Groningen Journal of International Law

International Law Under Construction

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Grand Challenges for Global Health Law: from Ebola, to Cancer and Diabetes

By Brigit Toebes, University of

In 2014, the largest and by far most serious outbreak of Ebola since the virus was first detected in 1976 occurred. With an overall death toll of 11.300, there were more cases and deaths in this outbreak than in all others combined. The disease quickly spread between countries, starting in Guinea and then spreading to Sierra Leone and Liberia.

The International Health Regulations, adopted by the World Health Organization (WHO) in 2005 to monitor such outbreaks, provide for a chain of responses requiring the country where the outbreak occurs to report to the WHO and the WHO to respond and to interfere. However, while the affected States were slow to report to the WHO, the WHO waited five months before it declared the epidemic a ‘public health emergency of international concern’. Consequently, the UN Security Council interfered with the adoption of UNMEER, the first UN emergency health mission. The Ebola outbreak reveals that the WHO, the primary organization to manage global health, is ill-equipped to deal with a global health security crisis. The International Health Regulations lack an enforcement mechanism and do not provide for the possibility to sanction States in case of non-compliance. The WHO itself lacks the financial means and the capacity to be the key player when a health emergency that potentially poses a threat to global health occurs. Continue reading