United States. Thus, the expanded NQS will have to operate within the disciplines created by the SPS Agreement. These disciplines do not, however, appear to present serious obstacles for the effective and efficient working of an expanded NQS.

Trade in Services: GATS and the Expanded NQS

In addition to liberalizing international trade in goods, international trade law also involves the movement of people through agreements that address international trade in services. At the WTO level, GATS provides an international legal framework designed to help liberalize international trade in services. GATS covers the temporary movement of natural persons supplying a service in the territory of another WTO member (Article 2.2[d] and Annex on Movement of Natural Persons Supplying Services under the Agreement). WTO members can make commitments to allow more foreign service suppliers to provide services on a temporary basis in their territories (Articles XVI and XVII). GATS commitments on the movement of natural persons do not apply to people seeking citizenship, residence, or employment on a permanent basis (Annex on Movement of Natural Persons Supplying Services under the Agreement, ¶2).

The United States could increase the number of foreigners coming to the United States to supply services temporarily under GATS if it made binding commitments to do so. Such binding commitments would not, however, limit or directly regulate the ability of the United States to apply its public health measures to foreign service suppliers entering the United States. GATS does not govern the application of such health measures, nor does any WTO agreement. Further, the disciplines of the revised IHR on health measures relating to entry to travelers do not preclude a state party from requiring medical examination, vaccination, or other prophylaxis as a condition for entry for any travelers seeking temporary or permanent residence (IHR, Article 31.1[b]).

In short, liberalization of trade in services through the temporary movement of natural persons into the United States under GATS would not weaken the expanded NQS’ authority to carry out its public health functions. The same principle and outcome appears in the provisions on cross-border trade in services in the North American Free Trade Agreement (NAFTA, Article 1201.3).


The revised IHR’s mandates that states parties implement their health measures “with full respect for the dignity, human rights, and fundamental freedoms of persons” (Article 3.1), “with respect for their dignity, human

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