Implementing Public Health Regulations in Developing Countries: Lessons from the OECD Countries

Abstract

Developing country efforts to enforce basic public health standards are often hindered by limited agency resources and poorly designed enforcement mechanisms, including excessive reliance on slow and erratic judicial systems. Traditional public health regulation can therefore be difficult to implement. This article examines innovative approaches to the implementation of public health regulations that have emerged in recent years within the OECD countries. These approaches aim to improve compliance with health standards among the different actors while reducing dependence on the legal system and the administrative resources of public health agencies in developing countries. Developing countries may find some useful lessons from these approaches that can be adapted for use in their own institutional settings.

The legal determinants of health: harnessing the power of law for global health and sustainable development

“…These governance mechanisms can incentivise public participation and help "dispel potential concerns of suspicion or mystification that might surround the development of public health laws". 327 Public participation and open forums also enable civil society to understand the purpose of health law and engage more effectively in the policy process. In turn, this can support adherence to the norms and standards established by health laws.…”

Criminalizing Health-Related Behaviors Dangerous to Others? Disease Transmission, Transmission-Facilitation, and the Importance of Trust

“…Although some forms of influenza are relatively mild, others such as the H1N1 epidemic of 1919 are not. For these infections, powerful arguments have been advanced for significant measures to prevent disease spread, especially vaccinations, social distancing, travel restrictions, isolation, or quarantine (Clarkson 2010;Mok et al 2010). With the attack on the World Trade 18 Canada, for example, requires all applicants for lawful permanent residency, all refugees, and applicants for temporary residency from high TB incidence areas to undergo TB screening.…”

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“…However, policy approaches within LICs depend upon a functioning governance system (Thomas and Gostin, ), which requires the necessary administrative resources and authority to implement health policies and regulations. LICs often lack these basic capacities, making it difficult for them to meet basic public health needs (Mok, , pp. 508–09).…”

“…Traditional methods of government regulation of medicine distribution include inspections and licensing systems. Inspections may be problematic, as they can be an expensive form of regulation in that they require significant time and experienced staff (Mok, , p. 511). While licensing sifts out unqualified distribution businesses by setting standards for compliance, it can also be administratively expensive, cumbersome and used to extort (Mok, , p. 511).…”

“…With the limited budgets of LICs, use of more flexible and less time‐ and money‐consuming methods will extend the impact of regulatory mechanisms. Mok and co‐workers recommend the following low‐cost mechanisms, as supported by their successful use in OECD countries: formal warnings, public disclosure, use of sanctions, alternative dispute resolution, use of ombudsmen, self‐regulation and public–private cooperation (Mok, , pp. 511–18).…”