Achieving SDG Health Targets Using ‘The Vital Role Of Law’

Effective laws, including those around intellectual property rights, and an enabling legal environment, are as essential to a healthy society as clean water, a group made up of a representative of the World Health Organization, academics and a legal expert for a civil society group, have asserted while launching a key report.

At an event held at the Graduate Institute in Geneva on 16 January, the WHO launched what speakers called “a ground-breaking report” titled, Advancing the Right to Health: The Vital Role of Law.

The report, available here, is the result of a collaboration between the WHO, the International Development Law Organization (IDLO), the O’Neill Institute for National and Global Health Law at Georgetown University in Washington DC, and the Sydney Law School at the University of Sydney in Australia.

Gian Luca Burci, adjunct professor of International Law at the Graduate Institute and a senior fellow at its Global Health Centre noted that public health challenges having a legal component include infectious and non-communicable diseases, injuries, mental illness and universal health coverage.

SDG Health Targets

Despite this, in many countries, legislation, policies and practices are antiquated, contrary to human rights obligations, and hostile to public health goals – threatening the achievements of the UN Sustainable Development Goals (SDG) health targets in those countries and regions.

Law plays a role in universal health care the audience heard.

The report states that, “Any mediation relating to disputes arising under the license [for the report] shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization (WIPO).”

It explains that legal regimes, whether national or global, extend well beyond the health sector and can have a strong impact on the SDGs adopted by the United Nations that came into effect on 1 January 2016.

The WHO says that almost all the SDGs are directly related to health or will contribute to health indirectly and one goal (SDG3) specifically sets out to “Ensure healthy lives and promote well-being for all at all ages.”

The report says, “A ‘health-in-all policies’ or ‘all-of-government’ strategy is needed. Ensuring the public’s health and safety requires more than effective health policies. It requires active engagement with finance, justice, housing, energy, transportation, and other ministries – with leadership at the highest levels of government.”

The same applies to the global level says the report.

The Role of Trade and Intellectual Property

“Consider, for example, the role of trade and intellectual property in ensuring (or denying) access to essential medicines or vaccines. Or consider the role of agriculture in reducing the proliferation of antimicrobial resistance. Indeed, health requires an ‘all-of-society’ strategy that fully engages civil society and businesses for the public good,” the report notes.

David Patterson, program manager/advisor, health law, International Development Law Organization (IDLO), highlighted how people who contested intellectual property laws had helped in the fight against AIDS.

“The Global Fund to Fight AIDS, Tuberculosis and malaria has adopted human rights as a pillar of its global strategy,” he said. “In 2015 some $19 billion was invested in the AIDS response in low and middle income countries. The HIV movement has driven down the price of medications and broken the myth that new treatments for HIV and other diseases must be beyond the reach of the global poor.

“As of 2016, over 18 million people were accessing HIV treatment. This is largely because of the early efforts of HIV activists and lawyers in South Africa, who challenged prevailing approaches to intellectual property law, patents and prices.”

Still, said Patterson, hostile legal frameworks and discrimination deter people from HIV testing and treatment. He noted that some 2 million people are newly infected every year and that figure has not declined since 2010.

He added that in several West Africa countries a model law on HIV led to the criminalization of HIV transmission, which drives people away from HIV testing and treatment.

The meeting looked at why is the law’s role in protecting and promoting health still neglected in many countries, and what opportunities there are for the future.

“Process is as important as substance. The quality of the process to assess, reform and adopt law is very important. We are talking about community participation, inclusiveness and transparency. We are talking about good governance and the rule of law,” said Burci, who moderated the meeting.

The report looks at the Pandemic Influenza Preparedness Framework (PIP) that requires WHO to establish an electronic traceability system to enable the tracking in real time of all PIP biological materials. It says that under the first material transfer agreement, between providers and recipient laboratories within the GISRS (Global Influenza Surveillance and Response System), both parties are encouraged not to seek to obtain any intellectual property rights in the materials.

Commercial Determinants of Health

Marie-Paule Kieny, assistant director-general, Health Systems and Innovation at the WHO, said, “We [have] come a long way in understanding how different sectors contribute to health. We also much better understand the commercial determinants of health and can harm people’s health and put additional burdens on people’s health systems.”

She said there is a range of tools to advance people’s health and a powerful and sometimes underutilized one is law.

She cited soda tax in Mexico, salt limits in South Africa, plain tobacco packaging in Australia, national health insurance in Ghana, mandatory motorcycle helmets in Vietnam, lead-free fuels in Europe and health care in the United States.

“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,” said Kieny.

“This is a ground-breaking report. It is the first of its kind and it illustrates how countries have enacted a implemented wide range of laws and regulations with a demonstrable effect on health and safety of their populations….the control of infectious diseases is perhaps the best understood and the most powerful illustration of laws in public health,” she said, referring to the recent outbreak of Ebola and Zika viruses.

Prof. Lawrence Gostin, faculty director of the O’Neill Institute for National and Global Health Law at Georgetown University (US), said, “This report offers a pathway to using evidence-based legal interventions for human health and wellbeing.”

“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. Law can be a really good partner,” he said.

This view was supported by Prof. Roger Magnusson, professor of health law and governance at the University of Sydney, and one of the report’s authors, who said the report gives a real sense of public health law as a global public health good.

“There is tremendous, untapped potential to use law more effectively to strengthen health systems and change lives for the better,” he said. “The law is a powerful tool to help people live longer and healthier lives, and for economies to be more resilient.”

“We can all only gain by sharing knowledge about powerful ways to improve health. Knowledge about public health law is non-excludable and non-rivalrous” and thanks to the WHO report it will build new knowledge that everyone can share, said Magnusson.

 

Image Credits: Peter Kenny