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International Public Health Law Test Case: Ebola PROF. ANN MARIE MARCIARILLE UMKC SOL TUESDAY, SEPTEMBER 23, 2014 INTERNATIONAL LAW Today’s Goals: Introduction to International Public Health Law ◦ Why have international public health law? ◦ World Health Organization ◦ What’s wrong with national public health law? ◦ What are the police powers of the state? ◦ Does the same analysis apply to international law? ◦ Haven’t we dealt with infectious diseases before? ◦ Cordon sanitaire ◦ Rationing of vaccines ◦ Involuntary treatment ◦ What is the Ebola virus? ◦ What is an epidemic? ◦ What is a pandemic? ◦ Is international public health law up to the challenge of Ebola? ◦ What if the Ebola virus were weaponized internationally? ◦ Is our national public health system up to the challenge of Ebola? What Do We Actually Know About EbolaVirus? Is it like the disease in the 2011 movie Contagion? https://www.youtube.com/watch?v=bdzWcrXVtwg If not, how is it different? https://www.youtube.com/watch?v=flNrTPpmlB8 Ebola Can Be Difficult to Diagnose Ebola Control Is Scary – Particularly in Cultures Where People Are Expected to Die at Home and to Be Prepared for Burial at Home https://www.youtube.com/watch?v=uozTwmuFnuA Ebola can be carried by dead bodies, so live people and dead people and the people who have contact with their bodily fluids are of concern. Hasty Burial Robs the Rite of Death HIGASHI-MATSUSHIMA, JAPAN (2011) LIBERIA (2014) Background Questions Is Ebola new? Where did this flare-up begin? Why has this flare-up grown so large? What does it mean for the WHO to declare an international public health emergency? What Are Public Health Compulsory Powers? Surveillance Reporting Partner Notification Contact Tracing Quarantine Involuntary Treatment City of New York v. Antoinette R. (NY, 1995) (Gostin,p. 420) What did the city health commissioner seek? Under what authority? What is the standard that must be met? What does it mean to have multi-drug resistant TB? Can TB ever be “cured”? Who Remembers Attorney Andrew Speaker (2007)? (Goslin, p. 429) World Health Organization What are the International Health Regulations? (Gosling, p. 246) ◦ Are they focused on borders: entry and exit? ◦ Are they focused on surveillance and response capacities internal to a country? ◦ What authority do they give the WHO? (Goslin, p. 251) Are they self-activating? Aspirational? With 20-20 Hindsight, What Will the World Think of Our Treatment of This Ebola Flare-Up? Because Ebola is Not One Disease, But Rather One Disease With Multiple Strains, Multiple Outbreaks, and Multiple Host Environments (JV Chamary, 2014)