Unseen Scars: The Devastating Impact of Corruption on Mental Health Systems in Low and Middle-Income Countries

by Daniela Cepeda Cuadrado

There is a wealth of research demonstrating that corruption — the abuse of entrusted power for private gain — has contributed to weakening health systems and worsening public health globally. Corruption is associated with a higher infant mortality rate, the rise of antimicrobial resistance, and the diversion of key resources to invest in strengthening health systems. Corruption’s impact on health systems is well documented – that is if we see health systems only as the structures in place to cater to people’s physical health needs.

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Photo of Alicia Ely Yamin doing fieldwork courtesy of Marion Brown.

Q&A with PFC Director of Global Health and Rights Project, Alicia Ely Yamin

Alicia Ely Yamin J.D. (1991), M.P.H. (1996), Ph.D. is a Lecturer on Law and the Director of the Global Health and Rights Project at the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics (PFC) at Harvard Law School; Adjunct Senior Lecturer on Health Policy and Management at the Harvard TH Chan School of Public Health; and Senior Adviser on Human Rights and Health Policy at the global health justice organization, Partners In Health.

Frequently labelled a scholar-activist, she combines academic research and scholarship that bridges law, development, and public health with grassroots work and policy advocacy. She has lived in seven countries on four continents, and worked with and for local advocacy organizations, including co-founding a program on health and human rights in the Asociación Pro Derechos Humanos (Lima, Peru; 1999).

In the interview below, she shares more about her career and life.

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Clockwise from top left: Daniela Cepeda Cuadrado, Lucía Berro Pizzarossa, Natalia Pires de Vasconcelos, Thalia Viveros Uehara

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

(Clockwise from top left: Daniela Cepeda Cuadrado, Lucía Berro Pizzarossa, Natalia Pires de Vasconcelos, Thalia Viveros Uehara)

The Petrie-Flom Center is excited to welcome four new affiliated researchers to the Global Health and Rights Project (GHRP).

Through regular contributions to Bill of Health, as well as workshops and other projects, GHRP affiliated researchers will bring their expertise to bear on both national and global problems, advancing critical socio-legal scholarship both within and beyond Latin America. We look forward to learning from and sharing their insights with a wider audience, and to contributing to enlarging international networks of critical praxis in global health and human rights.

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Close-up Of An Open Law Book On Wooden Desk In Courtroom.

Can Rights Make Any Difference for Access to Health? Insights from a Scoping Review on Constitutional Rights for the WHO Council on the Economics of Health for All

By Luciano Bottini Filho, Camila Gianella Malca, and Alicia Ely Yamin

The intersection of health financing and the right to health is a common concern in public health advocacy. However, it is challenging to isolate the mechanisms that connect individuals’ rights with increased public investment. As scholars, we grapple with the question of what happens once the right to health is constitutionalized and whether it has a transformative effect on the economy, government funding, and the material reality people face in struggling health care systems. In this article, we shed light on this significant gap between the adoption of the right to health through constitutions or legislation and actual changes in the economy and government funding for health. Our study was commissioned by the WHO Council on the Economics of Health for All, which received the mandate of formulating a new global economic model to achieve health for all.

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Blue biohazard sign in front of columns of binary code.

The International Weaponization of Health Data

By Matthew Chun

International collaboration through the sharing of health data is crucial for advancing human health. But it also comes with risks — risks that countries around the world seem increasingly unwilling to take.

On the one hand, the international sharing of health-related data sets has paved the way for important advances such as mapping the human genome, tracking global health outcomes, and fighting the rise of multidrug-resistant superbugs. On the other hand, it can pose serious risks for a nation’s citizens, including re-identification, exploitation of genetic vulnerabilities by foreign parties, and unauthorized data usage. As countries aim to strike a difficult balance between furthering research and protecting national interests, recent trends indicate a shift toward tighter controls that could chill international collaborations.

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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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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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Doctors performing surgery.

The Need to Go Back to Basics in Patient Safety

By John Tingle and Amanda Cattini

In the hustle and bustle of our daily professional lives, it is sometimes all too easy to forget about the basics. In terms of health care practice and patient safety, these underpinning basic, foundational concepts include the need for proper patient communication strategies.

The consequences of failures in patient communication can be devastating. There is a need to go back to this basic issue at regular intervals.

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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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Illustration of multicolored profiles. An overlay of strings of ones and zeroes is visible

Taking Data Sharing Seriously: Public Interest and Solidarity as Principles for an International Pandemic Treaty

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

By Ciara Staunton and Deborah Mascalzoni

COVID-19 demonstrated the interconnectedness of the world and that our collective protection and well-being is contingent on our individual response. The importance of solidarity and acting in the public interest became key messages in public health, as too were these principles justified as the basis for data-sharing across borders. Accessing this data was critical and its timely access to this data was essential in research for the much-needed new vaccines.

Solidarity can be understood as the commitment to carry costs to assist others. In the same way that we were told to keep away from loved ones (the cost) to stop the spread of the virus (to assist others), individuals were encouraged to share their data with researchers and in turn researchers were encouraged to share their data with other researchers (the cost) to develop vaccines (to assist) for the global collective benefit (others). The response was remarkable. Data sharing became the default (the cost), vaccines were rapidly developed (to assist), but herein the solidarity pathway stopped. Access was (and still is) largely driven by national and private interests rather than the global collective benefit.

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