rights and obligations under international law concerning what happens in their territories. Stationing federal public health personnel and assets in other countries as part of the expanded NQS will have to involve cooperation with foreign governments and–in all likelihood–the negotiation of formal, written agreements governing the relationship between host governments and the U.S. public health presence in those countries.

1. INTRODUCTION

The federal government of the United States plans to expand the national quarantine system (NQS), currently operated and managed by the Division of Global Migration and Quarantine of the Centers for Disease Control and Prevention (CDC). The federal government has long operated a national quarantine program to protect the United States against the introduction of communicable diseases from foreign countries and to prevent and control infectious disease spread between the states of the union. The federal government reduced the scale of the NQS in the 1970s when public health experts believed that the threat from communicable diseases had significantly diminished. Growing concerns in the last decade about emerging and reemerging infectious diseases and the threat of bioterrorism have prompted the federal government to develop plans to enhance the NQS to address the communicable disease threats posed to the United States today.

The committee’s mandate is to review the federal government’s plans for expanding the NQS. As part of its review, the committee commissioned the Consultant to analyze the expansion of the NQS with respect to applicable international law. The committee believes that such an analysis will inform its deliberations of the international implications of the plans to expand the NQS. The United States will operate any expanded NQS in an environment affected by international law, making some understanding of this law pertinent to the committee’s overall mandate.

2. BASIC DYNAMICS OF INTERNATIONAL LAW WITH RESPECT TO PUBLIC HEALTH PROTECTION

International law comprises the set of rules states have created to regulate their interactions with each other. For purposes of the international legal rules analyzed in this memorandum, the relevant actor is the United States. Typically, international legal analysis does not enquire into how constitutionally, or as a matter of domestic law, a state organizes itself to fulfill international legal obligations it has undertaken. As a federal system, the United States’ acceptance of international legal obligations is occasionally affected by federalism. The revised International Health Regulations (IHR) are a case in point because the United States has indicated that it will



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