기능주의 관점에서 본 세계보건기구의 설립과 역할

고한수,김창엽 한국보건행정학회 2012 보건행정학회지 Vol.22 No.1

Since its establishment in 1948, World Health Organization (WHO) has tried and facilitated international cooperation of public health under the goal of “the highest attainable health,”and gained outcomes like the eradication of smallpox and polio, turning itself into the representative of international public health. However, there was discord between member nations during the cold war era, and the status of WHO experienced rise and fall after its establishment. WHO, the representative international health organization, also has not been freed from influences from international regime changes, which means that the discussion on the internal causes of WHO functionings should be expanded more. In this study, functionalism was tested as one of international relations theory that tries to explain the establishment and role of WHO. Especially, this study analyzed the problems and problem-solving process that WHO had to face by using Imber’s five steps theory that arranged chronologically the theory of Mitrany. We mainly investigated the secondary source that described historic facts on the rise and fall of WHO in terms of roles and functionings during establishment of WHO, the cold war era, and international cooperation of public health. The roles of WHO were analyzed by selecting the gains of WHO in the post cold war era. The functionalism arrangement of Imber was appropriate to some extent in explaining the establishment and role of WHO. The first step was International Sanitary Conference in 1851 that made nations to recognize international cooperation of public health, and the second step was the establishment of WHO that handles public health as an international organization. Recent cases of the Framework Convention on Tobacco Control and International Health Regulations showed that each nation agreed with an international norm that they had to cooperate each other to tackle infectious diseases and smoking, and this implies that these were emergence of global governance. This process was the third step of Imber’s theory (nations had a gain from international cooperation would agree with the expansion of authority of international organization). However, the last two steps of the theory are still not realized. The partial success of WHO was based on the functional elements that WHO deals with non-political elements, human resources centering on professionals, and democratic decision making process. This essential and non-political characteristics mean that necessity of international cooperation catalyzed by WHO would continue despite of the global governance era when global health governance get faced more challenges.

국제 정신건강 지표에 대한 고찰 및 지표의 정책적 응용

이용주,윤민희,한혜리 한국보건의료기술평가학회 2019 보건의료기술평가 Vol.7 No.1

Objectives: This study aims to examine current mental health indicators in South Korea comparing international mental health indicators, and to review their policy implications for better mental health. Methods: We examined the international mental health indicators provided by the World Health Organization and the Organization for Economic Cooperation and Development, and explored the policy implications of the Australian mental health indicators. Results: We found that indicators for system effectiveness are commonly used while indicators for efficiency are not relatively often used. The indicators for economic budget to see efficiency are limited still in South Korea. However, international mental health indicators for expenditure and budget are frequently provided and used for diverse reasons. Conclusion: It is necessary to generate the systematic reasonable mental health indicators to monitor efficiencies of mental health programs using reliable database and to evaluate them for better mental health system.

코로나19 이후 국제보건법과 팬데믹 조약

박진아 국제법평론회 2023 국제법평론 Vol.- No.65

Since the outbreak of COVID–19, the process of considering a treaty for pandemic prevention, preparedness, and response has been entirely led by World Health Organization (WHO) member states. To overcome the fundamental limitations of the International Health Regulations (2005) (IHR 2005) system, it is possible to consider a more comprehensive revision of the IHR, perhaps even more drastic than the 2005 revision. Alternatively, a new fundamental and comprehensive treaty for pandemic response could be considered, independent of any revision of the IHR. The WHO and its member states have chosen the latter option and are now pursuing a two–track legislative process to adopt a new pandemic treaty in parallel with some revisions to the IHR. This article examines the international community's efforts to improve international health law for pandemic prevention, preparedness, and response in the wake of the COVID–19 pandemic. To do so, it first examines the failures of international health rules and lessons learned from COVID–19, and then analyzes the progress of the WHO's Member States in revising IHR and negotiating a draft pandemic treaty, as well as the differences in legal basis articles under the WHO’s Constitution. The IHR have not responded effectively to the COVID–19 pandemic, and as Report of the Review Committee on the Functioning of the IHR during the COVID–19 response, revision of the Regulations seems inevitable. However, IHR revision alone are not enought to address the problems that have arisen during the pandemic. While a major revision of the IHR could be considered, it would be more difficult to incorporate new legislation into the existing framework of the IHR to create a harmonized and unified normative framework than to create a new treaty. Furthermore, maintaining the form of the Rules in Article 21 is not the best option, despite the fact that the WHO’s Constitution authorizes the Organization to enter into “conventions or agreements” under Article 19. In this regard, amending the International Health Regulations and creating a new pandemic treaty at the same time is the most effective legislative approach in the current context to prevent, prepare for, and respond to diseases that could cause an international health crisis. This article reviews the highlights of 「the Zero Draft of the WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response (“WHO CA+”)」, published in February 2023, for consideration by the Intergovernmental Negotiating Body (INB). The Zero Draft provides a framework for legal regulation at all levels of the pandemic response and is extensive in its substantive content. The Zero Draft emphasizes equity at all levels and provides concrete measures to achieve it. It covers and documents many issues relevant to pandemic governance, from crisis–resilient health systems and a strong health workforce to measures related to one health and antibiotic resistance, health literacy, and even social determinants of health. The Zero Draft is completely open–ended, meaning that it could change over the course of future negotiations, but it is unlikely to change much in terms of the main content that will be included in a pandemic treaty.

공중 보건 문제에 대한 국제법적 대응 - WHO 및 UN에서의 논의를 중심으로 -

이경화 ( Kyoung Hwa Lee ) 한국환경법학회 2015 環境法 硏究 Vol.37 No.2

신종 전염병의 확산으로 인해 국제사회는 위기를 겪고 있다. 냉전의 종식 이후 국가 간 무력 분쟁을 인한 위협이 상대적으로 감소한 상황에서, 전염병은 사상자규모나 국가의 존립에 미치는 사회·경제적 파급효 측면에서 볼 때 전쟁 등 전통적인 안보 위협보다 오히려 더욱 위협적인 요소로 부각되고 있다. 특히, 2013년 12월 이래 서아프리카 기니, 시에라리온, 라이베리아 등에서 창궐한 에볼라 출혈열의 급속한 전이는 서아프리카 일부 국가의 보건 문제를 넘어서, 아프리카 지역 전체의 평화와 안보에 영향을 미치는 복합적인 위기상황으로 전개되었다. 이에 대해 WHO는 2014년 8월 8일 에볼라 발병의 확산을 국제보건규칙상 ‘국제적 공중보건 비상사태’(PHEIC)로 선포하고, 유엔 안전보장이사회는 2014년 9월 18일 2177호 결의를 채택하여 “아프리카에서의 전례 없는 에볼라 발병의 확산이 국제평화와 안전에 위협을 구성”한다고 선언하였다. 안보리 결의 2177은 역사상 최초로 전염병의 발병을 ‘국제평화와 안전에 대한 위협’으로 선언하였다는 점에서 의의가 있다. 보건 안보는 어느 한 국가의 개별적인 노력만으로는 극복하기 어려운 초국경적 문제임이 분명하고, 국제법적 시각에서 규범화가 추진되어야 할 것이다. 전염병이 국제평화와 안전에 위협을 초래한다는 공통된 인식하에 유엔, WHO 등 국제기구의 권고, 지침, 결의, IHR 개정 논의 및 국가들의 관행의 축적 등 여러 가지 방법을 통해 보완해 나가야 할 문제일 것이다. International community suffers from severe emerging infectious diseases. Although threats from inter-state armed conflicts have been reduced after the end of the Cold War, “non-traditional” security threats, including outbreaks of deadly diseases pose more serious threat to international community, given their lethality and ripple effects on the entire countries and regions crossing the borders and continents. Especially, Ebola which broke out in Guinea, Sierra Leone and Liberia in December 2013 spread out in the West Africa, thereby threatening peace and security in the entire region of Africa. On August 8, 2014, the World Health Organization(WHO) declared the Ebola outbreak a“Public Health Emergency of International Concern(PHEIC)” under the International Health Regulations(IHR 2005). On September 8, 2014, the United Nations Security Council adopted resolution 2177, determining that “the unprecedented extent of the Ebola outbreak in Africa constitutes a threat to international peace and security.”Resolution 2177 states for the first time in the history of the United Nations that it has considered a disease outbreak as such“a threat to international peace and security”. Since securitization of the public health has become a cross-border issue which can not be effectively managed by the effort of an individual country, internationally binding regulations need to be established. In facilitating the legalization of the cross-border issues of public health, the international community, based upon the shared recognition of infectious diseases as a threat to international peace and security, need to facilitate mechanisms of the United Nations, the World Health Organization and other relevant international organizations, such as adoption of recommendations, guidelines or resolutions, amendment of IHR and accumulation of the state practices.

우리나라 기후보건 탄력성의 현황과 과제: 보건의료체계 관점의 국제비교를 중심으로

이한솔,박예인,김재희,이유리 한국보건사회연구원 2023 保健社會硏究 Vol.43 No.4

Climate change is emerging as a significant global health risk. While previous studies have highlighted the health impacts of climate change, there remains a limited understanding of the adaptation strategies remains limited within the healthcare system in South Korea. This study, grounded in the World Health Organization’s framework for building climate health systems, evaluates South Korea's health resilience to climate change from an international perspective. Drawing insights from major countries like the UK, Germany, and Japan, we assessed how the South Korean health system responds to climate change and identified areas for improvement. Our findings indicate that the recognition of the link between climate change and health in South Korea is relatively low, and there is a lack of systematic response strategies. To address these challenges, we propose the following: enhance public education and promotional activities to raise awareness of the health implications of climate change; invigorate research to establish a systematic response strategy; incorporate diverse stakeholder opinions to develop a comprehensive response strategy; strengthen inter-departmental collaboration for efficient strategy implementation; and bolster international cooperation to integrate global standards and experiences into the strategy. Through these systematic responses, we anticipate that South Korea’s ability to address the health implications of climate change will be strengthened, thereby safeguarding the health of its citizens.

Korean Policy on Young Children's Environmental Health

정선아,문미옥 한국유아교육학회 2009 INTERNATIONAL JOURNAL OF EARLY CHILDHOOD EDUCATION Vol.15 No.2

In this paper, we will mainly address policy issues for promoting young Korean children’s environmental health. In specific, we will, first, discuss the global actions of promoting a healthy lifestyle which was established based on WHO’s MEME (Multiple Exposures-Multiple Effects) model and Children’s Environmental Health Indicators (CEHI). Second, we present and analyze current recent laws and regulations on children’s environmental health in Korea by using the MEME model and CEHI. Third, we suggest future directions for establishing policy on young children’s environmental health. One of our suggestions is to apply the MEME model and implement the CEHI for promoting young children’s environmental health. We also suggest that environmental education should be used as an indicator of exposure to the environment rather than as a way of prevention and intervention. Finally, we suggest establishing a Children’s Environmental Health Office which governs all matters of children’s health.

포스트 코로나19의 ‘국제적 거리두기’ - 루만과 토이브너의 체계이론에 입각한 국제보건법 체계에 대한 분석 -

이주은 ( Ju Eun Lee ) 연세대학교 법학연구원 공공거버넌스와 법센터 2021 연세 공공거버넌스와 법 Vol.12 No.1

In the midst of the coronavirus pandemic, countries have leaned towards ‘international distancing’ rather than cooperation with the World Health Organization (WHO). In particular, countries have ignored the WHO’s initial response recommendations for the pandemic and enforced individual self-isolation measures instead, including strong entry-limit policies and travel restrictions. This phenomenon has exposed the limitations of the WHO - lack of binding measure to ensure compliance with the obligations of state parties and absence of an independent dispute settlement body. Member states have lost confidence in the WHO as a result, casting doubt on the organization’s ability to establish and maintain normative expectations under an international health law regime. This article examines the legal status and function of the international health law regime based on Niklas Luhmann and Gunther Teubner’s systems theory. Systems theory views law as reproducing itself in accordance with its own system-specific codes and programs as a legal ‘system’. Such self-reproducing system is recognized as an autopoietic system, and an autopoietic law stabilizes normative expectations for its actors. Under Luhmann and Teubner’s theoretical framework, this article examines the international health law regimes - the WHO and International Health Regulations (2005) - to analyze whether they can enable state parties to reach international cooperation and secure normative expectations as an autopoiesis in the post-corona era. Before COVID-19, the international health law regime could be understood as a ‘partially’ autopoietic system considering its self-descriptive, self-referential operation and its function as a stabilizer of normative expectations. Especially with the major amendment of IHR in 2005, it seemed that international health law had gradually been established as a legal system. However, through the coronavirus pandemic, internationally distancing states proved that the system’s status and function cannot be seen as that of an autopoietic one. Therefore, this article argues that without major reform to 1) secure the means of implementation and 2) structuralize an independent dispute settlement measure to establish substantial normative expectations, the international health law regime in the post-corona era will not be able to stand as an autopoietic system. Thus, international cooperation among states in global health crisis will be difficult to garner, at least through the current WHO and IHR.

코로나19와 국제보건규칙의 대응 : 그 한계와 문제점을 중심으로

박진아(Jina PARK) 서울국제법연구원 2020 서울국제법연구 Vol.27 No.1

2005년 세계보건기구는 기존의 법을 전면 개정한 국제보건규칙을 채택함으로써 국제공중보건위기상황을 예방·방어·관리 및 대응하기 위한 현재의 법적 틀을 형성했다. 국제보건규칙은 국제이동과 무역에 대한 불필요한 방해를 피하면서 공중보건 대응에서 인권을 보호하고 보다 높은 수준의 세계 보건 안보를 달성하도록 고안됐다. 그러나 코로나19 위기의 상황에서 국제보건규칙은 제 역할을 하지 못하고 있다. 감염병 위협 속에서도 법의 지배, 인권, 연대와 협력의 핵심 가치를 유지하면서 국제보건규칙을 구현하는 것이 코로나19의 확산을 통제하고 향후에 감염병 예방과 대응에 있어 여전히 중요하다. 따라서 이 글은 2005년 개정 이후에 꾸준히 제기되었던 국제보건규칙의 문제점 중에서도 코로나19 사건을 통해 특히 부각된 4가지 쟁점, 즉, 1) 국제보건규칙상의 당사국의 통고 의무 및 정보 제공 의무의 비준수, 2) 국제공중보건위기상황의 선포 절차와 관련하여 국제공중보건위기상황의 선포 시기 및 선포 기준, 3) 국제보건규칙상의 임시 권고를 위반한 당사국의 감염병 대응조치, 4) 세계보건기구의 재정난과 감염병 대응 자금 부족 문제 등을 검토한다. 코로나19 사건은 현재의 국제보건규칙이 국제적보건위기상황을 구성하는 감염병 대응에 효과적이지 못하다는 것을 증명했다. 이제 코로나19와 향후 등장할 질병으로부터 모든 사람의 ‘도달할 수 있는 최고 수준의 건강’을 지키기 위해 국제보건규칙을 포함한 국제보건규범 전반을 총체적으로 개혁하는 것이 시급해졌다. In 2005, the World Health Organization formed the current legal framework for preventing, defending, managing and responding to a ‘public health emergency of international concern’ (PHEIC) by adopting the International Health Regulations(2005) which completely revised the former International Health Regulations. The IHR (2005) are designed to protect human rights in public health response and achieve a higher level of global health security while avoiding unnecessary interference with international traffic and trade. However, in the event of Coronavirus disease (COVID-19), the IHR (2005) have not functioned properly as the number of countries violating the regulations is increasing. Given the serious threat posed by infectious diseases, implementing the IHR (2005) while maintaining the core values of rule of law, human rights, solidarity and cooperation is important to control the spread of COVID-19 and to prevent and respond to infectious diseases in the future. This article reviews four issues that have been particularly highlighted during the COVID-19 crisis, among the problems that have continually arisen since the revised IHR were adopted in 2005. First, the issue of non-compliance with a State Party’s obligations of notification and providing information under the IHR (2005) is reviewed. At the same time, the measures to strengthen compliance with the obligations of State Parties are addressed. Second, this article examines a PHEIC under the IHR (2005). To strengthen the appropriateness of the timing and standards for declaration of a PHEIC, the article looks for ways to increase the transparency and objectivity of the process for determining a PHEIC. Third, the health measures taken by State Parties are assessed according to the World Health Organization"s temporary recommendations under the IHR (2005). Finally, the WHO’s chronic financial difficulties and the lack of funds to cope with infectious diseases are discussed. The COVID-19 outbreak has shown the IHR (2005) to be ineffective in responding to infectious diseases constituting a PHEIC, while also revealing that a State"s independent health measures alone are inadequate to respond to an infectious disease pandemic. It is now urgent to reform the entire structure of international health norms, including IHR (2005), in order to ensure everyone"s ‘highest attainable standard of health’ in the face of COVID-19 and future diseases.

Infrastructure-building for Public Health: The World Health Organization and Tuberculosis Control in South Korea, 1945-1963

김규리,박범순 대한의사학회 2019 醫史學 Vol.28 No.1

This paper examines WHO’s involvement in South Korea within the context of the changing organization of public health infrastructure in Korea during the years spanning from the end of the Japanese occupation, through the periods of American military occupation and the Korean War, and to the early years of the Park Chung Hee regime in the early 1960s, in order to demonstrate how tuberculosis came to be addressed as a public health problem. WHO launched several survey missions and relief efforts before and during the Korean War and subsequently became deeply involved in shaping government policy for public health through a number of technical assistance programs, including a program for tuberculosis control in the early 1960s. This paper argues that the principal concern for WHO was to start rebuilding the public health infrastructure beyond simply abolishing the remnants of colonial practices or showcasing the superiority of American practices vis-à-vis those practiced under a Communist rule. WHO consistently sought to address infrastructural problems by strengthening the government’s role by linking the central and regional health units, and this was especially visible in its tuberculosis program, where it attempted to take back the responsibilities and functions previously assumed by voluntary organizations like the Korea National Tuberculosis Administration (KNTA). This interest in public health infrastructure was fueled by WHO’s discovery of a cost-effective, drug-based, and communityoriented horizontal approach to tuberculosis control, with a hope that these practices would replace the traditional, costly, disease-specific, and seclusion-oriented vertical approach that relied on sanatoria. These policy imperatives were met with the unanticipated regime change from a civilian to a military government in 1961, which created an environment favorable for the expansion of the public health network. Technology and politics were intricately intertwined in the emergence of a new infrastructure for public health in Korea, as this case of tuberculosis control illustrates.

Health as Human Rights under National and International Legal Framework: Bangladesh Perspective

Md. Ershadul Karim (사) 이준국제법연구원 2010 Journal of East Asia and International Law Vol.3 No.2

Few would dispute that good health is fundamental to a full and active life. It is the key to wealth and prosperity. Good health contributes directly to economic growth while poor health drives poverty. The right to health is considered directly in many international instruments including the World Health Organization. Every single country in the world is now a member of at least one of the many international instruments where health is treated as a human right. Sound health is a pre-condition to enjoy right to live peaceful. This right to health is guaranteed by the Constitution of the People’s Republic of Bangladesh. If anybody in Bangladesh is deprived of enjoying his life then he can go to the court in order enforce his right. This paper aims at giving an overview of legal and regulatory framework of different international legal instruments and national laws of Bangladesh relating to healthcare and shares the response of Bangladesh Government in relation to the framework.