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This viewpoint discusses the challenges of accountability faced by individuals engaged in the sex trades who are also victims of abuse by state actors. The authors describe their participatory action research project with sex workers to explore forms of accountability. They highlight the need to address police abuse and the lack of recourse for victims. The text also discusses the impact of increased policing on marginalized communities and the efforts of organizations to resist surveillance and state violence. The authors emphasize the importance of recognizing power imbalances and working towards transformative justice. They suggest that participatory action research can support advocacy efforts and help create more just systems by addressing power structures and inequities.

This viewpoint discusses the importance of upholding non-retrogression in the human rights system, particularly in relation to gender-based violence and accountability norms. The authors, a collective of academics and advocates, highlight the need for comprehensive standards that recognize new understandings of harm and extend state obligations to prevent abuses by nonstate actors. They argue that conflicting expert statements on gender and gender-based violence can lead to normative retrogressions, threatening decades of progress in gender analysis. The authors critique the current practices of the UN Special Rapporteur on violence against women and girls, pointing out normatively retrogressive efforts that undermine existing protections. They emphasize the principles of non-retrogression and accountability as essential for the prevention of gender-based violence and the protection of health rights. The authors call for greater transparency, ethical practices, and constructive civil society critiques to guide and safeguard professional practices by experts and ensure the independence of the human rights system., particularly in relation to gender-based violence. The authors, highlight the need for comprehensive standards that recognize new understandings of harm and extend state obligations to prevent abuses by nonstate actors. They argue that accountability norms for gender-based violence are essential for advancing state accountability and protecting the right to health. The authors critique UN expert practices that contribute to normative retrogressions and call for constructive civil society critiques to guide and safeguard professional practices. They specifically focus on the UN Special Rapporteur on violence against women and girls, highlighting normatively retrogressive efforts that threaten fragile achievements in gender equality. The authors emphasize the principles of non-retrogression and accountability in human rights law, stressing the importance of maintaining existing standards while expanding human rights protections. They propose that the Office of the United Nations High Commissioner for Human Rights take a more strategic and proactive approach to ensuring transparency and ethical practices within the UN human rights system.

Introduction of Vibrio cholerae to Haiti during the deployment of United Nations (UN) peacekeepers in 2010 resulted in one of the largest cholera epidemics of the modern era. Following the outbreak, a UN-commissioned independent panel recommended three pre-deployment intervention strategies to minimize the risk of cholera introduction in future peacekeeping operations: screening for V. cholerae carriage, administering prophylactic antimicrobial chemotherapies, or immunizing with oral cholera vaccines. However, uncertainty regarding the effectiveness of these approaches has forestalled their implementation by the UN. We assessed how the interventions would have impacted the likelihood of the Haiti cholera epidemic. We developed a stochastic model for cholera importation and transmission, fitted to reported cases during the first weeks of the 2010 outbreak in Haiti. Using this model, we estimated that diagnostic screening reduces the probability of cases occurring by 82% (95% credible interval: 75%, 85%); however, false-positive test outcomes may hamper this approach. Antimicrobial chemoprophylaxis at time of departure and oral cholera vaccination reduce the probability of cases by 50% (41%, 57%) and by up to 61% (58%, 63%), respectively. Chemoprophylaxis beginning 1 wk before departure confers a 91% (78%, 96%) reduction independently, and up to a 98% reduction (94%, 99%) if coupled with vaccination. These results are not sensitive to assumptions about the background cholera incidence rate in the endemic troop-sending country. Further research is needed to (1) validate the sensitivity and specificity of rapid test approaches for detecting asymptomatic carriage, (2) compare prophylactic efficacy across antimicrobial regimens, and (3) quantify the impact of oral cholera vaccine on transmission from asymptomatic carriers. Screening, chemoprophylaxis, and vaccination are all effective strategies to prevent cholera introduction during large-scale personnel deployments such as that precipitating the 2010 Haiti outbreak. Antimicrobial chemoprophylaxis was estimated to provide the greatest protection at the lowest cost among the approaches recently evaluated by the UN.

Readers of Sexual and Reproductive Health Matter are no strangers to interrogating evidence in all its forms, assessing which claims it can support, and about challenges and uncertainties in international norms in the fields of sexual and reproductive rights and health. Questions of evidence, positionality and the role of testimony are particularly live in the context of sex work and human rights. As an exploration about good and bad practices in research and evidence, in this Commentary we highlight the errors, mistakes and wrongly shaped conclusions arising in the recent report by the UN Special Rapporteur on violence against women and girls about prostitution law, sex worker health and rights, and the status of international human rights law on sex work and trafficking. We do this not only to reinforce more accurate information about the status of human rights law, public health evidence and the needs of people of all genders in the sex sector, but also as an opportunity to remind us of the principles around evidence, transparency, and self-determination. We are conscious of the current vulnerability of global rights and health systems. Our Commentary seeks to contextualise our criticisms to this current moment of rights and health systems' fragility and multi-pronged attacks on the emancipatory potential of rights for persons in the sex sector as workers especially as they intersect with racist stereotypes. Practices of deploying evidence matter for rights advocacy: its legitimacy as well as its efficacy depend on good practices.

This Guide seeks to provide insight and resources to actors interested in the development of rights claims around sexuality and sexual health. After engaging with the vexed question of the scope of sexual rights, it explores the rules and principles governing the way in which human rights claims are developed and applied to sexuality and sexual health, and how that development is linked to law and made a matter of state obligation. This understanding is critical to policy and programming in sexual health and rights, as it supports calling on the relevant range of human rights, such as privacy, non-discrimination, health or other universally accepted human rights, as well as demanding the action of states under their international and national law obligations to support sexual health. Ce Guide cherche à transmettre des connaissances et des ressources aux acteurs intéressés par le développement de revendications relatives aux droits autour de la sexualité et la santé sexuelle. Après avoir abordé la question controversée de la portée des droits sexuels, il explore les règles et les principes qui gouvernent la manière dont les revendications fondées sur les droits de l’homme sont développées et appliquées à la sexualité et la santé sexuelle, et comment ce développement est lié à la législation et devient une obligation étatique. Cette compréhension est essentielle pour définir les politiques et la programmation en matière de santé et droits sexuels, car elle soutient les actions exigeant de bénéficier de tout l’éventail des droits de l’homme, comme la protection de la vie privée, la non-discrimination, la santé ou d’autres droits fondamentaux acceptés universellement, tout en demandant aux États de prendre des mesures au titre de leurs obligations juridiques nationales et internationale de soutenir la santé sexuelle. Esta Guía tiene como objetivo brindar conocimientos y recursos a los actores interesados en la formulación de afirmaciones de derechos relacionados con la sexualidad y salud sexual. Después de abordar la controvertida cuestión del alcance de los derechos sexuales, explora las reglas y principios que rigen la manera en que las afirmaciones de derechos humanos son formuladas y aplicadas a la sexualidad y salud sexual, y cómo esa formulación está vinculada con la ley y pasa a ser cuestión de obligación del Estado. Este entendimiento es fundamental para las políticas y programación en salud y derechos sexuales, ya que apoya hacer un llamado a los diversos derechos humanos pertinentes, tales como privacidad, no discriminación, salud u otros derechos humanos aceptados universalmente, así como exigir que los Estados tomen medidas, de conformidad con sus obligaciones de derecho internacional y nacional, para apoyar la salud sexual.

Although women's rights advocates came to human rights demanding accountability for all human rights, this demand has been stymied. Specific elements of violence against women (VAW) as a human rights issue, coupled with sexual harm's particular operation to make VAW visible, produced a parodox: the harms themselves are not yet effectively responded to, yet women's sexual vulnerability is now firmly on the global agenda. This piece explores the state-oriented focus of rights work on the suffering body, its reliance on criminal law, and its failure to develop a theory of economic justice. Health and human rights work must consider the complexities of portraying women as sexual agents, targets of abuse and citizens at the same time, if it seeks to fulfill its original promise. /// Bien que les partisans des droits des femmes soient venus aux droits humains en exigeant une obligation de rendre compte pour tous les droits humains, cette demande n'a pas abouti. Des éléments particuliers de la violence à l'égard des femmes en tant que sujet des droits humains, combinés à la façon particulière dont les exactions sexuelles rendent la violence visible à l'égard des femmes, ont abouti à un paradoxe: il n'a pas été remédié effectivement aux torts par eux-mêmes, mais la vulnérabilité sexuelle des femmes figure maintenant fermement dans le programme d'action mondial. Cet article explore la priorité accordée par les États à la protection du corps contre la souffrance, son recours au droit pénal et l'absence de formulation d'une théorie de la justice économique. Les activistes défendant le droit à la santé et les droits humains doivent tenir compte des complexités des femmes productives dans leur rôle sexuel, comme objects d'abus et comme citoyennes, tout en s'efforçant de tenir leurs promesses initiales. /// A pesar de que los partidarios de los derechos de la mujer se dirigieron a las instituciones de derechos humanos exigiendo el respeto de todos los derechos humanos, tal demanda ha sido frustrada. Elementos específicos de violencia contra la mujer (VCM) como tema de derechos humanos junto al papel particular del daño sexual en hacer visible la VCM, produjo la siguiente paradoja: aún no se responde efectivamente a los daños en sí, y, sin embargo, la vulnerabilidad sexual de la mujer se encuentra ahora bien establecida en la agenda política mundial. En este artículo, se estudia el enfoque sobre el estado del campo de los derechos humanos, y como con relación a la sexualidad el teoría ha centrado en el sufrimiento del cuerpo, y ha mostrado una dependencia en las leyes penales y una falta de desarrollar una teoría de justicia económica. El campo de salud y derechos humanos, para cumplir con su promesa original, debe considerar las complejidades de presentar a la mujer como agente sexual, blanco de abuso, y ciudadana--todo al mismo tiempo.

Abstract Although past resistance to sexual rights in global debates has often been grounded in claims to culture, nation and religion, opposition voices are now using, rather than rejecting, the frame of international human rights. This Commentary argues that, despite opponents’ attempts to defeat sexual rights with other rights claims, a careful understanding of the principles of international human rights and its legal development exposes how the use of rights to oppose sexual rights should, and will ultimately, fail. The Commentary briefly takes up three kinds of “rights” claims made by opponents of sexual rights: limiting rights to protect rights, textual basis, and universality, and explores the rationales and impact of their application to countering sexual rights. Because sexuality and reproduction intersect as well as diverge in the opposition they face, this struggle matters intensely and plays out across advocacy, programmatic and policy worlds. Underpinning this Commentary is the understanding that opposition to sexual and reproductive health rights uses common arguments about rights principles that must be understood in order to be countered.

Over the past 20 years, advocates have gained formal recognition for some rights in sexuality and reproduction and established the application of human rights standards to sexual and reproductive health issues more generally. However, careful reflection on the state of norm development across sexuality and reproduction as a field reveals fractures and stagnation in the development of standards, and a lack of synergy among advocates and between frameworks for similar rights. This paper seeks to stimulate a more careful accounting for these realities. It examines the formal processes and rules guiding standard-setting, in light of the different intellectual and ideological genealogies of sexual and reproductive rights. We use (homo)sexual orientation and abortion as case studies of current high-profile human rights standard-setting, with specific attention to the contemporary state of human rights law-making in the United Nations today. By placing these two issues in conjunction, we seek to make visible relationships between the vicious political debates in the UN on abortion and sexual orientation, and the multiple and sometimes divergent statements of independent experts and expert bodies in the UN human rights system on these and other sexual and reproductive rights issues. We offer no answers but seek to highlight the need for more investigation and self-reflection by advocates and scholars on how these forces operate and how to work with them. Ces 20 dernières années, le plaidoyer a obtenu la reconnaissance de certains droits en matière de sexualité et de procréation, et établi une application plus généralisée des normes des droits de l'homme aux questions de santé génésique. Néanmoins, une réflexion attentive révèle des fractures et une stagnation dans la formulation de normes sur la sexualité et la procréation, et un manque de synergie parmi les activistes et entre des cadres pour des droits similaires. Cet article s'efforce d'encourager une analyse plus précise de ces réalités. Il examine les processus formels et les règles guidant la définition des normes à la lumière des différentes généalogies intellectuelles et idéologiques des droits génésiques. Nous utilisons l'orientation (homo)sexuelle et l'avortement comme études de cas sur des questions très en vue qui font actuellement l'objet d'une formulation de normes sur les droits de l'homme, avec une attention particulière à l'état de la rédaction d'instruments juridiques relatifs aux droits de l'homme dans le système des Nations Unies aujourd'hui. En confrontant ces deux questions, nous souhaitons établir des liens visibles entre les débats politiques virulents aux Nations Unies sur l'avortement et l'orientation sexuelle, et les déclarations multiples, et parfois divergentes, d'experts indépendants et d'organes spécialisés du système des Nations Unies sur ces questions et d'autres en rapport avec les droits génésiques. Nous ne proposons pas de réponse, mais voulons souligner la nécessité pour les activistes et les chercheurs d'élargir leurs recherches et leur autoréflexion sur la manière dont ces forces opèrent et comment il est possible de travailler avec elles. En los últimos 20 años, los defensores de los derechos humanos lograron cierto reconocimiento oficial de algunos derechos en sexualidad y reproducción y establecieron la aplicación de los estándares de derechos humanos a los asuntos de salud sexual y reproductiva en general. No obstante, una cuidadosa reflexión sobre el estado de la elaboración de normas en el campo de la sexualidad y reproducción revela fracturas y estancamiento en la elaboración de estándares y falta de sinergia entre defensores y entre los marcos de similares derechos. Este artículo intenta estimular una explicación más cuidadosa de estas realidades. Se examinan los procesos y las reglas oficiales que guían el establecimiento de estándares, en vista de las diferentes genealogías intelectuales e ideológicas de los derechos sexuales y reproductivos. Se utilizan la orientación (homo)sexual y el aborto como estudios de casos de temas preponderantes en la actualidad con relación a la elaboración de estándares de derechos humanos, prestando atención específica al estado contemporáneo del proceso legislativo de los derechos humanos en las Naciones Unidas. Al plantear estos dos asuntos en conjunción, procuramos crear relaciones visibles entre los despiadados debates políticos de las Naciones Unidas respecto al aborto y la orientación sexual, y las múltiples y a veces divergentes declaraciones de expertos independientes y organismos de las Naciones Unidas expertos en el sistema de derechos humanos, con relación a estos y otros asuntos de derechos sexuales y reproductivos. No ofrecemos respuestas sino que procuramos destacar la necesidad de realizar más investigaciones y de que los defensores y especialistas reflexionen sobre cómo funcionan estas fuerzas y cómo se debe trabajar con ellas.

Shifting political alliances and new environmental challenges are prompting debate over processes of sub-regionalisation and whether the interplay between multiple scales of governance leads to positive synergistic outcomes or negative institutional disruption. Regional management of tuna fisheries in the Western and Central Pacific Ocean is an example where a web of treaties, conventions and institutional frameworks underlie international cooperation. Through examining the interplay between the regional Western and Central Pacific Fisheries Commission and sub-regional Parties to the Nauru Agreement, this paper explores the extent to which the PNA and WCPFC interact in the management of regional tuna fisheries. The results demonstrate that for contested marine resources such as fisheries, international sub-regions can go beyond functional units to also present wider opportunities to shift power relations in favour of small island states. Additionally, the presence of sub-regional groups like the PNA has served to challenge the performance of the WCPFC, stimulating greater debate and progress within the regional body. The paper concludes that the combined work of the PNA and the WCPFC puts them ahead on many issues and may represent a testing ground for a functional multilateralism utilising both regional and sub-regional governance platforms for the management of shared resources.

Human rights advocacy today engages with criminal law at international and national levels with a new and rather conflicted posture. It is reorienting from an approach that primarily treated human rights as a shield from (unjust) prosecutorial and carceral power, and toward one calling for criminal penalties and vigorous prosecutions as a remedy for harms. The human rights abuses for which state prosecution is invoked today include not only past and present state violations, such as torture, but crimes by non-state actors, such as sexual and gender-based violence. At the same time, paradoxically, many rights groups are calling for the review and reduction of criminal regulation of a range of sexual and reproductive health practices, including abortion, consensual sexual conduct outside of marriage (same sex, heterosexual, and sex for money), and HIV transmission.