Unanswered Questions of the UN Summit on Non-communicable Diseases

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 The United Nation’s High-Level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases (NCDs), convened at UN Headquarters September 19-20, brought with it high expectations. The only previous UN General Assembly Special Sessions on a health issue had been on HIV/AIDS, with the first, in 2001, credited with helping spur the global AIDS response. NCDs – the four categories that the summit addressed being heart disease, cancer, diabetes, and chronic respiratory illnesses – already are responsible for more than 60% deaths globally [Political Declaration, para. 14], and are the leading cause of death even in many developing countries. They are on track to be responsible for 70% of deaths in developing countries by 2020 [Abdesslam Boutayeb and Saber Boutayeb, “The Burden of Non Communicable Diseases in Developing Countries,” International Journal for Equity in Health 4(1) (2005): 2]. 

Until now low on the global health agenda – consider that a mere 3% of WHO’s 2010-2011 budget was programmed to address NCDs – NCDs are certainly worthy of a special session at the United Nations. The question is, will the summit mobilize a global response against NCDs?

The honest answer may be the least satisfying: time will tell. Read More

Posted in Global Health, Tobacco, Trade, WHO; Tagged: , .


After Several Other Circuits Split on the Constitutionality of Health Reform, Which Way Will the D.C. Circuit Go?

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This post was authored by O’Neill Institute research assistant and second-year Georgetown University Law Center student Dinesh Kumar.

For more information on all of the pending challenges to the Affordable Care Act, visit http://www.healthlawandlitigation.com.  The website, a joint effort by the O’Neill Institute and the National Health Law Program, tracks the progress of litigation through the federal courts and provides a compendium of related academic literature.   

On the morning of September 23, 2011, a crowd of about 150 members of the press and public filed steadily into the E. Barrett Prettyman Federal Courthouse to hear oral arguments for Seven-Sky v. Holder, the latest challenge to the Affordable Care Act (ACA) to be heard at the circuit level.  

As with the other ACA cases, Seven-Sky focused on the constitutionality of the ACA’s minimum coverage provision (a.k.a. the “individual mandate”), which requires all U.S. citizens and legal residents to purchase health insurance or, beginning in 2014, pay a fine to the IRS that increases annually.  Three appellate courts had previously ruled in three different ways.  The Sixth Circuit upheld the individual mandate in Thomas More Law Center v. Obama, the Eleventh Circuit struck it down in Florida v. HHS, and the Fourth Circuit rejected the challenge outright in Liberty University v. Geithner, saying the court had no jurisdiction to hear the case under the Anti-Injunction Act (more on the AIA later).  In a fourth case, Virginia v. Sebelius, the Fourth Circuit said the state of Virginia had no standing to bring suit.  Read More

Posted in Health reform, National Healthcare; Tagged: , , .


Hunger breeds discontent

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The direct translation of an old Chinese saying is “people regard food as their heaven” (min yi shi wei tian, or food is what matters to people). However, the average person’s heaven seems broken in the Middle Kingdom. Chinese people still feel insecure about what they eat on a daily basis because nowadays food safety incidents are more frequent than ever.

Recently, the main character on the stage is refined trench oil. It is used as industrial oil in developed countries, yet in China, it hides in restaurant dishes. News media discover that small restaurants in different provinces mix cooking oil with refined trench oil, which contains tens of carcinogens as a way to reduce costs.  A professor said that the chance of encountering refined trench oil when you dine out is 10%.

Chinese government agencies started another special campaign against refined trench oil. As usual, several suspects were put into jail. However, it is hard to find refined trench oil through normal lab tests under the national standard for cooking oil, which does not include indicators referring to any illegal substance. Read More

Posted in Global Health, Health reform, Resources; Tagged: , , .


Briefing paper on tobacco product regulation and the WTO after US – Clove Cigarettes

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For those interested in matters of trade and health we have posted a briefing paper on the recent World Trade Organization panel report in US – Clove Cigarettes on the O’Neill Institute homepage (www.oneillinstitute.org). See the ‘recent news’ section.

The abstract is as follows:

On September 2, 2011, the World Trade Organization (WTO) released the report of a panel tasked with considering a complaint brought by Indonesia concerning prohibitions on certain flavored tobacco products implemented by the United States (US). The panel concluded that the US violated WTO law by prohibiting clove-flavored cigarettes, but not menthol-flavored cigarettes. More specifically, the measure was found to discriminate against Indonesian clove cigarettes in favor of menthol cigarettes of US origin. 

This briefing paper discusses those aspects of the dispute most relevant to public health, explains the panel’s decision, examines the implications for tobacco control and public health more generally and outlines the options open to the US. The analysis suggests that the decision represents a mixed outcome for public health. Some aspects of the decision reinforce domestic regulatory autonomy, while other aspects are a concern from a public health perspective.  As a next step, the US will have to choose between appealing the outcome, implementing the decision by prohibiting menthol cigarettes or permitting clove cigarettes, or refusing to comply with the outcome of the decision. 

I also recommend the ongoing discussion of the case on the worldtradelaw blog (http://worldtradelaw.typepad.com/ielpblog/).  Whereas the briefing paper aims at providing a summary of the dispute and its implications, there are a few blog posts and comments focused on the question of how the Agreement on Technical Barriers to Trade should be applied. The dispute is quite an important one in terms of how WTO law affects domestic regulatory autonomy in a health context and it will be interesting to see whether either the US or Indonesia will appeal. On the one hand, the US was found to violate WTO law, and in the absence of a successful appeal, will have to bring its domestic law into conformity with WTO law. On the other hand, Indonesia also did not get the outcome it was seeking because the panel rejected the argument that bans on clove cigarettes are not necessary to protect human health.



Posted in FCTC, Tobacco, Trade;


A debate about the international criminalization of falsification of medicines: responding to Attaran, Bate and Kendall

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Neil Boister and Benn McGrady

In a recent article in Journal of International Criminal Justice, we responded to a proposal by Amir Attaran, Roger Bate and Megan Kendall that a treaty should be negotiated under the auspices of the World Health Organization (WHO). More specifically, we responded to the suggestion that a treaty for the criminalization of falsifying medicines should be negotiated under the auspices of the WHO.

We argued that Attaran, Bate and Kendall had failed to consider questions of institutional choice. Working on the assumption that international legalization is an appropriate response to the problem of falsified medicines, we argued that the ‘WHO is not the only forum in which these issues may be addressed and nor is it clear that negotiations under the auspices of the WHO would be better than negotiating an optional protocol to [the UN Convention on Transnational Organized Crime] UNTOC or pursuing a joint initiative of the WHO and the UN Office on Drugs and Crime (UNODC).’ We stressed that if criminalization through international law is the approach to be adopted, it may be more appropriate to locate negotiations within the pre-existing UN criminal justice framework. Read More

Posted in FCTC, Global Health, Trade, WHO;


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The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.

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