Source: https://www.ejiltalk.org/more-on-public-international-law-and-infectious-diseases-foundations-of-the-obligation-to-report-epidemic-outbreaks/
Timestamp: 2020-01-28 04:13:00
Document Index: 768970202

Matched Legal Cases: ['Art. 2', 'Art.2', 'Art.12', 'Art.16', 'Art. 11', 'Art. 10', 'Art. 11', 'Art. 55', 'Art. 25', 'Art. 12', 'Art. 12', 'Art. 12', 'Art.12', 'Art.12']

EJIL: Talk! – More on Public International Law and Infectious Diseases: Foundations of the Obligation to Report Epidemic Outbreaks
Home EJIL Analysis More on Public International Law and Infectious Diseases: Foundations of the Obligation to Report Epidemic Outbreaks
So, should it be founded upon the duty to co-operate, the obligation to report epidemic outbreaks will end up being no more enforceable than the latter. Still, there is a chance of enhancing the enforceability by putting the duty of co-operation into a specific context. In particular, the ICESR (Art. 2(1)) requires states to co-operate for fulfilling the rights enshrined in the instrument. The UN Committee on Economic, Social and Cultural Rights (CESCR) considers the obligation under Art.2(1) to be founded upon and corresponding to the respective provisions of the UNC and well-established principles of international law (CESCR, General Comment No. 3, para. 14). Besides, within the ICESCR, this obligation clearly relates to the protection of public health (ICESCR, Art.12).
However, even if the duty to co-operate under the ICESCR might be specified and narrowed in the field of public health (yielding inter alia the obligation to report infectious outbreaks), the enforceability will still be problematic as is the case for all obligations of conduct (for the “progressive realization” approach see CESCR, General Comment No.3, para. 1). An argument is made that applying the duty of co-operation to the field of public health is futile as states differ greatly in abilities and resources and cannot be expected to achieve any uniform standards (J. Tobin, The Right to Health in International Law (2012), p. 331).
Indeed, states refusing to report an epidemic outbreak would hardly be brought to an international responsibility for breaching the obligation to co-operate. But for the IHR, the international legal regime of disease control would face a real and a very practical gap.
Epidemic reporting and the human right to health
Efforts to enroot the duty of epidemic reporting in a more specific source will necessarily lead to human rights. The “human right based approach to securing public health” jumps to our minds first (see e.g. here). However, the connection between human rights law and the obligation related to epidemic control appears somewhat unusual: human rights law serves not as a standard setter, but as a general framework giving rise to a narrow and a very specific duty related to public health.
In this respect, one shall basically inquire whether the duty to report infectious diseases proceeds from the human right to health, or, in other words, whether non-compliance with the former means non-compliance with the latter.
The human right to health is recognized by almost all regional human rights instruments (1987 African Charter on Human and People’s Rights, Art.16; 1948 American Declaration of the Rights and Duties of Man, Art. 11; 1988 Additional Protocol to the American Convention on Human Rights on the Area of Economic, Social and Cultural Rights, Art. 10; 1996 European Social Charter, Art. 11). It is as well proclaimed at the universal level (UNC, Art. 55; WHO Constitution, Preamble; 1948 Universal Declaration of Human Rights, Art. 25). Still, the ICESCR (Art. 12) looks like the most “promising” source.
Art. 12 of the ICESCR defines the right to health and non-exhaustively enumerates actions states need to undertake to fulfil the right (CESCR, General Comment No. 14). The examples include securing “the right to prevention, treatment and control of diseases” (ICESCR, Art. 12(3)). This requires states to create a system of medical care to efficiently address cases of epidemics or other health hazards (CESCR, General Comment No. 14, para. 16). The CESCR comments that states shall improve epidemiological surveillance and data collection, as well as other strategies of disease control. States are also required to take measures against any potential hazards in reliance upon epidemiological data which necessarily implies data collection and processing. Failure to co-operate against transborder health emergencies entails joint and individual liability (CESCR, General Comment No. 14, para. 40).
The CESCR interpretation implies that the duty of reporting epidemic outbreaks can hardly be excluded from the scope of the human right to health, even though nowhere mentioned explicitly. Assuming states were not bound to timely share information on infectious disease emergencies, “potential hazards” could hardly be prevented through an “effective medical care system”, obviously depriving the respective part of Art.12 of the ICESCR of its raison d’etre.
In reading the obligation to report epidemic outbreaks from the ICESCR, the “silver bullet” of the good faith interpretation principle is especially helpful. In the cases like the one here discussed, good faith interpretation would serve as a useful tool to discern specific narrow obligations from a broader duty formulated in most neutral and general terms.
Besides, many interested scholars share quite a consistent belief that the obligation to report epidemic outbreaks forms a part of the minimum core obligations under the ICESCR (L. Gostin, Z. Lazzarini, Human Rights and Public Health Law in the AIDS Pandemic (1997), p. 29). This is further confirmed by reference to other international instruments laying down the right to health (D. Fidler, International Law and Infectious Diseases (1999), p. 193). Some even go as far as to suggest a human right to infectious disease control (C. Pannenborg, A New International Health Order: An Inquire into the International Relations of World Health and Medical Care (1979), p. 318). Still, “the more the better” principle does not work in this case, as it is reasonable to note that “if the right to health covers everything, then it means nothing (S. Jamar, The International Human Right to Health 1994, p. 53).
As the bottom line, it can be safely concluded that the duty to report infectious disease outbreaks forms a part of states’ obligations with respect to the human right to health. The non-compliance with the former necessarily means non-compliance with the latter. Hence, a state’s concealment of an epidemic outbreak shall entail international responsibility under Art.12 of the ICESCR, however hard that may be to implement given the hardships of enforcing human right law as such.
Finding additional grounds (i.e. beyond the IHR) of the obligation to report infectious disease outbreaks is of practical value.
No doubt, the IHR is best tailored for the purpose. However, several alternative sources of the same duty make it more compelling as well as widen the institutional tools for making the duty operational. States may be enticed to comply with WHO rules if only to keep it within the WHO and prevent the “leak” of the issue to other forums. Given the current (and, actually, everlasting) uncertainties of WHO’s mandate and powers, including the field of disease control, this would be a meaningful achievement. On the other hand, given that the credibility and efficiency of the IHR are frequently challenged and considering current global health-related concerns, one be better equipped with a “fall back option”.
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Many thanks, Olha, for the comments to my previous blogpost.
I completely agree on the points underscored by your piece. Particularly, on the relevance of good faith in the obligation of states to notify the WHO ought to be continuously emphasized. It stands at the core of the current international pandemic preparedness and response system. As the post argues, without states’ observance of the obligation to notify under the IHR, the effectiveness of the whole system erodes.
As an addendum: A recent back-and-forth between the WHO and one of its Member States, namely due to the latter’s delays in responding to a request for information on cases of “undiagnosed febrile illness”, highlights the relevance of your arguments. See https://www.who.int/csr/don/21-september-2019-undiag-febrile-illness-tanzania/en/
Olha Bozhenko
Olha Bozhenko is a Life Sciences & Healthcare Associate at the Ukrainian law firm. She is a graduate from the Institute of International Relations of the Kyiv National Taras Shevchenko University specializing in International Litigation (Public International Law). Read Full