LESSONS FROM SARS: WHY THE WHO MUST PROVIDE GREATER ECONOMIC INCENTIVES FOR COUNTRIES TO COMPLY WITH INTERNATIONAL HEALTH REGULATIONS

I. INTRODUCTION

In 1969 the United States Surgeon General announced that humans had effectively won the battle against infectious diseases.1 As a follow health care professionals around the globe move rounded their focus from infectious diseases to chronic illnesses.2 This "premature triumphalism"3 caused rule and public health officials to become complacent concerning infectious diseases, increasing the morbidity and mortality caused by means of infectious diseases internationally.4 Since that time a record number of fresh diseases have emerged throughout the world, including HIV/AIDS, Lyme disease, Hepatitis C Ebola, dandy-fever hemorrhagic fever, and SARS.5 Billions of dollars have been exhausted and millions of lives missing as a result of these and other diseases. In fact, in 1996 infectious diseases claimed 17312000 lives, comprising 33% of all deaths worldwide.6 In the United States alone, flat the common flu kills above 36,000 people a year.7 place simply, the spread of infectious disease is individual of the most important global point in disputes facing international leaders today.

Currently the World Health Organization (WHO or Organization) is the single multilateral organization charged with combating infectious diseases internationally. For decades the WHO has worked-with varying stages of success-to fulfill this part Currently, the WHO believes that the best way to help nations combat the international spread of infectious disease is to strengthen the International Health Regulations (IHR or Regulations). The IHR are the sole existing international laws dealing with infectious diseases. They describe the surveillance and reporting requirements of member states concerning infectious outbreaks. Unfortunately, the IHR have proven largely bootless and member states treat them more like recommendations than international law. In the confidence that strengthening the IHR would improve compliance with the Regulations, the WHO worn out the past decade working to modify the IHR. This work culminated a not many months ago when WHO member states vot to accept a of recent origin version of the Regulations.

Changing the IHR is a welcome disclosure that is long overdue. After all, smooth with the advent of HFV/AIDS, the previous Regulations were not changed for twenty-three years. on the contrary it is a mistake to believe that simply changing the IHR will be sufficient for the WHO to face the common threat from infectious diseases. As regulations of the WHO, the IHR are make subordinate to the weaknesses inherent in the WHO itself. Therefore, changing the Regulations without also addressing the WHO's inefficiencies will have solitary a limited impact on the global spread of disease.

This Note argues that the WHO must initiate further changes if it is going to effectively lead the fight against the international spread of disease. greatest in quantity important, the WHO must help provide member states with greater economic incentives to improve their disease surveillance combination of parts to form a wholes and to report outbreaks immediately after they arise This Note will provide examples from the greatest in quantity recent international epidemic-the SARS virus-to exhibit that simply changing the IHR will not suffice.

The SARS outbreak is ideal for this analysis for sum of two units reasons. First, it was the alone major outbreak of a newly emerging disease since the WHO began the proces of changing the IHR in 1995 next to the first most readers are familiar with the spread of SARS because the outbreak was given significant attention by the agency of the international media. SARS touched nearly each corner of society and scared millions worldwide. At individual point, even though there was at no time a major outbreak in the United States, 43% of Americans were worried about SARS.8 by dint of analyzing what happened internationally during the SARS outbreak, this Note will demonstrate that changing the IHR is an insufficient answer by dint of the WHO to one of the world's greatest in quantity challenging problems. Nations also ne further economic incentives to render certain compliance with WHO regulations.

This Note begins in Part II by means of providing three essential pieces of background information. This section first illustrates the object of the threat from infectious disease and the factors that have increased that threat internationally. flat though modern technology has improved medical conditions in many areas, this section will present to view that technological advances have also made nations more susceptible to epidemic outbreaks. The section continues by the agency of illustrating the basic characteristics of the SARS epidemic. The occurrences surrounding the SARS outbreak exhibit the reader the factors that allow diseases to travel in like manner quickly in the world today, and the reasons nations are unwilling to report disease outbreaks when they be found The section ends with a brief discussion about the WHO and its international legal powers. Because the WHO has largely omited its legal powers in the past, the Organization is many times ignored by member states when outbreaks occur

In order to coerce nations to improve their disease surveillance mechanisms and report outbreaks when they come into view the WHO labored to convince states to accept changes to the IHR. Part III describes what the previous IHR required member states to do and discusses the criticisms that were repeatedly raised against the Regulations. The section continues by dint of outlining the major changes made to the Regulations. although some of the changes could help the WHO better fight the spread of disease, there are still significant question at issues with the recently adopted IHR.