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

Global health hazards have common underlying causes such as dangerous pathogens, unhealthy behaviours, or unsafe environments.

“(ii) they have common underlying causes, such as dangerous pathogens, unhealthy behaviours, or unsafe environments;”

• cites [2] sourceCould not verify

  The Abstract discusses transnational risks and political and social determinants of health, but it does not identify common underlying causes of global health hazards. Searches for pathogens, unhealthy behaviours, unsafe environments, and shared risk factors found no passage making the attributed point. (LLM, conf=0.73)

  Experimental — accuracy not yet measured
• cites [3] sourceSupported
• cites [4] sourcePartly supported

  The ‘Under-regulation of transnational activities and effects on health equity’ section describes environmental toxins as health hazards, supporting the unsafe-environments example. But ‘Market dominance’ calls biological and behavioural factors immediate causes of illness, while ‘Power asymmetries and competing norms’ places the root causes of avoidable health outcomes beyond the health sector. The paper does not present dangerous pathogens, unhealthy behaviours and unsafe environments together as common underlying causes of global health hazards. Page numbers were not available in our copy. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

Global health hazards are not bound by borders, ranging from infectious diseases to non-communicable diseases and injuries.

“Global health hazards nowadays share four important features: (i) health hazards are not bound by borders, ranging from infectious diseases, to non-communicable diseases, and injuries;”

• cites [2] sourcePartly supported

  The Abstract describes 21st-century risks as transnational and gives infectious diseases, including SARS and avian influenza, as examples. It does not substantiate the full stated range of hazards: the passages do not identify injuries, and they do not explicitly characterize non-communicable diseases as cross-border hazards. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites [3] sourceSupported
• cites [4] sourceSupported

Global health hazards are exacerbated by inequities linked to socio-economic determinants of health.

“(iii) they are exacerbated by inequities linked to the socio-economic determinants of health;”

• cites [2] sourceSupported
• cites [3] sourceSupported
• cites [4] sourceSupported

Between 1999 and 2008, Colombia recorded 674,612 actions for protection of constitutional rights related to health.

“between 1999 and 2008 there were 674 612 actions for protection of constitutional rights in relation to health issues.70, 71”

• cites [70] sourceCould not verify

  The Introduction (p. 4) discusses constitutional review and rights generally, while the Results (p. 14) analyze cross-country measures of freedom. Searches for 674,612, Colombia, health-related rights actions, and 1999–2008 found no passage in our copy addressing the claimed count. (LLM, conf=0.78)

  Experimental — accuracy not yet measured
• cites [71]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Studies show that for every dollar spent on key health services, direct and indirect benefits exceed costs by a factor of 9 to 20.

“Furthermore, studies show that for every dollar spent on key health services, the direct and indirect benefits would exceed costs by a factor of between 9 and 20, further showing the benefits that arise from investing in health.3”

• cites [3] sourcePartly supported

  The National opportunities and Costs and consequences of convergence sections report projected benefits exceeding costs by about 9-fold for low-income countries and about 20-fold for lower-middle-income countries. These are estimates for a specified scale-up of interventions toward convergence by 2035, conditional on targeting the right interventions and strengthening health systems—not a general return for every dollar spent on key health services. No page numbers were provided for these passages. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Brazil's Constitution recognises health as a social right.

“Brazil's Constitution likewise recognises health as a social right.86, 143”

• cites [86]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [143]Could not verify

  The paper’s “Internal GHO policies” section discusses the WHO constitution and organizational human-rights policies, not Brazil’s Constitution. Searches for “Brazil” and for health as a social right in Brazil found no passage addressing the claimed constitutional provision; the available passages therefore do not verify it. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

Law has been central to many major public health achievements of the past century, including motor vehicle safety, tobacco control, infectious disease control, safer food, workplace safety, and childhood vaccination.

“As a result, law has been integral to many of the great public health successes of the past century, including motor vehicle safety, tobacco control, infectious diseases control, a safer food supply, workplace safety, and childhood vaccinations.200”

• cites [200] sourceCould not verify

  The Discussion (page unavailable) compares legislation with voluntary salt-reduction targets in South Africa and the UK; the Conclusions say it remains unknown whether mandatory targets are more effective. Searches for the listed achievements and for law’s role in past public health successes found no passage addressing the historical claim. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

Despite past successes, law remains underutilised as a tool for population health.

“Despite past successes, law remains underutilised as a tool for population health.207”

• cites [207]Partly supported

  The Article and Conclusion (page numbers unavailable) say that more can be done to strengthen legal responses to obesity and call for a global legal framework. They do not establish that law remains underutilised across population health generally; the Conclusion also says earlier taxation and education did little to stem obesity, rather than describing past successes. (LLM, conf=0.81)

  Experimental — accuracy not yet measured

In California, the beverage industry engaged in an aggressive and ultimately successful strategy to preempt local taxation authority.

“For example, in response to local efforts to implement SSB taxes within California (the largest state in the USA, with over 39 million residents), the beverage industry engaged in an aggressive and ultimately successful strategy to preempt local taxation authority.”

• cites [251] sourceCould not verify

  The United States section discusses prevention of mental disorders, not beverage taxation. Searches for California, beverage-industry preemption, and sugar-sweetened beverage taxes found no passage addressing the claim. (LLM, conf=0.79)

  Experimental — accuracy not yet measured
• cites [252]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [253]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Compliance and enforcement challenges are made more difficult by aggressive opposition from vested commercial interests.

“Furthermore, compliance and enforcement challenges are only made more difficult in the presence of aggressive opposition from vested commercial interests.225”

• cites [225] sourcePartly supported

  The paper states that compliance and enforcement of road-safety laws in many low- and middle-income countries is poor (body text; page unavailable). It does not mention aggressive opposition from vested commercial interests or say that such opposition worsens those challenges; searches for that phrase and related terms found no supporting passage. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

An SSB tax that increases consumer prices by 20% can lead to an approximate 20% reduction in consumption.

“WHO supports adoption of SSB taxes as a strategy to help combat non-communicable diseases, particularly obesity and diabetes, citing evidence that an SSB tax that increases consumer prices by 20% can lead to an approximate 20% reduction in consumption.249”

• cites [249] sourceCould not verify

  The paper’s discussion of the Improving Access to Psychological Therapies programme (p. 637) concerns treatment for anxiety and depression. Searches for the 20% price-and-consumption estimate and for WHO guidance on sugar-sweetened beverage taxes found no passage addressing either point. (LLM, conf=0.78)

  Experimental — accuracy not yet measured

The UN Office on Drugs and Crime has stated that the UN drug conventions do not require penalisation of drug use or drug possession for personal use.

“The UN Office on Drugs and Crime has stated that the UN drug conventions do not require penalisation of drug use or drug possession for personal use,280, 281”

• cites [280] sourceCould not verify

  The Abstract and the section on building momentum for soda taxes discuss sugary-drink policy, not UN drug conventions. Searches for the UN Office on Drugs and Crime and penalties for personal drug use or possession found no passage addressing the claim in our copy. (LLM, conf=0.78)

  Experimental — accuracy not yet measured
• cites [281]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Evidence shows that legislating on five key behavioural risk factors-speeding, drink driving, helmet use, seat belt use, and child restraint use-could significantly reduce the road traffic injury toll.

“Evidence shows that legislating on five key behavioural risk factors—speeding, drink driving, helmet use, seat belt use, and child restraint use—could significantly reduce this toll.266”

• cites [266] sourceCould not verify

  The passages from “Impact on displaced Syrians in Lebanon” and “The 2015–2016 Lebanon crisis response” discuss refugee welfare and public services, not road traffic injuries. Searches for the five named risk factors and for road-safety legislation found no passage in our copy addressing whether such laws could reduce injuries. (LLM, conf=0.78)

  Experimental — accuracy not yet measured

Outside of sub-Saharan Africa, up to 30% of all new HIV infections occur among people who inject drugs with unsafe injecting practices.

“Outside of sub-Saharan Africa, up to 30% of all new HIV infections occur among people who inject drugs with unsafe injecting practices.285”

• cites [285] sourceCould not verify

  The discussion of syringe exchange programs (Toward a Transdisciplinary Public Health Law Infrastructure, p. 5) does not give an HIV-infection estimate. Searches for the 30% figure, new HIV infections, unsafe injecting, and sub-Saharan Africa found no passage in our copy addressing the claim. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

The Colombian Constitutional Court's decision provided necessary definition and limits to the right to health in Colombia.

“The decision provided necessary definition and limits to the right to health for Colombia.”

• cites [73]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Health-related tutelas in Colombia were often exploited by wealthier individuals rather than creating a more equitable dispute resolution system.

“rather than creating a more equitable dispute resolution system for all Colombians, tutelas were often exploited by members of the wealthier class.72”

• cites [72]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

In some cases, WTO and ICSID have protected industry interests over the public's health.

“In some cases, they have protected industry interests over the public's health.”

Tobacco companies used ICSID and WTO processes to challenge tobacco control laws in Uruguay (marketing restrictions) and Australia (plain packaging).

“Tobacco companies have used both ICSID and WTO processes to challenge tobacco control laws in Uruguay (marketing restrictions) and Australia (plain packaging).”

In US tobacco litigation, industry defendants imposed enormous delays and high costs over decades and multiple waves before health advocates gained traction in the courts.

“In the US tobacco litigation, industry defendants imposed enormous delays and high costs over the course of decades and multiple waves of litigation before health advocates eventually gained traction in the courts.76”

• cites [76]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

In many jurisdictions, intellectual property protections have limited individuals' access to medicines.

“However, in many jurisdictions, these intellectual property protections have limited individuals' access to medicines.”

States have an obligation to ensure available, accessible, affordable, and acceptable health facilities.

“States have an obligation to ensure available, accessible, affordable, and acceptable health facilities.”

• cites [29] sourceNot checked — no full text of the source

Law can strengthen the governance of national and global health institutions.

“The second legal determinant states that law can be used to strengthen the governance of national and global health institutions.”

• Also stated in: § Executive Summary · plain

  “Legal determinant 2 states that law can strengthen the governance of national and global health institutions.”

Processes to develop soft rules can include a more diverse coalition of actors beyond nation states, including voices from civil society traditionally marginalised in treaty negotiations.

“Furthermore, processes to develop soft rules can include a more diverse coalition of actors beyond nation states, including voices from civil society that are traditionally marginalised in treaty negotiations.22”

• cites [22]Not checked — no full text of the source

Laws exert a powerful influence on all social determinants of health by establishing rules and frameworks that shape social and economic interactions.

“By establishing the rules and frameworks that shape social and economic interactions, laws exert a powerful force on all the social determinants of health.”

• Also stated in: § Law and global health · plain

  “Law exerts a powerful influence on health by structuring, perpetuating, and mediating the risk factors and underlying conditions known as the social determinants of health:10 education, food, housing, income, employment, sanitation, and health care.”

• cites [10] sourceNot checked — no full text of the source

SDG 16 links the rule of law to development as a crucial foundation for just, inclusive and peaceful societies.

“SDG 16 links the rule of law to development, as a crucial foundation for the creation and maintenance of “just, inclusive and peaceful societies”.25”

• cites [25]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Governments are often more willing to sign up to goals framed as targets or declarations rather than obligations.

“Governments are often more willing to sign up to goals that are framed as targets or declarations rather than obligations.21”

• cites [21] sourceNot checked — no full text of the source

Because patent regimes are country-specific, a patent granted in one country might not be granted by, or even filed in, another country.

“Although these patents cover a broad range of features, the reality of country-specific patent regimes means that a patent granted in one country might not be granted by, or even filed in another country.”

These cases, along with other right to health litigation, have contributed greatly to social movements.

“These cases, along with other right to health litigation, have contributed greatly to social movements.63”

• cites [63]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

The South African Constitutional Court found that limiting access to nevirapine was a breach of the right to health care, inconsistent with a positive state obligation to progressively realise the rights of mothers and infants to essential health services.

“The Court found that limiting access was a breach of the right to health care, which was not consistent with a positive state obligation to progressively realise the rights of mothers and infants to essential health services.60”

• cites [60]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Tobacco litigation is perhaps the most familiar example of successful strategic litigation to drive public policy.

“Tobacco litigation is perhaps the most familiar example of successful strategic litigation to drive public policy.57”

• cites [57]Not checked — no full text of the source

More than 60% of people with hepatitis C nowadays live in a country that could access generic direct-acting antivirals.

“The former is promising because more than 60% of people with hepatitis C nowadays live in a country that could access generic direct-acting antivirals.46”

• cites [46]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Despite the existence of an effective cure, the number of people treated for hepatitis C remains a relatively small fraction of those infected or diagnosed.

“Despite the existence of an effective cure, the number of people treated for hepatitis C still remains a relatively small fraction of those infected or diagnosed.45, 46”

• cites [45]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [46]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Strategic litigation can precisely interpret broad or abstract principles, such as the right to health, leading to improved health care.

“Strategic litigation can also precisely interpret broad or abstract principles, such as the right to health, leading to improved health care.”

Countries often have broad discretion as to how, and to what extent, they conform to international norms and standards.

“Countries often have broad discretion as to how, and to what extent, they conform to international norms and standards.”

Patents covering various aspects of direct-acting antivirals prevent the entry of competitors, allowing originator companies to select the price for the market.

“Patents covering various aspects of direct-acting antivirals prevent the entry of competitors, allowing originator companies to select the price for the market.48”

• cites [48] sourceNot checked — no full text of the source

Many international instruments, including WHO's constitution and treaties, contain state obligations to safeguard health-related rights.

“Many international instruments, including WHO's constitution and treaties, contain state obligations to safeguard health-related rights.”

In Minister of Health versus Treatment Action Campaign (2002), the Constitutional Court of South Africa held that government limits on the public sector provision of nevirapine were unreasonable and unconstitutional.

“In Minister of Health versus Treatment Action Campaign (2002), the Constitutional Court of South Africa held that government limits on the public sector provision of nevirapine were unreasonable and unconstitutional.”

Patent-related barriers that keep prices high substantially contribute to the problem of low treatment rates for hepatitis C.

“Patent-related barriers that keep prices high substantially contribute to this problem.46”

• cites [46]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

The state's primary obligation is to protect the health and safety of its inhabitants, including citizens, lawful residents, asylum seekers, refugees, and undocumented immigrants.

“The state's primary obligation is to protect the health and safety of its inhabitants, not only citizens and lawful residents, but also asylum seekers, refugees, and undocumented immigrants.”

Without the rule of law, neither health nor development can be fully realised.

“In the absence of the rule of law, neither health nor development can be fully realised.”

WHO's treaty dispute mechanisms are weak.

“In contrast to certain well established dispute settlement systems, WHO's treaty dispute mechanisms are weak.”

Governments employ all three functions of law to create the authority frameworks needed to turn principles into action.

“Governments use all three functions of law to establish the frameworks of authority needed to move from principles to actions.”

WTO members are required to implement the 1995 TRIPS Agreement through national legislation recognising and enforcing pharmaceutical patents.

“WTO members are required to implement the 1995 Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) through national legislation recognising and enforcing pharmaceutical patents.54”

• cites [54] sourceNot checked — no full text of the source

Checks and balances are crucial to the rule of law.

“Checks and balances are crucial to the rule of law (panel 5 ).84”

• cites [84]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

WHO's PIP Framework uses a combination of non-binding norms and legally binding contracts to achieve its aims.

“WHO's PIP Framework uses a combination of non-binding norms and legally binding contracts to achieve its aims.”

Many industries, including food, beverage, alcohol, and tobacco, often use litigation to diminish innovative public health laws.

“Many industries, including the food, beverage, alcohol, and tobacco industries often use litigation to diminish innovative public health laws.”

Regional and international human rights treaties often have quasi-judicial dispute settlement systems for states that accept to be bound, available once domestic avenues have been exhausted.

“Furthermore, regional and international human rights treaties often have quasi-judicial dispute settlement systems for states that accept to be bound by them, which are available once domestic avenues have been exhausted”

• cites [80] sourceNot checked — no full text of the source

In 2005, the 58th World Health Assembly adopted a resolution on sustainable health financing, universal coverage, and social health insurance that called on countries to plan for transition to UHC.

“In 2005, the 58th World Health Assembly (WHA) adopted a resolution for sustainable health financing, universal coverage, and social health insurance, calling on countries to plan for the transition to UHC.126”

• cites [126]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Participation by non-state actors and civil society organisations in governing processes increases the legitimacy, transparency, justice, and democracy of such processes.

“Whether at the grassroots level or internationally, participation by non-state actors and civil society organisations in governing processes increases the legitimacy, transparency, justice, and democracy of such processes.”

WHO and the World Bank estimate that at least half of the world's population cannot obtain essential health services.

“The WHO and the World Bank both estimate that at least half of the world's population cannot obtain essential health services.117”

• cites [117]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

The SDGs cover multiple conditions required for health and safety across the lifespan, not only health-care services.

“Going well beyond health-care services, they encompass the multiple conditions needed for health and safety throughout the lifespan.”

Because health systems vary from single- or multi-payer national systems to government-subsidised access and public or private insurance, there is no single path to UHC.

“Health systems range from national health systems with single or multiple payers, to government subsidised access, to public or private insurance; therefore, no single path exists to UHC.134”

• cites [134]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Industries' use of the commercial speech doctrine has undermined public health regulations designed to prevent obesity and other non-communicable disease risk factors.

“Industries' use of the commercial speech doctrine has also undermined public health regulations designed to prevent obesity and other non-communicable disease risk factors.”

Law can help make the SDGs effective by shifting attention from what sustainable development is to how it can be achieved.

“In turn, law can help give these goals tangible effect, moving the question from “what is sustainable development?” to “how can sustainable development be achieved?”116”

• cites [116]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Laws are necessary to create new institutions with a specific or broad health mandate.

“to establish new institutions with a specific or broad health mandate (eg, governing institutions)”

In countries with a longer history of UHC, funds are traditionally raised through compulsory pre-payment schemes such as taxation, compulsory insurance contributions, or both.

“In countries with a longer history of UHC, funds are traditionally raised through compulsory pre-payment schemes, such as taxation, compulsory insurance contributions, or a combination of both.86”

• cites [86]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

The duty to provide UHC comes from two sources of law: national and international.

“The duty to provide UHC derives from two sources of law: national and international.”

States are not entirely free to make trade-offs; their actions are constrained at least by human rights obligations, especially the right to health.

“States, of course, are not entirely restricted in the ability to make trade-offs: their actions are constrained, at the very least, by their human rights obligations—especially the right to health.”

OHCHR guidelines on maternal morbidity and mortality, UNAIDS and OHCHR guidelines on HIV and AIDS, and the Maastricht Principles on Extraterritorial Obligations all confirm an international obligation to provide assistance on UHC.

“The Office of the UN High Commissioner for Human Rights (OHCHR) guidelines on maternal morbidity and mortality and human rights, the UNAIDS and OHCHR guidelines on HIV and AIDS and human rights, and the Maastricht Principles on Extraterritorial Obligations of States in the Area of Economic, Social and Cultural Rights all confirm the international obligation to provide assistance on UHC.”

When the rule of law is weak, it is difficult to use other legal mechanisms to achieve UHC and even basic governance tasks.

“If the rule of law is weak, it will be difficult to engage other legal mechanisms to achieve not only UHC, but also more basic tasks of governance.”

A state's duty and power to implement UHC derive from its constitution or legislation.

“The State's duty and power to implement UHC derives from its constitution or legislation.”

• cites [141]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [142] sourceNot checked — no full text of the source
• cites [86]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Low-income and lower-middle-income countries that have moved towards UHC are using novel mixes of funding mechanisms for their national health insurance models.

“Conversely, low-income and lower-middle-income countries that have moved towards UHC are using novel mixes of funding mechanisms for their national health insurance models.158”

• cites [158]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

The UN Committee on Economic, Social and Cultural Rights gave an authoritative interpretation of the right to the highest attainable standard of health in General Comment 14.

“As described above, the UN Committee on Economic, Social and Cultural Rights offered an authoritative interpretation of “the right to the highest attainable standard of health” in General Comment 14.29”

• cites [29] sourceNot checked — no full text of the source

Whatever a government's reason for pursuing UHC, the legal foundation is the same: the state has a sovereign duty and authority to protect public health and safety.

“Regardless of a government's motivation for pursuing UHC, the legal foundations remain the same in that a state has the sovereign duty and authority to safeguard the public's health and safety.15”

• cites [15]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Effective access, especially for the poorest, depends not only on health system design but also on how health insurance systems are designed.

“Effective access, particularly for those with the least means, will not only depend on how health systems are designed (eg, strengthening primary health services), but also on how health insurance systems are designed.”

Legal mechanisms and policy choices affect each crucial measure of UHC: access, equity, quality, cost, and choice.

“These mechanisms and choices will affect each of the crucial measures of UHC: access, equity, quality, cost, and choice.”

Countries that embrace UHC tend to treat health as a basic human right, often written into their national constitutions or laws.

“However, countries embracing UHC tend to consider health a basic human right, often enshrined in their national constitutions or laws.”

Governments are also obligated to provide international assistance to protect and promote the right to health, for example under ICESCR Article 2(1).

“Yet, governments are also obligated to provide international assistance to protect and promote the right to health, for example under article 2(1) of the ICESCR.”

• cites [42]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Without mutual responsibility, the international system allows governments to blame each other for insufficient action.

“Otherwise, the international system creates a situation in which governments can blame each other for not doing enough.150”

• cites [150]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Many treaties beyond the ICESCR protect health rights, including non-discrimination in access, such as the Convention on the Rights of the Child, the Convention on the Elimination of All Forms of Discrimination Against Women, and the Convention on the Rights of Persons with Disabilities.

“Beyond the ICESCR, many treaties safeguard health rights, including non-discrimination in access—for example, the UN Convention on the Rights of the Child, the Convention on the Elimination of all Forms of Discrimination Against Women, and the Convention on the Rights of Persons with Disabilities.”

Governments often exclude many vulnerable people from high-quality services, including asylum seekers, refugees, undocumented immigrants, expatriate workers, indigenous peoples, nomadic people, and groups historically marginalised because of sexual orientation, gender identity, sex characteristics, disability, political beliefs, or religious affiliation.

“Governments often exclude a wide swath of vulnerable people from high quality services, including asylum seekers, refugees, undocumented immigrants, expatriate workers, indigenous peoples, nomadic people, or groups that are historically marginalised because of sexual orientation, gender identity, sex characteristics, disability, political beliefs, or religious affiliation.153, 154”

• cites [153]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [154]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

UN Special Rapporteurs on the Right to Health have been clear about states' obligations in both hard law and soft rules.

“Furthermore, the UN Special Rapporteurs on the Right to Health have been clear on the obligations of states in so-called hard law and soft rules.145”

• cites [145]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Without adequate legal frameworks, universality may be only an aspiration and may do little to change policies under which governments deliberately or passively deny access to health services to some people within their borders.

“Without adequate legal frameworks to support it, so-called universality might be no more than an aspiration, doing little to change “policies under which many governments either deliberately or passively refuse to grant access to health services to some people living within their national borders”.153”

• cites [153]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Countries representing half of the world's population-Brazil, China, India, the Russian Federation, and South Africa-are undertaking health system reforms to extend service coverage and increase financial protection.

“Countries representing half of the world's population (Brazil, China, India, Russian Federation, and South Africa) are engaged in health system reforms to extend service coverage and increase financial protection.135”

• cites [135]Not checked — no full text of the source

If governments highly value individual choice in the private market, this affects access, equity, quality, and cost.

“If governments place a high value on individual choice in the private market, this will affect measures such as access, equity, quality, and cost.151”

• cites [151]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Inability to enforce and ensure compliance with international law has stymied use of human rights law to prevent or ameliorate gross inequalities.

“The inability to enforce and ensure compliance with international law has stymied the international community's ability to fully use human rights law to prevent or ameliorate gross inequalities.”

In South Africa, the Constitutional Court required access to antiretroviral medication for pregnant women.

“In South Africa, the Constitutional Court required access to antiretroviral medication for pregnant women,60”

• cites [60]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Weak monitoring, assessment, and follow-up capacity challenges effectiveness of international instruments like IHR.

“Weak monitoring, assessment, and follow-up capacity can also present a challenge to the effectiveness of international instruments like the IHR.”

FCTC and IHR have been plagued by incomplete state compliance.

“The FCTC and IHR—the two major international legal instruments under the direct authority of WHO—have been plagued by incomplete state compliance.39”

• cites [39] sourceNot checked — no full text of the source

No comprehensive global mechanism exists to assist low-income countries finance reforms for gaps identified by JEE.

“Furthermore, regarding the points at which JEE does identify gaps in IHR competencies, no comprehensive global mechanism exists to assist low-income countries to finance required reforms.”

Monitoring and evaluation provide crucial information on health system performance that helps countries make further progress towards UHC.

“Monitoring and evaluation provide crucial information on health system performance, which assists countries in making further progress towards UHC.118”

• cites [118]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Higher-income states have largely ignored IHR norms of international financial and technical cooperation, with exceptions such as GHSA.

“Although the IHR encourage international assistance to build capacity in lower-income states, higher-income states—with notable exceptions, such as the US-led Global Health Security Agenda (GHSA)—have largely ignored the treaty's norms of international financial and technical cooperation.”

Mandates of national and global health actors frequently overlap, impeding effective use of law to set norms and standards and resolve disputes.

“The mandates of national and global health actors frequently overlap, which can impede the effective use of law to set norms and standards, and to resolve disputes.”

Robust public accountability and participation are more likely to produce reasonable and legitimate decisions and fair, effective implementation.

“Robust public accountability and participation are more likely to result in reasonable and legitimate decisions, and fair, effective implementation.”

These IHR core capacity activities are largely unsupported by WHO or other international assistance.

“These activities are largely unsupported by WHO or through other forms of international assistance.183”

• cites [183]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Treaties' implementation can be suboptimal because of weak enforcement and inadequate compliance.

“However, even though treaties are binding legal instruments, their implementation can be suboptimal because of weak enforcement and inadequate compliance.”

Fragmentation exists in the international legal system governing global health.

“Fragmentation also exists in the international legal system governing global health.”

Treaty oversight bodies often have few means to compel or incentivise compliance.

“The norms of international law guide behaviour, but often, treaty oversight bodies have few means by which to compel, or even incentivise, compliance.”

Multiple ministries can have profound and sometimes conflicting effects on health, resulting in policy incoherence.

“At the national level, multiple ministries can have profound and sometimes conflicting effects on health, resulting in policy incoherence.”

Good governance is an important role of law in achieving UHC.

“Finally, good governance is an important role of the law in achieving UHC.”

Litigation can create problems, including the concern that it may favour wealthy litigants and thereby entrench health inequalities.

“Litigation can raise its own problems, including the concern that it could favour wealthy litigants and thus entrench health inequalities.163”

• cites [163]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Law can promote good governance in UHC adoption and implementation, including transparency and inclusive participation.

“Law can also promote good governance in UHC adoption and implementation, including transparency and inclusive participation.”

Colombia's Constitutional Court required priorities to be decided through a participatory, evidence-based process.

“Conversely, Colombia's Constitution Court required priorities to be decided through a participatory, evidence-based process (panel 4).”

• cites panel 4Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Each of these funding mechanisms can raise legal issues.

“Each of these mechanisms can raise legal issues.”

International law can be important for global health because it creates norms binding on states parties.

“International law can be an important tool for global health because of its power to create norms that are binding on states parties.”

At every stage of the financing process-revenue raising, pooling, and purchasing-regulation plays an important role in ensuring funds are allocated fairly and transparently.

“Furthermore, at each stage of the financing process (from revenue raising, to pooling, to the purchasing of services by providers and governments) regulation plays an important role in ensuring funds are allocated fairly and transparently.86”

• cites [86]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Law can strengthen governance of national and global health institutions.

“The second legal determinant states that law can be used to strengthen the governance of national and global health institutions.”

In global health, options to incentivise or coerce behaviour in the face of non-compliance are even more limited.

“In global health, the options to incentivise or coerce behaviour in the face of non-compliance are even more limited.181”

• cites [181] sourceNot checked — no full text of the source

Multiple institutions can claim a mandate on particular global health issues.

“Given the broad definition and remit of global health, multiple institutions can claim a mandate on particular issues.”

Governance failures reveal institutional and systemic weaknesses.

“Failures of governance, including the WHO's response to the west Africa Ebola epidemic, or national scandals relating to food poisoning, or tainted milk or medicines, highlight institutional and systemic weaknesses.”

In deciding what is covered, states use various legal mechanisms and institutions, including independent statutory authorities, administrative agencies, legislation, and courts and tribunals.

“In determining what is and is not covered, states use a variety of legal mechanisms and institutions, including the following four examples. First, independent statutory authorities are tasked with reviewing clinical and epidemiological evidence and providing advice to governments about the effectiveness and cost-effectiveness of treatments and technologies—for example, the UK's National Institute”

Throughout modern history, law has played a major role in reducing infectious diseases through national public health laws, regulatory frameworks, international legal agreements, and governance reforms.

“Throughout modern history, law has played a major role in reducing infectious diseases through national public health laws and regulatory frameworks, international legal agreements, and governance reforms.”

HIAs dynamically improve health and wellbeing across sectors.

“HIAs dynamically improve health and wellbeing across sectors.”

Interventions targeting inequalities are fundamentally linked to interventions addressing ill health.

“Interventions that target inequalities are thus fundamentally linked to those that address ill health.203”

• cites [203] sourceNot checked — no full text of the source

By creating and implementing social norms and redistributing resources, law can create the conditions for public health.

“By creating and implementing social norms and redistributing resources, law can create the conditions for the public's health.”

As of 2019, more than 200 international agencies and initiatives occupy the global health space.

“As of 2019, the same space is occupied by more than 200 international agencies and initiatives.191”

• cites [191] sourceNot checked — no full text of the source

Law can perpetuate injustice, for example through a multi-tier UHC insurance system that gives substantial benefits to some groups but only limited benefits to others.

“Law could also perpetuate injustice, such as by establishing a multi-tier UHC health insurance system that provides real benefit to some people (eg, civil servants, formal sector employers) but only limited benefits to others (eg, informal sector workers).”

The Democratic Republic of Congo used investigational new vaccines and therapies during the 2018-19 Ebola response before regulatory agencies had determined the vaccine and drugs to be safe and effective.

“For example, the Democratic Republic of Congo deployed investigational new vaccines and therapies in response to Ebola in 2018–19, even though regulatory agencies had not yet found the vaccine and drugs to be safe and effective.”

The interaction between national and international health law shows the multidimensional nature of creating and diffusing effective health laws from global to local levels and vice versa.

“This interaction shows the multidimensional nature of creating and diffusing highly effective health laws from the global level to the local and national levels, and vice versa (figure 1).”

Legal and regulatory interventions across infectious diseases, non-communicable diseases, and injuries have been effective because they share the previously discussed characteristics.

“These interventions have been effective because they share the characteristics previously discussed.”

Governance regimes are evolving in response to new players.

“To some extent, governance regimes are evolving in response to these new players.”

Large PPPs often have limited transparency and accountability because of private actor participation.

“Large PPPs often have limited transparency and accountability because of participation of private actors.195”

• cites [195]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

During the 20th century, improvements in sanitation and hygiene, vector abatement, and surveillance produced substantial advances in infectious disease control.

“During the 20th century, improvements in sanitation and hygiene, vector abatement, and surveillance ushered in substantial advances in infectious disease control.208”

• cites [208]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Lower-income states often require financial and technical assistance to comply with treaty obligations.

“Lower-income states often require financial and technical assistance to comply with treaty obligations.”

Absence of a global mechanism to finance IHR reforms presents a potential threat to global security, as observed during Ebola.

“As observed during the Ebola crisis, this absence of a global mechanism presents a potential threat to global security.39, 99”

• cites [39] sourceNot checked — no full text of the source
• cites [99]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Private law dispute resolution can assist compliance.

“The final tool that can be used to assist compliance is private law dispute resolution.”

Poor and disadvantaged communities often carry a disproportionate burden of illness, premature death, and the social and economic consequences of disease and injury.

“Poor and disadvantaged communities often have a disproportionate burden of morbidity and premature mortality, as well as the social and economic consequences of disease and injury.”

Laws in sectors beyond health can have strong adverse health effects if they are not designed with health objectives in mind.

“If not conceived with due consideration for health objectives, laws in these sectors could have powerful adverse effects on health.”

Oversight of new players and new legal entities presents a greater challenge than oversight of WHO and other post-WWII intergovernmental agencies.

“Although WHO and other post-World War II intergovernmental agencies often have clear governance arrangements, oversight of new players and new legal entities (eg, civil society organisations, foundations, and PPPs) presents a greater challenge.”

Statutes and regulations can implement interventions that reduce population-wide exposure to risk factors.

“Statutes and regulations can be used to implement interventions that lower the exposure to risk factors across entire populations.”

If policy makers always waited for exhaustive research, many serious public health threats would remain unaddressed.

“If policy makers always had to wait for an exhaustive research study, many substantial threats to the public's health would persist.”

Laws can facilitate effective health interventions, such as school-entry immunisation requirements or safe injection sites for drug users.

“In other cases, laws facilitate effective health interventions, such as immunisation requirements for school entry or creation of safe injection sites for drug users.”

Poor health outcomes further entrench disadvantage.

“Poor health outcomes, in turn, further entrench disadvantage.”

No single state can fully control activities of large transnational corporations operating in multiple countries and regions.

“However, no single state can fully control the activities of large, transnational corporations that operate in multiple countries and regions.”

States' oversight of major non-profits such as the Gates Foundation is inadequate.

“States' oversight of major non-profits such as the Gates Foundation is also inadequate.”

Laws outside the health sector influence the conditions needed for population health and for reducing inequalities.

“Laws far beyond the health sector influence the conditions for achieving population health and reducing inequalities.”

Sound scientific evidence is the most important feature of effective public health laws.

“Sound scientific evidence is the most important characteristic of effective public health laws.201”

• cites [201] sourceNot checked — no full text of the source

Several countries and sub-national jurisdictions, including Thailand, Slovakia, and several US states, have laws requiring HIAs for policies that substantially affect public health or for policies or programmes in certain sectors.

“Several countries and sub-national jurisdictions, such as Thailand, Slovakia, and several US states, have laws requiring HIAs for policies substantially affecting public health or for policies or programmes in certain sectors.”

National laws and regulations give public health agencies broad powers to control infectious diseases, including testing, screening, notification, contact tracing, vaccination, directly observed therapy, isolation, and quarantine.

“National legal frameworks in the form of laws and regulations give public health agencies wide-ranging powers to control infectious diseases.”

WHO Executive Board's official relations criteria has excluded smaller NGOs working in health, separating them from WHO.

“This criteria has excluded smaller non-governmental organisations working in the health space, separating them from WHO.”

Old regimes have often not fully adapted to new players, raising concerns about participation and internal governance.

“In many cases, old regimes have not fully adapted to the emergence of these new players, raising concerns relating to finding the appropriate level and means of participation by new institutions in governance processes such as those of WHO, and improving the internal governance arrangements of both old and new institutions.”

Statutes and regulations used without adequate evidence or without attention to justice and human rights may fail or may harm health.

“When used without sufficient evidence, or without regard for justice and human rights, statutes and regulations may be ineffective—or worse, could undermine health.”

Powerful entrenched actors might influence international institutions to advance private interests rather than public health.

“Powerful, entrenched actors might influence international institutions to advance their private interests, rather than the health of the public.”

Law can be highly effective in defining and operationalising government action.

“We argue that law can be highly effective in defining and operationalising government action.”

Poor and marginalised populations in both low-income and middle-income countries and wealthier countries often live, work, recreate, travel, and attend school in unsafe or unhealthy environments.

“Poor and marginalised populations—whether living in low-income and middle-income countries, or in wealthier countries—often live, work, recreate, travel, and go to school in unsafe or unhealthy environments.”

Vaccination laws greatly reduced deadly childhood diseases such as measles, mumps, and rubella.

“The advent of vaccination laws vastly reduced deadly childhood diseases such as measles, mumps, and rubella.”

Urban planning, education, social services, and other portfolios can have major health-enhancing features.

“Urban planning, education, social services and other portfolios can have major health-enhancing features.”

Innovative use of legal and governance tools can enhance compliance with international rules, strengthening global health governance.

“However, the above examples describe ways in which the innovative use of legal and governance tools can enhance compliance with international rules, ultimately strengthening the governance of global health.”

Many public health interventions depend on laws and regulations, including taxes on tobacco, alcohol, or sugar-sweetened beverages; marketing or sponsorship bans; and minimum purchase ages.

“Many public health interventions require enactment and enforcement of laws and regulations, such as taxes on tobacco, alcohol, or sugar-sweetened beverages; marketing or sponsorship bans; and minimum age of purchase requirements.”

The common theme among legal and regulatory interventions to prevent non-communicable diseases is that they promote small changes, across entire populations, for a mass impact.

“The common theme among legal and regulatory interventions to prevent non-communicable diseases is that they promote small changes, across entire populations, for a mass impact.”

Evidence indicates that social and economic circumstances can significantly raise the risk of non-communicable diseases.

“Evidence shows that social and economic circumstances can significantly increase the risk of non-communicable diseases.219”

• cites [219]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

During the Ebola epidemic, the PIP Framework was not applicable because its scope is limited to pandemic influenza strains.

“During the Ebola epidemic, the PIP Framework was not even applicable, as its narrow scope is limited to pandemic influenza strains.”

In many countries, processed foods substantially contribute to salt intake, regardless of any action individuals might take to reduce the salt they add to food.

“In many countries, processed foods substantially contribute to salt intake,238 regardless of any action individuals might take to reduce the salt they add to food.”

• cites [238] sourceNot checked — no full text of the source

Research shows that SSB taxes are an effective legal tool to help combat the non-communicable disease epidemic.

“Although research shows that SSB taxes are an effective legal tool to help combat the non-communicable disease epidemic, the industry has mobilised to defeat any important new regulation.”

From a population perspective, the most effective and equitable means of reducing salt consumption is to reduce the salt content of manufactured foods.

“From a population perspective, the most effective and equitable means of reducing salt consumption is to reduce the salt content of manufactured foods.236, 237”

• cites [236]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [237]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

The UK's voluntary salt reduction approach, with strong government leadership and oversight, resulted in a 15% decrease in salt intake across the population.

“Using a voluntary approach, but with strong government leadership and oversight, UK manufacturers agreed to progressive reduction targets for around 80 categories of processed foods. Their reformulation efforts were supported by consumer education and improved food labelling. The approach was highly successful, resulting in a 15% decrease in salt intake across the population.239”

• cites [239]Not checked — no full text of the source

The 2014-15 Ebola epidemic in west Africa revealed deep inadequacies in the national and international institutions responsible for protecting the public from the consequences of infectious disease outbreaks.

“The 2014–15 Ebola virus epidemic in west Africa revealed “deep inadequacies in the national and international institutions responsible for protecting the public from the far-reaching human, social, economic, and political consequences of infectious disease outbreaks.”99”

• cites [99]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

A regulatory intervention to reduce salt intake by 3 g/day in the USA would save 194,000-392,000 QALYs and US$10-24 billion in health-care costs annually.

“In the USA, it has been estimated that a regulatory intervention designed to achieve a reduction in salt intake of 3 grams per day would save 194 000 to 392 000 quality-adjusted life-years and US$10–24 billion in health-care costs annually, and would be more cost-effective than using medications to lower blood pressure in all people with hypertension.235”

• cites [235]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

An increasingly strong evidence base exists on how population-level interventions can prevent and control non-communicable diseases.

“An increasingly strong evidence base exists regarding how population-level interventions can be used to prevent and control non-communicable diseases.”

Regulatory frameworks such as intellectual property, ownership of viruses, inconsistent approval pathways, legal liability for pharmaceutical companies, and divergent clinical trial standards can hinder rapid development of medical technologies for public health emergencies.

“Yet, regulatory frameworks such as intellectual property, so-called ownership of viruses, inconsistent regulatory approval pathways, legal liability for pharmaceutical companies, and divergent clinical trial standards can hinder rapid development of medical technologies to respond to public health emergencies.”

Women tend to be further disadvantaged in their opportunities for physical activity where cities are not walkable.

“A gender equity dimension is also present, as women tend to be further disadvantaged in their opportunities for physical activity where cities are not walkable.259”

• cites [259]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Population salt reduction is among WHO's best-buys to reduce chronic disease.

“Population salt reduction is among WHO's so-called best-buys to reduce chronic disease—an intervention that could lead to substantial health benefits as well as cost savings.233, 234”

• cites [233]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [234] sourceNot checked — no full text of the source

Especially in high-income countries, a suite of national and local laws and regulations has produced large declines in tobacco use.

“Particularly in high-income countries, a so-called suite of national and local laws and regulations has resulted in large declines in tobacco use.”

Such a regulatory intervention would be more cost-effective than using medications to lower blood pressure in all people with hypertension.

“In the USA, it has been estimated that a regulatory intervention designed to achieve a reduction in salt intake of 3 grams per day would save 194 000 to 392 000 quality-adjusted life-years and US$10–24 billion in health-care costs annually, and would be more cost-effective than using medications to lower blood pressure in all people with hypertension.235”

• cites [235]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

The FCTC faces substantial compliance challenges, especially in low-income and middle-income countries.

“However, the FCTC faces substantial compliance challenges, particularly in low-income and middle-income countries.”

Restrictions on reproductive rights generated major concern during the Zika epidemic because of fears about neurological disorders and neonatal malformations.

“These restrictions caused major concern during the Zika epidemic, given fears about neurological disorders and neonatal malformations.303”

• cites [303]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

The increase in access to IAPT helped narrow the treatment gap by improving treatment rates for adults with anxiety or depression from 24% in 2007 to 37% in 2014.

“This increase in access has helped narrow the treatment gap by improving treatment rates for adults with anxiety or depression from 24% in 2007 to 37% in 2014.294, 296”

• cites [294]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [296]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

By changing a default option, law has the power to facilitate profound changes in behaviour.

“By simply changing a default option (eg, reducing salt in processed food, forbidding smoking in certain areas, or making public transport easier than car use), law has the power to facilitate profound changes in behaviour.”

The history of laws relating to mental health, substance abuse, sexual and reproductive health, sexually transmitted infections, and poverty are often particularly harmful.

“The history of laws relating to mental health, substance abuse, sexual and reproductive health, sexually transmitted infections, and poverty are often particularly harmful.”

Several countries affected by Zika have strict barriers to abortion, including laws that criminalise abortion for any purpose.

“However, at the same time, several affected countries have strict barriers to accessing abortion, including laws that criminalise abortion for any purpose.306”

• cites [306]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

The illegality of sex work often results in scant protection against abuse, violence, and financial extortion.

“Sex workers are a highly marginalised group, and the illegality of their work often results in scant protection against abuse, violence, and financial extortion.300”

• cites [300]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Too often, the criminal law is used in ways that cause harm to health and to dignity.

“However, too often, the criminal law is used in ways that cause harm to health and to dignity.”

Consequently, their health and wellbeing are harmed.

“Consequently, their health and wellbeing are harmed.”

Seatbelts are a proven way to reduce road traffic injuries.

“For example, seatbelts are a proven way to reduce road traffic injuries and have been mandatory in northern Europe and the USA since the 1970s.268, 269”

• cites [268]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [269] sourceNot checked — no full text of the source

India has traditionally underfunded its mental health services, spending only 0.06% of its total health expenditures on outpatient mental health care.

“India has traditionally underfunded its mental health services, spending only 0·06% of its total health expenditures on outpatient mental health care,297”

• cites [297]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Good laws can make healthier and safer behaviours the easier or normal choice.

“Good laws can make healthier and safer behaviours the easier or normal choice.”

In some countries, women are imprisoned for involuntary miscarriage.

“Despite WHO guidance, many countries have criminalised abortion and restricted family planning, and in some countries, women are imprisoned for involuntary miscarriage.301”

• cites [301]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

A 2016 study found that abortion rates are not substantially different across groups of countries classified according to the grounds under which abortion is legally allowed.

“A 2016 study found that “abortion rates are not substantially different across groups of countries classified according to the grounds under which abortion is legally allowed.”302”

• cites [302]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

WHO observes that mental health policies and laws are inadequate in most countries.

“WHO has identified the development of mental health policies and laws that promote human rights as crucial to the protection of people with mental health disorders, observing that such policies and laws are inadequate in most countries.292”

• cites [292]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Incarcerating people with a mental health disorder results in further marginalisation and discrimination of an already vulnerable group.

“Beyond lack of any therapeutic intent, incarcerating people with a mental health disorder results in further marginalisation and discrimination of an already vulnerable group (panel 9 ).”

Criminal laws have posed barriers to the treatment and rehabilitation of people who use drugs.

“Similarly, criminal laws have also posed barriers to the treatment and rehabilitation of people who use drugs (panel 8 ).”

Laws that criminalise or restrict abortion endanger women's health, particularly women who resort to unsafe abortion because legal services are unavailable.

“Such laws endanger the health of women, especially those who seek unsafe abortions because of the lack of access to legal abortion services.”

WHO has identified the development of mental health policies and laws that promote human rights as crucial to the protection of people with mental health disorders.

“WHO has identified the development of mental health policies and laws that promote human rights as crucial to the protection of people with mental health disorders, observing that such policies and laws are inadequate in most countries.292”

• cites [292]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

India has a severe shortage of mental health providers, even when compared with other low-income and middle-income countries.

“and has a severe shortage of mental health providers, even when compared with other low-income and middle-income countries.298, 299”

• cites [298]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [299]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Criminal laws can provide a powerful incentive for behaviour change that improves public health, as in the case of road safety.

“Criminal laws can provide a powerful incentive for behaviour change that improves public health, as in the case of road safety.”

The overly broad criminalisation of HIV non-disclosure, exposure, or transmission has been shown to negatively affect health outcomes.

“The overly broad criminalisation of HIV non-disclosure, exposure, or transmission are not only contrary to established public health evidence, but have also been shown to negatively affect health outcomes.275, 276”

• cites [275] sourceNot checked — no full text of the source
• cites [276] sourceNot checked — no full text of the source

Since 2004, there has been a significant increase in the number of states that have legislated for national mandatory seatbelt use.

“Since then, there has been a significant increase in the number of states that have legislated for national mandatory seatbelt use.270”

• cites [270] sourceNot checked — no full text of the source

The Ministry of Health in Vietnam and WHO reported that road traffic head injuries and deaths had decreased by 16% and 18%, respectively, 3 years after Vietnam's 2007 helmet law was introduced.

“The Ministry of Health in Vietnam and WHO reported that road traffic head injuries and deaths had decreased by 16% and 18%, respectively, 3 years after the law was introduced.274”

• cites [274]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Drug control efforts often have a disproportionate effect on vulnerable groups and marginalised communities, including indigenous populations, the poor, and racial or ethnic minorities.

“Drug control efforts often have a disproportionate effect on vulnerable groups and marginalised communities, including indigenous populations, the poor, and racial or ethnic minorities.286”

• cites [286]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

In many jurisdictions, reproductive choice and health, including access to safe contraception and abortion, are threatened.

“In many jurisdictions, reproductive choice and health, including access to safe contraception and abortion, are threatened.”

HIV prevalence in countries that rely on punitive approaches is substantially higher (37-42% vs less than 5%) than countries that use public health approaches to drug use.

“In fact, HIV prevalence in countries that rely on punitive approaches is substantially higher (37–42% vs less than 5%) than countries that use public health approaches to drug use.275”

• cites [275] sourceNot checked — no full text of the source

The overly broad criminalisation of HIV non-disclosure, exposure, or transmission is contrary to established public health evidence.

“The overly broad criminalisation of HIV non-disclosure, exposure, or transmission are not only contrary to established public health evidence, but have also been shown to negatively affect health outcomes.275, 276”

• cites [275] sourceNot checked — no full text of the source
• cites [276] sourceNot checked — no full text of the source

When novel pandemics or new paradigms such as non-communicable diseases emerge, existing laws may not be fit for purpose.

“In the face of emerging threats—whether novel pandemics, or new paradigms such as non-communicable diseases—these laws might not be fit for purpose.”

The migration journey increases refugees' susceptibility to tuberculosis after they leave their home country.

“After refugees leave their home country, the journey exacerbates their susceptibility to tuberculosis.”

Such barriers can raise tuberculosis prevalence in countries of asylum.

“These barriers, in turn, can lead to increases in the prevalence of tuberculosis in countries of asylum.”

The 1951 Refugee Convention and the 1967 Protocol protect refugees by prohibiting refoulement, or forcibly returning them to places where they fear for their lives or freedom.

“The core instruments of international refugee law—the 1951 Convention relating to the Status of Refugees, and the 1967 Protocol308—provide protection for refugees by prohibiting refoulment of refugees, or forcible returning of refugees to places where they fear for their lives or freedom.309”

• cites [308]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [309]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Lebanon has served as a country of asylum for Syrian refugees since the conflict began in 2011.

“Lebanon has been a country of asylum for Syrian refugees from the start of the conflict in 2011.313”

• cites [313]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Inappropriate use of criminal law has caused deep harm in multiple areas.

“Inappropriate use of the criminal law has been deeply harmful in multiple spheres.”

Strong legal capacity for health will be a key determinant of progress toward global health and sustainable development.

“Strong legal capacity for health will be a key determinant of progress towards global health and sustainable development.”

International law requires states to take only measures that are consistent with human rights and other international obligations.

“However, international law requires that states only undertake measures that are consistent with human rights and other international obligations.”

Without sound legal infrastructure, law may even undermine health goals.

“In the absence of a sound legal infrastructure, the law might even undermine health goals.”

Refugees and other forcibly displaced people are vulnerable to tuberculosis from the beginning of their journey through arrival in the country of asylum.

“From the start of the journey, through to arrival at the country of asylum, refugees and others who are subject to forced migration are susceptible to contracting tuberculosis.”

• cites [310]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

A substantial body of evidence and experience shows that legal interventions can advance global health with justice.

“A substantial body of evidence and learned experience shows that legal interventions can advance global health with justice.”

Lebanon experienced a 27% rise in tuberculosis cases in the first year it received Syrian refugees.

“In the first year of receiving Syrian refugees, Lebanon saw a 27% increase in tuberculosis cases.311”

• cites [311]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Law has been used worldwide to reduce health risks, including through vector control, immunisation, tobacco control, food reformulation, healthy built environments, vehicle and road design, and road safety measures.

“Around the world, law has been used to reduce health risks, examples of which include vector control and immunisation for infectious diseases, tobacco control, food reformulation, healthy built environments for non-communicable diseases, vehicle and road design, and increased road safety measures.”

Governments have frequently used law for improper purposes or with little regard for health with justice.

“Too often, governments have used law for improper purposes, or with little consideration for the values of health with justice.”

As a result, health officials may lack the mandate and legal powers to implement new evidence-based interventions.

“Therefore, health officials might lack the mandate and legal powers to implement new, evidence-based interventions.”

These international obligations include non-discrimination on the basis of other status, which encompasses health status.

“These obligations include non-discrimination on the basis of other status, which includes health status.”

National laws and policies on refugees and tuberculosis exemplify the combined problem of unmet need and avoidable harm.

“This twin dynamic of unmet need and avoidable harm is exemplified in national laws and policies surrounding refugees and tuberculosis.310”

• cites [310]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Under international law, countries have the right to exercise sovereignty by imposing immigration restrictions.

“With respect to international law, countries have a right to exercise their sovereignty in imposing immigration restrictions.317”

• cites [317]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Refugees' tuberculosis vulnerability starts in their home countries, where health-care infrastructure may be absent or destroyed by war.

“This vulnerability begins with refugees' experiences in their home country, where health-care infrastructure might be lacking or have broken down because of war.”

A range of professions, including public health, food and drug, and environmental health officers, medical and nursing practitioners, scientists, and sometimes police, are responsible for monitoring and enforcing public health laws.

“A range of different professions—including public health, food and drug, and environmental health officers; medical and nursing practitioners; scientists; and even police in certain contexts17 —will have responsibility for monitoring and enforcing public health laws.”

• cites [17]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Public participation can also open the door to powerful vested interests.

“Public participation can also mean opening the door to powerful vested interests.”

Following the first case of HIV transmission via drug-injecting equipment in 1985, Australia quickly introduced a Needle and Syringe Programme.

“For example, following the first case of HIV transmission via drug-injecting equipment in 1985, Australia quickly introduced a Needle and Syringe Programme (NSP).”

• cites [337]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Later research showed that much of the opposition to the soda ban was led by organisations supported by the sweetened beverage industry.

“However, research subsequently showed that much of this opposition was led by organisations supported by the sweetened beverage industry.330”

• cites [330]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

A New York Times exposé describes Nestlé using direct marketing to sell sugary foods to poor people in Brazil under the guise of nutrition and community empowerment.

“An exposé in The New York Times,332 describes the use of direct marketing by multinational Nestlé to sell sugary foods to poor people in Brazil, under the guise of nutrition and community empowerment.”

• cites [332]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Medical-legal partnerships guide patients through the complex terrain of the health-care system, enabling them to claim their rights and gain access to the services they need.

“Medical–legal partnerships guide patients through the complex terrain of the health-care system, enabling them to claim their rights and gain access to the services they need.”

• cites [346]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

As sales of unhealthy foods have begun to lag in higher-income countries, food companies are expanding into developing countries by targeting community networks.

“Furthermore, as sales of unhealthy foods in higher-income countries have begun to lag, food companies are expanding their markets in developing countries by targeting community networks.”

Public participation and open forums help civil society understand the purpose of health law and engage more effectively in policy making.

“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 the medical profession, as in the wider public, understanding or recognition of the power of law to drive behavioural and social change is lacking.

“In the medical profession, as in the wider public, understanding or recognition of the power of law to drive behavioural and social change is lacking.”

• cites [340]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Health professionals might have a negative view of the legal profession, perceiving lawyers as adversaries bringing malpractice litigation.

“Health professionals might even have a negative view of the legal profession, perceiving lawyers as adversaries bringing malpractice litigation.340”

• cites [340]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

In other places, the food industry has spent heavily to influence legislation on issues from menu labelling to taxes on sweetened beverages.

“Elsewhere, the food industry has spent lavishly to influence legislative processes on issues ranging from menu labelling to taxes on sweetened beverages.331”

• cites [331]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

In Denmark, public health groups worked with government, industry bodies, and civil society organisations to raise awareness of the cardiovascular risks of artificial trans fats.

“For example, in Denmark, public health groups worked with the government, industry bodies, and civil society organisations, to raise public awareness of the cardiovascular risks of consuming artificial trans fats.328, 329”

• cites [328]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [329]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

New York City's regulation limiting sugary drink portion sizes, known as the soda ban, faced substantial community opposition.

“New York City's regulation limiting the portion size of sugary drinks (known popularly as the soda ban) received a great deal of community opposition.”

A few exception areas, including alcohol and tobacco control, demonstrate the importance of evaluation in developing and spreading highly effective legal solutions.

“A few exception areas, including alcohol and tobacco control, have showed the importance of evaluation in developing and spreading highly effective legal solutions.”

These grassroots efforts occur while food and beverage conglomerates hold enormous political and economic power in Brazil.

“These grassroots efforts take place while food and beverage conglomerates enjoy an enormous amount of political and economic power in Brazil.”

The lack of complete evidence did not act as a barrier to innovation in many public health successes.

“As observed with so many public health successes, the lack of complete evidence did not act as a barrier to innovation.”

The availability of skilled professionals who can implement and evaluate such interventions is not matched to the growing recognition.

“however, this is not matched by the availability of skilled professionals who can implement and evaluate such interventions.340”

• cites [340]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Recognition of the potential for legislative and regulatory interventions to improve population health is growing.

“Recognition of the potential for legislative and regulatory interventions to improve population health is growing”

• cites [340]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Evaluations of NSPs in Australia found them to be the single most important and cost-effective strategy in reducing drug-related harms among persons who inject drugs.

“Evaluations of NSPs in Australia found them to be “the single most important and cost-effective strategy in reducing drug-related harms among [persons who inject drugs]”,338”

• cites [338]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Greater civil society understanding and engagement can support adherence to the norms and standards set by health laws.

“In turn, this can support adherence to the norms and standards established by health laws.”

In no other area of public health are interventions applied to so many people with so little evaluation of their effects.

“Yet, nowhere else in the realm of public health are interventions used to treat so many people with so little evaluation of the effects.201”

• cites [201] sourceNot checked — no full text of the source