Volume 108

The Origins and Future of Global Health Law: Regulation, Security, and Pluralism

by Sam F. Halabi

Part I of this Article traces the origins and definitions of “global health law” as that phrase has changed since the formation of the World Health Organization and the formal, legal commitment of the world’s sovereign states to a human right to health. Part I challenges the conventional history of global health law, which tends to emphasize the International Health Regulations and the Framework Convention on Tobacco Control. It claims that the welfare of infants, children, and mothers reoriented the post-World War II focus of global health law and aimed it at multinational enterprises and the importance of food and agriculture; and that it did so increasingly as a function of international peace and security.

Part II first identifies the emerging and expanding sources of supranational regulation of global firms, including the regulation of their behavior imposed through contract or binding agreements and the growth in global health law formed through adjudication. Part II further analyzes the developing impact of one-health principles on global health law, and how it is likely to recharacterize global health law over this century. Finally, Part II ties these trends to the “securitization” of global health law at the U.N. Security Council, including the stale-mate that has developed between China and the United States over the characterization of the COVID-19 threat to international security.

Part III concludes that global health law became increasingly focused on the protection of infant, child, and maternal health over the course of the 1950s and 1960s, a focus that expanded the diversity and number of subjects it targeted, especially multinational businesses. As disease threats expanded and became more severe, global health law also “securitized,” such that the U.N. Security Council and auxiliary, security-oriented organizations became key sources of new global health law. As a result, the future of global health law lies in more supranational regulation of global firms; the influence of agreements between firms, foundations, and governments (including international organizations); and the growing body of law generated by adjudicative bodies like international- investment and trade tribunals. COVID-19, as a dramatic illustration of these movements, has shown that biomedical interventions are being produced under the guidance of a bundle of contracts constraining firms that would otherwise seek to exploit the potential market for a therapeutic or vaccine; the response being coordinated as a fundamental threat to global security, and that response has been shaped by stakeholders ranging from regional and national governments to global financing institutions to global companies. The result of these movements is the future of global health law: regulation, security, and pluralism.

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