Ghana, in 2014, experienced another nationwide cholera outbreak, one that served to potentially add to our numbness and nonchalance towards this disease. Because like malaria, cholera has become a household name, and too much familiarity with a particular disease makes a people let their guards down. A young man—a university student—had died during this outbreak. A friend, in a conversation, quipped, “How does an educated man, die of a disease so preventable and treatable?” That was a nuanced question, deserving an equally nuanced answer. I wasn't ready for the challenge, so I just changed the topic.
I am not going to talk about cholera at this point in our national lives—our global lives. Let's touch oninternational law and global health; the WHO and the unrealised potential and narrow mandates of International Health Regulations (IHR)—a legislation inspired by communicable diseases of which cholera features prominently.
International Law trying
In the mid-1800s, Europe, having been plagued with a series of communicable diseases—yellow fever, cholera, plague—decided they had had enough, and convened what would become known as the earliest examples of global conventions on public health, and what they termed the International Sanitary Conference. Sequels to this conference ensued, with discussions into global health (of Europe specifically). No real enforceable laws resulted from these conferences, but their legacy was to remain through to the 19th century, and resulted in the creation of the International Health Regulations by the WHO, mid-20th century. The IHR now serves to “prevent, protect against, control and provide public health response to the international spread of diseases…”
It comes as no surprise to human beings that as they become increasingly interconnected, diseases are able to easily and quickly cross national borders. So then, if a communicable disease originating from Ghana can easily traverse Chinese borders, and cause infections and deaths, then Ghana's national/cultural practices, if any, responsible for causing such diseases, must be China's business—China cannot be expected to keep quiet about them—or vice versa. Hence the submission of global health issues under the umbrella of international law.
Apart from the fact that the globalisation of diseases requires them to automatically be matters of international concern, it seems also that mostly, national laws of certain countries prove insufficient to contain the emergence and spread of these diseases within their national borders.
In the article 'On Animal/Human Relationships', I made note of the indispensableness of the relationship between humans and animals.
Zoonotic diseases are inevitable. But we can do something about their frequency—and the law can help. In the case of China, experiences with pandemics such as SARS, and endemics like avian influenza (H7N9), HPAI H5N1, SFTS, Encephalitis, etc. have conclusively proven that the nation's over-indulgence in certain wild animals (of which bats feature prominently) and their tendencies to assemble these wide varieties of animals in the same confinement—their wet markets—increase dramatically, the likelihood of the spread of diseases from animals-to-animals, then ultimately animals to humans. Humans' constant trespass into the wild's habitats exposes us to diseases foreign to our immune system.
This has caused many—Chinese locals and international observers—to call on the country to abolish its wildlife and endangered species trade. Some have mentioned the need for a re-socialisation for nationals to fully understand the frustrations (local and international, economical, ecological, and the health implications) caused by the illicit trade.The nation has been employed to impose higher safety standards on these wet markets. But what has been experienced are interim shutdowns of wet-markets, interim bans on wildlife trade, whenever another zoonotic disease breaks out of the country.This is where observers begin to wish for more robust international law regimes.
If, at this point, you agree that since certain diseases cross national borders, those diseases must be elevated from national discourse to subjects for global discussions; then you might just agree that international laws must be enacted to regulate the emergence/re-emergence of these diseases. If this be your conclusion, then you must be very concerned to hear that international law itself has—through no fault of it, sometimes—proved insufficient at this task.
One major concern for international law, with its many branches, is enforcement. It is comparatively easy enacting new laws, and getting member states to sign and ratify these laws. But when it comes to enforcement, international law fares horribly—and there is good reason for that. A huge chunk of international laws, unlike other laws we are familiar with, come with little to no sanctions attached. Now, how are you going to ensure compliance to a law when there are no, and cannot feasibly be real punishments attached for non-compliance? Non-observance by member states of international regulations is rampant (sometimes for good reason), because really, how does the international law literally keep an eye on, and ensure full enforcements of each of its stipulations?
The law follows the fact. In the field of communicable diseases, novel situations are bound to spring up—COVID-19, for instance. When this happens, the law finds it difficult catching up, and effectively preventing and controlling said disease. These laws also do little to ensure the actual prevention of the emergence/re-emergence of these diseases from various countries.
No lashes required
If both national and international laws are proving inadequate at curbing the emergence and spread of communicable diseases, where do we go?
A nation does not need punitive laws to see the importance of maintaining high standards across all sectors when it comes to the prevention of diseases. There are countless repercussions that inevitably result whenever a country is responsible for the emergence of an epidemic or pandemic disease. They range from economic, socio-economic, sociological—all dire in their effects. A nation suffers massive economic strain, resulting from excessive embargoes placed on it by trading partners and neighbouring states, et al. The country's tourism sector suffers immensely; unnecessary stigmatization of a nation and its nationals is inevitable. Someof these consequences do spill over onto the international stage—but the transmitting country suffers perhaps greatest. A nation needs not be lashed by international law into obedience; a nation can only do itself (and the world) a favour by checking itself constantly and closely.
Now tell me, how would Ghana fare in this—this self-check? Would we like China hold on to potentially deadly practices, stubbornly insisting upon their cultural relevance? Or would we be quick to re-evaluate our national/cultural practices for the sake of humanity?
The author is the co-founder of Blarney Stone Inc. (www.blarneystoneinc.com)
Email: [email protected]
By Yao Afra Yao