Between rules and resistance: moving public health emergency responses beyond fear, racism and greed

Abstract

In times of a public health emergency, lawyers and ethicists play a key role in ensuring that government responses, such as travel restrictions, are both legally and ethically justified. However, when travel bans were imposed in a broadly discriminatory manner against southern African countries in response to the Omicron SARS-CoV-2 variant in late 2021, considerations of law, ethics or science did not appear to guide politicians’ decisions. Rather, these bans appeared to be driven by fear of contagion and electoral blowback, economic motivations and inherently racist assumptions about low-income and middle-income countries (LMICs). With a new pandemic treaty and amendments to the WHO’s International Health Regulations (IHR) on the near-term horizon, ethics and international law are at a key inflection point in global health governance. Drawing on examples of bordering practices to contain contagion in the current pandemic and in the distant past, we argue that the current IHR is not adequately constructed for a just and equitable international response to pandemics. Countries impose travel restrictions irrespective of their need or of the health and economic impact of such measures on LMICs. While the strengthening and reform of international laws and norms are worthy pursuits, we remain apprehensive about the transformative potential of such initiatives in the absence of collective political will, and suggest that in the interim, LMICs are justified in seeking strategic opportunities to play the same stark self-interested hardball as powerful states.

Increasing compliance with international pandemic law: international relations and new global health agreements

“…A recent proposal suggested that countries facing unfair, non-evidence-based travel restrictions on their citizens as South Africa did during Omicron might consider withdrawing cooperation in data sharing and specimen sharing with those countries that impose such bans. 50 4. Formal structure for civil society reporting and accountability.…”

Data Sharing During Pandemics: Reciprocity, Solidarity, and Limits to Obligations

“…When South Africa shared information about this novel SARS-CoV-2 variant with the World Health Organization (WHO), the country (and, inexplicably, many of its African neighbours) were met with travel bans. This response was ethically problematic in at least two ways: first, it was a policy decision based on racism and fear, not science, ethics, or law (Jackson, Habibi, Forman et al 2022 ). These travel bans were enacted in contravention of the International Health Regulations (IHR) (World Health Organization 2016 ) and were resoundingly considered unnecessary by the scientific community (Mallapaty 2021 ; Mendelson et al 2021 ; World Health Organization 2021 ).…”

Development of New Stringency Indices for Nonpharmacological Social Distancing Policies Implemented in Korea During the COVID-19 Pandemic: Random Forest Approach

“…Standard policies included school closures, travel restrictions, bans on public gatherings, stay-at-home orders, closure of public transportation, emergency investments in the health care system, contact tracing, and investments in COVID-19 vaccines. Due to its high recovery rate of above 95% [34], the implementation of the restriction policies was also met with resistance from the general population as the social distancing period lengthened mainly toward vaccination and wearing masks [35][36][37][38][39][40][41][42][43].…”