Implementation of International Health Law: A Challenge for the Future

Article excerpt

The panel was convened at 9:00 a.m., Friday, March 30, by its moderator, Fernando Gonzalez-Martin of the World Health Organization, who introduced the panelists: Gian Luca Burci of the World Health Organization; Lawrence Gostin of Georgetown University Law Center; and Bruce Plotkin of the World Health Organization.

INTRODUCTORY REMARKS BY FERNANDO GONZALEZ-MARTIN **

International health law is an expanding field. In 2003, with support of the World Health Organization Secretariat, the member states of that specialized agency of the United Nations adopted the Framework Convention on Tobacco Control and, more recently, the International Health Regulations (2005), which will enter into force on June 15, 2007. The number of international legal instruments and norms that deal with or affect health, however, are much more varied and are often considered soft law as opposed to hard law. Yet the challenges encountered in implementing these norms and agreements can be strikingly similar. This panel on the implementation of international health law aims to:

(1) survey the field of international health law and the dynamics of its expansion;

(2) give a concrete example of one particular international legal instrument and how it is being implemented: the International Health Regulations (2005); and

(3) identify some the key global health problems and future challenges that the international community has yet to address through law and regulation, and propose possible multilateral solutions.

A PROPOSAL FOR A FRAMEWORK CONVENTION ON GLOBAL HEALTH

By Lawrence O. Gostin ([dagger])

Why should rich countries care about the world's least healthy people? The reason why rich countries should care is that global health serves their national interests. Helping the most disadvantaged also is ethically the right thing to do. If international health assistance could be structured in a way that was scalable (sufficient to meet deep needs) and sustainable (to create enduring solutions), it would have a dramatic influence on the life prospects of the world's poorest populations.

Governments have no choice but to pay close attention to health hazards beyond their borders. DNA fingerprinting has provided conclusive evidence of the migration of pathogens from less- to more-developed countries. In fact, more than thirty infectious diseases have emerged over the last two-three decades. Wealthy countries, moreover, are less able to ameliorate these harms because many resurgent diseases have developed resistance to frontline medications.

Beyond narrow self-interest, there are broader, "enlightened" interests in global health. A forward-looking foreign policy would seek to redress extremely poor health in the world's poorest regions. Epidemic disease dampens tourism, trade, and commerce, as the 2003 SARS outbreaks demonstrated. Animal diseases such as foot and mouth disease, bovine spongiform encephalopathy, and avian influenza similarly had severe economic repercussions involving mass slaughter of animals and bans on trade.

In regions with extremely poor health, economic decline is almost inevitable. The World Bank, for example, estimates that AIDS has reduced GDP nearly 20% in the hardest-hit countries in Africa. Countries with extremely poor health become unreliable trading partners lacking the capacity to develop and export products and natural resources, pay for essential vaccines and medicines, and repay debt. Countries with unhealthy populations also require increased financial aid and humanitarian assistance. In short, a foreign policy that seeks to remedy health threats in poor countries can benefit the public and private sectors in developed, as well as developing, countries.

Extremely poor health in other parts of the world can affect the security of highly developed countries, as well. Research shows a correlation between health and the effective functioning of government and civil society. …