Over the past 15 years Monteverde, Costa Rica has undergone rapid economic, social, political, and environmental change due to a flourishing ecotourism economy. While the effects of ecotourism development in Monteverde are many, two important consequences have been: 1) the immigration of Nicaraguan nationals to the area seeking low-skilled wage labor; and 2) compromised water resources management due to pollution and rapid population growth. The objective of this research is to investigate and identify the inter-relationships between ecotourism development in Monteverde and its affect on infectious diseases outcomes within the context of immigration and water resources management. Specifically, this dissertation uses both anthropological and public health methods within a political ecology of health framework to compare prevalence rates of intestinal parasites between Nicaraguan immigrants and Costa Rican residents living in Monteverde. Results indicate that Nicaraguan immigrants suffer disproportionately from infections with intestinal parasites compared to Costa Rican residents. The results further indicate that community based water resources are not a significant source of infection. Instead, the prevalence of intestinal parasites is most likely the result of fecal-oral transmission at the household level and is related to indicators such as access to health care, underemployment, home ownership, and household sanitation infrastructure.

The purpose of this study was to explore the securitization of communicable disease in the case of the Ebola outbreak in West Africa 2014. Applying the Copenhagen School’s theory of securitization, this thesis conducted a discourse analysis of speech acts occurring at different levels of the global community in relation to the outbreak. The focus lay on two major events, namely the UN Security Council meeting on 18 September 2014 and the UN high-level meeting on Ebola a week later. Investigating to what extent the securitizing discourse apparent in Resolution 2177 which identified Ebola as a “threat to international peace and security” was upheld and justified by the speakers at these events, this study determined that Ebola virus disease has been “successfully” securitized on all levels of global governance. Despite the incredible amount of human suffering which the Ebola outbreak provoked in West Africa, the discourse employed by global governance identified the referent object nearly exclusively at the state-level. Further research is suggested in the concluding parts of this thesis that can build upon the findings of this study.

Infectious diseases attract a lot of mediatic, cultural and political attention. But are those diseases like Ebola, or ‘disease x’ actually what kills us? Since 1946, the WHO is the most authoritative figure in the fights against infectious disease outbreaks. So how does the WHO maintain this power and authority after tremendous budget cuts, competition for authority, and a shift to non-communicable disease epidemiology? This thesis uses a mixed-methods approach of quantitative analysis of ‘Disease Outbreak News’ reports, and qualitative analysis of key WHO literature, to develop the alternative narrative answering those questions. This thesis found that the WHO activities surrounding the collection and distribution of data create a political and institutional environment in which the WHO seems to be the only logical solution to prevent them. Additionally, the narrative put forth by the WHO prioritizes the ‘alert and response’ and operational capabilities of the organization to further expand authority in outbreak response. This study concludes that the WHO, through the collection and distribution of knowledge, and efforts to increase operational capability as seen through the Global Outbreak Alert and Response Network (GOARN), seeks to maintain normative authority and power as an international organization. / M.A. / Globalization of trade and travel has only increased the fear of infectious disease transmission. There is a great demand for a global health security system that is alert and capable. Based on this ‘threat’ the WHO justifies their role as global health leader. The Global Outbreak Alert and Response Network (GOARN) is the system that currently acts as the operational arm of the WHO, monitoring and coordinating response to infectious disease outbreaks globally. Despite the critical role of GOARN, its day-to-day endeavors remain unexplored by the public health field. This thesis analyzes how the WHO uses GOARN and its surveillance capabilities to collect and transform data as a method to maintain normative authority, and projects a powerful narrative as the leader of ‘alert and response’. In a competitive environment with limited financial resources, the WHO has adapted in terms of surveillance and operational capability to maintain its leadership and authority in the global public health field.

This dissertation examines the rise of global health assistance among states, multilateral institutions and NGOs. Resources devoted to global public health expanded rapidly in the 1990s and 2000s, outpacing other areas of development. New agencies have emerged to address public health issues, and existing organizations such as the UNDP, World Bank and EU have expanded their global health operations. Critics fear that the global health regime will become inefficient as it grows, duplicating tasks and skewing resources. The regime complex literature predicts similar suboptimal outcomes. These fears are overblown. While certain inefficiencies are likely as any regime expands, data shows that the allocation of resources generally reflects global health needs. Increased competition, thought to lessen efficiency, has actually pressured multilateral actors to specialize. Specialization offsets the problem of overlapping tasks. The modern global health regime is characterized by increased size, competition, specialization, and a prevailing consensus that emphasizes health as a central component of international development. This consensus holds that societal health prefigures economic growth. The international community, moreover, should cost effectively use increased aid to address the worst disease burdens in the poorest countries. In the cases of states, domestic interests play a role in shaping specialization patterns. Pressure from increased international competition has pressed multilateral institutions to reform and adapt to changing conditions in order to remain relevant in a denser global environment. The diverse cases explored in this dissertation (US, Japan, Sweden, Canada, World Bank, WHO, UNDP and EU) show high degrees of specialization and a surprisingly similar adherence to the consensus. / Political Science