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A Critical Analysis of the Eurocentric Response to COVID-19: Western Ideas of Health

By Hayley Evans

The international response to COVID-19 has paid insufficient attention to the realities in the Global South, making the response Eurocentric in several ways.

This series of blog posts looks at three aspects of the COVID-19 response that underscore this Eurocentrism. The first post in this series scrutinized the technification of the international response to COVID-19. This second post looks at how the international pandemic response reflects primarily Western ideas of health, which in turn exacerbates negative health outcomes in the Global South.

This series draws on primary research conducted remotely with diverse actors on the ground in Colombia, Nigeria, and the United Kingdom, as well as secondary research gathered through periodicals, webinars, an online course in contact tracing, and membership in the Ecological Rights Working Group of the Global Pandemic Network. I have written about previous findings from this work here.

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Bolivar Square with Cathedral and Colombian Palace of Justice - Bogota, Colombia.

The Stakes of the Pending Colombian Constitutional Court Abortion Decision

By Alicia Ely Yamin

Amid the massive social protests wracking Colombia, the Colombian Constitutional Court is currently considering whether to decriminalize abortion beyond the narrow exceptions already recognized in law.

The petition was brought before the court by the Causa Justa (“Just Cause”) movement, a group of activists and organizations who argue that the country’s broad criminalization of abortion through Article 122 of the Penal Code poses an unconstitutional violation of women’s rights.

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WASHINGTON, DC - OCT. 8, 2019: Rally for LGBTQ rights outside Supreme Court as Justices hear oral arguments in three cases dealing with discrimination in the workplace because of sexual orientation.

The Many Harms of State Bills Blocking Youth Access to Gender-Affirming Care

By Chloe Reichel

State legislation blocking trans youth from accessing gender-affirming care puts kids at risk, thwarts physician autonomy, and potentially violates a number of federal laws, write Jack L. Turban, Katherine L. Kraschel, and I. Glenn Cohen in a viewpoint published today in JAMA.

So far this year, 15 states have proposed bills that would limit access to gender-affirming care. One of these bills, Arkansas’ HB1570/SB347, already has become law.

This legislative trend should be troubling to all, explained Cohen, Faculty Director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. In an email interview, he highlighted “how exceptionally restrictive these proposed laws are,” adding that they are “out of step with usual medical, ethical, and legal rules regarding discretion of the medical profession and space for parental decision-making.”

Turban, child and adolescent psychiatry fellow at Stanford University School of Medicine also offered further insight as to the medical and legal concerns these bills raise over email.

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WASHINGTON, DC - OCT. 8, 2019: Rally for LGBTQ rights outside Supreme Court as Justices hear oral arguments in three cases dealing with discrimination in the workplace because of sexual orientation.

Now Is the Time for a Sex-Based Civil Rights Movement in Health Care

By Valarie K. Blake

The Biden administration and all three branches of government are poised to finally deliver a sex-based civil rights movement in health care that generations have waited for.

Sex discrimination is prevalent in health care, but especially so for LGBTQ people. Combine this with other forms of discrimination that LGBTQ people experience, and the result is a population that suffers from serious health disparities, including heightened risks of mental health conditions, substance use disorders, and suicide.

A much needed ban on sex discrimination in health care finally passed in 2010, as part of the Affordable Care Act (ACA). Section 1557 of the ACA prohibits health care entities that receive federal money from discriminating on the basis of sex, along with race, age, and disability. Specifically, Section 1557 bans sex discrimination in health care by way of extending Title IX, which previously applied to educational entities only. Section 1557 reaches most hospitals, providers, and insurers. Sex equality in health was a long time coming. Similar bans on discrimination by recipients of federal money had passed decades earlier: race discrimination in 1964, disability discrimination in 1973, and age discrimination in 1975.

Despite its historic nature, Section 1557 has yet to deliver on its promise, owing to delays and volatility in rulemaking and near-constant litigation. The statute was barebones, requiring interpretation, but the Obama administration only promulgated a rule and began full enforcement six years after the passage of the ACA. The Obama rule broadly banned gender identity and sexual orientation discrimination, but the part of the rule banning gender identity discrimination was judicially stayed only months later in Franciscan Alliance v. Burwell.

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Illustration of fetus, DNA, lab supplies

Assisted Reproductive Technologies: A Bioethical Argument for Medicaid Coverage

By Sravya Chary

Assisted reproductive technologies (ARTs) such as artificial insemination, egg retrieval, and in-vitro fertilization (IVF) have revolutionized the landscape for people facing reproductive obstacles. Disappointingly, none of these technologies are covered under Medicaid — an insurance program for low-income adults and children, and people with qualifying disabilities.

Given the high prices of ARTs, those on Medicaid, which includes a disproportionate number of BIPOC individuals, are left behind in sharing the benefits of advancements in reproductive technologies. It is vital for ARTs to be covered under Medicaid to uphold reproductive justice and autonomy for this patient population.

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international connections concept art.

‘We Claimed Victory Before Time’: COVID-19 in Uruguay

By Chloe Reichel

Leer en español.

Uruguay, once hailed as a model for its pandemic response, recently has seen some of the world’s sharpest increases in COVID-19 cases. Earlier this month, the infection rate in the country surpassed 1,300 cases per 100,000 residents over a 14-day period.

What happened?

I asked Dr. Gonzalo Moratorio, virologist at the Institut Pasteur de Montevideo and professor on the Faculty of Science at the Universidad de la República, to explain the shift. Moratorio was instrumental to Uruguay’s early successes in the pandemic, developing and distributing test kits that allowed the country to efficiently identify and isolate cases.

In this Q&A, which has been edited and condensed, he offers a look at the past, present, and future of the COVID-19 pandemic in Uruguay.

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globe.

‘I Think of It in Terms of Years’: The Future of the COVID-19 Pandemic in South Africa

By Chloe Reichel

“No One Is Safe Until Everyone Is Safe” goes the rallying cry for global vaccine equity.

We would think that the COVID-19 pandemic already has made this point clear enough.

And yet, pundits are heralding the “end” of the pandemic in the U.S., all while viral variants that may be capable of evading the protection of vaccines continue to crop up both domestically and internationally.

In this Q&A, South African journalist and human rights activist Mark Heywood offers a look at the national COVID-19 epidemic in South Africa. The sobering reality there, in terms of morbidity and mortality, and in terms of expectations for the future, underscores the urgency for globally coordinated leadership and action to address the pandemic.

Our conversation from late March 2021, which has been edited and condensed, follows.

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Cape Town, South Africa - 6 April 2020 : Empty streets and stay home sign in Cape Town during the Coronavirus lockdown.

One Year Later: COVID-19, Human Rights, and the Rule of Law in South Africa

By Chloe Reichel

South Africa has faced a devastating national COVID-19 epidemic, with over 1.5 million confirmed cases, and over 50,000 confirmed deaths.

The true toll, in terms of cases and deaths, is likely much higher. Research shows the country has recorded 150,000 excess deaths since May 2020.

The pandemic has also profoundly affected South Africans’ constitutionally recognized rights.

Since the start of the pandemic, the country has experienced varying degrees of lockdown, which, at different points, included a curfew, bans on the sale of alcohol and tobacco, and the closure of most businesses. The lockdown has been enforced strictly, resulting in hundreds of thousands of arrests for violations.

Mark Heywood highlighted some of these rights concerns last June in “Human Rights, the Rule of Law, and COVID-19 in South Africa,” a contribution to Bill of Health‘s digital symposium on global responses to COVID-19.

I spoke with Heywood in late March 2021 to get an update on the state of human rights and the rule of law in South Africa one year into the COVID-19 pandemic. Our conversation, which has been edited and condensed, follows.

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America divided concept, american flag on cracked background.

The Health Implications of Xenophobia Directed Toward Asian Americans

By Sravya Chary

In response to the March 16, 2021 attacks targeting spas in Atlanta, GA that resulted in the deaths of eight individuals, six of whom were Asian women, President Biden urged Congress to pass the COVID-19 Hate Crimes Act.

The legislation was first introduced nearly a year ago, on May 5, 2020, but did not receive a congressional vote at that time.

The COVID-19 Hate Crimes Act, although beneficial as a reactive solution to hate crimes, does little to mitigate the long-term negative health implications of xenophobia on Asian Americans.

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Prison watch tower.

Government Report Finds Care Deficits for Pregnant People in Federal Custody

By Elyssa Spitzer

Pregnant and postpartum people in the custody of the Bureau of Prisons (BOP) and U.S. Marshals Service receive care directed by policies that fail to meet national standards, according to a report recently issued by the Government Accountability Office (GAO). 

This, despite the fact that, incarcerated women are among the most vulnerable people, according to the American College of Obstetricians and Gynecologists. In the GAO report’s terms, incarcerated women: “often have medical and mental health conditions that make their pregnancies a high risk for adverse outcomes, which is compounded by inconsistent access to adequate, quality pregnancy care and nutrition while in custody.”

Notably, the report found that the BOP and U.S. Marshals’ policies failed to satisfy the national standards — to say nothing of the gaps that may exist between written policy and the care that is, in fact, provided. Read More