Researching Law Fall 2020 - Flipbook - Page 5
VO L 31 | NO 2 | FA LL 2020
municipalities. These global and
national health laws intertwine as
they work to promote and protect
health while ensuring transparency
and accountability.
The history of this legal environment
is long, convoluted, and tangled with
other global concerns like trade and
tourism. As early as 1851,
worldwide regulations were crafted
to control diseases like cholera,
yellow fever, and the plague. At that
time, regulations such as quarantines
were intended to keep sailing ships
from taking diseases from one place
to another. As the world economy
and travel have become more
integrated, these regulations have
only become more vital.
“The history of disease surveillance
makes it very clear that it’s difficult
to get countries to share information
because the sharing of information
threatens trade, tourism, and
national reputations,” said Heimer.
“There’s a lot of strategizing and
gaming that goes on at the country
level about what they’re going to
reveal, and on what timetable.”
The formation of the World Health
Organization (WHO) was key
to the global legal environment
surrounding pandemics. Formed in
1948, the WHO and its member
states quickly adopted the
international sanitary regulations.
These were the precursors to the
original IHR, which were first
adopted in 1969 to help monitor and
control serious diseases. The IHR
comprise a legally binding
instrument of international law.
They require all countries to have the
ability to detect, assess, report,
respond to public health events.
“The key issue at stake in these
agreements is collecting and
publicizing information about
disease outbreaks,” said Heimer.
“Only with transparency is there any
hope of protecting public health and
curbing existing, eradicated, nearlyeradicated, and emerging disease.”
The Change in
International Public
Health Law: From SARS to
COVID-19
In the seventeen years between the
onset of SARS (Severe acute respiratory
syndrome, also called SARS-CoV) and
COVID-19, the international public
health legal environment changed
significantly. To understand these
changes, Heimer examined the
differences in the time lines and
reactions to SARS and COVID-19.
This examination provided a useful
lens for understanding the updated
regulations and fundamental
changes that occurred in the
intervening time.
SARS began in China in November
2002. China did not report the
disease domestically until February
2003, and the WHO did not receive
information on the disease until
March 11, 2003. The lapse from
November to March, according to
Heimer, is a long time in the world
of infectious diseases. After the
WHO received the information, the
organization sent out an alert and
issued a travel advisory.
“The history of
disease surveillance
makes it very clear
that it’s difficult to
get countries to share
information because
the sharing of
information threatens
trade, tourism, and
national reputations,”
said Heimer.
The virus was then sequenced by
April, and it rather quickly became
controlled through ordinary public
health measures. The first country
became virus-free in April, and the
epidemic ended by July 2003.
“The consensus about SARS seems
to be that the epidemic would
have been far worse if it hadn’t
been stopped in its tracks by pretty
effective actions,” says Heimer.
“But, at the same time, there was
also a consensus that it could have
remained within China’s borders
had China been a little more
forthright about the existence of
the disease when it started.”
At the time of SARS, the original
1969 IHR were in place. Under the
1969 IHR, China was not obligated
to report on SARS, and the WHO
was not legally empowered to act
on the “informal” information it
had in hand. These IHR were
revised significantly in 2005, and
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