international health regulations

Conclusion to the Symposium: From Principles to Practice: Human Rights and Public Health Emergencies

January 18, 2024January 18, 2024 The Petrie-Flom Center Staff Leave a comment

By Timothy Fish Hodgson, Roojin Habibi, and Alicia Ely Yamin

In developing the digital symposium, From Principles to Practice: Human Rights and Public Health Emergencies (which ran from October – December 2023), as editors we endeavored to get scholars, human rights advocates, judges, and policy makers to engage critically with the expert Principles and Guidelines on Human Rights and Public Health Emergencies (the PHE Principles), published by the International Commission of Jurists and the Global Health Law Consortium in May 2023. In doing so, we encouraged contributors to comment on the Principles’ potential usefulness as guidance in addressing real emergency situations, as well as any possible gaps and weaknesses.

While summarizing the entire content of the 13 blogs comprising this symposium in any depth is not possible here, this concluding post will attempt to synthesize some of the major inputs from the contributions. We also provide some of our own observations, as participants in the drafting of the Principles, with the aim of pushing the discussion prompted by the posts forward.

see saw with earth as fulcrum and a pile of vaccines weighing down one side with nothing on the other side.

The Case for Procurement Transparency

December 12, 2023December 4, 2023 The Petrie-Flom Center Staff Leave a comment

By Tara Davis and Nicola Soekoe

In January 2021, the Director General of the World Health Organization (WHO) observed that the world was on the brink of a “catastrophic moral failure” if wealthier nations did not ensure the equitable distribution of COVID-19 vaccines. Global health activists and civil society organizations who worked transnationally to curtail what came to be referred to as “vaccine apartheid” faced a pharmaceutical industry that globally relied on secrecy, capital-friendly trade laws, and brute economic force to shirk considerations of human rights. In many ways, pharmaceutical companies and the states that protected them, including by failing to achieve consensus at the World Trade Organization (WTO) for a waiver of intellectual property rights with respect to vaccines, seemed impenetrable.

Unsurprisingly, given the extreme position of power from which pharmaceutical companies were negotiating contracts, there were widespread reports and allegations of inequitable contractual terms and a culture of bullying in the development of contracts. This was an issue of global concern for a long period during the pandemic. In South Africa, the Health Justice Initiative (HJI), a local advocacy organization, joined the global calls for greater procurement transparency.

However, when the South African Department of Health refused to disclose even the names of the entities with which it had entered into vaccine-related agreements, the HJI was forced to turn to the courts for relief.

Strasbourg, France - April 13, 2018: the Hemicycle of the Parliamentary Assembly of the Council of Europe, PACE.

The Parliamentary Assembly of the Council of Europe: Responding to Public Health Emergencies by Upholding Human Rights, Democracy, and the Rule of Law

December 7, 2023December 7, 2023 The Petrie-Flom Center Staff Leave a comment

By Anita Gholami

The Parliamentary Assembly of the Council of Europe, which brings together parliamentarians from 46 member States, has been a vigilant guardian of respect for the European Convention on Human Rights and other international standards throughout the COVID-19 pandemic. The Assembly has adopted a number of resolutions and recommendations seeking to equip parliaments in our European member States and beyond with the relevant tools and expertise to uphold human rights, democracy and the rule of law. It has been an important forum for enabling States to address the fault lines in national public health systems, bridge gaps in global health security and policy, and strengthen collective efforts to build back better.

In June 2023, the Assembly adopted Resolution 2500 (2023) on “Public health emergency: the need for a holistic approach to multilateralism and health care.” The report supports the ongoing processes taking place at the international level to transform global health governance. It considers that States must build on the principles of equity and the protection of human rights and fundamental freedoms during public health emergencies, and thus makes specific and productive reference to the Principles and Guidelines on Human Rights and Public Health Emergencies (“the Principles”).

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

December 5, 2023December 4, 2023 The Petrie-Flom Center Staff Leave a comment

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.

Public Health Emergencies and Human Rights Principles: A Solidarity Approach

November 30, 2023December 8, 2023 The Petrie-Flom Center Staff Leave a comment

By Anne Kjersti Befring and Cecilia Marcela Bailliet

Introduction

The COVID-19 pandemic posed a grave threat to humanity and revealed the need for a new approach to improve transnational cooperation within the global health system and new perspectives on solidarity addressing the cross-border spread of infection and distribution of vaccines.

The Principles and Guidelines on Human Rights and Public Health Emergencies (“the Principles”), developed by the Global Health Law Consortium and the International Commission of Jurists, set forth a human rights-based solidarity approach that can provide a basis for implementing the obligations of States and responsibilities of Non-State actors to achieve the goal of limiting the harmful effects of serious health crises.

Group of Diverse Kids Playing in a Field Together.

Securing a Place for Children’s Rights in Public Health Emergencies

November 28, 2023November 27, 2023 The Petrie-Flom Center Staff Leave a comment

By Sheila Varadan, Ton Liefaard, and Jaap Doek

The Principles and Guidelines on Human Rights and Public Health Emergencies (Principles) make a significant contribution towards clarifying the scope of States’ legal obligations under international human rights law during public health emergencies. What is missing, however, is a specific and detailed discussion on the rights obligations and principles owed to children during public health emergencies. This leaves open the question of how States will guarantee respect for and protection of children’s rights in future public health emergencies, and what measures, if any, will be taken to ensure children are actively listened to and engaged with in the prevention of, preparedness for, and response to public health emergencies (PPRR).

Judging in the Pandemic – A Malawian Perspective

November 21, 2023November 21, 2023 The Petrie-Flom Center Staff Leave a comment

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”).

Bill of Health - Gavel on mask during pandemic, class action lawsuits during pandemic

Old Dogs and New Tricks: A Case for the Principles and Guidelines on Human Rights & Public Health Emergencies

November 16, 2023November 14, 2023 The Petrie-Flom Center Staff Leave a comment

By Nerima Were and Allan Maleche

Taking into account our experiences as human rights lawyers working in Kenya during the COVID-19 pandemic, in this article we briefly analyze the Principles and Guidelines on Human Rights and Public Health Emergencies (the Principles) and make a case for their utility in guiding State measures to prepare for, prevent, and respond to future pandemics consistently with international human rights law and standards.

Reflections on the United States Health Care System and the Right to Health

November 9, 2023November 8, 2023 The Petrie-Flom Center Staff Leave a comment

By Brianna da Silva Bhatia, Michele Heisler, and Christian De Vos

American health care too often fails to protect the right to health or promote health-related rights. Despite efforts to increase access to health care and to better incentivize high-quality, value-based care, the United States’ health care system remains fragmented, largely profit-based, and predominantly disease-focused rather than prevention-focused.

To design systems and policies that promote the right to health, a holistic and proactive approach is needed, one in which people, institutions, and corporations have a shared responsibility in promoting physical, mental, and social well-being. The Principles and Guidelines on Human Rights and Public Health Emergencies (the Principles), allow us to imagine a new future and help outline a path for how to get there. In this piece, we discuss how the Principles might be applied in a rights-based approach to address some of the core problems in the U.S. health care system.

gavel and old papers on grey background.

Human Rights Principles in Public Health Emergencies: From the Siracusa Principles to COVID-19 and Beyond

November 7, 2023November 6, 2023 The Petrie-Flom Center Staff Leave a comment

By Eric A. Friedman and Lawrence O. Gostin

In 1984, the United Nations Economic and Social Council (ECOSOC) adopted the Siracusa Principles, which state that restrictions on human rights must meet standards of legality, necessity, and proportionality. States must use the least restrictive means available when putting in place rights-restricting measures.

One of us (LG) was involved in the drafting of the Siracusa Principles, which have become the chief international instrument governing permissible human rights limitations during national emergencies. Yet when COVID-19 – the greatest health emergency in a century – devastated the world, the Siracusa Principles seemed unequal to the task – too narrow, including with their remit limited to civil and political rights, not sufficiently specific, and above all, without sufficient accountability.

During the pandemic phase of COVID-19, human rights violations were widespread and spanned the full gamut of rights: from arbitrary detentions and suppression of free expression, to violations of the right to health, failure to ensure sufficient food and other necessities during lockdowns, quarantines, and isolations, and woefully inadequate international cooperation and assistance, including discriminatory travel and trade restrictions.

Extensive abuses of human rights during the pandemic led international experts to draft the Principles and Guidelines on Human Rights and Public Health Emergencies (HR Principles). Firmly embedding these principles in international law and creating accountability will be critical for realizing the HR Principles’ potential.

Tag: international health regulations