Using the Law to Prepare for Global Health EmergenciesPosted on by
Countries need to be prepared to handle emergencies. Having the right laws in place is an important part of the preparation.
When laws are not clearly defined, responders can have a hard time figuring out what to do during a public health emergency and who has the authority to take action. When a deadly disease outbreak hits, this can have devastating consequences.
Liberia knows firsthand what can happen when laws don’t match the needs in the field. Their experience with the recent Ebola epidemic exposed gaps in legal authority during the response. This is one reason why Liberia’s government recently reached out to the GHSA Public Health Law Project. The project team is helping them document issues that could be improved by updating Liberia’s public health law, which was last fully revised in 1976.
Advancing the Global Health Security Agenda
The GHSA Public Health Law Project takes a close look at how the law can help (or hinder) countries as they prepare to handle public health emergencies through the Global Health Security Agenda (GHSA). Right now, over 50 countries around the world are working through the GHSA to improve their ability to prevent, detect, and rapidly respond to infectious disease threats. The GHSA Public Health Law Project currently covers nearly half of the GHSA countries. The team helps analyze the laws of a country and provides training to country officials to help them understand the importance of law as a public health tool.
The team begins its work by gathering information about existing laws and talking to experts about how public health law works in their country. In Liberia, the team found that people felt unclear about their roles during the Ebola response. As one country health official told the team, “There is confusion about roles in an emergency and enforcement. What is the role of the police? The ministry of health? The military? [This] needs to be better defined.”
Public Health Law in Liberia
Before the CDC team arrived in Liberia, the Ministry of Health’s Legal Counsel were already taking the lead to help modernize the law. This is a massive undertaking that the Government of Liberia hopes to accomplish as soon as possible.
The Liberian Ministry of Health’s (MOH) Legal Counsel and CDC’s Country Office Director invited the CDC project team to help them reach this goal through research and analysis of where there may be gaps in the law. The project team worked with a team from the University of North Carolina’s School of Government, who were invited for public health law support by Liberia’s Chief Medical Officer.
Liberia will be able to use the information gathered by the team as they update their public health law. Once the laws are updated, the next step is making sure people are aware of them. A county health official laid out the problem he saw in Liberia: “Fundamentally, what is wrong is that the public health law is not widely known.” This official had been a practicing doctor for 11 years, but he had only read Liberia’s public health law for the first time two weeks prior to talking with the team.
Planning for the Future
The GHSA Public Health Law Project is being done collaboratively between CDC’s Center for Global Health and the Public Health Law Program. The project is compiling the laws from these countries into a single, searchable database to give a more complete picture of the legal landscape relating to the GHSA. The legal data obtained from this project will be a valuable resource when countries want to update their public health laws.
This initial legal mapping phase is only the beginning. What is really vital is how countries will use this information to help guide their work. The law can be an effective tool in meeting global health security goals and protecting people’s health — not only when a crisis hits, but every day.
6 comments on “Using the Law to Prepare for Global Health Emergencies”
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I work Executive Director for http://www.facebook.com/chesslib04 (Community Health Education and Social Services-CHESS) a Liberian national NGO specialized in preventive health services and sustainable development. In northern Liberia, CHESS was at the hub of the Ebola Response especially along the Liberians-Guineans borders where the Ebola prevalence was high due to denial, porous borders but most importantly long standing cultural practices including respect for the dead. One thing the impeded the Liberian (may include Guinea and Sierra Leone) Ebola response/s and partly explains the VIRUS RAPID SPREAD was the confusion in who leads the Ebola response? Liberia MOH in my view should be but surprisingly the Ministries of Internal Affairs and Defense (MIA& MOD) were in the midway mediated to lead even-though they lacked the technical know hows. I believe this was a political decision but innocent women and children paid the prices, for example the most publicized WEST POINT CASE.. All happened because the Liberian Law on Public Health Emergency response is not clear and known to actors including government officials. I personally trust that Liberia Public Health Law amendment is a great step forward for Liberia’s emergency readiness and preparedness.
I echo that what is really vital is that countries use this information. This means that MOH staff understand what is in the law, they operationalize it and that only when necessary laws are revised or supplemented and that ministerial regulations are used to their fullest extent.
The information collection process is sorely needed and it is unfortunate that development donors have overlooked this step which is essential to any health development activity – whether emergency preparedness, health system strengthening or otherwise. This step can be undertaken even by law students or legal interns, such as LexLead interns I have used and guided by a senior lawyer. Once collected this information needs to be made digital and available to all. In my experience this step takes a few weeks but once it is done it is done and has broad applicability.
Law is eye opening to many and once transparent, it is a game changer like few other interventions.
We are taking part in this public work.
Your massive thrust for Global Health Security has the merits of public health concern. Your methods of doing so lack base methodology and revelation of people, culture, geographic location, and political persuasion. Being an initiator of infection control practices prior to The Bloodborne Pathogen Fed. Reg. 1910:1030, and introducing and teaching them after Dec. 21, 2001, CDC’s current approach (within the last 4 yrs.) has transformed from public wellness concern to law and political persuasion and requirement (for the world). The “experts” and CDC, USPH, OSHA, AMA, WHO, NIH may be applauded for organizing, writing, and publishing recommendations, requirements, and now laws for global health, but they lack the method and implementation to do so.
eg: The Liberian “bleach bucket” pictured above for decontamination in and out of public buildings. WHAT is the concentration of bleach in the bucket? 10 to 100? WE know what 100 percent bleach does to tissue and expensive surgical equipment. Gross negligence…..perhaps the “experts at CDC and the universities should look closely at what they recommend to WORLD countries prior to requiring them to partake in your world control initiatives. CDC and the Government are so intoxicated with ebola, zika and transgender concerns and neglect the millions of other diseases, viruses, parasites, and chemical and nuclear contaminates. JAPAN still leaking nuclear waste at Fukisema. (sp) Americas’ toxic water in N.Y. and other states. Slow and silence on these and millions of other devastating events. Where is Gretchen Gerberding?
Jan Mengle, MHS
It has to start with law and policies. In a time of crisis, time is vital, and policies and responsibilities have to already be outlined and well defined so as to not waste valuable time that needs to be devoted in crisis management, rescue, or restoration. The recent Ebola epidemic is a prime example of how time sensitive the management of the crisis is. The Global Health Security Agenda (GHSA) is a great tool to get these countries in the right direction. Additionally, when proper laws and policies are in place, preparation can be properly funded and managed to enhance readiness of a country in terms of logistics, supplies, and resource allocation. As a public health nurse, my role in an active crisis is to manage the situation in the acute phase (triaging patients, sending patients to appropriate treatment areas, reporting to appropriate authorities), nothing can be more devastating to this effort than waiting on bureaucratic red tape to get proper resources and support in these situations while waiting on responsible departments to act because those departments don’t know who is responsible for what.
Thanks for sharing this blog…..
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