International Law and Communicable Diseases. (Theme Papers)

By Aginam, Obijiofor | Bulletin of the World Health Organization, December 2002 | Go to article overview

International Law and Communicable Diseases. (Theme Papers)


Aginam, Obijiofor, Bulletin of the World Health Organization


Abstract Historically, international law has played a key role in global communicable disease surveillance. Throughout the nineteenth century, international law played a dominant role in harmonizing the inconsistent national quarantine regulations of European nation-states; facilitating the exchange of epidemiological information on infectious diseases; establishing international health organizations; and standardization of surveillance.

Today, communicable diseases have continued to re-shape the boundaries of global health governance through legally binding and "soft-law" regimes negotiated and adopted within the mandate of multilateral institutions--the World Health Organization, the World Trade Organization, the Food and Agriculture Organization, and the Office International des Epizooties. The globalization of public health has employed international law as an indispensable tool in global health governance aimed at diminishing human vulnerability to the mortality and morbidity burdens of communicable diseases.

Keywords Communicable disease control/legislation; Public health practice/legislation; Epidemiologic surveillance; Disease outbreaks/legislation; International law; Treaties; Intersectoral cooperation; Interinstitutional relations; World Health Organization (source: MeSH, NLM).

Mots cles Lutte contre maladie contagieuse/legislation; Exercice en sante publique/legislation; Surveillance epidemiologique; Epidemie/legislation; Droit international; Traites; Cooperation intersectorielle; Relation interinstitutionnelle; Organisation mondiale de la Sante (source: MeSH, INSERM).

Palabras clave Control de enfermedades transmisibles/legislacion; Practica de salud publica/legislacion; Vigilancia epidemiologica; Brotes de enfermedades/legislacion; Derecho internacional; Tratados; Cooperacion intersectorial; Relaciones interinstitucionales; Organizacion Mundial de la Salud (fuente: DeCS, BIREME).

Bulletin of the World Health Organization 2002;80:946-951.

Introduction

While most scholars trace the origin of international law to the Treaty of Westphalia of 1648, which ended the Thirty Years War, and led to the evolution of the nation-state concept, communicable diseases did not come within the normative confines of international law until the mid-nineteenth century.

The "transnationalization" of infectious diseases across geopolitical boundaries during the European cholera epidemics of 1830 and 1847 catalysed the evolution of the earliest multilateral governance of communicable diseases. Thus, the link between international law and communicable diseases is rooted in the mid-nineteenth century, more precisely in 1851, when France convened the first International Sanitary Conference. Notwithstanding more than the 150 years of subsequent multilateral linkage of law and communicable diseases, contemporary multilateral/global health governance continues to evoke debate in public health discourses. What then is the relevance, if any, of international law in global health governance today?

This article discusses the complexities of this question with respect to global communicable disease surveillance. The conceptual framework for the analysis focuses principally on the treaty-making powers of WHO and those parts of the World Trade Organization (WTO) Agreements on Trade-related Aspects of Intellectual Property Rights (TRIPS) and Sanitary and Phytosanitary Measures (SPS) that deal with prevention and control of global communicable diseases. The challenges posed by the globalization of communicable diseases in an inter-dependent world are explored and it is argued that in the absence of sanctions there is a range of factors that could compel nation states to observe international rules/regulations on transboundary spread of emerging and reemerging infectious diseases.

Globalization of public health and the challenge of governance

The term "globalization of public health" has emerged in policy discourses to express the transnational or globalized nature of public health threats (including the spread of communicable diseases) in an interdependent world (1-4) and de-emphasizes the "territorialization" or "nationalization" of diseases brought about by the process of globalization. …

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