Health and Human Rights最新文献

Under the United Nations Framework Convention on Climate Change and its protocols, states have legal obligations to address the climate crisis. The principle of participation is increasingly acknowledged as central to the protection and promotion of human rights, including the right to health. This paper explores states' obligations to address the climate crisis-and concomitant health crises-from a right to health perspective. The right to health lens provides a valuable opportunity for engaging diverse civil society constituencies in the response to the climate crisis. However, civic space must be protected if these actors are to participate meaningfully. The climate crisis discourse has lacked an explicit recognition of the interconnected nature of the right to health, environmental degradation and climate change, and civic space. There is also concern that restrictions on civic space will continue after the COVID-19 pandemic. While the public health community is an important constituency in the design and implementation of laws, policies, and programs to address climate change, the human rights literacy of this community remains to be strengthened. This paper addresses these lacunae within the context of the right to health as enshrined in United Nations human rights treaties and related international law.

Despite the imperatives to reduce coercive practices such as substitute decision-making, seclusion, and restraint, the psychiatric profession has struggled to realize these aspirations. Education delivered by people with lived experience of mental distress can help facilitate change. We introduced a service user-led academic program for psychiatry residents focused on promoting human rights and reducing coercive practices in mental health care. Few published reports of such service user-led education exist. In this qualitative study, we analyze data exploring this new program's impact in practice. Four major themes were identified. Service user-led training was challenging but highly valued and prompted a paradigm shift, changing residents' thinking. Residents had so much promise in their early intentions to reduce coercive practices. However, numerous barriers impeded them from implementing these intentions. Power differentials that existed at multiple levels caused residents to experience themselves as "pawns" playing set roles working under a system with entrenched hierarchies, resource limitations, legislative frameworks, and public expectations operating to maintain the status quo. The apprenticeship model under which psychiatry residents work is a significant socializing influence. If only the "old paradigm" is modeled and taught, then this hinders more progressive thinking. Service user-led education should be offered more broadly.

Researchers and global policy makers are increasingly documenting negative health impacts from climate change, raising concerns for realizing the right to health. Importantly, courts have held that anthropogenic activities affecting climate may threaten a population's standard of health and compromise its inviolable right to health. However, legal hurdles-such as the fragmentation of climate change and human rights laws and the difficulties in proving causal links-hamper efforts to litigate right to health claims in the context of climate change. To address these challenges, this article assesses the detrimental effects of climate change from an international human rights perspective and analyzes climate change litigation to explore potential avenues to press for the right to health in the face of climate change.

Given that the health-related impacts of climate change in Latin America disproportionately affect the most marginalized sections of the population, there is a need to enhance countries' adaptive capacity through improved health systems. Though public health institutions have delineated guidelines to enhance health care systems' preparedness for climate change, embedding a human rights perspective in their translation into laws and policies further adds important value. Crucially, a rights-based approach strengthens health responses to climate change by calling attention to how climate law and policy fail to account for persistent and interlocking socioeconomic inequalities. This is an area that has not been fully present in the provision of health services in Latin America, which rely almost exclusively on a conventional epidemiological perspective and do not consider the historical and sociocultural nature of health challenges. Hence, this paper draws on two case studies-Brazil and Colombia-to identify the extent to which their national climate change laws and adaptation plans incorporate a human rights-based approach in their tasks to enhance their adaptive capacity through the expansion of affordable and quality health care. With respect to the countries' laws, the absence of explicit references to the right to health exemplifies the fragmentation between the international human rights framework and international climate change law. Further, both countries' adaptation plans hold considerable room for improving their engagement with the human rights framework, particularly by establishing mechanisms to promote transparency, monitoring, and the participation of marginalized groups.

Three crises-climate change, the COVID-19 pandemic, and extreme economic and social inequality-intersect and have had devastating impacts on workers' rights to health, as well as the right to decent work, an underlying determinant of health. Yet these crises may act as catalysts, as responses present opportunities for transformation. Indeed, multiple international governance institutions and nongovernmental organizations have proposed new social contracts that aim to address the multiple challenges facing workers today. These initiatives promise to transform society to make workers and their families healthier and the planet more sustainable. They join and supplement earlier efforts at transformation, such as the 2030 Agenda for Sustainable Development. This article critiques (1) the market-fundamentalist neoliberal social contract, which gave rise to, or exacerbated, the three crises, and (2) the 2030 agenda and recent International Labour Organization proposals, which are all built on this neoliberal platform. Finally, the article argues for a social contract that is grounded in human rights-specifically worker rights-to address these crises and ensure greater protection of the health.

Community health workers (CHWs) have the capacity to bring essential health services to under-resourced communities. Globally, CHWs have made significant contributions to poverty alleviation, increased food security, and reductions in health inequalities. India's one million accredited social health activists (ASHAs), the largest cohort of CHWs in the world, have been credited with increasing the rate of institutional deliveries and the uptake of vaccinations. ASHAs operate at the margins of health systems and the formal health workforce, often due to misperceptions of their skills and discrimination based on gender, socioeconomic status, education, and rurality. The "voluntary" nature of their work can entrench their precarious status, which is characterized by a lack of access to employment rights, adequate remuneration, and institutional support. This article argues that the prioritization of the labor rights of CHWs in the design and implementation of the World Health Organization's 2018 Guideline on Health Policy and System Support to Optimize Community Health Worker Programmes can serve to ensure safe working conditions and freedom from discrimination, coercion, and violence. It further argues that the resultant enhancement and protection of CHWs' rights and long-term security provides an essential pathway for harnessing their potential to transform universal health coverage.

The COVID-19 pandemic has shone a bright light on industrial slaughterhouses in the United States and their impacts on the vulnerable beings-both human and animal-they exploit. But the severity of these impacts is the result of a long history of failed regulatory oversight. This paper highlights the inadequacies of the current regulatory system in the United States and how they have contributed to dangerous conditions for slaughterhouse workers, environmental degradation, and severe animal suffering. Further, it argues that a rights-centered One Health approach would provide the necessary conceptual foundation for a new regulatory framework that can meaningfully address the interconnected rights, health, and well-being of humans, animals, and the environment. As a first step in establishing this new framework, the United States should create a federal Slaughterhouse Oversight Commission to strengthen the rights, health, and well-being of humans and animals.

Pesticide exposure and poisoning among children can lead to devastating long-lasting health effects that impact their human rights, with communities in low- and middle-income countries experiencing the negative impacts of pesticides more profoundly than those in high-income countries. While United Nations agencies recommend banning highly hazardous pesticides responsible for serious pesticide poisonings, childhood pesticide poisoning is rarely discussed, especially from a human rights perspective. In India, a country with a large population of children and widespread pesticide use, no law or policy addresses pesticide poisoning among children. This lack of prioritization leads to gaps in poisoning surveillance and lack of government action to prevent poisoning, causing violations of children's rights. The proposed pesticides ban can reduce pesticide poisoning among children in India, but to fully protect children's rights, the government needs to establish comprehensive pesticide poisoning surveillance and ensure the mainstreaming of pesticide poisoning prevention into law and policy based on a human rights framework.