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Am J Public Health. 2015 Aug;105(8):1523-30. doi: 10.2105/AJPH.2015.302726. Epub 2015 Jun 11.

Assessing Proposals for New Global Health Treaties: An Analytic Framework.

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Steven J. Hoffman is with the Global Strategy Lab, Faculty of Law, University of Ottawa, Canada, and the Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA. John-Arne Røttingen is with the Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway, and the Department of Health Management and Health Economics, University of Oslo, Norway. Julio Frenk is with the Harvard T. H. Chan School of Public Health and the John F. Kennedy School of Government, Harvard University.


We have presented an analytic framework and 4 criteria for assessing when global health treaties have reasonable prospects of yielding net positive effects. First, there must be a significant transnational dimension to the problem being addressed. Second, the goals should justify the coercive nature of treaties. Third, proposed global health treaties should have a reasonable chance of achieving benefits. Fourth, treaties should be the best commitment mechanism among the many competing alternatives. Applying this analytic framework to 9 recent calls for new global health treaties revealed that none fully meet the 4 criteria. Efforts aiming to better use or revise existing international instruments may be more productive than is advocating new treaties.

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