If enterprises and foundations represent new actors and sources of global health law, and international adjudicatory bodies represent the future of how global health law is applied, then animals, both domesticated and wild, represent the expansion of global health law’s subjects. Human health, narrowly defined, prevailed throughout most of the twentieth century. In some ways, the comprehensive approaches to animal, human, and plant life should have been obvious and inevitable from the earliest days of World Health Organization (WHO). Its most ambitious, early eradication effort focused on malaria. This effort made extensive use of DDT, which “appeared to be effective everywhere, making eradication of malaria a feasible objective. However, DDT’s effectiveness against agricultural pests and house-hold insects made prices soar, and its widespread application rapidly led to” resistance in some pests. Beyond those effects, it also imposed significant toxic risks on wildlife and posed serious health risks to humans as well. It was banned in most developed countries during the 1970s.
The need to widen the reach of global health law to include not only the health of humans but also the health of the animals they raised and ate as well as the environment in which they lived grew over the course of the 1970s. In 1972, the United Nations held the first of many global conferences on environmental issues: the Conference on the Human Environment in Stockholm, Sweden. In the decade after the 1972 conference, scientists and nongovernmental organizations had sounded the alarm on biodiversity losses generally and in the Amazon River basin specifically. Logging, extraction, and agriculture explained much of the loss. In 1987, the governing council of the United Nations Environmental Programme created a working group to explore the possibility of developing a legally binding treaty to protect biological resources. In 1991, formal multilateral negotiations began for a Convention for Biological Diversity.
The interconnectedness of habitat loss, pathogen emergence, and ecosystem collapse led researchers, governments, and public health scholars to develop what has been known as “One-Health” approaches to animal, human, and plant health. That humans, animals, and the environment are interdependent and that their respective welfare is mutually supportive has been acknowledged for centuries. Yet it is relatively recently that public health policies have focused on the nexus between humans, animals (domesticated and wild), and the environment. After the severe acute respiratory syndrome (SARS) epidemic, Covid 19 pandemic (which led to the revision of the International Health Regulations) and the H5N1 avian influenza outbreaks, one-health approaches must be enact or expand to include health-service delivery, environmental health, and ecosystem services.
Recent studies indicate that there may be parallels between SARS and the recent Covid19 pandemic. Scientists have found coronaviruses, genetically similar to the Covid19 virus, in pangolins, leading to a hypothesis that they served as an intermediate host, much like civet cats did with SARS.
We have affected these creatures in more ways than poaching them. As human populations grow, our incursion into a variety of habitats expands even as our appetite for certain animals remains unabated. As it has with civets, deforestation has dramatically affected the areas available for pangolins’ for-aging, putting them in closer contact with other animals including bats, which are reservoirs for other dangerous viruses like Nipah virus, and possibly Ebola. This may have facilitated the spread of disease.
This “One-Health” strategy means establishing systems that acknowledge the close relationship between animal and human health. These systems are oriented toward areas where rapid intensification of agriculture systems, especially with livestock keeping, have increased interactions between animals and humans, and consequently caused significant changes in habits and practices of proximate human communities.
The most significant manifestation of global health law at the nexus of animals, humans, and the environment is the Joint External Evaluation (JEE) process. The JEE is a “voluntary, collaborative, multi-sectoral process” that assesses countries’ capacities to identify the most critical gaps within their human and animal health systems, in order to prioritize opportunities for enhanced preparedness and response.
The JEE “bring[s] together national representatives from key sectors, including human and animal health, agriculture, wildlife, finance, defence, security, environment, communication, disaster management board, transportation, customs, civil aviation, universities or institutes, and political leadership.” The JEE exercise identifies whether a country has adopted laws specific to the International Health Regulations, maintains surveillance systems for animal health, and monitors the use of antibiotics and signals for the emergence of anti-microbial resistance.
The JEE process itself is a function of the increasing “securitization” of global health law. The Global Health Security Agenda (GHSA) was launched in 2014 to help build countries’ capacities to address infectious disease and other threats. The GHSA external assessment tool was developed in collaboration with relevant international organizations with mandates committed to “One-Health approaches”—WHO, FAO, and OIE—as well as member countries. In early 2016, the WHO International Health Regulations (IHR) monitoring and evaluation teams began working with the GHSA secretariat to introduce the Joint External Evaluation(JEE) tool. The JEE tool includes the original components of the GHSA tool but also adds in eight other key technical areas from the International Health Regulations.
The formation of the Global Health Security Agenda(GHSA) coincided with the emergence of the Ebola out-break in Guinea, Liberia, and Sierra Leone, which lasted through 2016 and claimed over 11,000 lives. Its formation signalled the tightening relationship between global health law and international peace and security, further inter-twined with the United Nations Security Council’s intervention into the Ebola outbreak in September 2014. The GHSA is a broad-based partnership comprised of approximately sixty countries who work with international organizations, foundations, and businesses. It explicitly acknowledges equivalence between infectious disease and biosecurity threats and integrates into its partnership not only WHO, FAO, and OIE but also security-oriented international organizations like Interpol. According to the GHSA, the fight against COVID-19 has been significantly enhanced by “national plans supported by the International Health Regulations and Joint External Evaluations [which are] are guiding action and providing resources for decision making, prioritisation, and actions.”
Although there had been global health emergencies before the International Health Regulations were adopted and expanded in the early 2000s (for example, pandemic influenza), they had never before been considered as proper concerns of the world’s most important authority for securing international peace and security. With the global threat posed by both HIV/AIDS and Ebola, the United Nations Security Council became a more regular player in the scope and applicability of global health law. It issued recommendations, established response organizations, and played a more coordinating role between relevant United Nations agencies. In 2014, the United Nations Security Council established the United Nations Mission for Ebola Emergency Response (UNMEER) to meet immediate needs related to the fight against Ebola. United Nations Security Council Resolution 1983 established that “United Nations troops and police are part of prevention, treatment and care” in countries battling HIV/AIDS. Given the lack of adherence to recommendations issued by the WHO Director–General during declared public health emergencies, one possibility, even likelihood, is for the Security Council to implement those measures with the greater force of the United Nations Charter.
The enhanced role of the United Nations Security Council means that global health law is more likely to be “securitized”—that is, “the risk of international spread of infectious diseases is seen not so much as a public health problem to be dealt with by civilian authorities but a security threat to be addressed primarily by security, military and intelligence authorities at the national and international levels”—in the future than it has been in the past. Indeed, the United Nations Security Council appears poised to intervene in the current Ebola outbreak in eastern Democratic Republic of the Congo (DRC). On August 2, 2019, the United Nations Security Council expressed “grave concern” about the Ebola virus outbreak in the Democratic Republic of the Congo (DRC) and “stressed the urgency of broad cooperation in the response, as ‘the disease could spread rapidly, including to neighbouring countries, possibly having serious humanitarian consequences and impacting regional stability.” In other words, the Security Council appeared ready to assume once again leadership on a specifically health-related crisis. It is now contemplating international action against COVID-19.
The “securitization” of health carries with it significant threats to other human rights. At the national level, measures curtailing civil liberties, like isolation and quarantine, have long been used pre-textually to detain those who may not in fact be infectious but may be politically unpopular, like migrants. Indeed, COVID-19 based measures have brought global migration to a grinding halt. At the international level, the securitization of health may mean the stigma or isolation of entire countries. This explains in significant part the dispute between the United States and China at the United Nations Security Council, with the former demanding at some points to refer to a “Wuhan” virus or a “China” virus.
On the other hand, the intervention of the United Nations Security Council in the contexts of HIV/AIDS and Ebola has been associated with a significant acceleration of the mobilization of international resources and a more rapid containment of epidemics once they are determined to fundamentally challenge international peace and
security. The same is hoped for COVID-19.
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