The responsibilities of states for the health of their own inhabitants can be at threat from external forces. Some years ago WHO played a key role in stopping the spread of severe acute respiratory syndrome (SARS). The initial indications of a pandemic began in China in the autumn of 2002. Internationally this caused alarm because of the gravity of the situation and serious outbreaks of the disease in several countries, mainly related to people who had visited China or Hongkong. The epidemic receded after a couple of years, but the fear it inspired had a strong impact on international collaboration under the auspices of WHO aimed at preventing pandemics. The most important result was the preparation of the International Health Regulations (IHR), which are now a legally binding instrument acceded to by practically every state in the world (adopted in 2007, now acceded to by 194 states) (8).
WHO has pointed out that the justification for international health regulations lies in the fact that in today’s globalized world, disease can spread swiftly and widely due to international travel and trade. A health emergency in one country can quickly impact on living conditions and the eco-nomy in many parts of the world. These emergencies include infectious diseases such as SARS but also chemical emissions, oil spills or nuclear melt-downs with the ensuing danger of radiation.
Many other examples could be given to indicate that to a growing extent the defence and protection of the right to health in the individual country demand international collaboration. Our economies and global trade make it increasingly essential to ensure that health is not endangered by visiting other countries.
The effect of globalization can also be experienced the other way round. Refugees, asylum-seekers and immigrant workers come to our countries, and the right to health must also apply to them. Some may also bring with them diseases that are more or less eradicated in Western countries. In June 2011 there was an outbreak of measles in Oslo among children who had visited the emergency medical service. The infection was carried by Somali children and was unexpected in Norway where measles is now a rare condition. Others may carry tuberculosis, sometimes caused by multi-resistant bacteria. In order to fulfil their health commitments vis-á-vis people in Norway, the Norwegian authorities must participate in international collaboration to improve the health situation in other countries, for example by reducing the incidence of infectious diseases.
International cooperation can also apply to the prevention of chronic diseases that are not infectious, but are a result of lifestyle. This can be achieved through cooperation on the marketing and sale of tobacco products, or on the marketing of undesirable food and drink products that can contribute to overweight and malnourishment. Active participation in international collaboration to regulate such conditions forms part of every individual state’s commitment to safeguard the right to health.
WHO’s framework convention on tobacco control is the first international treaty successfully negotiated under WHO’s auspices. It was adopted in 2003 and entered into force in 2005. Since then it has become one of the international conventions that has received speedy and broad support. On 21 June 2011 the convention received its 174th ratification.