Alexandra Phelan | Georgetown University Law Center (original) (raw)

Papers by Alexandra Phelan

SSRN Electronic Journal, 2000

On August 8, 2014, the World Health Organization (WHO) Director-General Margaret Chan declared th... more On August 8, 2014, the World Health Organization (WHO) Director-General Margaret Chan declared the West Africa Ebola crises a “public health emergency of international concern,” triggering powers under the 2005 International Health Regulations (IHR).

The most affected West African states have attempted classic public health measures with varied success, including quarantine and isolation, social distancing, risk communication, and travel restrictions. These have involved a trade off between population health and human rights; sometimes to the disadvantage of both. At the same time, the countries’ health systems and human resources are fragile, impeding an effective response.

Beyond the public health and humanitarian implications, this crisis has raised controversial ethical issues concerning the withholding or providing early access to investigational therapies, the preference given to foreign aid workers, and the disproportionate impact of Ebola on domestic health care workers.

The WHO director-general’s declaration of a public health emergency of international concern underscores the urgency of a coordinated international response and the imperative of raising the health systems capacity of low-income states. However, the current outbreak demonstrates how global governance has suffered from a lack of binding international commitment to sustainable capacity building and technical assistance in low-income states.

The WHO’s Pandemic Influenza Preparedness (PIP) Framework was a milestone global agreement design... more The WHO’s Pandemic Influenza Preparedness (PIP) Framework was a milestone global agreement designed to promote the international sharing of biological samples to develop vaccines, while that ensuring poorer countries would have access to those vaccines. Since the PIP Framework was negotiated, scientists have developed the capacity to use genetic sequencing data (GSD) to develop synthetic viruses rapidly for product development of life-saving technologies in a time-sensitive global emergency—threatening to unravel the Framework. Access to GSD may also have major implications for biosecurity, biosafety, and intellectual property (IP).

By rendering the physical transfer of viruses antiquated, GSD may also undermine the effectiveness of the PIP Framework itself, with disproportionate impacts on poorer countries. We examine the changes that need to be made to the PIP Framework to address the growing likelihood that GSD might be shared instead of physical virus samples. We also propose that the international community harness this opportunity to expand the scope of the PIP Framework beyond only influenza viruses with pandemic potential.

In light of non-influenza pandemic threats such as the Middle East Respiratory Syndrome (MERS) and Ebola, we call for an international agreement on the sharing of the benefits of research – such as vaccines and treatments – for other infectious diseases to ensure not only a more secure and healthy world, but also a more just world, for humanity.

Historically, the Oval Office has been a leader in global health assistance. From the President’s... more Historically, the Oval Office has been a leader in global health assistance. From the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI) under the Bush Administration, to the Global Health Initiative launched by President Obama in 2009. However, unlike PEPFAR and PMI, the Global Health Initiative met an untimely end with the launch of a bold new global health measure by the Obama Administration: the Global Health Security Agenda (GHS Agenda). The GHS Agenda aims to “accelerate progress toward a world safe and secure from infectious disease threats” through a US-led diplomatic collaboration with 30 countries, international organizations, nongovernmental organizations, and public/private entities.

The intertwining of global health and security follows a line of international agreements, including the revised International Health Regulations (2005), aimed at improving surveillance and response to public health emergencies of international concern. By mid-2012 however, only 22% of WHO member states had implemented the required core competencies. The GHS Agenda aims to address these global deficiencies in infectious disease preparedness. In doing so, the United States faces formidable obstacles including America’s lack of legal legitimacy in setting global norms, as well as the same domestic coordination difficulties that resulted in the dissolution of the Global Health Initiative, and the potential impediment of passing the President’s budget through a hostile Congress. While the securitization of global health has its criticisms, it also has the potential to be transformative, succeeding where international organizations have not always been able to, building a safer and healthier world.

SSRN Electronic Journal, 2000

On August 8, 2014, the World Health Organization (WHO) Director-General Margaret Chan declared th... more On August 8, 2014, the World Health Organization (WHO) Director-General Margaret Chan declared the West Africa Ebola crises a “public health emergency of international concern,” triggering powers under the 2005 International Health Regulations (IHR).

The most affected West African states have attempted classic public health measures with varied success, including quarantine and isolation, social distancing, risk communication, and travel restrictions. These have involved a trade off between population health and human rights; sometimes to the disadvantage of both. At the same time, the countries’ health systems and human resources are fragile, impeding an effective response.

Beyond the public health and humanitarian implications, this crisis has raised controversial ethical issues concerning the withholding or providing early access to investigational therapies, the preference given to foreign aid workers, and the disproportionate impact of Ebola on domestic health care workers.

The WHO director-general’s declaration of a public health emergency of international concern underscores the urgency of a coordinated international response and the imperative of raising the health systems capacity of low-income states. However, the current outbreak demonstrates how global governance has suffered from a lack of binding international commitment to sustainable capacity building and technical assistance in low-income states.

The WHO’s Pandemic Influenza Preparedness (PIP) Framework was a milestone global agreement design... more The WHO’s Pandemic Influenza Preparedness (PIP) Framework was a milestone global agreement designed to promote the international sharing of biological samples to develop vaccines, while that ensuring poorer countries would have access to those vaccines. Since the PIP Framework was negotiated, scientists have developed the capacity to use genetic sequencing data (GSD) to develop synthetic viruses rapidly for product development of life-saving technologies in a time-sensitive global emergency—threatening to unravel the Framework. Access to GSD may also have major implications for biosecurity, biosafety, and intellectual property (IP).

By rendering the physical transfer of viruses antiquated, GSD may also undermine the effectiveness of the PIP Framework itself, with disproportionate impacts on poorer countries. We examine the changes that need to be made to the PIP Framework to address the growing likelihood that GSD might be shared instead of physical virus samples. We also propose that the international community harness this opportunity to expand the scope of the PIP Framework beyond only influenza viruses with pandemic potential.

In light of non-influenza pandemic threats such as the Middle East Respiratory Syndrome (MERS) and Ebola, we call for an international agreement on the sharing of the benefits of research – such as vaccines and treatments – for other infectious diseases to ensure not only a more secure and healthy world, but also a more just world, for humanity.

Historically, the Oval Office has been a leader in global health assistance. From the President’s... more Historically, the Oval Office has been a leader in global health assistance. From the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI) under the Bush Administration, to the Global Health Initiative launched by President Obama in 2009. However, unlike PEPFAR and PMI, the Global Health Initiative met an untimely end with the launch of a bold new global health measure by the Obama Administration: the Global Health Security Agenda (GHS Agenda). The GHS Agenda aims to “accelerate progress toward a world safe and secure from infectious disease threats” through a US-led diplomatic collaboration with 30 countries, international organizations, nongovernmental organizations, and public/private entities.

The intertwining of global health and security follows a line of international agreements, including the revised International Health Regulations (2005), aimed at improving surveillance and response to public health emergencies of international concern. By mid-2012 however, only 22% of WHO member states had implemented the required core competencies. The GHS Agenda aims to address these global deficiencies in infectious disease preparedness. In doing so, the United States faces formidable obstacles including America’s lack of legal legitimacy in setting global norms, as well as the same domestic coordination difficulties that resulted in the dissolution of the Global Health Initiative, and the potential impediment of passing the President’s budget through a hostile Congress. While the securitization of global health has its criticisms, it also has the potential to be transformative, succeeding where international organizations have not always been able to, building a safer and healthier world.