Assessing the Expected Impact of Global Health Treaties: Evidence From 90 Quantitative Evaluations

Abstract

We assessed what impact can be expected from global health treaties on the basis of 90 quantitative evaluations of existing treaties on trade, finance, human rights, conflict, and the environment. It appears treaties consistently succeed in shaping economic matters and consistently fail in achieving social progress. There are at least 3 differences between these domains that point to design characteristics that new global health treaties can incorporate to achieve positive impact: (1) incentives for those with power to act on them; (2) institutions designed to bring edicts into effect; and (3) interests advocating their negotiation, adoption, ratification, and domestic implementation. Experimental and quasiexperimental evaluations of treaties would provide more information about what can be expected from this type of global intervention.

FIGURE 1—

Number of studies showing positive, negative, and no impact on (a) any outcome measure by policy area, (b) government policies by type of objective, and (c) people, places, and products by type of objective. Note. Outcomes were deemed either “positive” or “negative” on the basis of whether they aligned or contradicted treaties’ own stated goals as found in their preamble text. We coded studies that drew both positive and negative conclusions twice in the bar chart coloring but only once in the tally of studies presented beside each label. This explains why there are 2 studies evaluating the impact of international law on immunity agreements for international crimes although the bar chart coloring indicates that 66% of studies found a positive impact and 33% found a negative impact. This also explains why there are 4 studies evaluating the impact of international law on peace yet the bar chart coloring indicates that 2 studies found a positive impact, 2 found a negative impact, and 1 found no impact. The figure does not show the impact of international laws on derogation from rights, economic sanctions, public support, and water levels because these 4 outcome measures were only evaluated in a single study each.