hospital equipment

Scarcity Is Not an Excuse to Discriminate: Age and Disability in Health Care Rationing

By Silvia Serrano Guzmán

On July 4, 2023 the Constitutional Court of Colombia handed down a landmark decision on one of the most difficult dilemmas faced during the COVID-19 pandemic: the rationing of intensive care in situations of scarcity. Although the need for prioritization was a reality almost globally, many countries had no such regulation in place, which frequently led to the adoption of fragmented and discriminatory triage protocols.

The Colombian case reinforces that human rights and public health are not mutually exclusive. Importantly, this is reflected in the Principles and Guidelines on Human Rights & Public Health Emergencies (2023). Though the Principles did not exist during the litigation of the case, they will be of use in similar instances going forward, both for States working to develop human rights-compliant public health measures, as well as for courts reviewing such measures.

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scales on blue background.

Judging in the Pandemic – A Malawian Perspective

By Zione Ntaba

Malawi is not a stranger to public health crises in the last number of years, having faced a severe HIV epidemic and several cholera outbreaks continuing into 2023. Nevertheless, the onset of the COVID-19 pandemic caused a major panic in the country’s legal system and judiciary. COVID-19 brought to fruition a major ethical dilemma in ensuring the justice system’s continued functioning, while also protecting the lives of all those involved, and simultaneously ensuring the promotion and protection of human rights.

The constitutional mandate of ensuring access to justice in Malawi, a country which already struggles with effective and efficient justice delivery at the best of times, required urgent resolution, especially noting the potential of human rights violations arising from State responses to COVID-19 worldwide. Interestingly, in addition to the general need to safeguard the justice system as a whole, the pandemic itself brought before the courts issues relating to public health and human rights.

The prevailing principle in Malawi, as it is internationally, is for the judicial system to ensure that there exists an equal balance between the protection and promotion of human rights and the fair and just administration of justice. The courts in Malawi were called upon to rise above the political bureaucracy, to ensure judicial impartiality when dealing with pandemic-related issues. This was crucial in a context in which political responses to the pandemic sometimes remained unquestioned or unchallenged. However, unless these principles — of human rights and fair administration of justice — were properly upheld by the courts, sadly they may have remained in the world of the metaphysical.

It is with this context in mind that I turn to reflecting on the Principles and Guidelines on Human Rights and Public Health Emergencies (“Principles”).

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An ordinary classroom in an African school.

Two Years On: The Reversal of Tanzania’s Education Policies for Adolescent Mothers

By Joelle Boxer

In November 2021, Tanzania’s Ministry of Education reversed a policy preventing adolescent mothers from attending public schools. Two years on, research shows the movement for #ArudiShuleni (“Back to School”) requires continued support.

Prior to the policy change, an estimated 6,55015,000 Tanzanian girls and adolescents were forced out of school each year due to pregnancy, while thousands more were subject to coercive pregnancy testing. The reversal has fundamental implications at the intersection of rights to sexual and reproductive health care and education.

This article will review the expulsion policy, efforts leading to its reversal, and the government’s recent re-entry guidelines, with a focus on the driving role of civil society.

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U.S. Supreme Court

Context Matters: Affirmative Action, Public Health, and the Use of Population-Level Data

By Wendy E. Parmet, Elaine Marshall & Alisa K. Lincoln

Last June, in Students for Fair Admissions (SFFA), the Supreme Court ruled that universities could not consider race in admitting students. In support of that decision, the Court dismissed the relevance of data about the varied experiences of racial groups, insisting that admissions decisions must be based solely on the experiences and merits of individual applicants. The Court’s rejection of group-level data evinces a critical misunderstanding about the uses and limits of such data that, if applied more broadly, portends troubling implications for health equity and health policy.

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Women take part in a march in defense of legal abortion on International Safe Abortion Day at Paulista Avenue in Sao Paulo, Brazil, on September 28, 2023.

Why We Still Need a Day for Global Action to Decriminalize Abortion in Latin America

By Alma Beltrán y Puga

More than 30 years have passed since women gathered for the Fifth Feminist Latin American Meeting in Argentina and launched the September 28th Campaign in favor of decriminalizing abortion in the region.

The initiative, however, remains painfully relevant, as still today most countries in Central America and the Caribbean prohibit abortion even in cases of sexual violence and instances where the pregnant woman’s health (and, potentially, life) is at stake. Nicaragua, Honduras, El Salvador and the Dominican Republic hold the most restrictive abortion laws in the region.

Change may happen soon, though, as the Interamerican Court of Human Rights (IACtHR) is set to decide an abortion case from El Salvador; the case of Beatriz, which hopefully will catalyze reform to discriminatory abortion laws.

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Puebla, Mexico - September 28, 2020: With green scarves, members of feminist collectives demonstrate in the streets of the Historic Center of Puebla to demand the legalization of abortion.

Sex Equality in #SeptiembreVerde: Examining the Mexican Supreme Court’s Abortion Decriminalization Decision

By Joelle Boxer

Earlier this month, Mexico’s Supreme Court issued a ruling decriminalizing abortion nationwide, setting a powerful example in the global trend of abortion law liberalization, including on the grounds of sex equality.

Hailed as “incredible” by reproductive justice advocates, the decision will be most impactful in the 20 Mexican states where local laws still criminalize abortion, potentially removing access barriers for more than 42 million women.

This article will explain the origins of the case, what the decision holds, and what it says about sex equality.

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a man waves an intersex-inclusive progress pride flag in the wind on the sky.

Certainty and Uncertainty in Trans-Intersex Science Politics

By Maayan Sudai

Joanna Wuest’s Born This Way: Science, Citizenship, and Inequality in the American LGBTQ+ Movement describes the evolution of the “born this way” framework through pivotal moments in the history of the LGBTQI+ movement.

A central theme of the book’s analysis is the role that “certainty” and “uncertainty” play in the legitimation of science-based policy regarding sexuality and gender issues. Uncertainty of what might happen has been pitted against LGBTQI+ reforms, from when conservative researchers and practitioners argued the exposure of young children to an openly gay guardian or schoolteacher could be harmful (p.92), to present-day attempts to leverage uncertainty to block trans access to sex-segregated bathrooms, prisons, and shelters (p.181).

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Medical Caduceus Symbol as Scales with backlight over Wall in dark room.

Gender-Affirming Care, Abortion, and the Politics of Science: A Response to Wuest’s ‘Born this Way’

By Aziza Ahmed

On August 21, 2023, the 11th Circuit issued a decision that allowed a ban on transgender care to go into effect in Alabama. The Alabama ban, formally called the Alabama Vulnerable Child Compassion and Protection Act, is one of the most extreme of the many bans on gender affirming care. The law defines sex as the “biological state of being female or male, based on sex organs, chromosomes and endogenous hormone profiles…genetically encoded into a person at the moment of conception…” and targets physicians who might undermine this notion of sex with criminal prosecution. Their punishment could be up to ten years in prison.

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