المجلة الجزائرية للأمن والتنمية
Volume 15, Numéro 1, Pages 132-147
2026-01-01
Health As A Power Issue In The International System: Deconstructing The Authority Of Big Pharma
Authors : Bouhris Mohamed Seddik . Zeggagh Adel .
Abstract
This article argues that health has moved from a matter of human welfare to a central dimension of power in the international system. The ability to develop medicines and vaccines and to control their circulation now functions as a strategic resource for states and large private actors. The article conceptualizes “health power” as three-dimensional: materially, it rests on technological monopolies and control over production and supply chains; institutionally, it is embedded in intellectual property rules, trade agreements, and pricing regimes; discursively, it relies on the authority to define scientific truth and to frame the meaning and limits of the right to health. Drawing on International Relations theory and Steven Lukes’s three-dimensional view of power, the article examines how Big Pharma exercises authority through lobbying and confidential contracting, by shaping market rules, intellectual property and financial arrangements, and by steering procurement, clinical evidence, and ethical standards that govern medical knowledge. It concludes that reforming global health governance requires redistributing this power through legal and institutional change and through the democratization of knowledge production and circulation. Any serious critical agenda must connect the dismantling of pharmaceutical monopolies with sustained support for Global South initiatives in pharmaceutical manufacturing and open, non-proprietary innovation.
Keywords
Health power ; Big Pharma ; global health governance ; intellectual property regimes ; pharmaceutical monopolies
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