Doctors and patients sit and talk. At the table near the window in the hospital.

Does the Right to Health Enhance Patient Rights?

By Luciano Bottini Filho

Despite the value of a constitutionally enshrined right to health, such a guarantee, on its own, does not ensure patient rights or a nuanced understanding of patient-centered care.

This article will consider the case study of Brazil as an example. Despite Brazil’s recognition of the right to health, this constitutional protection does not set sufficient standards to guide judicial decision-making around patient care.

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Washington, DC, USA, May 5, 2022: people protest the leaked draft Supreme Court opinion overturning Roe v. Wade and the right to abortion

Reproductive Governance in a Post-Roe US: The Weaponization of Health Systems

By Alicia Ely Yamin

I was living and working in Peru in 2001, when Karen Noelia Llantoy discovered she was pregnant with an anencephalic fetus. Llantoy, a minor at the time, became profoundly depressed. Her own physician, a social worker, and a psychiatrist all concurred that she should have a termination, as anencephaly is a fatal brain defect that also poses an unnecessary risk to the mother’s physical health, and the pregnancy was having a severe impact on Llantoy’s mental health.

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Buenos Aires, Argentina – August 31, 2017: Horizontal view of some waste collector machines over Matanza River (also known as Riachuelo at its mouth in River Plate), La Boca neighborhood.

Searching for Environmental Justice in Argentina: Revisiting the Reality of the Matanza-Riachuelo River Basin Case after Fifteen Years

By Alicia Ely Yamin and María Natalia Echegoyemberry

The first thing that strikes you when you arrive in Argentina’s Villa Inflamable (literally “Inflammable Slum”) is the noxious sulfur smell of the air that mixes with other acrid chemicals, which makes it difficult to breathe deeply. When a breeze picks up, the sands that have been used to extract contaminated water from the nearby Riachuelo, one of the ten most highly contaminated rivers in the world, rain down on everyone, filling eyes and lungs with toxic particulate matter.

As petrochemical tanker trucks parade through nearby paved streets, the unpaved lanes of Villa Inflamable alternate between toxic dust blowing through the air on dry days to flooding raw sewage on rainy ones. Everyone knows someone who died of cancer, or had pregnancy complications and children with birth defects. More than 600 children have been born and are growing up exposed to highly carcinogenic chemicals, such as benzene and toluene.

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CABA, Buenos Aires / Argentina; March 9, 2020: international women's day. Women shouting slogans in favor of the approval of the law of legal, safe and free abortion.

Lessons from Latin America as the U.S. Regresses on Reproductive Rights

By Alma Beltrán y Puga

As the Supreme Court of the United States moves closer to overturning Roe and Casey, looking south to Latin America highlights the egregiousness of these developments.

Recently, Mexico and Colombia have provided landmark decisions that recognize a woman’s freedom to choose over her body is a fundamental right. Both rulings use strong arguments to frame abortion as protected under a constitutional umbrella that enshrines the right to equality and non-discrimination, and to health and reproductive freedom, as fundamental liberties.

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KYIV, UKRAINE - Feb. 25, 2022: War of Russia against Ukraine. A residential building damaged by an enemy aircraft in the Ukrainian capital Kyiv.

Misplaced Skepticism on Accountability for War Crimes Against Health Care in Ukraine

By Leonard Rubenstein

Russian attacks on hospitals, ambulances, and health workers in Ukraine — including more than 180 attacks confirmed by the World Health Organization, and double that number reported by the Ministry of Health — have gained global attention. In one case, viral photos document the evacuation of pregnant women, including one on a stretcher who later died, from a maternity hospital in Mariupol destroyed by Russian shelling. It is likely that investigations will show that many of these acts are war crimes. Accountability for these crimes must be pursued.

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Sign at train station in Berlin that describes free support for pet owners coming from Ukraine.

Ethical Challenges Associated with the Protection of Pets in War

(Photo: Sign at the central train station in Berlin (Berlin Hauptbahnhof) that offers free support for pet owners coming from Ukraine. Courtesy of Kristin Sandvik.)

By Kristin Bergtora Sandvik

Introduction

The care for animals rapidly became a part of the humanitarian narrative of the attack on Ukraine.

There are countless accounts of the efforts of activists, shelters and zoo staff to keep animals alive, as well as underground operations to get them to safety. And, as Ukrainians flee for their lives, they are frequently accompanied by their pets.

EU initiatives and advocacy efforts by animal rights groups pushed receiving countries to modify entrance requirements, waive fees, provide veterinary services, and shorten or eliminate quarantine times. The EU announced a special derogation in Regulation 2013/576, allowing the import of Ukrainian refugee pets without meeting standard requirements. Many governments have welcomed Ukrainian pets with or without their owners, and without documentation, rabies vaccine, and/or microchip.

Humanitarian action is typically human centric; this broad societal acceptance of pets as legitimate refugee companions, and the attendant rapid regulatory accommodations, are unique developments. In this blog, I draw on perspectives from disaster studies, international humanitarian law (IHL), refugee studies, and animal studies to articulate a set of ethical dilemmas around classification and policymaking that arise when pets are recognized as a humanitarian protection problem.

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GHRP affiliated researchers.

Introducing the Global Health and Rights Project’s New Affiliated Researchers

(Clockwise from top left: Alma Beltrán y Puga, Luciano Bottini Filho, Ana Lorena Ruano, María Natalia Echegoyemberry)

By Alicia Ely Yamin and Chloe Reichel

Leer en español.

In the years before the pandemic, and especially since the pandemic began, there have been increasing calls to decolonize global health. Setting aside what Ṣẹ̀yẹ Abímbọ́lá rightly characterizes as the slipperiness of both the terms “decolonizing” and “global health,” these calls speak to the need to reimagine governance structures, knowledge discourses, and legal frameworks — from intellectual property to international financial regulation.

Global health law itself, anchored in the International Health Regulations (2005), purports to present a universal perspective, but arguably rigidifies colonialist assumptions about the sources of disease, national security imperatives, priorities in monitoring “emergencies,” and governance at a distance. The diverse tapestry of international human rights scholarship related to health is often not reflected in analyses of the field from the economic North. In turn, that narrow vision of human rights has also increasingly faced critiques from TWAIL, Law & Political Economy, and other scholars, for blinkered analyses that fail to challenge the structural violence in our global institutional order — which the pandemic both laid bare and exacerbated.

In an attempt to enlarge discussion of these important topics and amplify diverse voices, the Petrie-Flom Center is welcoming four new affiliated researchers to the Global Health and Rights Project (GHRP).

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Bill of Health - Globe and vaccine, covid vaccine

COVID ‘Compromise’ on International IP Underscores Need for New Approach

By Cynthia M. Ho

The leaked compromise regarding a “waiver” of international intellectual property (IP) obligations under the TRIPS Agreement for World Trade Organization (WTO) members has met harsh criticism as a shadow of the original proposal to waive international obligations regarding patent, trade secret, and copyright obligations relating to any COVID vaccine, treatment, diagnostic, or personal protective equipment (PPE).

The compromise excludes diagnostics, treatments, and PPE. It only narrowly modifies compulsory licenses of patents covering COVID vaccines. Moreover, it imposes additional restrictions on use of compulsory licenses. But still, multinational pharmaceutical manufacturers have protested even these modest changes from the status quo, arguing that there is no IP problem that needs to be fixed.

Clearly there is a problem. It has taken 18 months since the original Indian and South African proposal to get to this limited compromise, while gross vaccine inequity between wealthy and poor countries continues. In addition, the leaked compromise between four WTO members is still being debated — and even if agreement can be reached, it needs agreement of over 100 other WTO members. We need a new approach.

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Traffic light.

The COVID-19 Pandemic, the Failure of the Binary PHEIC Declaration System, and the Need for Reform

This post was originally published on the Verfassungsblog as part of our joint symposium on international pandemic lawmaking.

By Ilja Richard Pavone

The COVID-19 pandemic has raised unprecedented challenges for the global health framework and its long-term consequences are not yet in full sight. The legal and institutional regime aimed at preventing and controlling the spread of infectious diseases, grounded on the International Health Regulations (IHR) was heavily criticized.

The alarm mechanism based on the declaration of Public Health Emergency of International Concern (PHEIC), in particular, has been severely tested. A PHEIC is an extraordinary event that constitutes a potential public health risk through the international spread of a disease outbreak. The WHO Director-General bases his decision to “ring the bell” upon the technical advice of an Emergency Committee (EC) carrying out “an assessment of the risk to human health, of the risk of international spread, and of the risk of interference with international traffic.”

A PHEIC, then, is declared only when an event is already sufficiently acute and has started to spread internationally. It is not an early warning, but a formal alert, and in the case of COVID-19 it was issued with extreme delay only on 30 January 2020, (one month after notification of early cases by the Chinese government), after Beijing had already adopted quarantine measures around the city of Wuhan, and draconian measures to curb the spread of the disease in the country had been announced.

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The Mexican-American border, with some construction still ongoing on the American side.

Pandemics without Borders? Reconsidering Territoriality in Pandemic Preparedness and Response Instruments

This post was originally published on the Verfassungsblog as part of our joint symposium on international pandemic lawmaking.

By Raphael Oidtmann

The COVID-19 pandemic has (yet again) disclosed that, in contemporary international law, the notion of borders resembles a distinct emanation of legal fiction, i.e., “something assumed in law to be fact irrespective of the truth or accuracy of that assumption.” This characterization of international borders holds particularly true with a view towards managing, containing, and countering the spread of highly contagious pathogens: especially in the context of responding to the global COVID-19 pandemic, it has hence become apparent that the traditional conception of borders as physical frontiers has been rendered somewhat moot. On the contrary, the pandemic experience has proven that a more flexible, fluid, and functional understanding of (international) borders might be warranted, also with a view towards (re-)conceptualizing international health law.

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