A Foundational Treatise to Shape a New Field

Global health law offers the promise of bridging national boundaries to alleviate global inequities. Arising out of international health law — which narrowly focused on binding agreements among states — the academic field of global health law has addressed the contemporary landscape for public health in a rapidly globalizing world, reflecting the rise of new actors in the global health landscape and new threats beyond the reach of the state.Reference Gostin and Meier¹ The field of global health law encompasses these legal and policy frameworks — both binding and non-binding — that structure global public health.

Global health law recognizes that all nations face interconnected public health threats, requiring collective global action to realize global health equity. Following World War II, the birth of the United Nations (UN) and World Health Organization (WHO) would provide a permanent foundation for collective action through global health governance. Through global health law, these global governance institutions could set norms for global action, form partnerships with key stakeholders, and develop consensus on shared goals for global health.Reference Gostin² Such global health governance has become crucial in developing international law and global policy to unite state and non-state actors against global threats.Reference Gostin and Sridhar³ Global health law has thus provided a shared normative framework to structure coordinated efforts by the global community to advance global health.

In Global Health Law, Gostin conceptualized a new academic field to study how global institutions can negotiate this shared vision of global health, coordinate with organizations across sectors, and align national laws to advance public health in a globalizing world. Looking beyond the formal sources and traditional subjects of international law, Gostin defined global health law to describe legal institutions that speak to:

• • Rising health threats — including communicable and non-communicable disease, injuries, mental health, dangerous products, and other globalized health threats,

• • Proliferating health actors — including transnational corporations, private philanthropists, civil society, and other non-state actors, and

• • Expanding health regulations — including “soft law” instruments, strategy documents, and other norms of global health policy.Reference Gostin⁴

These law and policy frameworks, placing public health obligations on the global community of state and non-state actors, can facilitate justice in global health through global institutions that are governed well, embracing values of transparency, inclusivity, and accountability.

Evolving Legal Scholarship to Address Global Health Threats

The expansion of health law scholarship to encompass global health law has brought new understanding to the normative frameworks that structure efforts by the global community to advance public health. Beyond WHO, global institutions have arisen to address global determinants of health, establishing a multisectoral global health governance landscape that serves to frame health policies, programs, and practices across the global sphere. Global health law has come to encompass these law and policy frameworks that apply to the new health threats, non-state actors, and regulatory instruments that structure global health. Ensuring justice in global health, global health law has been shaped by norms of equity, social justice, and human rights, striving for collective action and mutual solidarity throughout the world, with particular concern for the most disadvantaged.Reference Meier and Gostin⁵

The field has thus proven impactful in advancing global efforts to ensure justice for a healthier world. Through an extensive body of international organizations and global partnerships, state and non-state actors have come together to respond to global challenges, working through law and policy to establish coordinated global responses to rising health threats.Reference Meier⁶ In facing these new challenges, global health law research now studies binding and non-binding instruments of health law, human rights law, environmental law, trade law, and law and policy instruments across sectors to advance global health.Reference Burci and Toebes⁷ Global health law seeks to understand the changing global landscape, architecture, and governance necessary to respond to the health challenges of the twenty-first century. Preparing the next generation to engage with this advancing scholarship, global health law has become an independent discipline in academic institutions and degree programs.Reference Gostin and Meier⁸

This academic field has expanded swiftly since the publication of Global Health Law. As a distinct discipline, global health law has seen the development over the past decade of:

• • New academic programs — including the establishment of the O’Neill Institute’s global initiatives, the development of global health law degree programs across countries, and the launch of the Geneva Global Health Law Summer School,

• • New academic publications — including the Research Handbook on Global Health Law (Elgar, 2018), Global Health Law & Policy: Ensuring Justice for a Healthier World (Oxford, 2023), and the new Journal of Global Health Law (Elgar, 2024), and

• • New academic collaboratives — including the Global Health Law Consortium, which has brought together leading scholars throughout the world to develop the field, interpret global health law instruments, and facilitate collaborative research projects.

This rising scholarship has become crucial amid the challenges of the COVID-19 pandemic.

An Unprecedented Pandemic Challenges Global Health Law

The COVID-19 pandemic tested the legal foundations of global health governance, challenging domestic legal authorities in facing a shared global health threat and exposing the fragility of the international legal order. State actions in the COVID-19 response violated international legal obligations, as nationalist governments failed to report public health risks, neglected guidance from WHO leaders, and undermined global solidarity to ensure vaccine equity.Reference Gostin, Habibi and Meier⁹ These compounding legal violations across the COVID-19 response led states to launch a series of global health law reforms.Reference Meier, Habibi and Gostin¹⁰

Laying a new foundation for binding international law under WHO governance, these international negotiations are still underway. WHO member states successfully adopted amendments to the International Health Regulations in May 2024, but — in the absence of international consensus — have resolved to continue negotiating to develop a novel Pandemic Agreement.Reference Phelan¹¹ Where past reform efforts to prevent, prepare for, and respond to future pandemics have faced political challenges, these ongoing law reforms amid rising international divisions reveal renewed commitment to binding legal instruments to foster international collaboration under global health law.Reference Gostin¹²

A Special Issue to Reflect on an Incomparable Legacy

These contemporary challenges have brought together a range of scholars and policymakers to advance global health law, and the collaborative efforts of these thought leaders come together in this special issue. Through their contributions, this special issue reflects on the dramatic development of the field of global health law, highlighting the successes of law and policy in promoting global health, the challenges exposed by the COVID-19 pandemic, and the need for new normative frameworks in responding to rising threats. In addressing select issues of global health law, this special issue has brought together interconnected contributions — personal essays to reflect on the impact of Gostin’s leadership in the field and substantive articles to examine how the field has evolved.

This special issue is organized across four sections, with each section including articles that address a range of health issues. Section I introduces the theoretical conceptualization of the field, examining issues of global health governance, hard and soft law, and human rights obligations. This conceptual framework for global health law provides a foundation for addressing the most pressing normative challenges in global health, with Section II applying global health law and policy in global health governance for communicable disease, non-communicable disease, universal health coverage, and environmental health. Reflecting the specific challenges of recent years, Section III considers the health threats posed by the COVID-19 pandemic and the interconnected global health law reforms underway. These present challenges reveal the need for sweeping reforms to address rising threats, and Section IV analyzes these issues at the forefront of global governance, including civil society participation, maternal and child health, new health technologies, and emerging decolonial frames. These expansive contributions reflect the enduring legacy of Global Health Law, and the special issue ends with Gostin’s own reflections on the past, present, and future of the field.