Equity, Human Rights, and the Quest for Coherence in Global Health Law

The health crisis of COVID-19 has provoked a pivotal moment of global health law reform that comes against larger shifts against international law, democracy, and human rights. In this light, it is perhaps not surprising that state-led amendments to the International Health Regulations (IHR)—international law’s primary instrument governing state responses to public health crises—and a prospective Pandemic Agreement—designed to remedy the former’s defects—have shifted away from the language of human rights and toward the sweeping principle of equity. While these changes appear to herald an important normative and legal shift in international law, they also raise longer-standing questions about coherence and fragmentation in international law, and about the future of human rights within international law. In this essay, I first explore larger concerns around coherence and fragmentation in international law, and the practical manifestation of these threats in disparities in access to COVID-19 vaccines. Second, I consider the legal and political implications of the shift to equity in both instruments. I conclude by considering what this move may mean for coherence and human rights in international law.