COVID-19 and World Order: The Future of Conflict, Competition, and Cooperation

Victor S. Sierpina, MD

Fam Med. 2021;53(4):311-312.

DOI: 10.22454/FamMed.2021.648972

Book Title: COVID-19 and World Order: The Future of Conflict, Competition, and Cooperation

Edited by Hal Brands and Francis J. Gavin

Publication Information: Johns Hopkins University Press, Baltimore, 2020, 472 pp., $29.95


COVID-19 and World Order is a collection of essays edited by Hal Brands and Francis J. Gavin from the Johns Hopkins University School of Advanced International Studies and the Henry A. Kissinger Center for Global Affairs, respectively, with their colleagues from similar institutes and think tanks.

The book is organized into seven parts: Applied History and Future Scenarios; Global Public Health and Mitigation Strategies; Transnational Issues; Technology, Climate, and Food; Future of the Global Economy; Global Politics and Governance; Grand Strategy and American Statecraft; Sino-American Rivalry.

The instigating and unifying theme of the book is the pandemic and how it will affect all our lives going forward. It likens the impact of the pandemic in historical scope and rapidity to the two major world wars in the past century. I found this opening section a compelling comparison. Those wars shook the foundations of civilization, nations, commerce, diplomacy, and reordered the world.

Such a reordering is now taking place. While it does, we must make sure our health care systems including our public health programs are fully prepared and reinvented.

Perhaps most salient to practicing and teaching family doctors is the identification of the weaknesses of our public health systems worldwide. If we fail to recognize and respond to these issues, from problems in nursing homes to food supply to the environment, we will have missed a major opportunity to improve the health of our planet.

Dr Lainie Rutkow, author of the chapter, “Origins of the COVID-19 Pandemic and the Path Forward: A Global Public Health Policy Perspective” attests that public health is an “invisible discipline.”1 This is a striking statement as public health measures from sanitation, safe food and water supplies, widespread immunization programs, smoking cessation campaigns, and containment of epidemics like AIDS, SARs, malaria, cholera, yellow fever, tuberculosis, and many more have lengthened both quality and quantity of life throughout the world.

Perhaps we have become lackadaisical and take these advances as a given, as part of our infrastructure. Such advances in public health have created enormous impacts, extending life expectancy and reducing infant mortality globally over the last century. In so doing, perhaps we have unwittingly created the very overpopulation that has set the stage for future pandemics. Resultant environmental disruption, zoonosis, and viral spillovers will likely continue.

Only when the infrastructure fails do we take notice. The COVID crisis points to the fault lines and vulnerabilities of public health measures locally, nationally, and internationally. According to several authors in the book, the failures of the World Health Organization, overly influenced by financial support and political pressure from China, delayed the announcement of the Wuhan person-to-person infection for critical weeks while it spread globally by international travel.

Former Centers for Disease Control and Prevention Director Tom Frieden poses the question in a different forum of how we prepare the world for the inevitable next pandemic threat:

Public health systems world-wide need much better tracking systems to sound an early alarm, as well as laboratory networks to find new diseases, detectives to investigate them, rapid-response teams to tackle them, and legal, communication and financial frameworks to make all that possible. We will also need better primary care world-wide to deliver vaccines and manage chronic conditions. As an investment for wealthier countries, international organizations, and NGO’s, this is a bargain: Every dollar spent on global health security could save $100 or more in the costs of future pandemics. Like earthquakes, we know they are coming, even if we don’t know where or when. We were caught unprepared this time; that shouldn’t happen again.2

I was intrigued by the book’s title and contend that the public health focus could have been more front and center, with issues critical to those of us on the front lines facing a pandemic: epidemiology and public health, the role of primary care, vaccine distribution and administration, health care financing, access, and health care disparities.

More material from experts like Dr Frieden in health care would have strengthened the book for family doctors interested in the big picture, including geopolitics. In conclusion, this book is a good faith attempt to prognosticate an uncertain post-COVID world from a broad range of well-versed, articulate authors.


  1. Rutkow L. Origins of the COVID-19 Pandemic and the Path Forward: A Global Public Health Policy Perspective. In: Brands H, Gavin FJ, eds. COVID-19 and World Order. Baltimore: Johns Hopkins University Press, 2020: 94-96.
  2. Frieden, T. The Vaccine Solution—If We Handle It Right. Wall Street Journal, Dec 5-6, 2020: C1-2.

Lead Author

Victor S. Sierpina, MD

Affiliations: University of Texas Medical Branch – Family Medicine, Galveston, TX

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