I. Introduction

Advances in public health through medical attention to disease control and the rise of epidemiology and vaccination programs over the past two centuries of scientific work have made possible the eradication of some diseases and the control of many factors in the spread of human disease. Air travel, the ability to respond to natural and political disasters and displacements in the refugee context, and changes in health habits and addictions exported from one culture to another make global efforts possible and urgently necessary. The establishment of global health standards and practices as well as the imperatives of disease control have resulted in a growing role for international law. In addition to identifying the major organizations, treaty texts, and the research process for locating documents and evidence from within the organizations for international health law, all of which are outlined below in this guide, researchers in this developing field will need to understand treaty research, locate general treaty law, and incorporate sources for the law of international organizations.

,Transnational lawŠ can be defined as rules of conduct that bind actors in activities, relations, and transactions that transcend national borders. Transnational law recognizes the realities of multi-layered governance: local, national, bilateral, regional, and international. For general medical and statistical sources as well as United States law and policy sources, please consult the Georgetown Law Library guide Health Law, http://www.law.georgetown.edu/library/research/guides/health.cfm

While this guide is focused more narrowly on international and cross-border legal regimes for addressing health law, researchers may wish to consult additional Georgetown Law Library international law guides under the subjects Treaty Research, http://www.law.georgetown.edu/library/research/guides/TreatyResearch.cfm and IGOs and NGOs, http://www.law.georgetown.edu/library/research/guides/orgs/IGOsNGOs.cfm

For updated in-force status and numbers of parties for most of the agreements in this guide, consult the United Nations' Multilateral Treaties Deposited with the Secretary-General in the United Nations Treaty Collection Database, http://untreaty.un.org/English/access.asp (subscription required; available at GULC via http://www.ll.georgetown.edu/research/browse_alpha.cfm?1#u ) Information is usually current to within 24-48 hours.

II. World Health Organization (WHO) and Its Agreements

World Health Organization Constitution, 14 U.N.T.S. 185

Full Text of WHO Constitution [pdf]

In the wake of the 1918 influenza pandemic, International Sanitary Conferences that were convened starting in 1851 through 1938, and the setting up of the Malaria Commission in 1924 (after recurrent outbreaks in Russia, the Balkans, parts of eastern Europe, Greece and Italy), the League of Nations turned world attention to health as a continuing mission of the organization. Its own Health Organization set a precedent for the goal of the early United Nations diplomats, in the formative period from 1945, to create a special agency for global health, which it did when the WHO Constitution came into force 7 April 1948.

There are currently 193 member states.

The WHO web site, http://www.who.int/en/ is a well-established, well-organized, and content-rich site that is the obvious place to turn first for information sources pertaining to the history, structure, and current awareness materials for the organization. However, for legal researchers, the site is dense and the location of the most relevant documents not always apparent. Most of the major documentation is in PDF format.

An important annual publication is The World Health Report, http://www.who.int/whr/2007/en/index.html , which treats a different broad theme under a unique title each year; the 2007 report, subtitled A Safer Future: Global Health Security in the 21st Century, is posted in PDF at http://www.who.int/whr/2007/whr07_en.pdf .

The best place to begin is at the "about" section at the top of the left navigation pane, http://www.who.int/about/en/ Providing more than an introduction to the organization, this section contains links to six topical areas relating to global health: the WHO current agenda, core functions, structure, resources, and, the two most important for legal research, governance and historical resources.

A. Governance

Under Article 10 of the WHO Constitution (hereafter WHO-C), all member states send delegates to the World Health Assembly (WHA). Under Article 19, the Assembly has the authority to adopt conventions and agreements, and under Article 21, the Assembly also has authority to adopt binding regulations in the specified areas of competency:

1. sanitary and quarantine requirements and other procedures designed to
   prevent the international spread of disease;
2. nomenclatures with respect to diseases, causes of death and public
   health practices;
3. standards with respect to diagnostic procedures for international use;
4. standards with respect to the safety, purity and potency of biological,
   pharmaceutical and similar products moving in international commerce;
5. advertising and labeling of biological, pharmaceutical and similar
   products moving in international commerce.

Article 23 empowers the Assembly to make recommendations to member states on any issue within the competence of the organization. Finally, Article 63 provides that

Each Member shall communicate promptly to the Organization important laws, regulations, official reports and statistics pertaining to health which have been published in the State concerned.

The Executive Board sees that the resolutions of the World Health Assembly (WHA) are carried out and efforts have been made since 2002 to increase the transparency of this 34 member board, who are elected by WHO members and qualified in areas of public health as expert advisers.

With this extensive set of powers and the ability to generate standards and legislation, the WHO site remains the principal source of information and a reasonably complete one, although gaps appear in the areas of legislative process and the reporting of national health legislation. Strategies for accessing deeper strata of documentation appears further below.

The link on the "Governance" page leads to basic texts, such as the constitution and the International Health Regulations; World Health Assembly resolutions and decisions as well as the official records archive; Executive Board resolutions and decisions, and well as the Intergovernmental Working Group on Public Health, Innovation, and Intellectual Property.

Executive Board official documentation goes back to 1998.

World Health Assembly records go back to 2001.

The Rules of Procedure for the World Health Assembly are found among the Basic Documents, linked at http://www.who.int/gb/bd/PDF/bd46/e-bd46_p6.pdf

Amendments to Articles of the Constitution of the World Health Organization, as published in the United Nations Treaty Series, are as follows:

Amendments to articles 24 and 25 of the Constitution of the World Health Organization Geneva, 28 May 1959, 377 U.N.T.S. 380.

Amendment to article 7 of the Constitution of the World Health Organization Geneva, 20 May 1965, World Health Assembly resolution 18.48; Official Records of the World Health Organization, No. 143, p. 32.

Amendments to articles 24 and 25 of the Constitution of the World Health Organization Geneva, 23 May 1967, 970 U.N.T.S. 360.

Amendments to articles 34 and 55 of the Constitution of the World Health Organization Geneva, 22 May 1973, 1035 U.N.T.S. 315.

Amendments to articles 24 and 25 of the Constitution of the World Health Organization Geneva, 17 May 1976, 1347 U.N.T.S. 289.

Amendment to article 74 of the Constitution of the World Health Organization Geneva, 18 May 1978, World Health Assembly, resolution WHA 31.18, Official Records of the World Health Organization, No. 247, p. 11.

Amendments to articles 24 and 25 of the Constitution of the World Health Organization Geneva, 12 May 1986, Resolution WHA39.6, doc. WHA39/1986/REC/1, p. 3.

Amendments to articles 24 and 25 of the Constitution of the World Health Organization Geneva, 16 May 1998, Resolution WHA51.23, doc. WHA51/1998/REC/1, p. 26.

B. International Health Regulations (IHR)

The International Health Regulations are the "legally binding regulations adopted by most countries to contain the threats from diseases that may rapidly spread from one country to another." Revised in 2005 and in force since 15 June 2997, the IHR provide a legal framework for alerts and response to diseases and health crises at the source, the IHR now take into account the rights and obligations and procedures member states must respect in order to react swiftly but within the context of continuing international commerce and trade if possible. The IHR represent a "shift from control at borders to containment at the source."

From the alphabetical list of health topics, http://www.who.int/topics/en/ links may be followed to the IHR section of the site, http://www.who.int/csr/ihr/en/

The revised IHR were adopted by the 58th World Health Assembly as resolution WHA58.3
The English text of the IHR, http://www.who.int/gb/ebwha/pdf_files/WHA58/WHA58_3-en.pdf creates a kind of code of international health with monitoring and evaluation data collected at the Global Health Atlas, http://www.who.int/globalatlas/

Documentation of the Intergovernmental Working Group on the Revision of the International Health Regulations may be found at http://www.who.int/gb/ghs/e/index.html

C. Researching WHA Regulations

What is the legal status of the IHR (2005) and how do they enter into force for States?

The IHR(2005) will become legally binding on all WHO Member States except those that have rejected them or submitted reservations within 18 months of notification of adoption of the IHR(2005) by the World Health Assembly. However, if a reservation is compatible with the object and purpose of the IHR(2005) and it has not been objected to by at least one-third of the other States within six months of its notification, the Regulations enter into force for the reserving State, subject to the reservation. Non-Member States of WHO may notify the Director-General of WHO that they agree to be bound by the Regulations.

Some WHO documents one might want to consult for the answer:

• Review and approval of proposed health regulations under IHR, http://www.who.int/gb/ghs/pdf/IHR_IGWG2_ID2-en.pdf Jan. 27, 2005
• Drafting language on the reservations, http://www.who.int/gb/ghs/pdf/IHR_IGWG2_2-en.pdf
• Second U.S. Government Comments April 24, 2004, http://www.who.int/csr/ihr/revisionprocess/en/ihruscomments.pdf

Analysis:

Article 22 of the WHO Constitution provides that

Regulations adopted pursuant to Article 21 shall come into force for all Members after due notice has been given of their adoption by the Health Assembly except for such Members as may notify the Director-General of rejection or reservations within the period stated in the notice.

The legal issue of reservations and objections to the IHR was itself a subject of debate and is treated in the documents of the IGWG, particularly as set forth in Review and Approval of Proposed Amendments to the International Health Regulations, A/IHR/IGWG/2/INF.DOC./2 found at http://www.who.int/gb/ghs/pdf/IHR_IGWG2_ID2-en.pdf After a review of the reservations to older versions of the IHR and a comparison between the Article 22 provision (which exempts properly rejecting members from being bound by the resolution) and the Vienna Convention on the Law of Treaties, http://untreaty.un.org/ilc/texts/instruments/english/conventions/1_1_1969.pdf (whereby states may make reservations yet remain bound by the treaty as a whole). Each regulation may require widespread acceptance to be effective, but the IGWG left this interpretation to the WHA itself in its future role as having

... The authority to devise a mechanism to enable reserving States to become parties to regulations within the context of Article 22 of the Constitution lies with the Health Assembly, as the governing body competent to adopt regulations and to interpret the Constitution. (A/IHR/IGWG/2/INF.DOC./2 at 5)

Documents such as this are a starting point for investigating the debate and the role that member countries may have played in it or other controversial issues. A first step in locating this document was to perform a simple search on the WHO web site search engine in the box at the upper right corner of the main page with the term "reservations." The best result was identified by context as the fifth hit returned.

The documentation section should be the repository of documents going forward after the June 2007 entry into force of the revised IHR, and these will eventually become part of the Official Records, http://www.who.int/gb/or/ Transparency would be enhanced by recording member state delegate positions and meeting summaries for the WHA as for the EB to indicate positions taken by member states.

The United States statement on adoption of the IHR via the U.S. State Department, USInfo.state.gov, and a statement of its reservations may be found at the U.S. Statement for the Record Concerning the World Health Organization's Revised International Health Regulations, http://www.state.gov/p/io/rls/rm/46714.htm and at the U.S. Department of Health and Human Services, http://www.hhs.gov/news/press/2006pres/20061213.html

D. Summary of Important WHO norms:

1. WHO
   1. Preamble
   2. Constitution
      1. Article 19 ‹ grants the power to adopt conventions
      2. Article 21 ‹ grants the power to promulgate regulations that are binding on members
      3. Article 23 ‹ grants the power to make recommendations
      4. Article 63 ‹ grants the power to monitor national health legislation
      5. Articles 20 & 62 - member states undertake that they will, within 18 months after the World Health Assembly (WHA) adopts a convention or agreement, take action and notify the Director-General of the actions taken, as well as provide an annual report
2. Important Agreements under WHO
   1. International Health Regulations (IHR)
      1. Adopted in 1951 as the International Sanitary Regulations pursuant to Article 21 of WHO
      2. Amended in 2005
      3. Focus on key aspects of global preparedness, ranging from surveillance and capacity building to public health response and border control
      4. Contain 66 articles organized into 10 parts, with 9 annexes
      5. Purpose, Scope and Principles
         1. Article 1 ‹ scope ‹ covers ,public health risksŠ and ,public health emergencies of international concernŠ
         2. Article 2 ‹ purpose/health and trade ‹ ,to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and tradeŠ
         3. Article 3 ‹ health and human rights ‹ IHR have ,universal application for the protection of all people of the world,Š and States Parties must have ,full respect for the dignity, human rights and fundamental freedoms of personsŠ
         4. Article 42 ‹ health and human rights ‹ health measures taken must be applied in a transparent and non-discriminatory manner
         5. Article 32 ‹ health and human rights ‹ States Parties must, in particular, treat international travelers with ,respect for their dignity, human rights and fundamental freedoms and minimize any discomfort or distress;Š respectful treatment requires consideration of traveler‰s gender, culture, ethnicity, and religion
      6. National Capacities for Public Health Preparedness
         1. Articles 5(1), 13(1), & Annex 1 ‹ public health preparedness - States Parties have the duty to develop, strengthen, and maintain core public health capacities to detect, assess, notify, and report events; and to respond promptly and effectively to public health risks and emergencies of international concern
      7. Surveillance
         1. Article 6 ‹ Requires States Parties to notify WHO within 24 hours of all events in their territory which may constitute a ,public health emergency of international concernŠ
         2. Article 7 ‹ States Parties must share all relevant public health information during an unexpected or unusual public health event, irrespective of origin or source, which may constitute a public health emergency of international concern
         3. Article 8 ‹ States Parties must also consult and keep WHO appraised of events that may not be notifiable due to incomplete scientific information
         4. Articles 9 & 10 - WHO may take into account unofficial sources of information (e.g., NGOs and independent scientists), which must be assessed according to established epidemiological principles
         5. Article 9(1) ‹ require WHO to share non-governmental information with states parties ,and only where it is duly justified may WHO maintain the confidentiality of the sourceŠ
         6. Article 45(1) ‹ States Parties must keep personally identified or identifiable information ,confidential and processed anonymously as required by national lawŠ
         7. Article 45 ‹ WHO must, as far as practicable, provide individuals with their personal data in an intelligible form and allow for correction of inaccuracies
      8. WHO Recommendations
         1. Article 15 ‹ Director General must issue temporary recommendations upon determining that a public health emergency of international concern is occurring
         2. Article 16 ‹ WHO may also make standing recommendations on the appropriate health measures to be applied routinely or periodically in relation to specific, ongoing public health risks
         3. Article 18 ‹ contains applicable health measures for persons, baggage, cargo, containers, conveyances, and goods
            1. International Travelers
               1. Article 23 ‹ States Parties may require, for public health purposes, information about the traveler‰s destination and itinerary, and a non-invasive medical examination that is the least intrusive necessary to achieve the public health objective

E. Framework Convention on Tobacco Control (FCTC)

The WHO Framework Convention on Tobacco Control [http://www.who.int/gb/ebwha/pdf_files/WHA56/ea56r1.pdf], 2302 U.N.T.S.166 was adopted as WHA Resolution 56.1, and entered into force on 27 February 2005. Going forward, the Conference of the Parties to the WHO Framework Convention on Tobacco Control, at http://www.who.int/gb/fctc/ posts sessional documents and meeting records. Also posted are documents of the Intergovernmental Negotiating Body and the Open-Ended Intergovernmental Working Group [http://www.who.int/gb/fctc/].

1. Summary of Tobacco Convention norms:
   1. Framework Convention on Tobacco Control (FCTC):
      1. The first treaty negotiated under WHO auspices
      2. Adopted in 2003
      3. Entered into force in 2005
      4. Objectives, Principles and Legal Force
      5. 1. Article 3 ‹ objective ‹ to protect present and future generations from ,the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smokeŠ
         2. Article 4 ‹ objective ‹ aims to keep citizens informed of the health hazards, and to facilitate political commitment, international cooperation and financial assistance
         3. Article 5 ‹ States Parties mandated to develop and implement comprehensive multisectoral national tobacco control strategies
      6. Reduction of Demand for Tobacco
         1. Articles 6-14 ‹ establish core demand reduction strategies including price and tax measures, as well as non-price measures, like protection from exposure to tobacco smoke, regulation of the contents of tobacco products, and disclosure requirements for manufacturers
      7. Reduction of Supply of Tobacco
         1. Articles 15-17 ‹ establish core supply reduction strategies including measures to control illicit trade and sales to minors, as well as create economically viable alternatives to tobacco production.
      8. Civil and Criminal Liability
         1. Article 19 ‹ asks States Parties to consider criminal and civil liability for the tobacco industry
         2. Articles 20-22 - provisions encouraging reporting, scientific and technical cooperation, and communication of information

F. Additional WHO Agreements

1. Protocol concerning the Office international d'hygiène publique, New York, 22 July 1946, 9 U.N.T.S. 3
2. Agreement on the establishment of the International Vaccine Institute, New York, 28 October 1996, 1979 U.N.T.S. 199

III. World Trade and Health

A. World Trade Organization and General Agreement on Trade and Tariffs (GATT) 1994

The GATT (http://www.wto.org/english/docs_e/legal_e/06-gatt.pdf and http://www.wto.org/english/docs_e/legal_e/gatt47_e.pdf ) seeks to promote trade in goods (and in other areas through some of the annexed agreements listed below) and to reduce protectionist tariff "wars" in international trade by assuring that in general all member states' goods and products are treated without discrimination as to the same good; it must treat these goods the same as its home-produced goods of the same type; and only agreed-upon tariffs under treaties are applied rather than quotas. Therefore, regional and bilateral free trade agreements (FTAs) may be approved by the parties and be deemed compatible with the GATT.

Article XX of the GATT provides for General Exceptions which are not disguised restrictions or "unjustifiable" discrimination but in particular part (b) of the article allows those "necessary to protect human, animal or plant life or health;..."

For an important overview of these potentially interlocking legal regimes, see WTO Agreements and Public Health: A Joint Study by the WHO and WTO Secretariat (2000), available at http://www.wto.org/english/res_e/booksp_e/who_wto_e.pdf

The following agreements are deemed relevant to health; the first two must be read in conjunction with GATT Article XX, XX(b):

1. Sanitary and Phytosanitary Measures (SPS)

Part of the Final Act of the Uruguay Round, the Agreement on Sanitary and Phytosanitary Measures (http://www.wto.org/english/docs_e/legal_e/15-sps.pdf )requires and sets forth the standards for testing a health measure. Measures must meet both science-based standards and "least restrictive" trade rules. Thus it is more specific than GATT XX(b). Recognizes the standards of the FAO/WHO Codex Alimentarius and the Codex Alimentarius Commission, http://www.codexalimentarius.net/web/index_en.jsp

SPS committee work and documentation may be found at the WTO web site linked from "trade topics" at http://www.wto.org/english/tratop_e/sps_e/sps_e.htm

a. Summary of SPS norms:

1. covers sanitary or phytosanitary measures, which are defined to include any measure applied: to protect human life or health from ,risks arising from additives, contaminants, toxins or disease-causing organisms in foods, beverages or feedstuffsŠ or ,arising from diseases carried by animals, plants or products thereof, or from the entry, establishment or spread of pests.Š (Annex A, ¶¶ 1(b)-(c))
2. measures must be ,based on scientific principlesŠ and must not constitute arbitrary, unjustifiable discrimination or a disguised restriction on international trade (Preamble, Art. 2(1),(2))
3. national health measures that conform to the SPS Agreement are deemed to fulfill the country's obligations under the umbrella WTO agreement and specifically the GATT 1994 (Art. XX) (SPS, Art. 2(4))
4. explicitly recognizes the international standards developed by the joint FAO/WHO Codex Alimentarius Commission
5. Article 5.7 ‹ risk assessment
6. The European Beef Hormone Case (1998) ‹ examined the concepts of international standards, necessity, and risk assessments in the SPS Agreement
   the European Genetically Modified (GM) Foods Case ‹ currently before the WTO ‹ concerns the adequacy of scientific data to support domestic health measures.
7. The WTO Analytical Index (see more below for dispute settlement) analyses cases and commentary on the agreement at http://www.wto.org/english/res_e/booksp_e/analytic_index_e/sps_e.htm
   

2. Agreement on Technical Barriers to Trade (TBT)

The TBT,( http://www.wto.org/english/docs_e/legal_e/17-tbt.pdf ) annexes a Code of Good Practice regarding for the Preparation, Adoption and Application of Standards by standardizing bodies.

TBT committee work and documents may be found at the WTO web site linked from "trade topics" at http://www.wto.org/english/tratop_e/tbt_e/tbt_e.htm

3. Trade-Related Aspects of Intellectual Property Rights (TRIPS)

The TRIPS Agreement (http://www.wto.org/english/docs_e/legal_e/27-trips.pdf ) and the cross-border protection of intellectual property in general lies at the center of issues regarding pharmaceutical patents and compulsory licensing for drugs used in the treatment or control of serious diseases such as HIV/AIDS. As a result, the WTO web site devotes a special section to TRIPS and public health at http://www.wto.org/english/tratop_e/trips_e/pharmpatent_e.htm where one can find links to decisions of the TRIPS Council and relevant declarations from Ministerial Conferences.
Production of life-saving drugs in sufficient quantities, in a health crisis through government intervention and for countries unable to produce them domestically, has given rise to additional agreements and modifications as well as clarifications of the TRIPS arrangements in the area of public health.

In aid of implementing paragraph 6 of the Doha Declaration on the TRIPS Agreement and Public Health, of 20 November 2001, there is a dedicated web page on the WTO decision of 30 August 2003 . This page was established as a requirement of the "paragraph 6 system" for the posting of notifications of importing and exporting members of their intention to use the system. Tracking dates of acceptance of this "waiver" amendment (so that Least Developed Countries could go beyond compulsory licensing just for domestic markets and obtain drugs made outside their countries) can be done by visiting http://www.wto.org/english/tratop_e/trips_e/amendment_e.htm

a. Summary of TRIPS norms:

Trade-Related Aspects of Intellectual Property Rights (TRIPS):

1. establishes minimum levels of intellectual property protection that each government must afford to creators
2. Article 33 ‹ requires patents for inventions to last for at least 20 years.
3. Article 27 ‹ patent protection must be available for both products (e.g., medicines) and processes (e.g., methods of producing chemical ingredients for medicines), in almost all fields of technology, with certain exceptions.
4. Article 31 ‹ allows countries to issue a compulsory license: a legal vehicle whereby a government grants to itself or a third party the right to produce or import a patented product without authorization of the patent holder, subject to certain conditions.

Finally, there is an additional TRIPS Gateway at http://www.wto.org/english/tratop_e/trips_e/trips_e.htm linking to documents of its negotiating history, fact sheets, and a separate link for dispute settlement in the area at http://www.wto.org/english/tratop_e/trips_e/intel5_e.htm

4. General Agreement on Trade in Services (GATS)

Medical professional services are treated with "professional services" under the GATS.

Health and social services (delivered by hospitals or under the care of a medical professional) are included in the new services negotiations that began in January, 2000, as mandated by Article XIX para. 1.

5. Dispute Settlement in the WTO

Sections of the WTO web site and many subscription databases collect the decisions of the dispute settlement panels and the Appellate Body under specific articles or agreements and through full-text searches. In addition to the WTO Analytical Index cited above (and available in print, but not as updated) for panel and Appellate Body decisions under specific articles of the GATT, consult the Georgetown subscription database Worldtradelaw.net for an excellent case law index by topic covering all the agreements by article. Links to full text and summaries by the expert editors are provided.
For additional guidance on the research process for international trade law and the WTO consult our additional Georgetown Law Library guide From GATT to the WTO (http://www.law.georgetown.edu/library/research/guides/FromtheGATTtotheWTO.cfm )

B. Regional Agreements

North American Free Trade Agreement (NAFTA) Dec. 17, 1992, 32 I.L.M. 289, 605 (1993) http://www.nafta-sec-alena.org/DefaultSite/index_e.aspx?DetailID=78

Central American Free Trade Agreement (CAFTA)
http://www.ustr.gov/Trade_Agreements/Bilateral/CAFTA/CAFTA-DR_Final_Texts/Section_Index.html (includes the Dominican Republic)

NAFTA Chapter 11 investment provisions, in tension with environmental hazards produced by multinational or foreign companies in the foreign investment arena, have created controversy and claims of expropriation when confronted by local controls or regulations on dangerous pollutants or activity. Sources for environmental law in relation to health are treated below.

C. European Union

Similar issues regarding the right balance of harmonized trade with standards to protect health exist in the European Union. Its Public Health portal at http://europa.eu/pol/health/index_en.htm brings together links to all sectors of EU activity with regard to public health, including relevant legal texts and legislation. There is a separate link to case law of the European Court of Justice and the Court of First Instance on that page.

For additional information on researching the law of the European Union, consult our Georgetown Law Library guide on the European Union, http://www.law.georgetown.edu/library/research/guides/EuropeanUnion.cfm and see also Raisch, Marylin, European Union Law: An Integrated Guide to Electronic and Print Research, http://www.llrx.com/features/eulaw2.htm

IV. Health and Human Rights, Right to Health

Defining a right to health in international law has remained difficult and has centered on the right of access to adequate health care. Environmental and occupational hazards and the extent of the obligations governments owe to their citizens or others beyond their borders to cooperate in global goals for optimizing health continue to generate issues for international legal initiatives for health.

Below are links to full texts of relevant treaties (in addition to the Preamble to the WHO Constitution itself) with indication of the specific articles mentioned in the literature as having relevance to the issue of human rights and human health.

• Univeral Declaration of Human Rights (UDHR)) G.A. Res. 217A (III), U.N. Doc. A/810 at 71 (1948) (http://www.unhchr.ch/udhr/index.htm)
  UDHR Article 25
• American Declaration of the Rights and Duties of Man (ADRDM), Res. XXX, Final Act of the Ninth International Conference of American States (Pan American Union), Bogota, Colombia, Mar. 30-May 2, 1948, at 38; reprinted in Handbook of Existing Rules Pertaining to Human Rights, OEA/Ser.L/V/II.23 Doc. 21 Rev. 6, at 5 (1979); 1 Annals of the O.A.S. 130 (1949); Basic Documents Pertaining to Human Rights in the Inter-American System, OAS/Ser.L/V/I.4 Rev. 9 (2003); and 43 Am. J. Int'l L. Supp. 133 (1949) (http://www1.umn.edu/humanrts/oasinstr/zoas2dec.htm )
  ADRDM Article XI
• International Covenant on Economic, Social and Cultural Rights (ICESCR), Dec. 16, 1966, 993 U.N.T.S. 3; S. Exec. Doc. D, 95-2 (1978); 6 I.L.M. 368 (1967) (http://www2.ohchr.org/english/law/ccpr.htm)
  ICESCR Article 12
• Committee on Economic, Social and Cultural Rights, General Comment No. 14, E/C.12/2000/4, 11 August 2000, "right to the highest attainable standard of health (art.12)", scroll down at http://www2.ohchr.org/english/bodies/cescr/comments.htm
• European Social Charter (ESC) Oct. 18, 1961, 529 U.N.T.S. 89; Europe. T.S. No. 35 (http://conventions.coe.int/treaty/en/Treaties/Html/035.htm)
  ESC Article 11
• African Charter on Human and Peoples' Rights (ACHPR) June 27, 1981, 1520 U.N.T.S. 217, 245; 21 I.L.M. 58, 59 (1982) (http://www1.umn.edu/humanrts/instree/z1afchar.htm )
  ACHPR, Article 16
• Convention on the Rights of the Child (CRC) Nov. 20, 1989, 1577 U.N.T.S. 3; 28 I.L.M.1456 (1989) (http://www2.ohchr.org/english/law/crc.htm)
  CRC Article 24
• Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights, "Protocol of San Salvador," O.A.S. Treaty Series No. 69 (1988), entered into force November 16, 1999, reprinted in Basic Documents Pertaining to Human Rights in the Inter-American System, OEA/Ser.L.V/II.82 doc.6 rev.1 at 67 (1992) (http://www.oas.org/juridico/English/Treaties/a-52.html )
  San Savador Protocol Article 10

A. Council of Europe treaties on health and human rights

The Council of Europe, founded in 1949, is a 47-member organization distinct from the European Union (albeit with several overlapping member states) which has as its central mission human rights and the social well-being of member states; it did not originate as a customs union focused on trade and economic cooperation. The Council of Europe health policy portal, with links to relevant recommendations of its Council of Ministers, is at http://www.coe.int/t/dg3/health/h.

There is a European Health Committee with a Committee of Experts on Good Governance in Health Care linked from http://www.coe.int/t/dg3/health/CDSP_en.asp

A list of the 15 major European agreements pertaining to public health may be found by accessing the search page of the COE Treaty Office site, http://conventions.coe.int/Treaty/EN/v3MenuTraites.asp and then selecting the options >Search for several treaties and then >List by subject matter; a drop-down menu will appear where one can select "public health" to obtain the list, date, status, and full text of the treaties.

B. International Covenant on Civil and Political Rights (ICCPR), Dec. 16, 1966, 999 U.N.T.S. 171; S. Exec. Doc. E, 95-2 (1978); 6 I.L.M. 368 (1967)
and Human Rights Enforcement Systems

United Nations treaties with optional protocols, the Inter-American system based on the American Convention cited above, and the European Convention on Human Rights (officially titled Convention for the Protection of Human Rights and Fundamental Freedoms, Nov. 4, 1950, Europ.T.S. No. 5; 213 U.N.T.S. 221 http://conventions.coe.int/Treaty/en/Treaties/Html/005.htm ) all provide, through monitoring bodies or special regional commissions and courts, mechanisms whereby individual and group complaints for violations of treaty provisions may be brought for decision, normally after exhaustion of local remedies and with an initial adjudication of admissibility under the applicable treaty. Case law has treated issues relating to the tension between individual liberties and the application of restrictive public health measures. For sources useful in the process of researching human rights and health in the jurisprudence of the treaty compliance systems (complaints or ,communicationsŠ) see the Georgetown Law Library Human Rights Law guide http://www.law.georgetown.edu/library/research/guides/HumanRightsLaw.cfm

1. U.N. Council on Human Rights (CHR) (formerly the U.N. Commission on Human Rights until 2005) and the Special Rapporteur on the Right to Health

As a charter body of the U.N. human rights system, the CHR has the power to appoint Special Rapporteurs in areas of special importance for investigation of certain issues. Under the Office of the U.N. High Commissioner for Human Rights, issues such as health are identified. The Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health was appointed, and its duties continued in 2004, under the following mandate announced at the Special Rapporteur's site, http://www2.ohchr.org/english/issues/health/right/ and reading as follows:

"In resolution 2002/31, the Commission on Human Rights decided to appoint, for a period of three years, a Special Rapporteur whose mandate will focus on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, as reflected in article 25 (1) of the Universal Declaration of Human Rights (UDHR), article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR), article 24 of the Convention on the Rights of the Child (CRC) and article 12 of the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), as well as on the right to non-discrimination as reflected in article 5 (e) (iv) of the International Convention on the Elimination of All Forms of Racial Discrimination (ICERD)."

Annual Reports (http://www2.ohchr.org/english/issues/health/right/annual.htm) on the activities carried out under the mandate are submitted and Country Visits (http://www2.ohchr.org/english/issues/health/right/visits.htm) are undertaken; a variety of reports and expert consultations are also posted under Documents at http://ap.ohchr.org/documents/dpage_e.aspx?m=100 .

2. Summary of important human rights norms:

1. International Bill of Human Rights (IBHR)
   1. Universal Declaration of Human Rights (UDHR)
      
      1. ,a common standard of achievement for all peoples and all nationsŠ to promote human rights (Preamble)
   2. International Covenant on Civil and Political Rights (ICCPR)
   3. 1. Article 40 - States Parties are required to report to the Human Rights Committee (HRC) on the measures adopted and progress made in the enjoyment of civil and political rights
      2. Articles 42 & 43 ‹ enforcement
   4. International Covenant on Economic, Social, and Cultural Rights (ICESCR)
      
      1. Article 2 ‹ guide to actions of States Parties
      2. Article 22 ‹ economic, social, and cultural rights are those rights ,indispensable for [a person‰s] dignity and the development of his personalityŠ
   5. Valid limitations on human rights
      1. UDHR, Article 29(2) ‹ sole purpose of limitation is to secure ,due recognition and respect for the rights and freedoms of others and of meeting the just requirements of morality, public order and general welfare in a democratic societyŠ
      2. ICCPR, Article 4 - allows States Parties ,in time of public emergency that threatens the life of the nationŠ to suspend most other civil and political rights
      3. iracusa Principles (1985)
         1. widely recognized as a legal standard for measuring valid limitations on human rights
         2. require that state limitations must be: in accordance with the law; based on a legitimate objective; strictly necessary in a democratic society; the least restrictive and intrusive means available; and not arbitrary, unreasonable or discriminatory
2. Right to Health
   
   1. UDHR, Article 25 - ,Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.Š
   2. ICESCR recognizes ,the right of everyone to the highest attainable standard of physical and mental health.Š Article 12 defines the steps needed to achieve the full realization of the right to health
   3. Committee on Economic, Social and Cultural Rights, General Comment No. 14
      
      1. proclaims that ,health is a fundamental human right indispensable for the exercise of other human rights. Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity.Š
      2. norms ‹ address the ,availability, accessibility, acceptability, and qualityŠ of public health and health care services
      3. Obligations - imposes ,core obligationsŠ to ensure minimum services
      4. Violations
      5. Implementation ‹ contains detailed standards for implementing the right to health
   4. Special Rapporteur on the Right to Health
      1. established by the Commission on Human Rights in 2002
      2. work includes gathering and sharing information, reporting on the status of the right to health, proposing recommendations, and responding to individual complaints
      3. has issued reports on the elements of the right to health, reproductive rights, mental disabilities, and the effects of trade on health
      4. Special Rapporteur main page
      5. Annual Reports
      6. Country Visits
      7. Other Documents

V. International Environmental Law and Health

The known and probable human and animal health impacts of environmental pollution and degradation constitute a large and important area of international law in relationship to public health around the world. The treaties and monitoring regimes listed below are merely a selection of the most often discussed agreements out of the many treaties that deal with more specific issues and threats. For a separate guide on researching international environmental law, see the Georgetown Law Library guide Environmental Law (International) at http://www.law.georgetown.edu/library/research/guides/InternationalEnvironmentalLaw.cfm

1. Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and Their Disposal, Mar. 22, 1989, 1673 U.N.T.S. 125; 28 I.L.M. 657 (1989) http://www.basel.int/text/con-e-rev.pdf
2. Convention for the Prevention of Marine Pollution from Land-Based Sources, June 4, 1974, 1546 U.N.T.S. 119; 13 I.L.M. 352 (1974) http://www.opcw.org/html/db/cwc/more/marine1974.html
3. Convention for the Protection of the Ozone Layer, Mar. 22, 1985, T.I.A.S. No. 11,097; 1513 U.N.T.S. 293, 324; 26 I.L.M. 1529 (1987) http://www.unep.ch/ozone/pdfs/viennaconvention2002.pdf
4. Convention on Nuclear Safety, June 17, 1994, 1963 U.N.T.S. 293, 317; S. Treaty Doc. No. 104-6 (1995); 33 I.L.M. 1514 (1994) http://www.iaea.org/Publications/Documents/Conventions/nukesafety.html
5. International Convention for the Prevention of Pollution from Ships, Nov. 2, 1973, 1340 U.N.T.S. 61; 12 I.L.M. 1319 (1973) http://sedac.ciesin.columbia.edu/entri/texts/pollution.from.ships.1973.html
6. Stockholm Convention on Persistent Organic Pollutants, May 22, 2001, 40 I.L.M. 532 (2001) http://www.pops.int/default.htm
7. United Nations Convention on the Law of the Sea, Dec. 10, 1982, 1833 U.N.T.S. 3, 397; 21 I.L.M. 1261 (1982) http://www.un.org/Depts/los/convention_agreements/convention_overview_convention.htm
8. United Nations Framework Convention on Climate Change, May 9, 1982, 1771 U.N.T.S. 107, 165; S. Treaty Doc No. 102-38 (1992); U.N. Doc. A/AC.237/18 (Part II)/Add.1; 31 I.L.M. 849 (1992) http://unfccc.int/essential_background/convention/items/2627.php
9. Kyoto Protocol to the United Nations Framework Convention on Climate Change, Dec. 10, 1997, U.N. Doc FCCC/CP/1997/7/Add.1, 37 I.L.M. 22 (1998) http://unfccc.int/essential_background/kyoto_protocol/background/items/1351.php

VI. International Labor Law and Health

The International Labor Organization (ILO) was created in 1919 within the League of Nations and went on to use its treaty-making powers, through its International Labor Conference, to adopt and implement labor standards. Its Constitution (http://www.ilo.org/ilolex/english/constq.htm) provides for a Committee of Experts and a unique tripartite Committee on the Application of Conventions and Recommendations to review periodic reports from member states on compliance with the treaties and recommendations. Government, corporations, and labor unions all have representation in the organization and contribute to greater effectiveness.

Standards of safety, hours of work, dangerous and hazardous occupations, and the effects of world and regional trade (especially as incorporated in NAFTA) remain concerns of the ILO and part of a continuing program of action. Documentation of labor standards in the form of treaties and recommendations are linked from http://www.ilo.org/global/About_the_ILO/Mainpillars/Therightsatwork/Labour_Standards/lang--en/index.htm and official meetings and records of the Labor conference and the Governing Body and linked from http://www.ilo.org/global/What_we_do/Officialmeetings/lang--en/index.htm

A Working Party on the Social Dimensions of the Liberalization of International Trade was established in 1994 in light of health impacts of continuing child labor and exploitation in some parts of the world, and the discussion paper The quest for a fair globalization three years on: Assessing the impact of the World Commission on the Social Dimension of Globalization (2007) has been released by the International Institute for Labour Studies and may be found at http://www.ilo.org/public/english/bureau/inst/download/dp17507.pdf

For researching the ILO see Charlotte Bynum, ILO Research Guide, http://library.lawschool.cornell.edu/WhatWeDo/ResearchGuides/ILO.cfm

VII. Biological and Radiological Weapons and International Law

In addition to the historic threat to health from infectious diseases spread among soldiers or through civil chaos and population displacement, conventional wartime and terrorist use of biological and nuclear weapons poses new types of danger to combatants and civilians across whole regions. Both WHO and the UN General Assembly have both asked for, and the General Assembly received, Advisory Opinions from the International Court of Justice on the use or threat of use of nuclear weapons and has regarded this use as unlawful "except in an extreme circumstance of self-defence, in which the very survival of a State would be at stake." Legality of the Threat or Use of Nuclear Weapons, Advisory Opinion of July 8, 1996 [pursuant to a request from the U.N.General Assembly], http://www.icj-cij.org/docket/files/95/7495.pdf

See also Legality of the Use by a State of Nuclear Weapons in Armed Conflict, Advisory Opinion of July 8, 1996 regarding a request from the World Health Organization for an Advisory Opinion, wherein the court concluded that while the specialized agencies may request an advisory opinion on legal questions in the scope of their activities, and the WHO Constitution also provides for it to request the same "within its competence and authorized by the UN General Assembly," once the question was characterized as legal and regarding the use of weaponry, this took it outside of the scope of its competence, http://www.icj-cij.org/docket/files/93/7407.pdf

VIII. National Legislation in Selected Areas

The WHO web site includes a publication of selected national laws in its electronic format, the International Digest of Health Legislation (IDHL)(note: this site is currently unavailable) at ( (http://www.who.int/idhl-rils/frame.cfm?language=english )Electronic access points include legislation by subject, by country, and by keyword. Items in specific volumes and issues of the print publication are available as well. Relevant excerpts of constitutions and health codes are provided, along with links to full text of the entire document at an official, reliable web site within that country. Sub-jurisdictions of federal states are included.

At the search page for keywords, entering the phrases below was successful for finding the specific phrases in all cases but the last, where no hits were found for "environmental toxins" -

• Public health
• Vaccines
• Essential medicines
• Non-communicable diseases and agents
• Tobacco
• Addictive substances
• Environmental toxins
  

While this search engine is not as flexible as it might be, results were acceptable for the fixed range of areas selected for inclusion in the list under "search by subject." Inter-disciplinary areas are not well represented. The IDHL is a good tool and the materials are translated into English. However, to perform complete research will of necessity involve texts in the original and in the several languages, and so this search engine should be supplemented by additional research in foreign law areas.

The International Labor Organization provides the ILOLEX and NATLEX systems for searching international and national labor legislation and standards, translated into English along a model similar to the IDHL.

The World Legal Information Institute, (http://www.worldlii.org/ ) is the best central web site for world laws overall, particularly for those countries in regions that have established separate Legal Information Institutes and therefore have a more powerful search engine across legislative and case law materials as a database. For other countries outside this system, there is a catalogue of more static links. For example, from the worldlii home page cited above, on the left navigation pane, select "all databases" and see a list of African to Asian and Commonwealth databases, Droit Francophone, and so forth, covering most jurisdictions of the world. At the database level for each region, or at the "all database" page, a search box may be selected, http://www.worldlii.org/forms/search1. and phrases such as public health (no quotation marks required) or Boolean searching may be performed. <environmental and toxins> limited to "WorldLII All Legislation databases" now yields results but included environmental and health laws; any keywords may be entered to supplement the IDHL, including a phrase search for "public health." Case law from higher courts may be included or searched across multiple jurisdictions by restricting the same search at that page to "All Case Law databases."

For selected internet links but primarily to verify citations to the printed and official legal materials of foreign jurisdictions, the database Foreign Law Guide is a subscription database available to Georgetown law students through the Research Databases collection, http://gull.georgetown.edu/screens/eresources_all.html; we also provide access to Indian law through Indlaw, and Chinese law through ISINOLAW (subscription databases, GULC only). Historic collections of British documents, cases, and laws as well as original PDF formats for treaties and classics of international law are now available through HeinOnline (GULC only).

For summaries in English or more detailed citations, searching the state reports under the periodic reporting system of the ICESCR treaty using the United Nations Treaty Body Database, http://www.unhchr.ch/tbs/doc.nsf ; the United Nations Human Rights Treaties site known as Bayefsky.com, http://www.bayefsky.com/ ; or the University of Minnesota Human Rights Library, http://www1.umn.edu/humanrts/index.html may prove useful. One would search within and not across documents.

Health recommendations of the Council of Europe and its Council of Ministers are to be found at http://www.coe.int/t/dg3/health/recommendations_en.asp

IX. International Organizations

A. Intergovernmental Organizations (IGOs)

1. World Bank, topical sector on Health, Nutrition & Population
2. Food and Agriculture Organzation, http://www.fao.org/
3. Regional Offices of the WHO:
   1. WHO African Region, http://www.who.int/about/regions/afro/en/index.html
   2. WHO Region of the Americas, http://www.who.int/about/regions/amro/en/index.html and the Pan American Health Organization, http://www.paho.org/
   3. WHO South-East Asia Region, http://www.who.int/about/regions/searo/en/index.html
   4. WHO European Region, http://www.who.int/about/regions/euro/en/index.html
   5. WHO Eastern Mediterranean Region, http://www.who.int/about/regions/emro/en/index.html
   6. WHO Western Pacific Region, http://who.int/about/regions/wpro/en/index.html
      
   7. USAID
   8. UNAIDS Joint United Nations Programme on HIV/AIDS
   9. UNESCO, Bioethics
   10. United Nations Population Fund (UNFPA)

B. Non-Governmental Organiztions (NGOs)

1. AIDS Law Project South Africa
2. Doctors Without Borders (USA)
3. François-Xavier Bagnoud Center for Health and Human Rights (Harvard School of Public Health)
4. Health, Development, Information and Policy Institute (HDIP)
5. Health Wrights Workgroup for People's Health and Rights
6. Médecins du Monde
7. Médecins sans Frontières (MSF)

C. Philanthropic Organizations

1. Bill & Melinda Gates Foundation, Global Health
2. Robert Wood Johnson Foundation
3. William and Flora Hewlett Foundation, Population
4. W.K. Kellogg Foundation, Health
5. The David and Lucile Packard Foundation, Population
6. John D. and Catherine T. MacArthur Foundation, Population and Reproductive Health
7. The California Endowment
8. The Annie E. Casey Foundation, Health
9. The Duke Endowment, Health Care
10. Wellcome Trust
11. The Wolfson Foundation, Health Care
12. Robert Bosch Stiftung, Health (German site)

D. Public / Private Hybrids

1. The Global Fund to Fight AIDS, Tuberculosis and Malaria

E. Media Outlets

1. CNN
2. BBC World
3. Al Jazeera (English page)
4. AllAfrica.com

X. General Topics

A. Health Disparities

1. MMWR Morbidity and Mortality Weekly Report (CDC)
2. Morbidity Data (WHO)
3. World Health Statistics 2007 (WHO)
4. GAO report on aspects of global health funding
5. WHO International Clinical Trials Registry platform

B. Health Systems

1. Health Systems (USAID)

C. HIV / AIDS

1. UN Millennium Development Goals, No. 6 - combat HIV / AIDS
2. Megalaw.com AIDS and HIV Law links (U.S. and global)

D. Infectious Disease

1. Zoonoses and Veterinary Public Health (WHO)
2. Report of the WHO/FAO/OIE Joint Consultation on Emerging Zoonotic Diseases (2004)
3. The Control of Neglected Zoonotic Diseases (2005)
   Report of a Joint WHO/DFID-AHP Meeting with the participation of FAO and OIE

E. Ecosystem degradation

1. Division of Healthy Environments and Sustainable Development (WHO Regional Office for Africa)

F. Poor health systems

1. Division of Health Systems and Services Developments (WHO Regional Office for Africa)

G. Bioterrorism

1. Bioterrorism (WHO)
2. Bioterrorism (CDC)
   Specific Bioterrorism Agents, Info for the General Public and Professionals, Related Resources

H. Noncomunicable Diseases (NCDs)

1. Division of Prevention and Control of Non-Communicable Diseases (WHO Regional Office for Africa)
2. World Bank Report, Public Policy and the Challenge of Chronic Noncommunicable Diseases (2007)

XI. Transnational Public Health Law Bibliography

A. Books

1. Aginam, Obijiofor, Global Health Governance: International Law and Public Health in a Divided World, (Toronto: University of Toronto Press, 2005).
2. Allyn L. Taylor, Douglas W. Bettcher, Sev S. Fluss, et al., ,International Health Instruments: An OverviewŠ in Oxford Textbook of Public Health, eds. Roger Detels, et al. (Oxford: Oxford University Press, 2002): 359-86.
3. David P. Fidler [Co-Author With Lawrence O. Gostin] (In Press), Biosecurity In The Global Age: Biological Weapons, Public Health, And The Rule Of Law (Palo Alto: Stanford University Press, 2007.
4. David P. Fidler Legal Review Of The General Agreement On Trade In Services (Gats) From A Health Policy Perspective (Geneva: World Health Organization, 2006) [Primary Author With Carlos Correa And Obijiofor Aginam], 257 Pp.
5. Fidler, David P. Ars, Governance, And The Globalization Of Disease (Basingstoke: Palgrave Macmillan, 2004), 219 Pp.
6. David P. Fidler, International Law and Infectious Diseases (Oxford: Clarendon Press, 1999).
7. David P. Fidler, International Law and Public Health (Ardsley, N.Y.: Transnational Publishers, 2000).
8. Frederick M. Abbott and Rudolf V. Van Puymbroeck, Compulsory licensing for public health [electronic resource]: a guide and model documents for implementation of the Doha Declaration paragraph 6 decision. World Bank working paper; no. 61. Electronic reproduction. Palo Alto, Calif.: ebrary, 2005. (Available via World Wide Web. Access may be limited to ebrary affiliated libraries. http://0-site.ebrary.com.gull.georgetown.edu/lib/georgetown/Doc?id=10083785
9. Gian Luca Burci and Claude-Henri Vignes, World Health Organization (Frederick, MD: Aspen Publishers, 2004).
10. Gudmundur Alfredsson and Katarina Toma?evski, eds., A thematic guide to documents on health and human rights: global and regional standards adopted by intergovernmental organizations, international non-governmental organizations and professional associations (The Hague; Boston: Martinus Nijhoff Publishers, 1998).
    Laurie Garrett, Betrayal of Trust: The Collapse of Global Public Health (New York: Hyperion, 2000).
11. Lawrence O. Gostin, Ronald Bayer, Bruce Jennings & Bonnie Steinbock eds., Public Health Ethics: Theory, Policy, and Practice (New York: Oxford University Press 2007).
12. Lawrence O. Gostin, The AIDS Pandemic: Complacency, Injustice, and Unfulfilled Expectations (Chapel Hill, N.C.: University of North Carolina Press 2004).
13. Lawrence O. Gostin, A Conflict Analysis of the Draft Revised International Health Regulations and Existing International Law: A Report to the World Health Organization (Washington, D.C.: Center for Law and The Public‰s Health 2004).
14. Lawrence O. Gostin, James G. Hodge, Jr., Nicole Valentine & Helena Nygren-Krug, The Domains of Health Responsiveness: A Human Rights Analysis (Geneva, Switz.: World Health Organization 2003).
15. Lawrence O. Gostin, Stanley S. Herr & Harold Hongju Koh eds., The Human Rights of Persons with Intellectual Disabilities: Different But Equal (Oxford: Oxford University Press 2003).
16. Michel Bélanger, Le droit international de la santé. (series Que sais-je ?) (Paris: Presses universitaires de France, 1997).
17. Robyn Martin and Linda Johnson, eds., Law and the public dimension of health (London: Cavendish, 2001).
18. Stephen P. Marks, Health and human rights: basic international documents. 2nd ed. (Cambridge, Mass.; London: Harvard University Press, Francois-Xavier Bagnoud Center for Health and Human Rights, 2006).
    

B. Articles

1. Allyn L. Taylor, ,Governing the Globalization of Public Health,Š Journal of Law, Medicine, and Ethics, 32 (2004): 500-02
2. David P. Fidler, Gender Politics, Gender Paradox: Establishing Global Standards for Women‰s Health, Emory International Law Review (2007) (in press).
3. David P. Fidler, Biosecurity Under The Rule Of Law, 37 Case Western Reserve Journal of International Law (2007) [Co-Author With Lawrence O. Gostin] (In Press).
4. David P. Fidler, Architecture Amidst Anarchy: Global Health‰s Quest For Governance, 1 Global Health Governance (2007), At Http://Diplomacy.Shu.Edu/Academics/Global_Health/Journal/Pdf/Fidler-Article.Pdf.
5. David P. Fidler, Calibrating The Wealth And Health Of Nations: Trade, Health, And Foreign Policy After The Wto‰s First Decade, 1 Asian Journal Of The WTO and International Health Law and Policy 53 (2006).
6. David P. Fidler, The New International Health Regulations: An Historic Development For International Law And Public Health, 34 Journal Of Law, Medicine & Ethics 85 (2006) [Co-Author With Lawrence O. Gostin].
7. David P. Fidler, The UN and The Responsibility To Practice Public Health, 2 Journal Of International Law & International Relations 41 (2005).
8. David P. Fidler, The Meaning of Moscow: ,Non-LethalŠ Weapons And International Law In The Early 21st Century, 87 International Review of The Red Cross 525 (No. 859, 2005).
9. David P. Fidler, Disaster Relief And Governance After The Indian Ocean Tsunami: What Role For International Law?, 6 Melbourne Journal Of International Law 458 (2005).
10. David P. Fidler, From International Sanitary Conventions to Global Health Security: The New International Health Regulations, 4 Chinese Journal Of International Law 325 (2005).
11. David P. Fidler, Constitutional Outlines of Public Health‰s ,New World Order,Š 77 Temple Law Review 247 (2004).
12. David P. Fidler, Germs, Norms, And Power: Global Health‰s Political Revolution, Journal Of Law, Social Justice & Global Development (2004), At Http://Elj.Warwick.Ac.Uk/Global/04-1/Fidler.Html
13. David P. Fidler, Fighting The Axis Of Illness: Hiv/Aids, Human Rights, And U.S. Foreign Policy, 17 Harvard Human Rights Journal 99 (2004).
14. David P. Fidler, ,Emerging Trends In International Law Concerning Global Infectious Disease Control,Š Emerging Infectious Diseases, 9 (2003): 285-90
15. David M. Fidler & Lawrence O. Gostin, ,The New International Health Regulations: An Historic Development for International Law and Public Health,Š Journal of Law, Medicine, and Ethics, 34 (2006): 85-94.
16. Laurie Garrett and Scott Rosenstein, ,Missed Opportunities: Governance of Global Infectious Diseases,Š Harvard International Review, 27 (2005): 64-69. Lawrence O. Gostin, Howard Markel & David P. Fidler, Extensively Drug-Resistant Tuberculosis: An Isolation Order, Public Health Powers, and a Global Crisis, 298 JAMA 83-86 (2007).
17. Lawrence O. Gostin, Meeting the Survival Needs of the World's Least Healthy People: A Proposed Model for Global Health Governance, 298 JAMA 225-228 (2007). [WWW]
18. Lawrence O. Gostin & Benjamin E. Berkman, Pandemic Influenza: Ethics, Law, and the Public's Health, 59 Admin. L. Rev. 121-175 (2007).
19. Lawrence O. Gostin, Why Rich Countries Should Care About the World's Least Healthy People, 298 JAMA 89-92 (2007).
20. Lawrence O. Gostin, Colleen M. Flood & Lance Gable, Introduction: Legislating and Litigating Health Care Rights Around the World, 33 J.L. Med. & Ethics 636-640 (2005).
21. Lawrence O. Gostin, Lance Gable, Javier Vásquez & Heidi V. Jiménez, Mental Health and Due Process in the Americas: Protecting the Human Rights of Persons Involuntarily Admitted to and Detained in Psychiatric Institutions, 18 Pan. Am. J. Pub. Health 366-373 (2005).
22. Lawrence O. Gostin, World Health Law: Toward a New Conception of Global Health Governance for the 21st Century, 5 Yale J. Health Pol'y L. & Ethics 413-424 (2005).
23. Lawrence O. Gostin & Lance Gable, The Human Rights of Persons with Mental Disabilities: A Global Perspective on the Application of Human Rights Principles to Mental Health, 63 Md. L. Rev. 20-121 (2004).
24. Lawrence O. Gostin, Influenza Pandemic Preparedness: Legal and Ethical Dimensions, Hastings Cent. Rep., Sept./Oct. 2004, at 10-11.
25. Lawrence O. Gostin, The International Health Regulations and Beyond, 4 Lancet Infec. Dis. 606-607 (2004).
26. Lawrence O. Gostin, International Human Rights Law and Mental Disability, Hastings Cent. Rep., Mar./Apr. 2004, at 11-12.
27. Lawrence O. Gostin, International Infectious Disease Law: Revision of the World Health Organization's International Health Regulations, 291 JAMA 2623-2627 (2004).
28. Lawrence O. Gostin, Law and Ethics in Population Health, 28 Austl. & N.Z. J. Pub. Health 7-12 (2004).

Revised September 2007 (mjr)
Links revised September 2008 (mjr)