scales on blue background.

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

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.

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gavel and old papers on grey background.

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

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.

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LOMBARDIA, ITALY - FEBRUARY 26, 2020: Empty hospital field tent for the first AID, a mobile medical unit of red cross for patient with Corona Virus. Camp room for people infected with an epidemic.

Non-State Actors and Public Health Emergencies

By Rossella De Falco

Strong, well-coordinated and resilient public health care services play a vital role in preventing and responding to public health crises. Under international human rights law, States have a positive, primary obligation to ensure that such health care services are of the highest possible quality and accessible to everyone, everywhere, and without discrimination.

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Making Explicit a Rights-Based Approach to Infodemic in a Public Health Emergency

By Calvin Wai-Loon Ho

With the mainstreaming of digital technology across many spheres of social life, infodemic management must be an integral part of public health emergency prevention, preparedness, response, and recovery.

While the Principles and Guidelines on Human Rights and Public Health Emergencies (the Principles) do not make explicit reference to infodemics, the application of digital technologies in response to a public health emergency is a clear concern. This article provides further elaboration and critique of the Principles and their treatment of this emergent phenomenon.

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Bill of Health - Globe and vaccine, covid vaccine

COVID-19 Showcased Failed Global Cooperation

By Kayum Ahmed, Julia Bleckner, and Kyle Knight

In mid-May, the World Health Organization officially declared  the “emergency” phase of the COVID-19 pandemic over. However, the deep wounds of the pandemic remain, compelling  those concerned about this pandemic and  future health emergencies to account for catastrophic failures by those in power. These reflections suggest that the public health crisis could have been addressed differently, both reducing COVID-19’s unprecedented magnitude of illness and death, and preserving human dignity.

The COVID-19 pandemic isn’t over, and the end of this pandemic’s emergency phase certainly doesn’t mean we accept the widely abysmal response as the model for the world’s reaction to the next one. Public health emergencies aren’t entirely preventable. We live in a complex world where health is increasingly affected by a changing climate, extraordinary levels of pollution, and inadequate preventive and responsive health services. Emergencies will happen. But when they do, responses that uphold human rights need to be the norm.

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Risograph clenched, raised fists with speech bubble and geometric shapes, trendy riso graph design.

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

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

Today, as the world transitions from living in the grips of a novel coronavirus to living with an entrenched, widespread infectious disease known as COVID-19, global appreciation for the human rights implications of public health crises are once again rapidly fading from view.

Against the backdrop of this burgeoning collective amnesia, a project to articulate the human rights norms relevant to public health emergencies led to the development of the 2023 Principles and Guidelines on Human Rights and Public Health Emergencies (the Principles).

This symposium gathers reflections from leading scholars, activists, jurists, and others from around the world with respect to the recently issued Principles.

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Bill of Health - Globe and vaccine, covid vaccine

Reclaiming Global Public Health

By Zain Rizvi

By December 2020, the world had astonishingly powerful tools against COVID-19. New mRNA vaccines, underpinned by decades of public investment, had been authorized by global regulators. Yet the promise of the vaccines was unevenly realized: deep fault lines emerged between those who were able to secure vaccines and those left behind, or what South Africa’s president Cyril Ramaphosa called “vaccine apartheid.”

Dose shortages elevated the role of pharmaceutical executives. Fielding calls from heads of state, they decided what vaccine deliveries to prioritize, shaping which countries could protect lives and livelihoods. The answer to one of the most important public health questions of our time — who gets access to vaccines? — was mostly determined neither by political representatives nor scientists, but by corporate executives.

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Bill of Health - Globe and vaccine, covid vaccine

Decolonizing the Pandemic Treaty Through Vaccine Equity

By Tlaleng Mofokeng, Daniel Wainstock, and Renzo Guinto

In recent years, there have been growing calls to “decolonize” the field of global health. Global health traces its roots back to colonial medicine when old empires sought to address tropical diseases which, if not controlled, could be brought by colonizers back home.

Today, many countries in the Global South may have already been liberated from their colonizers, but the colonial behavior of global health continues to manifest in policies, funding, research, and operations.

Unlike the tropical diseases of the past, SARS-CoV-2 has affected rich and poor countries alike, but the tools for putting this pandemic under control — most notably vaccines — remain unevenly distributed across the world. As of October 27, 2021, 63.5% of individuals in high-income countries have been vaccinated with at least one shot of the COVID-19 vaccine. Meanwhile, in low-income countries, only 4.8% of the population has been vaccinated with at least one dose.

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Mexico City 03082021 Feminist march against gender violence, March 8 in Mexico thousands of women protest in the streets for safety and better living conditions, using banners.

Strengthening Global and National Governance for Gender Equality in Health Emergencies

By Anna Coates

An international instrument on pandemic preparedness and response opens a much-needed space to highlight the centrality of gender inequality considerations in health emergency responses.

With an eye to inclusive governance, investment in gender expertise, and strengthening existing normative mechanisms and architecture for gender equality at global and national levels, a new intergovernmental instrument offers an opportunity for future health emergency preparedness and responses to meaningfully contribute to gender equality.

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Vial and syringe.

The Pandemic Treaty and Intellectual Property Sharing: Making Vaccine Knowledge a Public Good 

By Ellen ‘t Hoen

The COVID-19 pandemic has laid bare the lack of regulation for the sharing of intellectual property (IP) and technology needed for an effective and equitable response to the crisis.

The Pandemic Treaty (or other legal instrument) scheduled for discussion at the World Health Assembly in the fall of 2021 should focus on establishing the norm that the IP and knowledge needed to develop and produce essential pandemic health technologies become global public goods. It should also ensure predictable and sufficient financing for the development of such public goods.

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