Zika, Pregnancy, and the Law

The public health emergency surrounding the spread of the Zika virus has resurrected and brought into sharp relief some of the most vexing questions surrounding the relationship between pregnancy and law: the appropriate circumstances, if any, in which fetal tissue research is permissible; when and how the government may sponsor statements intended to influence reproductive decisions; and how to balance the health and rights of both women and their unborn children when health threats target both

Multipolarity, Intellectual Property, and the Internationalization of Public Health Law

This Article critically examines the proliferation of international legal agreements addressing global health threats like the outbreak of infectious diseases, tobacco use and lack of access to affordable medicines. The conventional wisdom behind this trend is that a global normative shift has occurred which has caused states to regard health as “special” and less subject to the normal rules of international law making because health threats endanger all of humanity. This Article challenges that thesis, arguing that at the same time the number and scope of international health law treaties has grown, developed states have subordinated health law to intellectual property protection for patents and trademarks, both of which erect substantial barriers to the objectives of public health law treaties. To the extent international health law has generated meaningful gains for global population health, it has not done so through a normative shift in how diplomacy works, but precisely because of politics as usual. International public health law gains have come largely from the efforts of an emerging group of middle-income, influential states like Brazil, India, Indonesia, South Africa and Thailand who have sufficient weight to force concessions from wealthier states. Using the parallel histories of international intellectual property treaties and global public health law, the Article demonstrates that the normative force of health-based arguments is relatively weak. To the extent public health advocates urge the adoption of more treaties, as they are now poised to do, they must more squarely address the threat posed by international intellectual property protection and make strategic calculations as to the political feasibility of those agreements given the changing distribution of global economic and political power

Participation and the Right to Health: Lessons from Indonesia

The right to participation is the “the right of rights” — the basic right of people to have a say in how decisions that affect their lives are made. All legally binding international human rights treaties explicitly recognize the essential role of participation in realizing fundamental human rights. While the substance of the human right to health has been extensively developed, the right to participation as one of its components has remained largely unexplored. Should rights-based health advocacy focus on participation because there is a relationship between an individual’s or a community’s active involvement in health care decision-making and the highest attainable standard of health? In the context of the human right to health, does participation mean primarily political participation, or should we take the right to participation to mean more specifically the right of persons, individually and as a group, to shape health care policy for society and for themselves as patients? Decentralization of health care decision-making promises greater participation through citizen involvement in setting priorities, monitoring service provision, and finding new and creative ways to finance public health programs. Between 1999 and 2008, Indonesia decentralized health care funding and delivery to regional governments, resulting in substantial exclusion of its poor and uneducated citizens from the health care system while simultaneously expanding the opportunities for political participation for educated elites. This article explores the tension between the right to participation as an underlying determinant of health and as a political right by reviewing the experience of Indonesia ten years after its decision to decentralize health care provision. It is ultimately argued that rightsbased advocates must be vigilant in retaining a unified perspective on human rights, resisting the persistent tendency to separate and prioritize the civil and political aspects of participation over its social component

Obstacles to pH1N1 Vaccine Availability: the Complex Contracting Relationship between Vaccine Manufacturers, WHO, Donor and Beneficiary Governments

Vaccines are the most important line of defense to protect public health and the spread of disease during influenza pandemics. Yet the 2009 experience with pandemic H1N1 influenza showed that manufacturers, wealthy and poor governments were completely unprepared for the demands that global demand for vaccine production and distribution might impose. This chapter analyzes the failures of the system in 2009-10 with the aim of facilitating greater preparedness for future influenza pandemics