Os regimes jurídicos da Organização Mundial da Saúde e a formulação de leis e políticas de saúde na Nigéria
| Autor | Benjamin Anaemene, John Iwuh |
| Cargo | Redeemer’s University. Ede, Nigeria |
| Páginas | 1-17 |
1
R. Dir. sanit., São Paulo v. 23, n. 1, e0004, 2023
10.11606/issn.2316-9044.rdisan.2023.180926
Artigo Original
http://revistas.usp.br/rdisan
ABSTRACT
Global health gover nance concerns the
collective responses needed within the public
health community to ef fectively tack le the
shared challenges ar ising in an increasingly
connected world. It is a truism that promoting
a robust health infrastructure is critical to the
attainment of good h ealth and wellbeing. Yet
the legal infrastr ucture – the laws and policies
that empower and obligate as well as limit
government and private action concerning
health, has been neglected in the mainstream
literature. This is because health infrastructure
has focused more on physical s tructures of
public health agencie s such as clinics, hospitals
and the human resources that operate them. The
purpose of the study was to explore the extent
to which the World Health Organization legal
regimes such as the Framework Convention
on Tobacco Control (2003) and the Revised
International H ealth Regulations, have impact ed
on health law and polic y in Nigeria. It posits
that the various conventions and regulations
adopted, which were subsequently ratified
and declared applicable to Nigeria, had been
domesticated. H owever, the lack of respe ct for
the rule of law has st ymied the maximisation of
the expected b enefits from such legal regimes.
It concludes that th e World Health Organization
should develop a programme for public health
law capacity-buil ding and policy surveillance to
ensure continuous and orga nised efforts to as sist
member states including Nigeria to strengthen
their legal infrastructure.
Keywords: Health; Human Rights; Nigeria;
World Health Organization.
RESUMO
A governança global da saúde diz respeito
às respostas coletivas necessárias dentro da
comunidade da saúde públic a para enfrentar com
eficácia os desafios compartilhados que surgem
em um mundo cada vez mais conec tado. É um
truísmo que a promoção d e uma infraestrutura de
saúde robusta seja fundamental para a obtenção
de saúde e bem-es tar. No entanto, a infraestrutura
legal – as leis e políticas que reforçam, obrigam
ou limitam as ações governamentais e privadas
em relação à saúde – tem sido negligenciada
na literatura dominante. I sso ocorre porque
a infraestrutura de saúde tem se concentr ado
mais nas estrutur as físicas dos órgãos de saúde
pública, como clínicas, hospitais, e nos re cursos
humanos que os operam. O objetivo deste
estudo foi explorar até que ponto marcos legais
da Organização Mundial da Saúde, como a
Convenção-Quadro para o Controle do Tabaco
(2003) e o Regulamento Sanitário Internacional
revisado, impactaram as leis e políticas de saúde
na Nigéria. O artigo postula que as várias
convenções e regulamentos adotados, que foram
posteriormente ratificados e declarados aplicáveis
a Nigéria, foram intern alizados no país, porém,
o desrespeito ao es tado de direito tem impedido
a maximização dos benefícios esperados de tais
marcos legais. Concluiu-se que a Organização
Mundial da Saúde deve de senvolver um programa
de capacitação em legislação e políticas de saúde
pública e vigilância em saúde p ara garantir esforços
contínuos e organizados, a fim de contribuir para
que os Estados-M embros, incluindo a Nigéria,
possam fortal ecer sua infraestrutura legal.
Palavras-Cha ve: Saúde; Direitos Humanos;
Nigéria; Organização Mundial da Saúde.
Benjamin Anaemene1
https://orcid.org/0000-0003-0032-6644
John Iwuh1
https://orcid.org/0000-0002-1495-4804
1 Redeemer’s University. Ede, Nigeria
Correspondence:
Benjamin Anaemene
anaemeneb@run.edu.ng
Received: 2 021/ 01/13
Revised: 20 22/0 5/13
Approved: 2022/06/13
Conict of interests:
The authors declare that there is
no conflict of interests.
Authorship:
All authors contributed equally for
the development of the article.
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The World Health Organization Legal
Regimes and the Shaping of Nigeria’s
Health Law and Policy
Os regimes jurídicos da Organização Mundial da Saúde e a
formulação de leis e políticas de saúde na Nigéria
2
The World Health Organization Legal Regimes and the Shaping of Nigeria’s Health Law and Policy Anaemene B., Iwuh J.
R. Dir. sanit., São Paulo v. 23, n. 1, e0004, 2023
Introduction
The World Health Organization (WHO) depends on international law through the structure
and processes created and supported by its Constitution (WHO, [1946]). Although the
WHO Constitution made provisions for the organisation to use innovative and fairly
radical legal mechanisms (treaties, regulations, soft laws) those mechanisms have largely
remained on the margins of the WHO international health work in over six decades of
its history. Since its establishment in 1948, the WHO is known to have adopted only
two legally binding normative instruments: the International Health Regulations and
Framework Convention on Tobacco Control. This is an indication that the organisation
has historically neglected international law in its work by underutilizing its enormous
constitutional powers. The common argument used to explain the WHO antipathy to
international law is that the WHO has been dominated by medical and public health
experts. As Fidler aptly noted:
WHO was isolated from general develop ments concerning international
law in the post-1945 period. This isolation was not accidental but
reflected a par ticular outlook on the formulation and implementation
of international health policy. WHO op erated as if it were not subject
to the normal dynamics of the anarchical societ y; rather, it acted as
if it were at the centre of a transnational Hippocratic society made
up of physicians, medical scientists, and public health exper ts.
The nature of this transnational Hippocratic society led WHO
to approach international public health without a legal strategy
(FIDLER, 1999).
Taylor also observed that:
WHO’s traditional reluctance to utilize law and legal institutions to
facilitate its health strategies is largely attributable to the internal
dynamics and politics of the organisation itself. In particular, this
unwillingness stems, in large part, from the organisational culture
established by the conser vative medical professional community that
dominates the institution (TAYLOR, 1992).
Other reasons for the historical neglect of international law by the WHO include the fact
that the Organisation came into existence at the beginning of a revolutionary period
for biomedical tools such as antibiotics and vaccines, and activities were focused on
delivering these, for which legal initiatives were not needed. Besides, the WHO’s limited
experience with regulatory regimes is fraught with controversy and conflict.
The WHO’s neglect of international law nonetheless produces a distorted image of the
role of international law in the area of public health. The protection of human health
is an objective that states, intergovernmental organisations, and non-governmental
organisations have embedded in many areas of international law (FIDLER, 1999).
A significant proportion of international law exists for example to protect human health.
Yet none of this international law was developed within the WHO. Other areas of
international law that contain rules and institutions that protect human health include
international trade law, international human rights law, international humanitarian law,
international law on arms control, international law on narcotic drugs and international
Labour law.
Nevertheless, as a multilateral institution, the WHO has the mandate and opportunity
to establish or influence laws, legislations, and guidelines that set the foundation for
international and national health law or policy. In international law, states are regarded
as the most important actors. It is obvious that if an international agreement is to
become applicable there is a need to implement the outcome of such negotiations
at the national level. States must translate an international agreement or treaty into
national laws or policies and develop enforcement mechanisms. International treaties
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