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The enforcement of public health standards is a common problem in many developing countries. Public health agencies lack sufficient resources and, too often, enforcement mechanisms rely on slow and erratic judicial systems. These limitations can make traditional public health regulations difficult to implement. In this article, we examine innovative approaches to the implementation of public health regulations that have emerged in recent years within OECD countries. These approaches aim to improve compliance with health standards, while reducing dependence on both the legal system and the administrative resources of public health agencies.

This article begins by discussing some traditional forms of public health regulations; these regulations include administrative searches and inspections as well as licensing measures. Within these traditional forms of public health regulation, there are several ways of improving compliance without substantially increasing administrative costs. These measures include public disclosure and several types of sanctions, which may escalate in severity as an actor continues to flout the public health regulation.

In addition to such traditional measures, we discuss more creative approaches to reducing dependence on the judiciary and reducing administrative costs. Dependence on the judiciary can be reduced through increased reliance on alternative dispute resolution methods, such as mediation and arbitrations, as well as through the use of a public health Ombudsman. Administrative costs could also potentially be reduced through the creative use of public-private cooperation measures, such as negotiated rulemaking and self-regulating codes of conduct. Developing countries may find some useful lessons in the innovative approaches described; however, these approaches will likely need to be adapted to fit each country’s particular institutional setting.

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38(3) J. Law, Med. & Ethics 508-519 (Fall 2010)