Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-25T19:55:02.479Z Has data issue: false hasContentIssue false
  • English
  • Français

The Duty of States to Assist other States in Need: Ethics, Human Rights, and International Law

Published online by Cambridge University Press:  01 January 2021

Lawrence O. Gostin  and
Robert Archer
Get access Rights & Permissions [Opens in a new window]

Extract

This article deals with a foreign policy question of extraordinary importance: what responsibilities do States have to provide economic and technical assistance to other States that have high levels of need affecting the health and life of their citizens? The question is important for a variety of reasons. There exist massive inequalities in health globally, with the result that poorer countries shoulder a disproportionate burden of disease and premature death. Average life expectancy in Africa is nearly 30 years shorter than in the Americas or Europe. In one year alone, an estimated 14 million of the poorest people in the world died, while only an estimated four million would have died if this population had the same death rate as the global rich.

Type
Symposium
Information
Journal of Law, Medicine & Ethics , Volume 35 , Issue 4 , Winter 2007 , pp. 526 - 533
Copyright
Copyright © American Society of Law, Medicine and Ethics 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organization, World Health Statistics, 2007, available at <http://www.who.int/whosis/en> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
Gwatkin, D. R. Guillot, M., The Burden of Disease Among the Global Poor: Current Situation, Future Trends, and Implications for Strategy, World Bank, Washington, D.C., 1999.CrossRefGoogle Scholar
World Health Organization, The World Health Report 2000, World Health Organization, Geneva, 2000, at Annex Table 8 (latest available data from 1997); Anderson, G. F. Hussey, P. S. Frogner, B. K. et al. , “Health Spending in the United States and the Rest of the Industrialized World,” Health Affairs 24 (2005): 903–914.Google Scholar
World Health Organization, “National Influenza Pandemic Plans,” available at <http://www.who.int/csr/disease/influenza/nationalpandemic/en/index.html> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
Gostin, L. O. Berkman, B. E., “Pandemic Influenza: Ethics, Law, and the Public's Health,” Administrative Law Review 59 (2007): 121–75.Google Scholar
Shah, A., “Government Cutting Back on Promised Responsibilities: Rich Nations Agreed at U.N. to 0.7% of GNP to Aid,” April 8, 2007, available at <http://www.globalissues.org/TradeRelated/Debt/USAid.asp#RichNationsAgreedatUNto07> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
U.N. Millennium Project, “The Costs and Benefits of Achieving the Millennium Development Goals,” in The Overview Report: A Practical Plan to Achieve the Millennium Development Goals (2005), available at <http://www.unmillenniumproject.org/documents/overviewEng55–65LowRes.pdf> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
Labonte, R. Schrecker, T., “Foreign Policy Matters: A Normative View of the G8 and Population Health,” Bulletin of the World Health Organization 85 (2007): 185–91.Google Scholar
Gostin, L. O., “Why Rich Countries Should Care About the World's Least Healthy People,” JAMA 298 (2007): 89–92; Gostin, L. O., “Meeting the Survival Needs of the World's Least Healthy People: A Proposed Model for Global Health Governance,” JAMA 298 (2007): 225–28.CrossRefGoogle Scholar
Charter of the United Nations, Articles 3 and 54, available at <http://www.un.org/aboutun/charter/> (last visited September 7, 2007).+(last+visited+September+7,+2007).>Google Scholar
Id., at article 22.Google Scholar
Id.Google Scholar
See Charter of the United Nations, supra note 10, at ArticleGoogle Scholar
Similar language can be found in other treaties, such as the Convention on the Rights of the Child, “State Parties shall undertake such measures to the maximum of their available resources and, where needed, within the framework of international cooperation.” Convention on the Rights of the Child, G.A. Res. 44/25, Art. 4 (September. 2 1990).Google Scholar
U.N. Economic & Social Council [ECOSOC], General Comment 3: The Nature of States Parties' Obligations, U.N. Doc. E/1991/23, annex III at 86 (Fifth session, 1990).Google Scholar
See, e.g., Charter of the United Nations, supra note 10, at Article 56; U.N. Declaration of Human Rights, Article 25, available at <http://www.un.org/Overview/rights.html> (last visited September 7, 2007).+(last+visited+September+7,+2007).>Google Scholar
Kinney, E. D. Clark, B. A., “Provisions for Health and Health Care in the Constitutions of the Countries Around the World,” Cornell International Law Journal 37 (2004): 285–355.Google Scholar
U.N. International Covenant on Economic, Social and Cultural Rights, Article 12, available at <http://www.unhchr.ch/html/menu3/b/a_cescr.htm> (last visited September 7, 2007).+(last+visited+September+7,+2007).>Google Scholar
U.N. Economic & Social Council [ECOSOC], General Comment 14, The Right to the Highest Attainable Standard of Health, U.N. Doc. E/C.12/2000/4 (Twenty-second session, 2000).Google Scholar
Declaration of Alma-Ata, International Conference on Primary Health Care, Alma-Ata, USSR, September 6–12, 1978, available at <http://www.who.int/hpr/NPH/docs/declaration_almaata.cpdf> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
U.N. Economic & Social Council [ECOSOC], General Comment 14: The right to the highest attainable standard of health, U.N. Doc. E/C.12/2004/4 (Twenty-second session, 2000).Google Scholar
Fidler, D. M. Gostin, L. O., “The New International Health Regulations: An Historic Development for International Law and Public Health,” Journal of Law, Medicine & Ethics 34, no. 1 (2006): 85–94.CrossRefGoogle Scholar
World Health Organization, Fifty-Eighth World Health Assembly, Revision of the International Health Regulations, W.H.A. Doc. 58.3 (May 23, 2005).Google Scholar
World Health Organization, Fifty-Eighth World Health Assembly, Revision of the International Health Regulations, Articles 5(1) and 13(1), annex 1, W.H.A. Doc. 58.3 (May 23, 2005).Google Scholar
Id., at Articles 13(4) and 13(5).Google Scholar
U.N. Millennium Declaration, available at <http://www.ohchr.org/english/law/millennium.htm> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
U.N. Millennium Development Goals, available at <http://www.un.org/millenniumgoals/> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
The White House, “G-8 Action Plan on Poverty,” available at <http://www.whitehouse.gov/news/releases/2004/06/20040609–35.html> (last visited September 7, 2007).+(last+visited+September+7,+2007).>Google Scholar
World Trade Organization, Ministerial Declaration on the TRIPS Agreement and Public Health, WT/MIN(01)/DEC/2, 41 I.L.M. 746 (20 02); see Correa, C. M., Implications of the Doha Declaration on the TRIPS Agreement and Public Health, WHO/EDM/PAR/2002.3, World Health Organization, EDM- Series no. 12, 2002.Google Scholar
Statement of the Civil G-8 HIV/AIDS Round Table, available at <http://www.interaction.org/files.cgi/5204_HIV-AIDS_Statement_from_Civil_G8_NGO_Forum_7–06.pdf> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
G-8 Gleneagles Agreement for Africa, 2005, available at <http://www.fco.gov.uk/Files/kfile/PostG8_Gleneagles_Africa,0.pdf> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
G-8 Summit 2006, “Fight Against Infectious Diseases,” “Center for Global Development,” “G-8 Progress on Advance Market Commitments for Vaccines,” (reporting that Canada, Italy, the U.K., the U.S., and Russia support AMCs, particularly for pneumococcal infections), available at <http://en.g8russia.ru/> (last visited September 7, 2007).+(last+visited+September+7,+2007).>Google Scholar
G.A. Res. 43–53 (December 1998) (although covering climate change directly, the declaration focuses on principles of equity basic to mankind).Google Scholar
Powers, M. Faden, R., Social Justice: The Moral Foundations of Public Health and Health Policy (New York: Oxford University Press, 2006).Google Scholar
World Health Organization, “Commission on Social Determinants of Health,” available at <http://www.who.int/social_determinants/en/> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
Satcher, D., “Eliminating Global Health Disparities,” JAMA 284 (2000): 2864.Google Scholar
Predictably, there are exceptions. Local resistance in Nigeria to the vaccination program against polio, due to political suspicion, led to a recrudescence of the disease two years ago. Also in Africa, a mix of local suspicion and medical insensitivity appear to have obstructed international interventions to manage outbreaks of Ebola. See Abraham, C., “Western Medicine Doesn't Have All the Answers,” New Scientist (July 21, 2007): 35–37.CrossRefGoogle Scholar
See World Health Organization, supra note 23.Google Scholar
Public Health Agency of Canada, Learning From SARS – Renewal of Public Health in Canada: A Report of the National Advisory Committee on SARS and Public Health, Public Health Agency of Canada, October 2003, available at <http://www.phac-aspc.gc.ca/publicat/sars-sras/naylor/index.html> (last visited September 4, 2007); Gostin, L. O. Bayer, R. Fairchild, A. L., “Ethical and Legal Challenges Posed by Severe Acute Respiratory Syndrome: Implications for the Control of Severe Infectious Disease Threats,” JAMA 290 (2003): 3229–37.Google Scholar
U.S. Department of State, “The United States and Developing Countries: Partnering for Growth,” U.N. General Assembly 2006–2007 (September 14, 2006), available at <http://www.state.gov/documents/organization/72352.pdf> (last visited September 7, 2007).+(last+visited+September+7,+2007).>Google Scholar
Feldbaum, H. Lee, K. Patel, P., “The National Security Implications of HIV/AIDS,” PLoS Medicine 3, no. 6 (2006): 774–78.CrossRefGoogle Scholar
The Responsibility to Protect: Report of the International Commission on Intervention and State Sovereignty, 2001, available at <http://www.iciss.ca/menu-en.asp> (last visited September 4, 2007).+(last+visited+September+4,+2007).>Google Scholar
U.N. High Level Panel on Threats, Challenges and Change, A More Secure World: Our Shared Responsibility (2004), available at <http://www.un.org/secureworld/> (last visited September 4, 2007); The Secretary-General, In Larger Freedom: Towards Development, Security and Human Rights for All, September 2005, available at <http://72.14.209.104/search?q=cache:tQw2EgyZ024J:www.un.org/largerfreedom/executivesummary.pdf+UN+In+Broader+Freedom&hl=en&gl=us&ct=clnk&cd=1&client=safari> (last visited September 4, 2007).+(last+visited+September+4,+2007);+The+Secretary-General,+In+Larger+Freedom:+Towards+Development,+Security+and+Human+Rights+for+All,+September+2005,+available+at++(last+visited+September+4,+2007).>Google Scholar
Anonymous, “Reversing the Failures of Roll Back Malaria,” The Lancet 365 (2005): 1439.CrossRefGoogle Scholar
Anonymous, “Predicting the Failure of 3 by 5,” The Lancet 365 (2005): 1597.CrossRefGoogle Scholar
Taylor, A., “Governing the Globalization of Public Health,” Journal of Law, Medicine & Ethics 32, no. 4 (2004): 500–16; Burris, S., “Governance, Microgovernance and Health,” Temple Law Review 77, no. 2 (2004): 335–58; Fidler, D. P., “Architecture Amidst Anarchy: Global Health's Quest for Governance,” Global Health Governance 1 (2007): 1–17.CrossRefGoogle Scholar
Gostin, L. O., “Meeting Basic Survival Needs of the World's Least Healthy People Toward a Framework Convention on Global Health,” Georgetown Law Journal (Forthcoming 2008); See Gostin, , supra note 9.Google Scholar
Benatar, S. R., “Moral Imagination: The Missing Component in Global Health,” PLoS Medicine 2, no. 12 (2005): 1207–10.CrossRefGoogle Scholar