INTRODUCTION
In this assignment I will discuss the link between sound laws and public health policies and
sustainable development. This paper will define law and public health policy and will also go
on to define sustainable development. The paper will further go on to look at what sustainable
development is really about before discussing health and its importance in sustainable
development. There will be an analysis of past and present, international and local laws and
the rationale for developing these laws. This will be followed by a short discussion on how
these laws and policies are being enforced and to what extend there has been a success.
Finally this paper will briefly look at other factors that also have to be considered in order to
achieve sustainable developed and then a conclusion will be given.
Definition of terms
According to Centre for Law, Health and Society 2017 of Georgia State University, law is a
broad and interdisciplinary field that involves any law which affects the health of individuals
and the public. The health law field includes specific laws that regulate the health industry,
the public’s health, and the delivery and financing of health care services. It also includes
more general laws that can impact health and health care, such as corporate and tax
law, environmental law, tort law, bioethics and law, constitutional law, family law, juvenile
and elder law, administrative law, intellectual property law, social welfare law and
international law. Health policy refers to decisions, plans, and actions that are undertaken to
achieve specific health care goals within a society (WHO 2017). An explicit health policy can
achieve several things: it defines a vision for the future which in turn helps to establish targets
and points of reference for the short and medium term. It outlines priorities and the expected
roles of different groups; and it builds consensus and informs people. The idea of sustainable
development grew from numerous environmental movements in earlier decades and was
defined in 1987 by the World Commission on Environment and Development (Brundtland
Commission 1987) as: Development that meets the needs of the present without
compromising the ability of future generations to meet their own needs. This contributed to
the understanding that sustainable development encompasses a number of areas and
highlights sustainability as the idea of environmental, economic and social progress and
equity, all within the limits of the world’s natural resources.
Sustainable Development in International Policy
Our Common Future, the influential 1987 Brundtland Report, sought for solutions to parallel
problems of global environmental degradation and global lack of social and economic
development, by asking for these challenges to be addressed in an integrated way, for the
interests of present and future generations. In the Brundtland Report, as mentioned above,
sustainable development was defined as “development that meets the needs of the present
without compromising the ability of future generations to meet their own needs.”At the
United Nations Conference on Environment and Development, in the 1992 Rio Declaration,
States committed to “the further development of international law in the field of sustainable
development” (Principle 27). In the 1992 Agenda 21 States elaborated that this involved the
“further development of international law on sustainable development, giving special
attention to the delicate balance between environmental and developmental concerns” (1.a).
In the 1997 Programme of Action for Further Implementation of Agenda 21, States further
agreed that “it is necessary to continue the progressive development and, as and when
appropriate, codification of international law related to sustainable development. Relevant
bodies in which such tasks are being undertaken should cooperate and coordinate in this
regard.” (para. 109). The 2002 World Summit on Sustainable Development Johannesburg
Declaration specifically commits to “assume a collective responsibility to advance and
strengthen the interdependent and mutually reinforcing pillars of sustainable development -
economic development, social development and environmental protection.
International Law and Health Policy
There is a historic disconnect between international health concerns and international law.
There are a number of reasons for this intellectual disengagement.
First, until recently, neither public health practitioners nor lawyers saw international health
law as an “outcome-determining factor” for public health progress. Health problems, in
general, have been seen as “technical” or “scientific” problems to be solved, rather than
social and political ones to be debated and negotiated. Accordingly it has been medical,
pharmaceutical, engineering and technological breakthroughs which have been given credit
for the greatest advances in twentieth-century health. While this approach was appropriate in
past decades, this approach is no longer viable; moreover, where “technical” has also come to
mean static, non political and non-interdisciplinary, this is no longer sufficient.
Secondly, any international health law which has developed is mainly the purview of public
health experts, rather than legal experts. Much international public health policy emanates
from health organizations, such as the World Health Organization (WHO), rather than from
judicial decision-making bodies. And, despite the tremendous international legal powers
given to the WHO, including the authority to adopt treaties addressing any matter in its
domain, health law has tended to be derived from soft law processes. Policy implementation
and enforcement have operated through recommendations and regulations rather than through
legally binding rules. Even the interpretation and dispute settlement of those
recommendations have tended to be governed by informal processes. In the words of one
author, this “ethos” has been based on the assumption that public health progress can be
better achieved through cooperation and consensus building rather than through a hard legal
approach.
The International Health Regulations system (IHR) is a prime example of the present-day
“soft law” approach to global health. The IHR was one of the earliest attempts by WHO to
act collectively with regard to world health. Its purpose was to ensure the “maximum security
against the international spread of disease with minimum interference with world traffic”.
The IHR creates a comprehensive surveillance programme for member states to monitor and
respond to infectious disease in their respective countries-yellow fever, plague and cholera.
However, neither the IHR nor the WHO Constitution permits action against States who fail to
comply with a regulation. Moreover, the three diseases that are the focus of the IHR have
been eclipsed by other infectious diseases in public attention and mortality. As such, the IHR
have been increasingly criticized for being neither relevant to nor useful for addressing the
public health problems of our time.
Rationale for the Development of International Sustainable Health Law
However, those interested in economic and social development are more likely to appreciate
the importance of investing in health. There are a number of factors which capture the
changing landscape. First, due to globalization, public health dangers now have a scale
beyond the capacity of any single national health care system. A population-based approach
is needed now, one that is transnational in orientation. These processes include increased
travel, migration and cross-border trade; changes in individual behaviour (especially sexual
behaviour); rapid urbanization (driven in part by the opportunities and constraints caused by
economic globalization) and hastened environmental degradation. The critical element in
these processes is the way in which cross-border channels have increased in numbers and
speed. Thus, populations have become vulnerable to disease-causing agents imported from
elsewhere in a manner unprecedented since the beginnings of the colonial period in the
Americas, Africa and Asia.
Globalization also has a negative effect For example, urbanization is associated with
overcrowding and poor sanitation; environmental degradation is associated with changing
weather patterns which affect habits and locales of disease-carrying insects and animals, the
liberalization of international trade has contributed to the dissemination of disease-causing
products such as tobacco; and cross-border travel has heightened the spread of Severe Acute
Respiratory Disease (SARS) and HIV/AIDS. All of these circumstances confirm that the
nature of public health is inherently global with causes related to the world's growing
interconnectedness and with consequences that must be addressed by international solutions.
An Opening for a New International Sustainable Health Law
Fortunately, the last ten years have seen a burgeoning interest, meetings and activities related
to national and international public health law. On the domestic front, States and health
organizations have begun to use legal means to pursue public health concerns. For example,
in Canada and the United States, State and provincial governments have pursued tobacco
litigation to bolster public health measures. In South Africa and Thailand, governments have
resisted pharmaceutical company pressure by asserting their legal rights under TRIPS to
provide for generic drugs.
In December 1997, the WHO and the Indian Law Institute sponsored an International
Conference on Global Health Law in New Delhi at which the delegates adopted the New
Delhi Declaration on Global Health Law. For the first time, the WHO has exercised its
treaty-making powers, in order to pursue the first international health treaty in the area of
tobacco control the WHO is also currently revising the International Health Regulations as a
prelude to the development of a convention on infectious diseases.
Finally, the WHO's “Health for All in the Twenty-First Century” policy emphasizes the
importance of international law, stating that “WHO will develop international instruments
that promote and promote health, will monitor their implementation, and will also encourage
its member states to apply international laws related to health”. The Health for All Policy
demonstrates an appreciation of the importance of different international legal regimes to
WHO's global work, including the three critical sustainable development regimes (human
rights, international trade and environmental protection).
International Environmental Law (IEL) and Health
All “traditional” health hazards (such as lack of access to safe drinking water; inadequate
basic sanitation; indoor air pollution from cooking and inadequate solid waste disposal) and
“modern” hazards (such as water pollution from industry and intensive agriculture; air
pollution from transportation or power stations, hazardous wastes, and other forms of
transboundary pollution) contribute to about a quarter of human morbidity and mortality.
Environmental changes too will increasingly affect human health. The fact that many people
are not able to adapt to such circumstances, while others are forced to do so is the antithesis
of sustainable development.
Fortunately much of international environmental law already does concern the protection of
human health. A great deal of IEL focuses on shielding people from the health-damaging
consequences of pollution and environmental degradation. IEL should be seen, therefore, as
an important part of the international law that supports public health objectives.
Sustainable Health Processes and Capacities
The New Delhi Declaration on Global Health Law states that “global health law” includes
“strengthening institutional and human capacity for law”; developing regulatory and
legislative approaches to support “health for all” and ensuring monitoring and
implementation of health law. These items do not represent principles of law but rather focus
on processes and capabilities needed (p.339) to improve the contribution of national and
international law to global public health.
Developing Countries
In 2002, in Johannesburg, at the Health and Sustainable Development meeting, Professor
Buch had the following to say; “while there had been improvements in some indicators, the
disease burden, for both communicable and non-communicable diseases, still remains high
and the poor carry a disproportionate burden of disease.” Global development goals and
targets were unlikely to be met unless efforts to achieve them were dramatically and rapidly
scaled up, he said. In looking at the linkages between poverty and ill-health, it could be seen
that poverty was at the root of much ill-health, and this poverty was multi-dimensional. At
the same time, poor health could lead to poverty, both at the national, and household levels.
Conversely, good health could add billions of dollars to gross domestic product, and
Professor Buch outlined some of the pathways through which this would happen. He asserted
that sustainable development was the key to improved health, since the poverty driving
ill-health was interconnected with factors such as poor economic growth, inequity,
globalization, environmental degradation and weak health services. Health services had an
important role to play in sustainable development by reducing the disease burden. However,
this role was being undermined by the insecurity of health services in many developing
countries, as well as under-funding and stunted technological development. In considering
ideas for a declaration on health and sustainable development, Professor Buch said that this
should be aimed at reinvigorating sustainable development, and focusing on ways to
bequeath a healthy life for present and future generations. Efforts should focus on the poor
and marginalized in all countries as they bear the greatest health burden.
Conclusions
From professoer Buch’s it can be summed up that there is a connection between the social
and economic aspects of life in both developed and developing countries. It can also be noted
that it is difficult for developing countries to sometimes maintain the international laws and
policies as they may not have the appropriate infrastructure and technology to meet the
specifications.
While health has long been central to the sustainable development agenda, academics and
scholars are only just beginning to analyse the relevance of international heath law to
sustainable development law. Health laws and policies, as part of sustainable development
law, are shaped by interconnections between social, environmental and economic law.
There is need for a great deal of future development, which should start from the
identification of a future legal research agenda. Such research seeks to encourage public
health practitioners and international legal specialists to consider health law from a genuinely
global perspective. Globalization has rendered many distinctions between national and
international policy objectives almost meaningless. Legal frameworks and implementation
efforts need to reflect this reality. The traditional schism must be bridged between health
policy and international law relating to sustainable development. A sustainable development
law perspective can help meet this challenge by addressing cutting edge areas of sustainable
development law related to health, especially in key policy areas where international treaties
and principles are fast becoming part of the operating environment for all actors.
Finally it should be noted that Health is only but one of the 17 goals of sustainable
development and this therefore means there is need to be conscious of the other 16 goals in
order to fully achieve sustainable development. These are four key messages that we could all
follow to achieve Sustainable Development Goals:
1. New Global Development Goals Must Look to the Future
2. Goals Need to Be Multi-Dimensional and Universal
3. Goals Should Be Few, Focused, and Simple
4. Goals Must Belong to Everyone
REFERENCEES
1. Health and Sustainable development. Summary Report, Johannesburg South Africa
19-22 Jan 2002
2. Carlos F. Carvalon, Health, Environment and Sustainable Development, Identifying
Links and Indicators to promote action. 2007
3. WHO lournal 2017
4. http://www.wri.org/publication
5. UN, Health as the pulse of the New Urban Agenda, Oct 2016
6. Norwegian Public Health Act
