LSTS Oration 2026 - Sovereignty and Global Health: Seeking the Political Kingdom

Sovereignty has come to the fore in global health, eclipsing the humanitarian values and Post-Westphalian governance model dominant since the late 1990s. Its return has been driven by experience during Covid-19, when global north states hoarded vaccines and imposed discriminatory restrictions on travellers from the global south. Concerned about the resilience of domestic health systems and the dependability of erstwhile partners given deep funding cuts, African leaders have adopted ‘health sovereignty’ as their common aim. Academics critical of the World Health Organization’s performance during the pandemic argue for national autonomy as a practical necessity and a moral imperative. Under its ‘America First Global Health Strategy’ the Trump administration too is committed to promoting sovereignty as a common goal. In place of multilateralism and engagement with non-governmental organizations, it favours bilateral, state-state deals which make health aid conditional on the promotion of US corporate and state interests. In turn these agreements have been challenged by activist litigants and repudiated by (some) governments invoking values of self-determination and south-south solidarity. ‘Sovereignty’ as deployed in these initiatives bears a variety of meanings, each shaped by histories of empire and nation. The tension between them is evident in current controversies over data-extraction provisions in Kenya’s health co-operation agreement with Washington, and the establishment of a quarantine station there for American citizens coming from Ebola affected regions of the Democratic Republic of Congo. The contest over sovereignty in these cases and their wider implications for global health can be clarified with reference to the goal of freedom from domination articulated by African thinkers and activists in the period of formal decolonization, and revived by critics of post-independence authoritarianism. Sovereignty on this republican model has two inextricably related dimensions, namely freedom of the state from external domination, and freedom of the individual from internal domination. Each is in play in the struggles playing out in Kenya in 2026. We follow Kwame Nkrumah, turning to the ‘political kingdom’ in order to understand the present and the future of global health. Refreshments will be served from 5pm in the foyer outside the Law Library, with the lecture commencing from 6pm.