Trade, foreign policy, diplomacy and health

9. Global Public Goods for Health: Use and Limitations

Richard D Smith, David Woodward


3. International legislation

  • Law, especially international law, creates the ‘rules’ that will govern collective action required to finance and produce GPGH
  • Need for change in role of international institutions
  • Need to account for trade-offs between ‘health’ and trade
  • Need for international policies and regulatory régimes to be fully representative of developing countries and their populations

Appropriate legislation, policies and regulations, and their co-ordination nationally, regionally and globally, varying according to the disease concerned, will be required to facilitate the production of GPGH. Law, especially international law, creates the 'rules' that will govern the collective action being required to ensure the finance and production of the GPGH in question.Three issues emerge as important in this respect:

  • The GPG concept highlights the need for a change in the role of international institutions, which have historically been reluctant to engage in the development of international law. This is especially true of the WHO which has not historically invoked its powers to create international law, especially treaties. However, developments in the International Health Regulations and Framework Convention on Tobacco Controlmay signal a move toward a role as international broker of treaties to ensure GPGH.
  • The GPG concept highlights the need to be aware of trade-offs that may be required. In the case of IHR, for example, there is a trade-off between epidemic control and trade, which the GPG framework can assist in tying together. It is important that public health considerations are fully and effectively taken into consideration in non-health fora where decisions have potential effects on health.
  • There will be a danger in international legislation as long as powerful countries and interests are still able to set the agenda and disproportionately influence the outcome of negotiations. The prospect of securing a favourable international policy and regulatory environment therefore depends on decision-making processes in those international bodies that develop international policies and regulatory régimes being fully representative of developing countries and their populations.
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