New report offers global resource on using the law to improve health

January 2017

Soda tax in Mexico. Salt limits in South Africa. Plain tobacco packaging in Australia. National health insurance in Ghana. Mandatory motorcycle helmets in Vietnam. Health care in the United States of America.

They're just some of the hundreds of examples of the vital role the law plays in safeguarding and promoting good health around the world.

A new report from WHO, in collaboration with the International Development Law Organization (IDLO), the University of Sydney, and Georgetown University in Washington, DC, describes the many ways in which the law makes a crucial difference for public health. The report features case studies from around the world on how the law has improved the health and safety of populations, providing a resource for countries to learn from the experience of others.

"Some of the best examples in this report use population-wide interventions to reshape the environments in which people make their lifestyle choices," said Dr Rüdiger Krech, Director in the Health Systems and Innovation cluster at WHO in Geneva. "This requires extraordinary government commitment, courage, and persistence in the face of powerful commercial interests."

The right to health is enshrined in WHO’s constitution, which affirms that the enjoyment of the highest attainable standard of health as one of the fundamental rights of every human. WHO provides assistance to countries that are seeking to use the law to improve their health systems, and to address health threats.

As far back as 1875, lawmakers in the United Kingdom passed legislation requiring landlords to provide proper sanitation, ventilation and drainage to stem the spread of infectious diseases. Today, the control of infectious diseases is one of the most powerful illustrations of how the law can make a difference to health. From smallpox to more recent outbreaks of SARS and Ebola, public health laws can help to improve screening, reporting, contact tracing and quarantine, stemming the spread of infections.

Health laws often make the headlines when they have a direct impact on the everyday consumption patterns of people, such as Mexico’s so-called soda tax, introduced in 2014 to reduce the consumption of sugar-sweetened beverages. In the same vein, Australia’s plain packaging laws for tobacco products have become a global standard-bearer in the effort to reduce smoking rates.

"The use of law to reduce smoking has been one of the great public health achievements, but there is so much more we could do with unhealthy foods, excessive alcohol use, injuries, and mental health," said Prof Lawrence Gostin, faculty director of the O’Neill Institute for National and Global Health Law at Georgetown University. "This report offers a pathway to using evidence-based legal interventions for human health and wellbeing."

Countries also use the law in many unseen ways to strengthen health systems and help make progress towards universal health coverage. Some countries use laws to create the institutions that govern health systems, such as national health insurers, or agencies that regulate medicines or ensure quality health services are available to all people. The global response to HIV has demonstrated how law can protect people from discrimination, and facilitate access to harm reduction services and treatment.

The law will be a vital tool for countries to make progress towards the health-related targets in the Sustainable Development Goals.

"There is tremendous, untapped potential to use law more effectively to strengthen health systems and change lives for the better," said Prof Roger Magnusson, professor of health law and governance at the University of Sydney, and one of the report’s authors. "The law is a powerful tool to help people live longer and healthier lives, and for economies to be more resilient."

While laws can help to protect health, their absence or neglect can expose entire populations to health threats. Weak regulation of tobacco products in some countries allows powerful companies to market those products unfettered, and to recruit young smokers. At a global level, WHO’s International Health Regulations and Framework Convention on Tobacco Control provide legal frameworks for responding to public health emergencies and the global tobacco epidemic. But the failure of some countries to comply with them puts the world at risk of potentially catastrophic outbreaks and the long-term costs and health impacts of smoking.

And unfortunately, the law can and has been used to harm health. Laws have been used to incarcerate people with mental illness, and to deny them the rights and services they need. Likewise, travel restrictions during West Africa’s Ebola outbreak prevented medical personnel from getting into the affected countries, prolonging the epidemic.

But when harnessed to protect, promote and advance the right to health, the law can be a potent ally.

"One of the most useful aspects of this report is that it links human rights to urgent public health challenges," said David Patterson, IDLO’s program manager for health law. "This approach, based on non-discrimination, participation, transparency and accountability, is the best way to ensure that responses are locally appropriate and sustainable."