The Paradox of Global Health Law: A Law and Political Economy Perspective

There is a paradox at the heart of the emerging field of Global Health Law (GHL), which lies in the relationship between GHL and governance for global health (GHG). The field of GHL has garnered increasing interest since the COVID-19 pandemic, the revisions of the International Health Regulations of 2005 in 2024 (IHR), 1 and the adoption of a Pandemic Agreement by the World Health Assembly in 2025. 2 The editors of the recently launched Journal of Global Health Law aptly assert, “global health law is fragmented without a coherent body of standards. It includes legally binding and non-binding instruments adopted under the framework of the WHO and other relevant international institutions/organizations … and a range of hard and soft law standards recognized in other branches of international law.” 3 GHG is defined here as: “the formal and informal structures, systems, and institutions through which actors: i) make decisions about global health standards, policies, and priorities; ii) finance, organize, and implement global health initiatives, programs, and plans; and iii) influence and engage with actors, systems, or institutions that lie outside the health sector but impact health.” 4 Thus, the newly revised IHR—like the Pandemic Treaty when in effect—empowers the WHO to declare pandemic emergencies as well as Public Health Emergencies of International Concern (PHEIC), 5 which then trigger actions and reporting requirements on the part of national governments. In this example, the legal agreements themselves are GHL and the worldwide administration they call for are governance arrangements, which are noticeably lacking in accountability for global institutions and private actors. 6