider what policies might be required and recommended.

Multilateralism and its criticism- the case of global health
Health has required multilateral responses across borders since the expansionof international trade from the latter half of the nineteenth century. Initiallythere was debate over the effectiveness of preventive measures due to the lackof knowledge regarding infection mechanisms, but the growth of science andaccompanying reduction of uncertainty led to the signing of an international
sanitary convention in 1893, and the establishment of the International Health
Office in 1907 (Shiroyama 1997). After the First World War, the League of
Nations incorporated the Health Organization, while after the Second World
War the World Health Organization (WHO) was established.
The basis of these multilateral systems for international health administration
were systems to notify and share information on disease outbreaks. But the
notifications were limited in their scope. The scope of International Sanitary
Regulations (ISR) enacted in 1951, later renamed as the International HealthRegulations (IHR) in 1961, were limited to yellow fever, cholera, and plague.
The IHR was thus unable to deal with health crises caused by new or resurgent
infectious diseases in recent years such as SARS or avian influenza. The need todeal with intentional spread of pathogenic caused by new threats such as
terrorism has also been pointed out.

2Social Cohesion, Global Governanceand the Future of Politics
In 2005 the IHR underwent a major revision to respond to these challenges(Shiroyama 2016). Firstly, the revised IHR now adopts an all hazards approach.
This all hazards approach requires reporting to WHO for all events which may
constitute “a public health emergency of international concern” (Article 6),
regardless of the causes. This applies to chemical and radioactive substances aswell as diseases. Secondly, WHO can ask relevant countries to cross-check orverify information acquired from various channels (Article 10), allowing it tomake active use of unofficial sources. Thirdly, National IHR Focal Points are to
be set up to maintain constant contact with WHO (Article 4). Fourthly, member
countries are expected to secure, within five years of the regulations coming
into effect, core capacity for discovery, evaluation, notification and reporting(Article 5). The all hazards approach adopted in this way focuses not merely on
naturally occurring but also man-made crises, requiring the formation of wideranging institutional networks on both a domestic and international level.
In 1997 the Global Outbreak Alert and Response Network (GOARN) wasestablished, officially becoming a program of WHO in 2000 (Heymann andRodier 2004). Expert network programs like GOARN were vital sources of
information allowing WHO to act with a certain level of autonomy when the
Chinese government proved reluctant to provide information during the 2003
SARS outbreak (Motoda, 2008). GOARN picked up information on an unnatural
outbreak in Guangdong in February 2003, providing this and reports on
Vietnam and Hong Kong to the WHO director-general, who then communicatedconcerns to the Chinese authorities in early March 2003. The Chinese Ministryof Health finally acknowledged the outbreak of SARS in Guangdong at the endof March 2003 (Heymann 2006).
But doubts over the efficacy of such multilateral mechanisms were highlighted
by the spread of infection in the 2014 Ebola outbreak primarily affecting thethree West African countries of Guinea, Sierra Leone, and Liberia. The NGO
Médecins Sans Frontières (MSF) emphasized the seriousness of the situationfrom the outset, yet WHO failed to respond quickly, leading ultimately tofatalities of over 10,000. The WHO Director-General recognized the spread ofEbola as a public health emergency of international concern (PHEIC) in August
2014, but by this stage the disease was difficult to control. As a result, in
September, under the initiative of the Secretary-General of the UN, the UN
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Social Cohesion, Global Governanceand the Future of Politics
Mission for Ebola Emergency Response (UNMEER) was established through a
resolution of the UN General Assembly and Security Council as the first mission
to respond to a global health threat. A large-scale team dressed in military-styledark camouflage uniforms was dispatched.
WHO faced widespread international criticism for its slow handling of this case.
Against this background of fault-finding, WHO itself took the lead in making
changes. Firstly, it recognized the need for a program to combine healthsecurity and humanitarian emergency response, ultimately leading to thedecision in the World Health Assembly (WHA) in May 2016 to form a concrete,
integrated program. The limited framework to procure funds for immediate use
in emergencies was another reason behind the delayed response. Accordingly,
WHO consented to set up the Contingency Fund for Emergencies (CFE) with
100 million dollars. Secondly, there were issues with implementation of the
IHR, particularly with formation of core capacity in developing countries, andstrengthening functions to evaluate the status of IHR implementation. The
WHA set up a Review Committee on the Role of the International HealthRegulations in the Ebola Outbreak and Response in 2015. This committee
submitted its report to the WHA in 2016. It recommended that (a) international
institutions such as WHO and the World Bank should provide funding for
implementing IHR core capacity, and (b) that core capacity, which up until thattime had been virtually entirely self-assessed, would undergo joint external
evaluation including outside persons by the end of December 2019, and to becontinued every five years hence (WHO A69/30).
WHO’s slow response to the Ebola outbreak led to the establishment of
UNMEER under the initiative of the secretary-general of the UN, and in
subsequent action the UN led a general multilateral framework. In April 2015,
a high-level panel was set up under the instigation of the UN Secretary-General,
to work toward the preparation of recommendations to strengthen domestic
and international level systems relating to prevention and response to future
health crises, based on the lessons learned from Ebola. In January 2016 it
published its report, titled Protecting Humanity from Future Health Crises (UN2016).
Developed countries like Germany and Japan supported this bolstering ofgovernance on a global health. The USA has been a primary source of funding
4Social Cohesion, Global Governanceand the Future of Politics
for global health, gaining domestic nonpartisan support for this aid (KFF,
2018b). The monetary amount from the USA has expanded from 2004, reachinga stable level at around 10 billion dollars from 2010. But since theestablishment of the Trump administration in the USA, the amount of funding
for global health requested from the US administration has declined. For
example, the sum for fiscal 2018 was 7.9 billion dollars, over 20% down on
fiscal 2017's 10.4 billion (Kates et al., 2018), while the fiscal 2019 budget
request figure for the GHSA is reduced to two-thirds the GHSA’s request ofprevious year (Youde 2018). This is generating a sense of crisis among those
involved (Kates et al., 2017).

Multilateralism and its criticism- the case of climate change
The problem of climate change has placed the demand for international
measures by national governments following the consensus on the outlook for
global warming presented by scientists at the 1985 conference held in Villach,
Austria. Following this, the WMO and UNEP combined efforts in 1988 for theestablishment of the Intergovernmental Panel on Climate Change (IPCC).
In 1990 the Intergovernmental Negotiating Committee for a Framework
Convention on Climate Change (INC/FCCC) was established under a resolutionof the UN General Assembly (Resolution 45/212). The INC/FCCC, after fiverounds of negotiations, adopted the United Nations Framework Convention on
Climate Change (UNFCCC) in May 1992. During the negotiating process thedeveloping countries asserted that the developed countries were primarily
responsible, and on that basis Article 3.1 of the UNFCCC states that “The Parties
should protect the climate system for the benefit of present and future
generations of humankind, on the basis of equity and in accordance with theircommon but differentiated responsibilities and respective capabilities.
Accordingly, the developed country Parties should take the lead in combatingclimate change and the adverse effects thereof.” (Takamura 2011). The
European countries asserted the need for the developed countries to adopt
reduction targets, but the USA stated it would only cooperate in monitoring,
maintaining that countries should not be subject to obligations for emission
reductions. As a result, the UNFCCC remained limited to having low binding
5Social Cohesion, Global Governanceand the Future of Politics
force on emission reduction targets for developed countries. Negotiations thenbegan seeking to institute reduction targets for developed countries withgreater binding force. The Kyoto Protocol agreed upon in 1997 placed a greater
emphasis on reduction targets, obliging the developed countries to reducegreenhouse gas emissions to set amounts for the five years the firstcommitment period) from 2008 to 2012 (Kameyama 2011).
But in 2001 the USA, under the Bush administration, announced that it would
not ratify the Kyoto Protocol, which was subsequently enacted in 2005 as aframework without the participation of what was then the country with thelargest emissions. Canada also announced it was withdrawing from the Kyoto
Protocol at the end of 2011. As this process shows, so far the top-down
approach of setting reduction targets with binding force from the viewpoint ofenvironmental regulations on developed countries has struggled to function
effectively.
Debate on a successor to the Kyoto Protocol tapered off. The United Nations
Climate Change Conference in Copenhagen in December 2009 (COP 15) was
attended by over 110 world leaders, including President Obama. The
Copenhagen Accord was formulated at the conference, but countries such as
Venezuela, Bolivia, Cuba, and Sudan criticized it for the lack of transparency andopenness in its preparation. In the end, the COP delegates only “took note” ofthe accord rather than adopting it (Takamura 2011). President Obama of the
USA showed a positive stance regarding the accord, but in the end, he could not
obtain official agreement on it. Given this situation, efforts were then made to
break with convention and use a bottom-up approach.
Specifically, bilateral efforts between the USA and China made progress (Cheng2017). Both countries prepared conditions enabling international cooperation.
Since 2008, China has reduced its use of coal as energy while maintaining its
high economic growth. This was due to tougher environmental regulations andthe addition of energy and environmental indicators to performance evaluation
items for local governments officials, as well as higher prices for coal following
a revision of the coal pricing system (Horii 2016). For the USA, President
Obama's attempt to demonstrate leadership at the Copenhagen Conference in2009 did not succeed, and domestically his emissions trading plan (American
Clean Energy and Security Act) reached a deadlock in the Senate in 2010.
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Social Cohesion, Global Governanceand the Future of Politics
Subsequently, in Obama’s second term from 2013, action moved forward under
the presidential authority. In June 2014 the Clean Power Plan was formulated
to set emission standards for existing domestic thermal power plants (Ueno
2016). While this was going on, the Joint US-China Climate Change Working
Group was set up in April 2013, followed by a joint statement by President
Obama and General Secretary Xi Jinping in November 2014 (Cole 2015).
The Paris Agreement was adopted at COP 21 in December 2015, and enteredinto force in November 2016. In this framework, each country will regularly
report its progress in achieving Nationally Determined Contributions (NDCs),
these reports allowing an overall global picture to be determined. This is
described in Article 14.1: “The Conference of the Parties serving as the meetingof the Parties to the Paris Agreement shall periodically take stock of theimplementation of this Agreement to assess the collective progress towards
achieving the purpose of this Agreement and its long-term goals (referred to as
the “global stocktake”). It shall do so in a comprehensive and facilitative
manner, considering mitigation, adaptation and the means of implementationand support, and in the light of equity and the best available science.”
As of February 2019, 194 countries and the EU have signed the Paris
Agreement. However, the US Trump administration announced its withdrawal
from the Paris Agreement, and is also dismantling domestic measures. There
are also doubts as to whether the goal of keeping the temperature rise within
two degrees above pre-industrial levels is actually feasible. Taking these facts
into account, it seems multilateralism for climate change measures is underchallenge.

Proposal
The facts shown indicate a certain level of resilience of multilateralism in theseparticular fields. At the same time, steps such as those outlined below arenecessary in order to further strengthen multilateralism.

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Social Cohesion, Global Governanceand the Future of Politics
Strengthening multilateralism with multiple layers
Strengthening multilateralism requires dedicated, functional organizations,such as WHO for global health or climate change treaty or agreement bodies(including secretariats). It also requires the formation of frameworks withmultiple layers between diverse nations.
Firstly, it is necessary to actively utilize frameworks involving powerfulcountries such as the G7/G8 or G20. The G7 summits in 2015 (Germany) and2016 (Japan), and at G20 summits in 2014 (Italy) and 2017 (Germany) playeda major role in the reforms of global health governance following the Ebola
outbreak at. The leaders’ declaration concerning Ebola at the G20 summit heldin 2014 indicated commitment to complete IHR implementation andsupporting capacity development for that. The G7 summit in 2015 indicatedsupport for implementation of the IHR and for the ongoing process oftransforming and upgrading the capacity of WHO. Furthermore, the 2016 G7
summit pointed out the importance of ensuring sound health systems, and theneed for WHO reform, funding mechanisms to rapidly procure contributions,cooperative implementation between related stakeholders and systems, and aeffective implementation of the IHR.
For climate change measures, “Gleneagles Process” began at the G8 summit
held in the UK in 2005. Dialogue also opened at the G20, which includes 20
countries with fast-growing economies such as China, India, South Africa,
Brazil, and Mexico.
Secondly, it is essential to actively utilize transnational networks connecting
private sector organizations, experts, and local governments. In the case of
global health, the GOARN (Global Outbreak Alert and Response Network)
network of experts played a major role. GOARN was established in 1997 as a
network of existing organizations at expert level. This network pools humanand technological resources to gather, verify, and act on information
concerning major international infectious disease outbreaks. GOARN functions
as a network of exports at then nongovernmental level rather than that ofcentral governments.

8Social Cohesion, Global Governanceand the Future of Politics
For climate change measures, the International Panel on Climate Change (IPCC)
also plays a key role as a network of experts in an intergovernmentalorganization. The IPCC has aspects of both being a panel of experts and anintergovernmental panel. The IPCC's summaries for policymakers included in
the assessment reports of its working groups and task force are studied line byline by the representatives of each country, the political requirements of eachnation being reflected through their consent. At the same time, it also has acertain level of social trust as an expert organization.
Networks of local governments are also starting to play a greater role in climatechange measures (Bulkeley 2010, Gordon and Johnson 2017). Efforts to copewith climate change by cities in North America and Europe from the early
1990s led to the formation of a network called the International Council for
Local Environmental Initiatives (ICLEI). A second wave of locally led action
occurred next around 2005, with local government involvement shifting froma symbolic to practical level (Gordon and Johnson 2017). One example is C40,
formed through a meeting of 18 major cities convened by Ken Livingstone, themayor of London, in October 2005. The private sector Clinton Climate Initiative
was invited to join in 2006, bringing the number of participating cities to 40.
Since then it has held a summit at San Paulo, and worked with the World Bankand ICEI. In 2011 Arnold Schwarzenegger, the former governor of California,
established the R20 Regions of Climate Action, with the aim of promoting
investment in infrastructure for a green economy at the local government level,collaborating with the UN, NGOs, and corporations.
This mobilization at the city level occurred in the preparatory process to thesigning of the Paris Agreement in 2015 (Hale 2016). The Lima-Paris Action
Agenda (LPAA) was established as a stepping stone to the Paris Agreement(Gordon and Johnson 2017). Over 10,000 companies and cities have pledged
their commitment to it (Hale 2016). As a result of these actions, they werereferred to as non-Party stakeholders at COP 21 in Paris in 2015 (Hale 2016).
The draft of the Paris Agreement adopted in December 2015 mentions inparagraph 118 that it “Welcomes the efforts of non-Party stakeholders to scale
up their climate actions, and encourages the registration of those actions in the
Non-State Actor Zone for Climate Action platform (NAZCA)”.

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Social Cohesion, Global Governanceand the Future of Politics
Strengthening the core capacity of each country
Boosting the core capacity of each country is an essential component forstrengthening multilateralism. Countries must be a basic source of support for
multilateralism, rather than being taken over as a critic of it.
Commitment at a national level is essential to ensure the effectiveness ofmultilateralism. For global health, ultimately the core capacity of each country
must be secured. But doing so is quite difficult for developing countries. The
reports of the countries themselves indicate the limited level achieved, and infact by the end of 2012, the initial completion deadline, only 42 of 192
signatories had attained this goal. There was also a serious problem withstrengthening functions to assess the IHR implementation status. The reportsubmitted in 2016 to the WHO General Assembly by the Review Committee on
the Role of the International Health Regulations in the Ebola Outbreak andResponse recommended that member countries complete joint external
evaluations (JEE) incorporating outside agencies.
For climate change measures, nationally determined contributions (NDCs)
have been set as goals as shown in the Paris Agreement. Each country will play
the main role in reporting and verifying these. Article 4.2 of the Paris
Agreement states that “Each Party shall prepare, communicate and maintainsuccessive nationally determined contributions that it intends to achieve.
Parties shall pursue domestic mitigation measures, with the aim of achieving
the objectives of such contributions.” Furthermore, Article 4.9 states that “EachParty shall communicate a nationally determined contribution every five
years…and be informed by the outcomes of the global stocktake referred to in
Article 14.” This shows how securing capacity at national levels is a key elementin multilateralism.
For countries to act as sources of support to underpin multilateralism,
multilateral domestic systems also play a vital role. In the USA, the Trumpadministration tried to greatly reduce the budget for global health and thebudget of the Environmental Protection Agency (EPA), which is necessary for
global health and environmental policies, but was unable to do so. This was
because an independent congress resisted the budget cuts. As an example, since
the establishment of the Trump administration in the USA, the amount of
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Social Cohesion, Global Governanceand the Future of Politics
requests for funding for global health from the US administration has declined.
But congress increased the amount in 2018 to 10.8 billion dollars (KFF, 2018c).
The figures in 2019 are at almost the same level as the previous year for major
institutions such as USAID, the Department of State. US funding to WHO was
520 million dollars in fiscal 2017, higher than the fiscal 2016 figure (KFF
2018a).
The Search for Collaborative Areas under Multilateralism
It is essential to search far and wide under multilateralism for areas wherecollaboration can be achieved in order to strengthen global social cohesion.
Examples are the co-financing of infrastructure investments in various fields by
the Asian Development Bank (ADB) led by the USA and Japan and the AsianInfrastructure Investment Bank (AIIB) led by China.
The field of international health also offers areas where China and the USA canseek collaboration. Though the USA is opposed to Universal Health Coverage(UHC), it is providing aid to strengthen health systems in African nations under
the framework of the Global Health Security Agenda (GHSA), from thestandpoint of promoting health security. China, at the same time, has developed
its domestic health capabilities since SARS in 2003, achieving the IHR corecapacity and forming a strong surveillance system. Based on these, it isproviding aid to strengthen health systems in African nations. Also, as part of
the One Belt One Road Initiative, it held a health conference for the countries
involved in the policy in August 2017, issuing the Beijing Communique, withthe aim of formulating a One Belt One Road health cooperation plan by 2020.
These efforts by the USA and China show sufficient ground for cooperation
together, such as in helping to strengthen health systems in African nations.

References• Harriet Bulkeley (2010) “Cities and the Governing of Climate Change”, Annual
Review of Environmental Resource , Vol. 35.

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Social Cohesion, Global Governanceand the Future of Politics• Fang-Ting Cheng（2017）, Complex Regime and Climate Change Negotiation:
Conflict to Cooperation between the USA and China, and Paris Agreement ,Tokyo, Gendai Tosho (in Japanese).

• Daniel H. Cole (2015), “Advantages of a Polycentric Approach to Climate
Change Policy”, Nature Climate Change Vol. 5.

• David J. Gordon and Craig A. Johnson (2017), “The Orchestration of Global

Urban Climate Governance: Conducting Power in the Post-Paris Climate
Regime”,• Environmental Politics , Vol. 26-4.
• Thomas Hale (2016), ““All Hands on Deck”: The Paris Agreement and Nonstate
Climate Action”, Global Environmental Politics , Vol. 16-3.

• David L. Heymann (2006), “SARS and Emerging Infectious Diseases: A

Challenges to Place Global Solidarity above National Sovereignty”, Annals
Academy of Medicine , Vol. 35-5.

• David Heymann and Guenael Rodier (2004), “Global Surveillance, National
Surveilance, and SARS”, Emerging Infectious Diseases , Vol. 10-2.

• Nobuhiro Horii （ 2016 ） , “Coal and Energy Issues in China and Climate
Change Policy ”, Aji Ken World Trend , Vol. 245 (in Japanese).

• Yasuko Kameyama （2011）, ”Framework of Climate Change Regime from the
Perspective of International Relations”, in Yasuko Kameyama and Yukari
Takamura eds., Climate Change and International Cooperation: The Kyoto
Protocol and the Future of the Multilateralism , Tokyo, Jigakusha Shuppan (inJapanese).

• Jen Kates, Adam Wexler, Josh Michaud and John Stover (2017), “What Could
U.S. Budget Cuts Means for Global Health?”, The Henry J. Kaiser Family
Foundation.

• Jen Kates, Josh Michaud, Ashley Kirzinger and Cailey Munana (2018), “A Check

Up on U.S. Global Health Policy, After One Year of the Trump Administ ration”,
The Henry J. Kaiser Family Foundation.

• KFF (2018a), “The U.S. Government and the World Health Organization”, The
Henry J. Kaiser Family Foundation.

• KFF (2018b), The U.S. Government Engagement in Global Health: A Premier,
The Henry J. Kaiser Family Foundation.

• KFF (2018c), “U.S. Global Health Budget: Overview”, The Henry J. Kaiser
Family Foundation.

• Yuka Motoda（2008）, “Measures against Infectious Disease across Borders”,
Ken Endo ed., Frontiers of Global Governance- between Past and Present ,Tokyo, Toshiondo (in Japanese).

12

Social Cohesion, Global Governanceand the Future of Politics• Hideaki Shiroyama, Yasushi Katsuma and Matsuo Makiko (2016) "Rebuilding
Global Health Governance - Recommendation for the G 7", PARI Policy Brief(http://pari.utokyo.ac.jp/publications/policy_brief_160513_globalhealthgovernance.pdf ).

• Hideaki Shiroyama （ 2016 ） , “Complex Risk and Global GovernanceDevelopments and limits of Functional Approach”, Atsushi Sugita ed., Politics
under Globalization , Tokyo, Iwanami Shoten (in Japanese).

• Hideaki Shiroyama (2018）, Science, Technology and Politics , Kyoto, Minerva
Shobou (in Japanese).

• Yakari Takamura (2011 ）, ”Meaning and Issues of Climate Change Regime
from the Perspective of International Law”, in Yasuko Kameyama and Yukari
Takamura eds., Climate Change and International Cooperation: The Kyoto
Protocol and the Future of the Multilateralism , Tokyo, Jigakusha Shuppan (inJapanese).

• Takahiro Ueno （ 2016 ） , “Climate Change Policy of 2 nd Term of Obama
Administration and Its Future”, Aji Ken World Trend , Vol. 245 (in Japanese).

• UN(2016), "Protecting Humanity from Future Health(http://www.un.org/News/dh/infocus/HLP/20160205_Final_Report_Global_Response_to_Health_Crises.pdf ).

Crises"• Jeremy Youde (2018), “The Securitization of Health in the Trump Era”,
Australian Journal of International Affairs , Vol. 72-6.

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