Category: Global Health

Climate Change and Sexual and Reproductive Health and Rights in Africa: The Urgent Need for Intersectional Approaches in Climate Change Policy and Governance

The Petrie-Flom Center Staff Leave a comment

Photo credit: @wambuigichobi | SMA

A Masai woman raises her fist as other women leaders look on at COP 27 in Sharm El Sheikh, Egypt during one of the debriefs by the Women and Gender Constituency. 

by Faith Lumonya, Esther Wambui, and Eunice Musiime

As global temperatures rise and the frequency of extreme weather events — such as floods, droughts, and heat waves — increases, climate change poses a growing threat to the progress of women’s sexual and reproductive health and rights (SRHR). Women face intersecting forms of vulnerability depending on their lived realities and experiences. For example, climate change reduces access to sexual and reproductive health (SRH) services, increases rates of sexual risk behavior, and leads to earlier sexual debut, higher prevalence of infectious diseases, and gender based sexual abuse and exploitation — however, these realities are not taken into account in climate change policy and governance.

Climate-related disasters frequently disrupt health care services, limiting women’s access to essential SRH care such as contraceptives and maternal health services. Associated economic and infrastructural damage further hamper access to vital health resources, while the increased instability exacerbates risks of gender-based violence and reproductive health challenges, especially for vulnerable women and girls. Given these compounded risks, it is crucial to integrate SRHR into broader global and national climate adaptation efforts. 

Read More

Lula’s environmental foreign policy, the global far-right, and the climate agenda

The Petrie-Flom Center Staff Leave a comment

by Danielle Hanna Rached and Denise Vitale

Donald Trump’s second term in office promises to bring turmoil to the global climate agenda. Against the scientific consensus that fossil fuel is leading the world to a climate breakdown, Trump has managed to impose his opportunistic views on the rest of the world. For the amount of $1 billion in campaign contributions, he initiated his vitriolic attacks against climate change (a “big hoax”), embraced the oil and gas industry (“liquid gold”), and vilified scientists and President Joe Biden’s clean energy legislation (“green new scam”). 

In such a scenario, our only hope lies in resistance that might be formed elsewhere. Since President Luiz Inácio Lula da Silva’s election in 2022, Brazil has desperately tried to claim a leadership position on the issue. Brazil is home to 60% of the Amazon and host to COP30 next year, and Lula’s socio-environmental agenda has had a prominent position from day one. He appointed Marina Silva, a historical leader of the environmental movement, to head the Ministry of the Environment and created the Ministry of Indigenous Peoples to push forward the Indigenous agenda. 

Read More

The impacts of climate change on the right to health in the United Kingdom 

The Petrie-Flom Center Staff Leave a comment

by Rossella De Falco

Climate change is one of the most pressing threats to health in the U.K. While climate change impacts everyone, marginalized groups and those with pre-existing health conditions are suffering the most, leading to greater health inequalities. This article explains how climate change impacts the health of the most marginalized populations in the U.K. from a human rights perspective. Read More

Reinventing South African Trade Unions to Protect the Health of Informal Workers in the Face of Climate Change

The Petrie-Flom Center Staff Leave a comment

by Cecile de Villiers

South Africa is considered the most unequal country in the world, with stagnant economic growth and staggeringly high unemployment. More than five million or 31.2% of workers in South Africa find economic opportunities in the “informal economy,” often because there are fewer barriers (training, skills, regulation) to entering the sector. 

Informal workers comprise a diverse group who may work in the formal or informal economy. Precarity of employment is common among these workers, who include, for example, casual workers as well as owners of microbusinesses (such as street vending or Spaza shops). However, workers in temporary, part-time or on-call work arrangements may also fall within this category, depending on the circumstances.

Read More

Climate Change and Health: Mobilizing Public International Law into Action

The Petrie-Flom Center Staff Leave a comment

This post launches a new Digital Symposium, Climate Change and Health: Mobilizing Public International Law into Action by Guest Editors Thalia Viveros Uehara and Alicia Ely Yamin. Check back for more posts twice a week!

The election of Donald J. Trump, who has called climate change a “hoax” and in his prior administration pulled the U.S. out of the Paris Agreement, has sent shock waves through government and civil society leaders gathered at COP29. Argentina has walked away from the negotiations. Meanwhile, top leaders from the world’s largest polluting nations have not attended. COP29 was supposed to mobilize commitments to finance climate action as well as solidify the growing “health turn” within the U.N. Framework Convention on Climate Change (UNFCCC), including WHO guidance on integrating health into Nationally Determined Contributions. But that progress seems now in jeopardy.

This digital symposium makes clear that stakes could not be higher for global health. Projections estimate that between 2030 and 2050, climate-related health impacts could lead to an additional 250,000 deaths per year, largely from undernutrition, malaria, diarrhea, and heat stress. Furthermore, mental health conditions are worsening as extreme weather, livelihood losses, and wildfire smoke increase trauma.

Read More

Abortion debt: revolutionary acts and reclamations of care

The Petrie-Flom Center Staff Leave a comment

Photo credit: Melisa Slep

by Rishita Nandagiri and Lucía Berro Pizzarossa

Discussions about abortion tend to be dominated by considerations pertaining to medicine (e.g., “safety”) and law (e.g., “legality”). Medication abortion — misoprostol alone or in combination with mifepristone — has dramatically shifted these discussions. Brazilian women used misoprostol to self-manage their abortions in the 1980s, galvanizing Latin American and transnational feminist efforts to share knowledge and organize access to pills. In 2005, these medicines were added to the WHO’s Essential Medicines List. Self-managed abortion (SMA), which includes self-sourcing of abortion pills, self-diagnosis, and management of abortion processes and post-abortion care outside formal health systems, unsettles traditional understandings of what an abortion is, where and how it can (or should) occur, who a provider is, and what a “safe” abortion is. 

In April 2024, Polish activists from Abortion Without Borders (AWB) invoiced the Sejm (Polish parliament) €11.5 million ($12.4 million) for the financial costs and reproductive labor associated with  providing abortion access, resources, and care for Polish residents. AWB, an initiative by nine feminist organizations working across multiple countries, was founded in 2019 to provide information, support, and funding for abortion in Poland, either via pills or travel for in-clinic care abroad. Poland has some of the most restrictive abortion laws in Europe, which many describe as constituting a de facto ban on abortions. Ministry of Health statistics report Polish hospitals conducted only 161 abortions in 2022. In contrast, Polish non-governmental organizations estimate that, every year, 120,000-150,000 abortions are obtained via pills or procedurally. 

Read More

Does History Matter?

The Petrie-Flom Center Staff Leave a comment

by Elena Caruso

While the exact definition of self-managed abortion remains blurred, it currently tends to refer to the end of a pregnancy through the autonomous administration of pills outside of a public health facility. The World Health Organization (WHO) recommends self-management for pregnancies under 12 weeks, using a combination of mifepristone and misoprostol (or misoprostol alone) and it includes both medications in its list of essential medicines. In its Abortion Care Guidelines, the WHO states that medication abortion has “revolutionized” access to abortion care, emphasizing the novelty of this method.  

While the origins of self-managed abortion with pills are not fully elucidated, it is generally accepted that this practice dates back to the second half of the 1980s in Brazil, when women discovered and disseminated the information that misoprostol (a medication legally available for the treatment of stomach and duodenal ulcers) could safely and effectively be used to prevent pregnancies. In the current debate on self-managed abortion, engagement with history is often limited to a few background sentences. This “ahistorical” approach can leave the impression that self-managed abortion lacks a significant and notable history. 

Read More

The Global Challenge of Unhealthy Diets: Front-of-Package Labeling for America

The Petrie-Flom Center Staff Leave a comment

by Alice Bryk Silveira

The alarming rise in diabetes and obesity rates in the United States has placed significant strain on health care systems and poses a serious public health threat. Americans’ overconsumption of ultra-processed foods high in sugar, salt and unhealthy fats is a concerning contributor. Globally, poor nutrition from such dietary habits plays a major role in the global burden of chronic diseases. In response, many countries have implemented policies to reshape their food environments. A prominent strategy is front-of-package (FOP) labeling systems, designed to help consumers make more informed choices, encourage healthier lifestyles, and push food manufacturers to align with public health guidelines by reducing ingredients such as sugar and salt.

Despite international momentum and calls from public health experts, the United States remains behind. Since 2009, the U.S. government has discussed the potential adoption of a uniform FOP label, with Congress directing the Centers for Disease Control and Prevention and Institute of Medicine (IOM) to produce recommendations on the topic. No standardized system exists but the U.S. Food and Drug Administration (FDA) is expected to propose new rulemaking on front-of-package labeling in 2024.

Read More

A full circle moment: legal risks to mifepristone and evidence for abortion with misoprostol alone

The Petrie-Flom Center Staff Leave a comment

Photo credit: Farrah Skeiky

by Patty Skuster and Heidi Moseson

Medication abortion did not begin with a clinical trial; it began at home as self-managed abortion, or abortion without supervision from a clinician. Decades before the 2000 U.S. Food and Drug Administration’s (FDA) approval of mifepristone for abortion, which is taken alongside misoprostol, feminists in Brazil found an opportunity to self-manage abortion with misoprostol, based on warning labels that cautioned about the risk of miscarriage if taken while pregnant. The genesis of abortion pills was therefore in self-managed abortion with misoprostol alone. 

Today, after several decades of clinical trials and heavy regulation of medication abortion, the practice of self-managed abortion with misoprostol-only is once again driving clinical practice. While medication abortion has been increasing in the U.S. since its introduction, major changes in recent years have dramatically increased usage. In 2021, the FDA relaxed enforcement of the requirement for in-person dispensing of mifepristone. This revolutionary change allowed the pills to be sent by mail for the first time, making them much more accessible. When, in 2022, the Supreme Court eviscerated the federal constitutional right to abortion in Dobbs v. Jackson Women’s Health Organization, the resulting abortion clinic closures led to even larger numbers of abortion seekers turning to medication abortion through telehealth and mailed medication from providers in supportive abortion states and clinicians outside the U.S. Combined, medication abortion now accounts for more than half of all abortions in the US. 

Read More

Doctors as Advocates for Self-Managed Abortion and Reproductive Justice

The Petrie-Flom Center Staff Leave a comment

Photo credit: Martina Šalov

by Jessica Morris

The International Federation of Gynecology and Obstetrics (FIGO) is the world’s largest alliance of national professional societies of obstetricians and gynecologists. FIGO supports comprehensive, equitable, and accessible sexual and reproductive health (SRH) for everyone, recognizing that these are fundamental human rights and essential components needed to achieve global health goals. 

FIGO works through its technical committee and its programmatic arm to improve access to abortion across the globe. Over the last two decades, FIGO has been a global advocate and played an important role in encouraging progressive, evidence-based thinking on abortion with its 130+ national professional societies and other stakeholder groups. FIGO has worked to strengthen and support these societies in becoming national leaders on SRH and driving important improvements, including  legal and policy developments, service provision, increasing supportive attitudes, and raising awareness and challenging bias.

What is the role of doctors in the de-medicalization of abortion?

Read More