Category: Global Health

Infrastructure as a Social Determinant of Health in Developing Economies

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By Matthew L Baum

Recently in the New England Journal of Medicine, D.S. Jones described the history of a dangerous new technology, the detrimental health effects of which had clinicians very worried. That technology was the automobile. While the public health concern spanned from inactivity to new maladies like “automobile knee”, by far the greatest concern was automobile accidents. Jones describes that in 1912, accident mortality was such a big problem that a New York coroner’s clerk said “’our streets are becoming as perilous as a battlefield’” and by 1957 the evaluation was not much better:  “Harvard researchers described accident mortality as a ‘mass disease of epidemic proportions’.” Interestingly, Jones highlights that doctors viewed this epidemic not merely as a governmental problem, but one in which there was a moral imperative that doctors themselves play a role in both studying what factors lead to car crashes and (more controversially) identifying high-risk drivers and thus contributing more directly to prevention.

Now in many developing economies across the globe, an interesting twist on this story is emerging: while modern cars have long existed in these locations, only very recently has there been a massive expansion of well-paved roads. And along with new and improved transport routes, new risks to public health.

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MONDAY: Conference, “Companies’ Global Health ‘Footprint’: Could Rating Help?”

The Petrie-Flom Center Staff Leave a comment

Imagine a rating or accreditation system for companies’ “global health footprint.” Such a system would rigorously assess companies’ overall impact on human health, including the health of the world’s poorest and sickest populations, then disseminate this information in ways that users could readily understand and act upon. If successful, such a system would inform and enhance choice for ethically-minded corporate executives, board members, investors, business partners, workers, consumers, and regulators.

Bringing together leaders and experts in ethics, global health, business, law, communication, and health-related quality and safety certification, this conference will discuss dilemmas, share best practices, and seek to identify forms of global health impact monitoring and labeling that could be affordable, rigorous, reliable, sensitive to community needs, and user-friendly.

The conference is free and open to the public, but registration is required. For more information, including the full conference agenda and registration links, please visit our website.

Organized by:
Nir Eyal, Associate Professor of Global Health and Social Medicine
Jennifer Miller, Edmond J. Safra Lab Fellow

Co-sponsored by the Edmond J. Safra Center for Ethics at Harvard University; the Division of Medical Ethics at Harvard Medical School; the Harvard Global Health Institute; and the Petrie-Flom Center, with support from the Oswald DeN. Cammann Fund.

12/9 conference: “Companies’ Global Health ‘Footprint’: Could Rating Help?”

The Petrie-Flom Center Staff Leave a comment

Imagine a rating or accreditation system for companies’ “global health footprint.” Such a system would rigorously assess companies’ overall impact on human health, including the health of the world’s poorest and sickest populations, then disseminate this information in ways that users could readily understand and act upon. If successful, such a system would inform and enhance choice for ethically-minded corporate executives, board members, investors, business partners, workers, consumers, and regulators.

Bringing together leaders and experts in ethics, global health, business, law, communication, and health-related quality and safety certification, this conference will discuss dilemmas, share best practices, and seek to identify forms of global health impact monitoring and labeling that could be affordable, rigorous, reliable, sensitive to community needs, and user-friendly.

The conference is free and open to the public, but registration is required. For more information, including the full conference agenda and registration links, please visit our website.

Organized by:
Nir Eyal, Associate Professor of Global Health and Social Medicine
Jennifer Miller, Edmond J. Safra Lab Fellow

Co-sponsored by the Edmond J. Safra Center for Ethics at Harvard University; the Division of Medical Ethics at Harvard Medical School; the Harvard Global Health Institute; and the Petrie-Flom Center, with support from the Oswald DeN. Cammann Fund.

Only a Right to Health

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By Nathaniel Counts

Human rights disaggregates otherwise related issues into separate rights.  We discuss rights to health, education, housing, association, etc., and, in countries where these rights are codified, we litigate each one separately in the courts.  We also know that each of these issues for which there is a corresponding right is, to some extent, a symptom of poverty.  In some cases it might not be possible to treat the symptoms without addressing the root cause.  For example, in 1966, the Coleman study on equality in education found that “[s]chools bring little influence to bear on a child’s achievement that is independent of his [or her] background and general social context.”  These findings have been contested, but it is likely that socioeconomic factors are a determinant of a child’s academic success, along with the educational experience itself.  If the socioeconomic background is the greater determinant, it may not make sense to use scarce government resources to fund school improvement rather than addressing poverty itself.  In a country with a right to education, school improvement could be litigated and potentially derail national efforts to address root causes.

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Video now available of panel on “Reproductive Rights around the Globe”

The Petrie-Flom Center Staff Leave a comment

Video of the panel discussion “Reproductive Rights around the Globe,” held at Harvard Law School on November 7, is now available via the Petrie-Flom Center’s website. The panel — cosponsored by the Petrie-Flom Center; the Human Rights Program; and the Child Advocacy Program at Harvard Law School; and the Harvard Global Health Institute — included legal experts on a variety of topics:

  • International trends in gamete donor identifiability v. anonymity – I. Glenn Cohen, Professor of Law, Harvard Law School; Faculty co-Director, Petrie-Flom Center
  • The politics of evidence and expertise in domestic and international abortion litigation – Aziza Ahmed, Associate Professor of Law, Northeastern University School of Law; Visiting Scholar, Petrie-Flom Center (Spring 2014)
  • Use of international fora, including courts and treaty bodies, to advance reproductive rights – Mindy Jane Roseman, Lecturer on Law, Harvard Law School; Academic Director, Human Rights Program
Link to the video here.

Going On Now: IOM Stem Cell Therapies Workshop

The Petrie-Flom Center Staff 1 Comment

The IOM is hosting a workshop *right now* on Stem Cell Therapies: Opportunities for Assuring the Quality and Safety of Unregulated Clinical Offerings.  You can sign up via a quick online form, and they’ll immediately send you a link to the live webcast (agenda here), which will hopefully be archived.  Our own Glenn Cohen is slated to discuss stem cell medical tourism at 1:15 this afternoon.

Here’s the description from the IOM site:

Stem cells hold tremendous potential to advance health and medicine. Through replacement of damaged cells and organs or supporting intrinsic repair, stem cell offer promising treatments for debilitating diseases and conditions such as Parkinson’s disease, diabetes, and spinal cord injury. Currently, however, the evidence base to support the medical use of stem cells is still limited, with few clinical applications shown to be safe and effective. Despite the preliminary nature of clinical evidence, consumer demand for treatments using stem cells has risen, fueled by direct-to-consumer advertising of stem cell-based treatments. Clinics have been established throughout the world, both in newly industrialized nations such as China, India, and Mexico, as well as developed countries such as the United States and within Europe, that offer “stem cell therapies” for a wide range of diseases and conditions. Often provided at great expense and often promoted as established and effective, these treatments have generally not received stringent regulatory oversight, have not been tested through rigorous trials to determine safety and likely benefit, and the claims remain largely unsubstantiated by medical science. Complications from treatments have ranged from tumor formation to the death of patients. Some feel that the false claims and potential for harm to patients could significantly damage the real potential of research to produce valid stem cell therapies.

The Institute of Medicine and the National Academy of Sciences will co-host a workshop with the International Society for Stem Cell Research that will take a critical look at the practice of unproven stem cell treatments. Speakers will examine the evidence base of unsubstantiated treatment offerings and the associated research and clinical risks and concerns. Discussions will delve into legal hurdles for establishing standards and criteria to govern stem cell trials and treatments and explore a range of potential solutions for assuring the quality of unregulated therapies.

A disenfranchising effect of the right to health?

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By Julian Urrutia

Human rights embody the humanist egalitarian principle that all human beings are morally important, and that they are morally important simply because of their humanity. Princes and paupers, bankers and bums, women and men . . . we’re all subjects of human rights that are not contingent on anything other than our humanity.

There is widespread agreement that the rise of humanism is one of the most important milestones in the history of moral progress. However, it also clear that the rise of humanism did not, by itself, bring us all the way down the path of progress to where we are today: throughout colonial history, for example, humanism failed to deliver us from outrageous discrimination when the boundaries of humanity were delineated too narrowly.

Humanists are just as prone to inhumane conduct when they fail to recognize other’s humanity. When we determine what is human (and must therefore be treated with respect), we tacitly also determine what is un-human (and can therefore be exploited). As Carl Schmitt put it “Given the coherence of this two-sided aspect of humanity, it should be remembered that Bacon opposed the axiom homo homini deus to that of homo homini lupus.” (The nomos of the earth, 1950)

That’s why contemporary, liberal constitutions that recognize human rights are so great. All people are recognized as being equally human, and therefore equally subjects of human rights. This is certainly a form of moral progress. However, narrow human rights-based approaches to politics, legislation and policy-making can have similarly perverse consequences as narrow forms of humanism. Instead of delivering us from outrageous discrimination, marginalization and exploitation, a narrow focus on rights might confine us to them. For example, there is growing evidence that human-rights-based legislation and litigation often fails to achieve an effective enjoyment of the right to health to among those who need it most. Even more troubling is the possibility that, sometimes, rights-based approaches not only have little positive effects, but might in fact lead to further marginalization and disenfranchising of the poor.

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