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"Yamin, Alicia Ely"
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Travel restrictions and variants of concern: global health laws need to reflect evidence
As the coronavirus disease 2019 (COVID-19) spread in the early days of the pandemic, governments neglected World Health Organization (WHO) guidance and imposed travel restrictions. These public health measures employed varied levels of restrictiveness at national borders, in some cases banning all travel between countries. Where these border control measures were undertaken for domestic political reasons, enacted without consideration of public health evidence, they divided the world when solidarity was needed most.1 Such measures undermined global health law that countries have established as a foundation for preventing and responding to public health emergencies of international concern. With the emergence of the Omicron variant, national governments once again returned to international travel restrictions, posing challenges for the rule of law in global health governance. Future reforms of global health law must account for this continuing impulse to enact travel restrictions, ensuring that international legal obligations reflect evolving public health evidence. The International Health Regulations, 2005 revision; IHR (2005) govern how countries address collective threats in global solidarity; yet international travel bans can drive countries apart through economic isolation, trade disruptions, discriminatory restrictions and rights violations.2 Fearing that government actions would undermine the IHR at the start of the COVID-19 pandemic, the Global Health Law Consortium in February 2020 examined the legality of targeted travel restrictions.3
Journal Article
Universal health coverage, priority setting, and the human right to health
Following endorsement by WHO,1,2 the World Bank,3 and the UN's Sustainable Development Goals,4 the drive towards universal health coverage (UHC) is now one of the most prominent global health policies. As countries progress towards UHC, they are forced to make difficult choices about how to prioritise health issues and expenditure: which services to expand first, whom to include first, and how to shift from out-of-pocket payment towards prepayment.
Journal Article
Pandemic treaty needs to start with rethinking the paradigm of global health security
[...]institutional arrangements for global health security need to be based on fundamental human rights principles as well as the specific legally binding norms in treaties countries have already ratified. Universal access to healthcare, the essential role of public health infrastructures and ensuring substantive equality for diverse human beings’ needs are core principles that underpin human rights in relation to health. Fifth, the geography of COVID-19 should make us question the criteria and institutions that might assess pandemic preparedness. [...]the surge of cases in India starting in early 2020, global incidence and deaths from COVID-19 have been overwhelmingly concentrated in North America and Western Europe.
Journal Article
Power, Suffering, and the Struggle for Dignity
Directed at a diverse audience of students, legal and public health practitioners, and anyone interested in understanding what human rights-based approaches (HRBAs) to health and development mean and why they matter, Power, Suffering, and the Struggle for Dignity provides a solid foundation for comprehending what a human rights framework implies and the potential for social transformation it entails. Applying a human rights framework to health demands that we think about our own suffering and that of others, as well as the fundamental causes of that suffering. What is our agency as human subjects with rights and dignity, and what prevents us from acting in certain circumstances? What roles are played by others in decisions that affect our health? How do we determine whether what we may see as \"natural\" is actually the result of mutable, human policies and practices?Alicia Ely Yamin couples theory with personal examples of HRBAs at work and shows the impact they have had on people's lives and health outcomes. Analyzing the successes of and challenges to using human rights frameworks for health, Yamin charts what can be learned from these experiences, from conceptualization to implementation, setting out explicit assumptions about how we can create social transformation. The ultimate concern of Power, Suffering, and the Struggle for Dignity is to promote movement from analysis to action, so that we can begin to use human rights frameworks to effect meaningful social change in global health, and beyond.
eBook
Chasing Accountability in Global Health
The story of United Nations (UN) efforts to create an independent mechanism to foster greater accountability across global health is one of high hopes, missed opportunities and, ultimately, planned project failure. The creation of the UN Secretary-General’s Independent Accountability Panel on Women’s, Children’s and Adolescents’ Health (IAP) in 2016 was born out of the idea that accountability was the missing link to achieve progress on the Sustainable Development Goals related to women’s, children’s, and adolescents’ health. The IAP produced four reports before it was dissolved in 2020. Subsequently, other independent accountability mechanisms have been proposed, such as for antimicrobial resistance. In this paper, I draw on my experience as a member of the IAP to examine the context for the creation of the IAP and share four lessons as to why meaningful accountability has been so elusive in global health and how future efforts might benefit from these insights. These lessons relate to the need for (1) normative grounding; (2) institutional legitimacy; (3) genuine independence; and (4) conceptual clarity with respect to the meaning of accountability. I conclude by arguing that the deeply neoliberal and colonial architecture of global governance for health constrains possibilities for transformative accountability. In telling this story, I do not pretend to represent the views of other IAP members, who may have very different reflections.
Journal Article
Human rights parables for a post-pandemic world
Against this context, Foundations of Global Health & Human Rights, edited by Lawrence Gostin and Benjamin Mason Meier, positions itself clearly, making an appeal to human rights as the expression of global justice, and articulating human rights implementation through global governance as an aspirational ideal. John Tobin on the right to health under international law; Colleen Flood on judicialisation of health rights; Brigit Toebes on non-communicable diseases; Aziza Ahmed on reproductive justice; Joseph Amon on human rights advocacy; and Stephen Marks on the right to development. Others may seek out additional reading, including from spectacular scholars and practitioners in the Global South, to complicate this knowledge discourse and to understand the many fault lines and critical debates around accounts of deploying human rights in global health.
Journal Article
Do not violate the International Health Regulations during the COVID-19 outbreak
Article 43 of this legally binding instrument restricts the measures countries can implement when addressing public health risks to those measures that are supported by science, commensurate with the risks involved, and anchored in human rights.1 The intention of the IHR is that countries should not take needless measures that harm people or that disincentivise countries from reporting new risks to international public health authorities.2 In imposing travel restrictions against China during the current outbreak of 2019 novel coronavirus disease (COVID-19), many countries are violating the IHR. WHO has issued COVID-19 technical guidance on several such measures, including risk communication, surveillance, patient management, and screening at ports of entry and exit.9 Third, and most importantly, Article 3.1 strictly requires all additional health measures to be implemented “with full respect for the dignity, human rights and fundamental freedoms of persons”,1 which in turn must reflect the international law principles of necessity, legitimacy, and proportionality that govern limitations to and derogations from rights and freedoms.10 Under no circumstances should public health or foreign policy decisions be based on the racism and xenophobia that are now being directed at Chinese people and those of Asian descent.11 Many of the travel restrictions implemented by dozens of countries during the COVID-19 outbreak are therefore violations of the IHR.12 Yet, perhaps even more troubling, is that at least two-thirds of these countries have not reported their additional health measures to WHO,12 which is a further violation of IHR Articles 43.3 and 43.5. [...]the IHR only governs countries, not corporations and other non-governmental actors. [...]some countries are finding themselves with de-facto travel restrictions when airlines stop flying to places affected by COVID-19.
Journal Article
Sexual and Reproductive Health & Rights: Advances and Setbacks
This article first describes shifts in human rights law that have led to improvements in the realization of sexual and reproductive health and rights (SRHR) over the last decade. The article does so, however, with careful attention to the structural factors beyond formal legal mechanisms that may undermine the ability of governments, even with the best of intentions, to fully develop the necessary robust health and justice systems. Second, this article considers two additional factors: the political economy factors that enable or limit the ability of States to realize SRHR, as well as the growing evidence base that supports positive legal transformation.
Journal Article
The legal determinants of health: harnessing the power of law for global health and sustainable development
Health risks in the 21st century are beyond the control of any government in any country. In an era of globalisation, promoting public health and equity requires cooperation and coordination both within and among states. Law can be a powerful tool for advancing global health, yet it remains substantially underutilised and poorly understood. Working in partnership, public health lawyers and health professionals can become champions for evidence-based laws to ensure the public’s health and safety. This Lancet Commission articulates the crucial role of law in achieving global health with justice, through legal instruments, legal capacities, and institutional reforms, as well as a firm commitment to the rule of law. The Commission’s aim is to enhance the global health community’s understanding of law, regulation, and the rule of law as effective tools to advance population health and equity.
Journal Article