This commentary in The Lancet explores the reasons why states comply with international law, analysing the compliance models that exist in international law. The writers offer policy recommendations for improving the compliance mechanisms of the pandemic treaty and IHR amendments.
Across multiple pandemics, global health governance institutions have struggled to secure the compliance of states with international legal and political commitments, ranging from data sharing to observing WHO guidance to sharing vaccines. In response, governments are negotiating a new pandemic treaty and revising the International Health Regulations. Achieving compliance remains challenging, but international relations and international law research in areas outside of health offers insights. This Health Policy analyses international relations research on the reasons why states comply with international law, even in the absence of sanctions. Drawing on human rights, trade, finance, tobacco, and environmental law, we categorise compliance mechanisms as police patrol, fire alarm, or community organiser models. We show that, to date, current and proposed global health law incorporates only a few of the mechanisms that have shown to be effective in other areas. We offer six specific, politically feasible mechanisms for new international agreements that, together, could create compliance pressures to shift state behaviour.
By Matthew M Kavanagh, Clare Wenham, Elize Massard da Fonseca, Lawrence R Helfer, Elvin Nyukuri, Allan Maleche, Sam F Halabi, Adi Radhakrishnan, Attiya Waris, Titled: Increasing compliance with international pandemic law: international relations and new global health agreements, published in The Lancet, 2023