Introduction to Written Symposium on Public Health and International Law

I. INTRODUCTION Public health has emerged as one of the most important issues of our global age. Despite health improvements and gains in life expectancy around the world in the twentieth century, the twenty-first century begins with developed and developing countries confronting a host of threats to, and controversies about, human health. The HIV/AIDS pandemic is wreaking enormous damage in the developing world, especially in sub-Saharan Africa,1 and this plague has yet to run its devastating course. Other infectious diseases, such as malaria, tuberculosis, and diarrheal diseases, are growing as public health threats around the world.2 A pandemic of noncommunicable diseases related to tobacco consumption is underway, with enormous morbidity and mortality in developing countries expected in the coming decades.3 Science-one of the engines of public health progress-confronts a controversial future as scientific developments become tools of malevolent behavior, as with bioterrorism, and the focus of hopes and fears about the future shape of health and human nature, as reflected by debates about genetic engineering. In the face of these challenges, the adequacy of national and international governance for public health is currently under intense scrutiny. Long a neglected aspect of the study of international relations and international law, public health has become prominent and hotly debated within and among states, international organizations, and global civil society. States have come face-to-face with new disease threats and the weaknesses of their public health systems to respond effectively. In the United States, for example, public health now registers in debates about both national security and homeland defense. Existing international organizations, such as the United Nations and the World Bank, spend significant time and money on public health issues. Sensing the challenges globalization poses to public health, the World Health Organization ("WHO") has attempted to revitalize its ability to fulfill its mandate. New institutions, such as the World Trade Organization ("WTO"), have become embroiled in debates about the impact of international trade rules on public health in developing countries, debates to which non-governmental organizations ("NGOs") have contributed. New global public health regimes are in gestation, including the Global Fund to Fight AIDS, Tuberculosis, and Malaria4 and the Framework Convention on Tobacco Control5 Initiatives to underscore the role of public health in economic development and to create increased flows of public health funds from rich to poor countries,6 attempt to elevate public health on national and international agendas. Reflecting on the growing prominence of public health in world politics and international law, the Chicago Journal of International Law has chosen to devote attention to the dynamic relationship that exists between public health and international law today. This symposium provides a glimpse of the scope and diversity of areas in which international law and public health intersect, but it does not exhaust the public health/international law discourse.7 One theme the symposium pursues is the controversy regarding the impact that international legal protections for pharmaceutical patents have had on the access of developing countries to drugs and medicines. The symposium also reflects the contributors' interest in national and global public health problems posed by infectious diseases, though this emphasis does not suggest that non-communicable diseases represent insignificant global public health problems that do not bear on the use or study of international law.8 CJIL hopes that the symposium not only focuses international legal analysis on the contributors' topics, but also conveys the importance of international law and legal analysis to the current policy debates concerning how nations, international institutions, and global civil society work to improve human health globally. …