Containment - lecture 7 - infectious disease and human rights

what are the 3 important articles that state the need to take steps to control epidemics 

• UDHR → universal declaration of human rights 

• ICESCR → international covenant on economic, social and cultural rights 

• ICCPR → the right to life

UDHR

• Article 25 → standard of living/health/wellbeing

• everyone has the right to a standard of living adequate for their health and wellbeing (food, clothing, housing, medical care) 

ICESCR

• article 12 → the right to health

• epidemic prevention and response are core elements of the right to health 

• requires to set up a health system

• the right of everyone to the enjoyment of the highest attainable standard of physical and mental health

• used to be the more russian approach 

ICCPR

• article 6 → the right to life 

• American approach

• freedom of speech, right of assembly 

difference between positive and negative rights

• negative rights → governments should not harm your rights (of speech/assembly) 

• positive rights → organize a lot

4 important rights / terms to know (equality, dignity, liberty, security) 

• equality → don’t discriminate, treat everybody equal 

• dignity → treat people with dignity and respect. don’t humiliate 

• liberty → freedom, autonomy. informed consent. free to make your own decisions. 

• security → individual safety (no unsafe medicine / treatment). also includes security against diseases (prevention). 

human rights based on these 4 principles

important terms about human rights (proportional, universal, subsidiarity, duration) 

• proportional → if we deviate from human rights it should be proportional (e.g. someone has Ebola, needs to be in isolation, do it for the 

• universal → for everyone around the world. 

• subsidiarity → there should not be an alternative that is better (we do not want to violate human rights)

• duration → if we violate human rights it should be as short as possible. 

timeline of human rights 

important; 

• 1978 declaration of Alma Ata

  • health is a state of complete physical, mental, and social well being not just the absence of disease

siracusa principle

• guidelines adopted by the UN to limit human rights restrictions during public emergencies.

• public health may invoke derogations

  • derogation → is an exemption from or relaxation of a rule or law

• They provide guidelines on how and when governments may lawfully restrict certain human rights under the International Covenant on Civil and Political Rights (ICCPR)

• important points → proportional, no alternative, temporal 

explain what increases stigma

• Discrimination and coercive tools such as compulsory testing, named reporting, travel restrictions, and isolation or quarantine were counterproductive

• this violates especially freedom and dignity

  
  

HIV AIDS and human rights in Africa

• treatment actions group (TAG) → went to court in south Africa

• sued pharmaceutical companies that anti retro viral medication should be available

• when they sued this pharmaceutical company they used human rights as an argument

PHEIC

• public health emergency of international concern

• formal declaration by the WHO of "an
  extraordinary event which is determined
  to constitute a public health risk to other
  States through the international spread
  of disease and to potentially require a
  coordinated international response"

• formulated when a situation arises that
  is "serious, sudden, unusual, or
  unexpected", which "carries implications
  for public health beyond the affected
  state's national border" and "may
  require immediate international action"

EXAM 7 moments of public health concern after SARS

• swine flu / mexican flu

• ebola (west africa)

• zika

• ebola (democratic republic of congo)

• covid

• mpox

• polio

adverse effects of Covid treatment 

• 47000 additional malaria deaths in 2020

• 100000 additional tuberculosis deaths.

• Severe disruption of vaccination programs

• 121 (93%) of 130 countries reported mental health
  service disruptions, as depression and anxiety
  levels greatly increased

• COVID-19 prevalence during Brazil’s first wave was
  four-times higher for Indigenous populations than
  White Brazilian people

• more than 200 million additional people faced acute
  hunger

• nearly 90 million people into extreme poverty.

• Policy was discriminatory and inequitable (migrants)

• 463 million (1/3) of children could not access (online)
  education

• Violence against women increased

• Leaders ignored evidence; Religious festivals, divine
  interventions, not closing businesses

• Critics / health workers were detained

importance when answering exam question

when something is asked about human rights argue it through the terms talked about (equality, dignity, liberty, security, proportional, universal, subsidiarity, duration)

some topics to think about that could be on the exam → argue via the important terms, equality, dignity, liberty, security

• Ebola outbreak 2014-2016 – forced quarantine of individuals and communities

• Lack of access to TB services in Nigeria (now)

• Stop PCR screening for HIV, HBV, and HCV PCR testing (€5,199,220 per QALY)