Health Treaties, Authoritarianism, and Geopolitical Competition 

Abstract 

This article examines the risks posed by emerging bilateral treaties between a Western superpower characterized by racialized exclusion and commercialized health governance, and the contemporary Ethiopian state, marked by authoritarian rule, entrenched corruption, and ethnicized power. Using insights from public health, and historical precedent, it argues that in such alliances there is a risk in which health systems can be packaged as instruments of control rather than care. In a world where finance lures criminals medical professionals to trade with organ harvest, health cooperation, when embedded in opaque agreements and implemented under authoritarian conditions, risks enabling population management, reproductive coercion, and structural violence. The article warns that these dangers are not hypothetical but structurally predictable, and that failure to question intent, governance safeguards, and historical analogues risk repeating some of the gravest abuses of twentieth-century bio-politics. 

Health Treaties, Authoritarianism, and Geopolitical Competition 

Health systems are not neutral technical utilities; they are political institutions included in economic structures, state power, ideological, and nowadays ethnical priorities. When health governance is shaped by unaccountable authority and unbalanced international agreements, it can become a mechanism of domination rather than protection. This risk is particularly alarming in the context of emerging treaties between a Western superpower marked by racialized exclusion, profit-focused health governance, “my nation first” populist slogan, and authoritarian regimes such as Ethiopia’s, where corruption, repression, and ethnicized rule are structural features of governance.  

It is an extremely dangerous mix for the ordinary Ethiopian. When two detrimental forces interact, their combined impact can grow exponentially.

A central error in health cooperation is the belief that it is inherently benevolent. Yes, it can be, and it usually is – where governance is inclusive and accountable, health institutions tend to improve population well-being. But history repeatedly demonstrates the opposite too: health systems reflect the values and power relations of those who control them – where governance is authoritarian and corrupt, health is either ignored or weaponized. 

Empirical public health research consistently shows that the strongest determinant of population health is not the number of hospitals or the sophistication of medical technology, but the quality of the underlying economy. Income security, education, nutrition, housing, sanitation, and social protection are far more predictive of health outcomes than medical services alone – particularly in underdeveloped (sic!) countries. High-technology medicine without addressing economic exclusion treats symptoms while leaving causes intact. This distinction is critical when evaluating international health treaties: agreements that emphasize technical systems while ignoring political economy often worsen inequality and health parameters. The advanced health care available in industrialized nations cannot be directly compared to the severely limited services in low-income countries; the two health systems operate in fundamentally different contexts.

Western health models exported through treaties frequently prioritize insurance-based access, privatization, data extraction, and cost-efficiency. These features already produce racialized exclusion domestically. Empirical studies in the United States and Europe show that immigrants and marginalized populations often avoid hospitals due to fear of deportation, leading to delayed treatment and preventable deaths. When such models are transferred to weaker states with limited safeguards lacking institutions, the consequences are magnified. 

Historical precedent illustrates the stakes. The Tuskegee Syphilis Study, in which Black men were deliberately denied treatment, remains a canonical example of how medical systems can be mobilized against marginalized populations under scientific pretexts. More recent investigations have documented coerced sterilizations of incarcerated women, Indigenous communities, and migrants in democratic states, demonstrating that ethical collapse is not confined to totalitarian regimes. These cases are not anecdotal, they reveal a consistent pattern: where affected populations lack political power, medicine becomes a site of experimentation and global control up to this day. 

The Ethiopian context heightens these dangers. Governance analysts describe Ethiopia as a highly centralized, opaque political system in which corruption is systemic and ethnic affiliation is a matter of life and death. In such environments, health cooperation treaties, particularly those involving digital health systems, insurance expansion, reproductive health services, or data sharing – are exceptionally vulnerable to misuse. Allegations and concerns regarding uneven health access and potential coerced birth control targeting Amhara women in particular, now non-Oromo populations in general, must therefore be analyzed structurally rather than dismissed as speculative.  

The concern is not intent alone, but capacity: authoritarian regimes possess both the means and incentives to weaponize health systems, and the superpower have the means and incentives to dictate their own conditions.   

Here we can mention a structural – not rhetorical – parallel to Nazi Germany. In both cases, medicine and public health are bureaucratically mobilized to shape demographic outcomes without openly violating legal legitimacy. Population management does not require explicit violence; it operates through selective access, concealed lies, coerced consent, data-driven exclusion, and reproductive/population manipulation. AI can make such control selective, more precise, less visible, and easier to deny. 

The danger intensifies when authoritarian regimes partner with external powers whose own health systems tolerate racialized exclusion and prioritize corporate interests over universal/human care. From a political economic perspective, such alliances reward secrecy over transparency, efficiency over ethics, and control over care – all in the name of aid and free market. Health treaties negotiated under these conditions risk becoming instruments of indirect domination -what may be described as a contemporary form of colonization through governance, capturing regime weaknesses, rather than force. 

Public health evidence speaks clearly: the most effective health interventions are structural. A few examples are: preventing war, fostering inclusive economic growth, ensuring food security, improving sanitation and hygiene, education on life-style adjustment, addressing trauma, vaccinations, and providing universal primary care save more lives than technologically spectacular interventions detached from social justice. Advanced medicine is good, not inherently harmful; it becomes dangerous when marketed as a substitute for equity rather than its complement. 

When health policy is subordinated to geopolitical ambition, financial motives, global domination, and authoritarian consolidation, it ceases to function as a public good – it becomes simply commerce.  

Therefore, treaties need frameworks – respect for the no-harm principle, a human rights base,  some intuitive assessment of intent supported by transparency, assessment of impact on sovereignty of the weaker partner, defined shared responsibility on liabilities, on unintended consequences, and structured dispute resolution mechanisms between un-equals.  

Unaccountable treaties between racist superpowers and tyrannical regimes do not merely risk policy failure – they create the conditions for systematic harm. History suggests that ignoring these warning signs is not neutrality, but deliberate complicity. 

Editor’s Note : Views in the article do not necessarily reflect the views of borkena.com  

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