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The provision of basic sexual and reproductive health services in humanitarian settings, including armed conflict, is extremely limited, causing preventable mortalities and morbidities and violating human rights. Over 50% of all maternal deaths occur in humanitarian and fragile settings. International humanitarian law falls short in guaranteeing access to the full range of sexual and reproductive health information and services for all persons. Guaranteeing access to sexual and reproductive health services under international humanitarian law can increase access to services, improving the health and well-being of civilians in conflict zones. This paper sets forth ways in which international human rights law on sexual and reproductive health and rights should be incorporated into the forthcoming International Committee of the Red Cross Commentary on Geneva Convention IV, regarding the protection of civilians, to ensure services in the context of armed conflict., Competing Interests: Competing interests: None declared., (Copyright © 2024 Zampas, Brown, and Afulukwe.)

Indigenous community-controlled health care organizations provide timely, sustained, and culturally safe care. However, their expertise is often excluded from health professional education. This limits the transfer of knowledges and protocols to future practitioners-those positioned to shape health care systems and practices that could achieve the health rights of Indigenous people and reduce health and social inequities. In Australia, despite national government commitments to transforming curricula, services, and systems related to Indigenous health, health care training organizations such as universities generally have low numbers of Indigenous staff and few strategies to engage Indigenous experts. The authors of this paper are part of the Bunya Project, an Indigenous-led participatory action research effort designed to support non-Indigenous university staff and curriculum development through partnerships with Indigenous community-controlled organizations. We conducted 24 interviews with Indigenous individuals to ascertain recommendations for health care curricula. Three themes emerged: (1) role-modeling and leadership of Indigenous-controlled health organizations; (2) specific learnings for health professionals; and (3) achieving human rights in practice. Interviews also highlighted the need for health professionals' extension beyond clinical caregiving, and staff and students' development of knowledge, skills, and actions regarding client self-determination in order to promote clients' rights across all aspects of their health care. Critical self-reflection by health professionals is a foundational individual-level skill necessary for cultural safety., Competing Interests: Competing interests: None declared., (Copyright © 2024 Manton, Williams, and Hayen.)

Different Council of Europe organs have been attentive and reactive to specific human rights issues in the COVID-19 context, quickly alerting on the risks of inequitable access to quality health care, vaccines, or medicines for vulnerable groups. Yet these reactions have mainly taken the form of nonbinding instruments such as declarations, statements, and recommendations. Although these reactions derive from the interpretation of binding Council of Europe conventions, the observance or implementation of these conventions is not always monitored. Strasbourg judges have on several occasions confirmed that European Convention on Human Rights case law must consider other international instruments, especially those of other Council of Europe organs, in order to interpret the guarantees of the convention. As a consequence, soft law rules can sometimes indirectly acquire binding force when used as an interpretation and implementation tool for binding treaties. In this paper, I examine how Council of Europe organs interpret the principle of equitable access to health care of appropriate quality in the context of a pandemic and whether and how this interpretation is being implemented within the Council of Europe's interpretation of binding treaties such as the Medicrime Convention, the European Social Charter, and the European Convention on Human Rights., Competing Interests: Competing interests: None declared., (Copyright © 2024 Gennet.)

Private actors' involvement in health care financing, provision, and governance contributes to economic inequality. This paper provides an overview of emerging normative trends regarding private actors' involvement in health care by reviewing and critically analyzing international and regional human rights standards on the right to the highest attainable standard of physical and mental health. Specifically, we survey statements from United Nations human rights treaty bodies and recent jurisprudence of the African Commission on Human and Peoples' Rights that discuss private actors' involvement in health care. We then identify strengths and weaknesses of the current international human rights law framework to address the human rights and inequality impacts of private health care actors, before concluding with a series of recommendations to further develop existing standards., Competing Interests: Competing interests: None declared., (Copyright © 2023 De Falco, Hodgson, McConnell, and Ahmed.)

This paper discusses economic inequality as a key social determinant of health. It highlights the potentially transformative role of social protection systems in addressing economic inequality and health inequalities. How to finance social protection and how to distribute benefits among people are key questions in the pursuit of a transformative social protection system that can adequately tackle economic inequalities. This paper argues that a human rights approach can provide a normative orientation in the political process that decides the distribution of burdens and benefits in relation to social protection, calling for an assessment of its impact on socioeconomic inequalities and on disadvantaged groups of people. While the right to social security is at the center of a human rights approach to social protection, the rights to health, education, housing, and work also provide important normative elements for social protection. A human rights-based social protection system requires comprehensive protection for major social risks and challenges throughout the life cycle; universal access to quality services such as health, education, child care, and services for older people or people with disabilities; and a progressive financing mechanism. In this regard, the International Labour Organization's Social Protection Floors Recommendation No. 202 provides strong guidance on the implementation of the right to social security for all., Competing Interests: Competing interests: None declared., (Copyright © 2023 Lee.)

The right to the highest attainable standard of health is a fundamental right of every human being without distinction as to race, religion, political belief, or economic or social condition. 1 Spent wisely, aid and other forms of government spending are essential for attaining this right, as well as driving development. However, taxpayer funds from high-income governments such as the UK, France, and Germany are increasingly being funneled through development finance institutions (DFIs) toward multi-million-dollar investments in for-profit health care corporations in low- and middle-income countries. This contributes to the corporatization and financialization of health care in these contexts and is implicated in profiteering and exploitation, the denial of treatment to those who cannot afford it, and a range of human rights abuses-all with little or no accountability. This paper examines the human rights obligations of a sample of European DFIs and the International Finance Corporation, drawing on the "availability, accessibility, acceptability, and quality" right to health framework. We find that this investment approach is not only limiting the realization of the fundamental right to health for all but also placing significant barriers to accessing quality, affordable health services. 2 ., Competing Interests: Competing interests: None declared., (Copyright © 2023 Marriott, Taneja, and Oduor-Noah.)

Economic policies that concentrate wealth and aggravate socioeconomic inequalities often have negative impacts on human rights. For example, evidence points to the unequal impact of austerity measures-such as the defunding and privatizing of health care-on already disadvantaged groups and individuals. Despite its detrimental impacts, austerity often appears as a necessary evil in times when difficult choices must be made. Justified through arguments of trickle-down economics to support growth, the realization of human rights is postponed. Human rights are sidelined as guidelines that inform rather than limit such measures. The assumption that wealth concentration and the consequent reduction of human rights standards may be justified suggests a problematic conception of equality in human rights law. In this paper, I critically examine the way that this assumption informs the exclusion of distributive considerations from the scope of equality within human rights law. I identify and evaluate the emerging interpretations of equality beyond the legal-technical notion of equal treatment and the prohibition of discrimination and the extent to which equality in human rights may take on a distributive function in combating policies of wealth concentration such as austerity., Competing Interests: Competing interests: None declared., (Copyright © 2023 Marcondes Smith.)

Recognizing law as a determinant of scarcity in health care is vital. This paper underscores the need for a comprehensive approach to manage scarcity beyond intellectual property, using targeted regulations to promote affordability and counter market distortions. I argue that relying on law solely to ensure democratic deliberations for resource allocation overlooks market failures and economic inequalities that contribute to scarcity. I examine different "legal determinants of scarcity" that can be used, on the basis of the right to health, to improve or positively influence the availability and affordability of health technologies through complementary policies such as direct price control, competitive procurement, competition laws, and public-private partnerships. I conclude by asserting that health care affordability must be a central positive human rights obligation in economic and health policies and that states must strive to diversify their approaches to eliminate persistent economic barriers., Competing Interests: Competing interests: None declared., (Copyright © 2023 Filho.)

Many individuals with disabilities utilize adult-sized changing tables to take care of their toileting needs with the help of a caregiver. 1 These tables are not explicitly required by the Americans with Disabilities Act (ADA), and no legal case in the United States has yet addressed whether the ADA requires public restrooms to have adult changing tables. 2 This paper draws on an analysis of op-eds and news articles published in the United States to explore how individuals with disabilities and their caregivers access public restrooms that do not provide adult-sized changing tables. These experiences demonstrate violations of the human rights to accessibility, integrity, and health as outlined in the Convention on the Rights of Persons with Disabilities. Utilizing a human rights analysis, I argue that adult-sized changing tables are inherently the same as toilets and that providing one but not the other in public facilities may constitute discrimination under the ADA. Finally, I briefly explore promising initiatives that would increase access to adult-sized changing tables in the United States., Competing Interests: Competing interests: None declared., (Copyright © 2023 Treiman.)

This paper proposes that US human rights experts and abortion rights advocates challenge the striking down of Roe v. Wade in June 2022 by the majority of US Supreme Court justices because of the multiple human rights violations it has engendered. The paper has three parts. The first part summarizes the compelling response of the three dissenting Supreme Court justices to the majority ruling, which spells out those violations in detail. The second part offers a history of cases of violations of human rights related to abortion in other countries that have been heard and adjudicated by a range of human rights bodies in the last 20 years, and their outcomes. It shows that working on these cases has created working relationships between national and international human rights experts and advocates. Based on this information, the third part proposes that US human rights and abortion rights advocates take a case to the Inter-American Commission on Human Rights against the US Supreme Court ruling, asking the commission to direct the US government to void the majority ruling on Roe v. Wade -on the grounds that it violates the human rights of anyone who seeks an abortion and potentially also of those whose wanted pregnancies become a risk to their health and life and need to be terminated. And if the United States does not agree, the commission should refer the case to the Inter-American Court of Human Rights., Competing Interests: Competing interests: None declared., (Copyright © 2023 Berer.)

Experience has shown the need to explicitly address human rights and gender-related barriers in the rollout of HIV-related biomedical innovations, including "undetectable equals untransmittable" (U=U). This paper brings to light rights and gender considerations relevant to supporting U=U, recognizing a range of barriers that remain to be addressed for all people to benefit equally from U=U. We conducted a literature review to ascertain how human rights and gender were addressed in relevant publications, including peer-reviewed articles published between 2006 and 2020, relevant nongovernmental and global organizations' publications, and abstracts presented at the 2019 International AIDS Conference, that explicitly addressed U=U or "treatment as prevention." Despite evidence to illustrate the importance of attention to human rights and gender within U=U policies and interventions, there remains a lack of explicit attention to human rights and gender considerations in research and programming, particularly with regard to the rights principles of participation and accountability. Explicitly engaging all of these dimensions is key to informing interventions and improving people's lives, health, and well-being., Competing Interests: Competing interests: None declared., (Copyright © 2022 Ferguson, Jardell, and Gruskin.)

In this paper, we examine the social construction of race as a determinant of health inequities in Palestine. Race myths about Palestinians conform to the "logic of elimination" integral to settler colonialism, predicated on the dispossession and removal of the Indigenous people from the land. Racialized legal categorizations of Palestinians are deployed in strategies of elimination that include policies and practices of extrajudicial killing, maiming, and excessive use of force; displacement, dispossession, isolation, and containment; and arbitrary detention and movement restrictions. Differential freedoms and entitlements derive from the deployment of racialized legal categorizations, regulating the material conditions of life and exposure to deliberate bodily harm that make up intermediary determinants of health. Our iterative model outlining the symbolic and systemic constitution of racialized health inequities in Palestine aims to support analysis of the root causes of human rights violations, essential to a human rights-based approach to health. Root-cause analysis confers appropriate recommendations for action. The radical dismantling of systematic racial oppression and domination in Palestine, tantamount to apartheid, is a precondition for realizing the right to health for all., Competing Interests: Competing interests: None declared., (Copyright © 2022 Bouquet, Muhareb, and Smith.)

Facing the unmet need for new, affordable medicines for public health crises, how should states' duty to ensure that everyone shares in the benefits of science be understood in relation to pandemic vaccine supply, and how has the United Nations Committee on Economic, Social and Cultural Rights monitored the implementation of this right? In this paper, we examine the contours and content of state obligations with regard to pandemic vaccine supply under the right to science (article 15(1)(b) of the International Covenant on Economic, Social and Cultural Rights), focusing on three aspects of state obligations: mobilizing public resources for developing and disseminating the benefits of scientific progress in areas of public health need; preventing unreasonably high medicines prices; and international cooperation, particularly in a globalized health emergency. The committee regularly assesses state parties' implementation of their obligations under the covenant, culminating in the issuing of concluding observations, which often serve as a basis for the next round of periodic reporting by states and can thereby direct future state action. Our analysis of the committee's concluding observations reveals that the committee has inconsistently applied its own guidance on the right to science regarding medicines and intellectual property in these monitoring exercises. These findings inform a rights-based response to medical innovation for health crises and advance the Sustainable Development Goal target on medicines research and development., Competing Interests: Competing interests: None declared., (Copyright © 2022 Perehudoff and Sellin.)

This paper connects two seemingly distinct subjects-the right to health and children's play in contexts of a militarized settler colony. Following Ignacio Martín-Baró's articulation of a critical psychology "of the people," we outline the spatial and psychosocial economies of childhood outdoor play as forms of social and political determinants of health and human rights. 1 We offer an analysis through the words and reflections of Palestinian Jerusalemite children that expose the mundane violence produced and sustained by the colonizer, whereby children's play creates spaces of livability against necropolitics. We draw on 50 observations of Palestinian children's play of Ghummeida-hide and seek-spanning 2020 through 2022 in four locations in occupied East Jerusalem. Our analysis proposes three overlapping fields through which Ghummeida operates: as a game, as resistance to spatial suffocation, and against unchilding. Across each of these fields, children's ways of embodying their right to play and live are presented as acts of refusing the chronic political violence they are exposed to. The produced processes include generativity, ownership of space, the surface and the body, and psychic repair. The paper concludes by unveiling how Ghummeida, with its metaphoric and embodied imprints, enables Palestinian children's psychosocial well-being, and pursuit of human rights, through defying their reality under a brutal system of apartheid., Competing Interests: Competing interests: None declared., (Copyright © 2022 Shalhoub-Kevorkian and Quran.)

In this paper, we seek to contextualize amputations sustained by Palestinians during the Great March of Return within a framework of settler-colonial ideology and practice. Utilizing case studies identified in our advocacy work at Physicians for Human Rights Israel, we evaluate the conditions in which these amputations occurred and their relationship to the politicized Palestinian body, land, and nation. Through evaluating themes of intentionality and subjugation, the politicized Palestinian body, and reflections on the challenges of navigating human rights and humanitarian possibilities, we reflect on our work and the ability to advocate for health justice in inherently violent and eliminatory bureaucratic and legal systems. We conclude with a discussion on the utility of a human rights approach that is divorced from a structural and historical analysis of the dire situation on the ground., Competing Interests: Competing interests: None declared., (Copyright © 2022 Majadli and Ziv.)

Global disparities in access to COVID-19 vaccines have brought back into focus questions about whether the right to medicines has assumed any level of binding legality within international law. In this paper, we attempt to answer this question by considering if there is evidence of subsequent state agreement and practice to read the right to medicines into the rights to health and science protected in the International Covenant on Economic, Social and Cultural Rights. We adopt the interpretive framework in the Vienna Convention on the Law of Treaties and the International Law Commission's 2018 report to analyze the work of the United Nations Committee on Economic, Social, and Cultural Rights relevant to medicines, and its relationship to the content and voting in successive resolutions of the United Nations General Assembly. We find that these resolutions provide some evidence of state agreement that the rights to health and science, as enshrined in the International Covenant on Economic, Social and Cultural Rights, include access to affordable medicines. Yet the legal implications of this right remain highly contested, particularly when it comes to trade-related intellectual property rights. The negotiation of a pandemic treaty offers possibilities for codifying this right beyond these discursive instances, while political opposition remains likely to continue to undercut this emerging legal norm., Competing Interests: Competing interests: None declared., (Copyright © 2022 Forman, Al-Alami, and Fajber.)

This paper examines the process of depoliticization of mental health in the occupied Palestinian territories (oPt) and links it to a critical analysis of post-traumatic stress disorder and the role of international humanitarian aid. It is based on a human rights framework that focuses on the right to health and that is instrumental in connecting human rights violations to demands of social justice. Efforts to weaken justice and reparations are analyzed by looking at the role of mental health professionals and assumptions of psychotherapy as a neutral and nonpolitical sphere. By drawing on models of decoloniality and liberation psychology, we advocate for a shift from a decontextualized and individualistic approach to mental health to acknowledging the structural, social, and political oppression that are the underlying factors for suffering in the oPt. In order to alleviate the social suffering of Palestinians and to prevent their victimization, interventions that acknowledge the political nature of mental health ill-being and promote a human rights approach are needed., Competing Interests: Competing interests: None declared., (Copyright © 2022 Helbich and Jabr.)

In China, although drug use is an administrative and not criminal offense, individuals detained by public security authorities are subject to coercive or compulsory "treatment," which can include community-based detoxification and rehabilitation and two years of compulsory isolation. Individuals are also entered into a system called the Drug User Internet Dynamic Control and Early Warning System, or simply the Dynamic Control System. The Dynamic Control System, run by the Ministry of Public Security, acts as an extension of China's drug control efforts by monitoring the movement of people in the system and alerting police when individuals, for example, use their identity documents when registering at a hotel, conducting business at a government office or bank, registering a mobile phone, applying for tertiary education, or traveling. This alert typically results in an interrogation and a drug test by police. This paper seeks to summarize, using published government reports, news articles, and academic papers, what is known about the Dynamic Control System, focusing on the procedures of (1) registration; (2) management; and (3) exit. At each step, people subject to the Dynamic Control System face human rights concerns, especially related to the right to privacy, rights to education and work, and right to health., Competing Interests: Competing interests: None declared., (Copyright © 2022 Lin, Sun, and Amon.)

Access to medicines and the right to health continues to be widely discussed in academic literature. United Nations human rights bodies have done much work to elaborate on the normative content of the right to health and the obligations of states to uphold this right, although translating this into tangible benefits to the public at national level remains a challenge. This paper explores the case of Peru to evaluate prominent decisions of the Constitutional Court that have been instructive in clarifying the state's obligations in relation to health. I argue that the court's rights-based approach offers lessons that other states can draw on to meet their obligations to ensure the right to health by securing access to essential medicines., Competing Interests: Competing interests: None declared., (Copyright © 2022 Davies.)

The international consensus to end compulsory drug treatments and close forced rehabilitation facilities needs urgent transformation to country policies. In the Philippines, as with other countries in Asia, rehabilitation can be compulsory and is seen as the humane alternative to the "war on drugs." In this paper, we present the landscape of rehabilitation and narrate the ways in which people who use drugs are forced to undergo treatment. We unpack the politics behind rehabilitation and explain the sociocultural foundations that support compulsory treatment. We argue that a transition to a human rights-based approach, including voluntary alternatives in community settings, is possible by capitalizing on the reforms that are, unwittingly, the result of the "war on drugs.", Competing Interests: Competing interests: None declared., (Copyright © 2022 Lasco and Yarcia.)

Globally, there are not enough services to meet the enormous demand for evidence-based community-based drug treatment. Further, the effectiveness of available services varies as much as the diversity of their treatment regimens. Capacity-building can help increase the scale and improve the quality of those interventions. Maximizing the impact of capacity-building requires a comprehensive and systematic approach considering three levels-the individual worker, organization, and service sector-and it starts with assessment and planning. This paper describes the areas to consider and steps to follow when planning and implementing a comprehensive capacity-building approach in community-based drug treatment services. Utilizing an empowerment model for capacity-building can increase the stakeholders and resources engaged in the process. Better engagement with community stakeholders increases the likelihood that capacity-building outcomes will be sustainable. Further, the institutionalization of capacity-building can establish and promote an organizational culture of continuous learning., Competing Interests: Competing interests: None declared., (Copyright © 2022 Cole.)

The global community is facing an existential crisis that threatens the web of life on this planet. Climate change, in addition to being a fundamental justice and ethical issue, constitutes a human rights challenge. It is a human rights challenge because it undermines the ability to promote human flourishing and welfare through the implementation of human rights, particularly the right to life and the right to health. It is also a human rights challenge because climate change disproportionately impacts poor and the vulnerable people in both low-income and high-income countries. Those living in many low-income countries are subject to the worst impacts of climate change even though they have contributed negligibly to the problem. Further, low-income countries have the fewest resources and capabilities at present to adapt or cope with the severe, long-lasting impacts of climate change. Building on human rights principles of accountability and redress for human rights violations, this paper responds to this injustice by seeking to make long-neglected societal amends through the implementation of the concept of climate reparations. After discussing the scientific evidence for climate change, its environmental and socioeconomic impacts, and the ethical and human rights justifications for climate reparations, the paper proposes the creation of a new global institutional mechanism, the Global Climate Reparations Fund, which would be linked with the United Nations Human Rights Council, to fund and take action on climate reparations. This paper also identifies which parties are most responsible for the current global climate crisis, both historically and currently, and should therefore fund the largest proportion of climate-related reparations., Competing Interests: Competing interests: None declared., (Copyright © 2021 Chapman and Ahmed.)

In October 2020, the Polish Constitutional Court held unconstitutional an exception in the Family Planning Act of 1993 that provided for legal abortion in cases of fetal abnormalities. This retrogressive step has led to an almost total ban on abortion in Poland. Drawing on existing Strasbourg case law and other relevant legal material, this paper attempts to anticipate a possible outcome of applications recently filed before the European Court of Human Rights by more than 1,000 Polish women who were denied abortions or who postponed their reproductive decisions out of fear. I focus on two factors that play a determining role in the adjudication of cases related to reproductive rights. The first one is a public interest in restricting abortion-namely, the "protection of morals." The second is the margin of appreciation doctrine, which determines the degree of freedom that states enjoy in regulating certain issues, such as abortion, and which is highly dependent on the concept of a European consensus. I argue that this consensus-revealed through the domestic laws and practice of 47 Council of Europe member states-shows considerable unity and should thus restrict individual states' discretion in limiting human rights and freedoms. The European Court of Human Rights, by acknowledging the relevance of a European consensus in abortion regulation, as well as evolving universal standards concerning reproductive rights, would avoid two pitfalls: one connected with analyzing the doubtful public interest in protecting morals, and another with a potential criticism of judicial activism and the court's imposition of its own moral evaluation of an abortion ban., Competing Interests: Competing interests: None declared., (Copyright © 2021 Julia Kapelańska-Pręgowska.)

Climate change is the greatest challenge of our century. Children, adolescents, and youth will bear the most severe impacts, physically, socially, economically, and psychologically. In response to this immense threat and to the failure of international climate negotiations to date, young people are taking to the streets and using global fora to call for climate justice. While these protests have received much attention, there has been limited examination of these and other youth-led efforts through the lens of a human rights-based approach and its operational principles: participation, equality and nondiscrimination, accountability, and transparency. This paper draws from academic and gray literature, as well as the authors' experience as practitioners and young activists, to argue that young people, by promoting human rights-based operational principles at the international, national, and local levels, are pioneering a human rights-based approach to climate change. The paper concludes by suggesting how policy makers can support and empower young people to advance an explicit human rights-based agenda, while concurrently translating human rights-based operational principles into climate change policies and practice., Competing Interests: Competing interests: None declared., (Copyright © 2021 Gasparri, El Omrani, Hinton, Imbago, Lakhani, Mohan, Yeung, and Bustreo.)

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., Competing Interests: Competing interests: None declared., (Copyright © 2021 Viveros-Uehara.)