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Gostin LO, Meier BM, Abdool Karim S, Bueno de Mesquita J, Burci GL, Chirwa D, Finch A, Friedman EA, Habibi R, Halabi S, Lee TL, Toebes B, Villarreal P. The World Health Organization was born as a normative agency: Seventy-five years of global health law under WHO governance. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002928. [PMID: 38602939 PMCID: PMC11008771 DOI: 10.1371/journal.pgph.0002928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The World Health Organization (WHO) was born as a normative agency and has looked to global health law to structure collective action to realize global health with justice. Framed by its constitutional authority to act as the directing and coordinating authority on international health, WHO has long been seen as the central actor in the development and implementation of global health law. However, WHO has faced challenges in advancing law to prevent disease and promote health over the past 75 years, with global health law constrained by new health actors, shifting normative frameworks, and soft law diplomacy. These challenges were exacerbated amid the COVID-19 pandemic, as states neglected international legal commitments in national health responses. Yet, global health law reforms are now underway to strengthen WHO governance, signaling a return to lawmaking for global health. Looking back on WHO's 75th anniversary, this article examines the central importance of global health law under WHO governance, reviewing the past successes, missed opportunities, and future hopes for WHO. For WHO to meet its constitutional authority to become the normative agency it was born to be, we offer five proposals to reestablish a WHO fit for purpose: normative instruments, equity and human rights mainstreaming, sustainable financing, One Health, and good governance. Drawing from past struggles, these reforms will require further efforts to revitalize hard law authorities in global health, strengthen WHO leadership across the global governance landscape, uphold equity and rights at the center of global health law, and expand negotiations in global health diplomacy.
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Affiliation(s)
- Lawrence O. Gostin
- O’Neill Institute for National & Global Health Law, Georgetown Law School, Washington, District of Columbia, United States of America
| | - Benjamin Mason Meier
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Safura Abdool Karim
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, United States of America
| | | | - Gian Luca Burci
- Global Health Centre, Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Danwood Chirwa
- Faculty of Law, University of Cape Town, Cape Town, South Africa
| | - Alexandra Finch
- O’Neill Institute for National & Global Health Law, Georgetown Law School, Washington, District of Columbia, United States of America
| | - Eric A. Friedman
- O’Neill Institute for National & Global Health Law, Georgetown Law School, Washington, District of Columbia, United States of America
| | - Roojin Habibi
- Faculty of Law, University of Ottawa, Ottawa, Canada
| | - Sam Halabi
- O’Neill Institute for National & Global Health Law, Georgetown Law School, Washington, District of Columbia, United States of America
| | - Tsung-Ling Lee
- Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taipei, Taiwan
| | - Brigit Toebes
- Faculty of Law, University of Groningen, Groningen, The Netherlands
| | - Pedro Villarreal
- Max Planck Institute for Comparative Public Law and International Law, Heidelberg, Germany
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The Public Health Response to COVID-19 in Vietnam: Decentralization and Human Rights. Asian Bioeth Rev 2022; 15:103-123. [PMID: 36311051 PMCID: PMC9589775 DOI: 10.1007/s41649-022-00226-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Abstract
Human rights constitute a universal concern in different countries’ responses to COVID-19. Vietnam is internationally praised for its success in containing the pandemic; nevertheless, human rights issues are a key area that needs to be assessed and improved. Little legal and ethical research is available on human rights in Vietnam, particularly in its response to COVID-19, however. In Vietnam, decentralization took place during the pandemic: higher authorities delegated power to lower ones to make and implement public health measures. Unfortunately, many measures made and implemented decentrally caused human rights concerns or breaches. This article aims to study what makes such measures cause human rights concerns or breaches. It argues that several social, legal, and political factors, including an inadequate understanding of human rights, the undefined breadth of discretion, and lack of supervision, are underlying factors for such problematic decentralized measures. Accordingly, this paper proposes two solutions (i) improving the supervision of the decentralization process, and (ii) improving the understanding of human rights. While Vietnam should learn from the international community to improve its measures, lessons and experience from Vietnam can also contribute to a richer dialogue and better protection of human rights globally.
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Gostin LO, Meier BM, Stocking B. Developing an Innovative Pandemic Treaty to Advance Global Health Security. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2021; 49:503-508. [PMID: 34665085 DOI: 10.1017/jme.2021.72] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Recognizing marked limitations of global health law in the COVID-19 pandemic, a rising number of states are supporting the development of a new pandemic treaty. This prospective treaty has the potential to clarify state obligations for pandemic preparedness and response and strengthen World Health Organization authorities to promote global health security. Examining the essential scope and content of a pandemic treaty, this column analyzes the policymaking processes and substantive authorities necessary to meet this historic moment.
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