Global Health Law

560 Pages·2014·3.344 MB·English

by  Lawrence O Gostin

G L O B A L H E A LT H L A W

G L O B A L H E A L T H L A W
Lawrence O. Gostin
Harvard University Press
Cambridge, Massachusetts
London, En gland
2014
Copyright © 2014 by the President and Fellows of Harvard College
All rights reserved
Printed in the United States of America
Library of Congress Cataloging- in- Publication Data
Gostin, Lawrence O. (Lawrence Ogalthorpe), author.
Global health law / Lawrence O. Gostin.
pages cm
Includes bibliographical references and index.
ISBN 978- 0- 674- 72884- 4 (hardcover : alk. paper)
1. Public health laws. 2. Public health laws, International. 3. Public health—
International cooperation. I. Title.
K3570.G67 2014
344.04—dc23 2013030764
For my wife, Jean;
sons, Bryn and Kieran;
and their loving partners, Jen and Isley

Contents
Preface xi
Global Health Narratives: Listening to the Voices of the Young 1
PART I Failures in Global Health and Th eir Consequences 11
Health Inequities in Today’s Globalized World
1 Global Health Justice 13
Toward a Transformative Agenda for Health Equity
Reconceptualizing “Health Aid” 18
A Shared Obligation: The Right to Health and Reinforcing
Frameworks 20
Four Defi ning Questions for the Future of the World’s Health 22
2 Globalized Health Hazards 32
The Need for Collective Global Action
Globalization and the Spread of Infectious Diseases:
Man- Made and Controllable 34
Transnational Spread of Infectious Diseases 38
The Epidemiological Transition from Infectious to
Noncommunicable Diseases: A Double Burden in
Low- Resource Countries 43
A World of Hurt: Global Injuries 46
International Trade and Commerce: Safe Food, Drugs, and
Consumer Products 50
The Benefi ts and Burdens of Globalization 58
3 Global Health Law in the Broader Currents of Global
Governance for Health 59
The Role of International Law 61
International Health Law: The World Health Or ga ni za tion’s
Normative Standards 64
viii Contents
Health as a Fundamental Entitlement 68
Interconnecting International Law Regimes 69
Interrelationships between International and Domestic Law 70
Global Governance for Health 71
Universal Values of Good Governance: The Responsibilities
of Stewardship 73
The Six Grand Challenges of Global Governance for Health 76
PART II Global Health Institutions 87
4 Fulfi lling the Promise of the World Health Or ga ni za tion 89
The Birth of the Premier Global Health Leader 90
Governing Structure: Membership, Organs, and Division
of Powers 92
The Milestones: From Disease Eradication to Health Systems 96
The WHO Constitution: A Progressive Vision of a Normative
Institution 103
The WHO Reform Agenda: Proposals to Assure the Future
of WHO Leadership 114
Concluding Refl ections: Systemic Tensions within the WHO 127
5 Old and New Institutions 129
From the World Bank to the Global Fund, the GAVI Alliance,
and the Gates Foundation
Phase One: A Preeminent World Health Or ga ni za tion 131
Phase Two: The Rise of the World Bank 134
Phase Three: The Era of Partnerships 143
Phase Four: Tomorrow’s Global Health Institutions 169
PART III International Law and Global Health 175
6 Th e International Health Regulations 177
Responding to Public Health Emergencies of International Concern
Antecedents to the IHR (2005) 179
The International Health Regulations (2005) 181
WHO Roles and Multisectoral Relationships 198
Lessons Learned from the H1N1 Pandemic 202
7 Th e Framework Convention on Tobacco Control 205
The Global Response to Tobacco
From Scientifi c Discovery and Industry Obfuscation to Social
Mobilization 209
Contents ix
The Framework Convention on Tobacco Control 213
The Tobacco Wars: Globalization, Investment, and Trade 230
The Tobacco Endgames: Toward a Tobacco- Free World 239
8 Health and Human Rights 243
Human Dignity, Global Justice, and Personal Security
Health and Human Rights: From Tension to Synergy 245
Civil/Po liti cal Rights and Economic/Social/Cultural Rights:
A Double Standard 246
International Human Rights Law: The Foundations 247
The Right to the Highest Attainable Standard of Health 257
Regional Human Rights Systems 260
The Right to Health in National Constitutions 263
9 Global Health, International Trade, and Intellectual Property 270
Toward a Fair Deal for the Global South
The World Trade Or ga ni za tion 272
WTO Agreements in Relation to Health 282
International Health Agreements with Implications for Trade 295
The Doha Development Round and the Future of the WTO 298
The Balance between International Health and Trade 301
PART IV On the Horizon 303
The Quest for Global Social Justice
10 “Getting to Zero” 305
Scientifi c Innovation, Social Mobilization, and Human Rights in the
AIDS Pandemic
The Social Construction of AIDS 308
Social Mobilization: The Vast Potential of Civil Society 314
Governing the AIDS Pandemic: Global AIDS Institutions
in the New Millennium 320
Science and Policy: The Ethical Allocation of Scarce
Resources 330
Refl ecting Back, Looking Forward 340
11 Th e International Migration of Health Workers 341
A Troubling Example of Global Injustice
Human Resource Inequalities: Magnitude of the
Health Crisis 342
Drivers of International Migration 344