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Global Health Law

Global Health Law

by Lawrence O. Gostin

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ISBN-10: 067472884X

ISBN-13: 9780674728844

Pub. Date: 03/10/2014

Publisher: Harvard

The international community has made great progress in improving global health. But staggering health inequalities between rich and poor still remain, raising fundamental questions of social justice. In a book that systematically defines the burgeoning field of global health law, Lawrence Gostin drives home the need for effective global governance for health and


The international community has made great progress in improving global health. But staggering health inequalities between rich and poor still remain, raising fundamental questions of social justice. In a book that systematically defines the burgeoning field of global health law, Lawrence Gostin drives home the need for effective global governance for health and offers a blueprint for reform, based on the principle that the opportunity to live a healthy life is a basic human right.

Gostin shows how critical it is for institutions and international agreements to focus not only on illness but also on the essential conditions that enable people to stay healthy throughout their lifespan: nutrition, clean water, mosquito control, and tobacco reduction. Policies that shape agriculture, trade, and the environment have long-term impacts on health, and Gostin proposes major reforms of global health institutions and governments to ensure better coordination, more transparency, and accountability. He illustrates the power of global health law with case studies on AIDS, influenza, tobacco, and health worker migration.

Today's pressing health needs worldwide are a problem not only for the medical profession but also for all concerned citizens. Designed with the beginning student, advanced researcher, and informed public in mind, Global Health Law will be a foundational resource for teaching, advocacy, and public discourse in global health.

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Table of Contents

Preface xi

Global Health Narratives: Listening to the Voices of the Young 1

Part I Failures in Global Health and Their 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 Denning 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 Benefits 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 Organization's Normative Standards 64

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 Fulfilling the Promise of the World Health Organization 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 Reflections: 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 Organization 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 The 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 The Framework Convention on Tobacco Control 205

The Global Response to Tobacco

From Scientific Discovery and Industry Obfuscation to Social Mobilization 209

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/Political 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 Organization 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

Scientific 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 ADDS Pandemic: Global AIDS Institutions in the New Millennium 320

Science and Policy: The Ethical Allocation of Scarce Resources 330

Reflecting Back, Looking Forward 340

11 The 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

Global Justice: Balancing the Interests of Source Countries, Destination Countries, and Health Workers 348

Global Governance: The WHO Code of Practice 349

12 Pandemic Influenza 359

A Case Study on Global Health Security

A Short History and Description of Influenza 360

Influenza Preparedness and Response: Therapeutic and Public Health Countermeasures 367

The PIP Framework: A Novel Compact for Virus Sharing and Access to Benefits 373

Dual Use Research of Concern: Influenza in an Age of Biosecurity 378

Global Health Justice: The Imperative of Innovative Governance 380

13 The "Silent" Pandemic of Noncommunicable Diseases 383

The Quiet Growth of a Pandemic 387

Domestic Law and Regulation as a Tool for Preventing NCDs 395

Marshaling a Transnational Response 402

The Status Quo Is Unacceptable 410

14 Imagining Global Health with Justice 412

What Should Global Health Look Like? 413

What Would Global Health with Justice Look Like? 423

How Do We Achieve Global Health with Justice? 428

Seizing the Moment for Global Health 439

Notes 443

Glossary of Abbreviations, Key Terms, and Actors in Global Health 503

Acknowledgments 521

Index 525

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