Development dimensions in International Relations: reflections on industry and health in times of pandemic

Abstract

This article presents the results of research on the effect of the coronavirus pandemic on the medical equipment industry in Argentina, focusing on the province of Buenos Aires. It is presented as a case study that contributes to generate reflections about the complex connection between the different dimensions of the concept of development.

The concept of development has been widely used in sociology and economics, but the discipline of International Relations ignored it for a long time frame. Therefore, from an international perspective, questions on development remained in the area of international economics and development studies. In Latin America, the first genuinely peripheral approach to development, structuralism, emerged also from the field of economics to discuss modernization theories. It promoted a new approach to development and industrialization to overcome the so-called underdevelopment of the region. Its central conceptual tool, dependency, was considered a fundamental pillar for Latin American International Relations and International Political Economy.

The discipline of International Relations expanded its scope, while the concept of development increasingly included other dimensions that were not strictly economic, such as health. The end of the Cold War implied an important challenge for considerations about the concept and the United Nations promoted a human development approach. This had practical effects which, for example, conditioned development cooperation: the percentage of official development aid allocated to the health sector between 1995-2000 and 2007-2011 went from 7 to 13%. This gave greater visibility to health in different reports and international meetings, such as the Commission on Health Research for Development or the Project on Priority Medical Devices of the World Health Organization, which drew attention to the incompatibilities of modern and technologically complex products and the (human, technological and infrastructure) resources available in low-income countries. This was followed by a series of publications on public policies, innovation, regulations, use, priorities and even conditions for the donations of medical equipment.

When the pandemic caused by the SARS-CoV-2 virus was declared, the WHO issued its list of priority medical devices for this illness, which served as a reference for the governments of the affected countries. However, the availability of these devices in regions, countries and local communities was highly uneven. At the international level, the demand for medical equipment increased notably, while different countries established export bans on those devices that were in short supply. Access to these resources became an indicator of the relative success or failure of countries in caring for the health of their citizens. The pandemic thus reinforced a certain homogenization in the priority given to medical products as indicators of development. Yet, at the same time, it generated opportunities to discuss their pertinence and relevance.

In this context, the supply capacity of these products in Argentina was at the center of concerns and facilitated a multiplication of policies to support the sector, as well as public-private initiatives for the production of medical equipment, both to face the pandemic and to strengthen this industrial sector in the future. The potential capacities of this sector, which until then had not been the target of specific policies, became evident. However, at the same time, a series of limiting factors were identified, linked to the country's position in the global medical equipment industry and to the structural economic difficulties that the country has historically faced.

This situation generated interest in more in-depth studies on the sector. Therefore, this article presents the characteristics of this sector in Argentina, and, in particular, the province of Buenos Aires, as well as the effects of the pandemic on it. The main part of the medical equipment industry is housed in this province. Buenos Aires represents 50% of the total manufacturing activity in the country. It is also the most populated province and this population has, at the same time, a wide margin of unsatisfied needs. In this analysis, questions about the convergence between the industrial and health dimensions, the role of public policies dedicated to one or the other, and the relevance of dedicating (material and/or human) public resources to an industrial sector, became evident. The goods produced by this sector may be a way of improving health, but they are neither the only way nor the sufficient means to do it; the social determinants of health have been widely recognized. Therefore, this case study recalls that, although the notion of development exceeds the industrial dimension, the exploration of the link between it and others, such as the health dimension, is complex and necessary.

To start this exploration, the research is carried out using a qualitative methodology, through bibliographic and documentary analysis, as well as in-depth interviews and statistical data. The article starts by synthesizing the main dimensions that formed part of the concept of development since the second post-war period, concentrating on the role given to industry and health in its evolution. It identifies the structuralist approach as a tool to understand the place of the Argentine industry in the structure of the global medical equipment market, concentrated in a few companies and countries that generate a large part of the production, sales and technology of the sector. It also identifies the circular way in which human development has conceived the relationship between health and economic development, underlining the role of social debate to define the priority each society gives to one or the other. In a second section, the paper synthesizes the characteristics of the medical equipment industry at a global level to facilitate locating the Argentine industry in this global structure. Finally, it presents the characteristics of the sector in Argentina, with a particular focus on the province of Buenos Aires: a marginal sector in terms of industrial income, which registers historical trade deficit and which, at the same time, shows potential industrial capacities in terms of innovation, technology and human resources. The effects of the pandemic for this sector were limited in terms of its economic indicators and historical industrial structure, but substantial in terms of visibility of the sector on the political agenda, which generated the mentioned opportunity to discuss the relevance and pertinence of dedicating public resources to foster it. In his way, the reflections triggered by the analysis of this specific case aim to enrich the research agenda of International Relations, in particular by encouraging debate on the relationship between health, industry and development.