Sunday, August 15, 2021
New Article: The Intellectual Property Turn in Global Health: From a Property to a Human Rights View of Health
Laura G. Pedraza-Fariña, The Intellectual Property Turn in Global Health: From a Property to a Human Rights View of Health, 36 Osiris 241 (2021), Northwestern Public Law Research Paper No. 21-20. Abstract below.
International intellectual property (IP) law for pharmaceuticals has fundamentally shifted in the twenty-first century from a property-centric to a human rights view. Scholars tend to explain this transformation in the context of both the power struggle between developing and developed countries, and the influence of a social movement that criticized IP rights as hindering access to essential medicines. Yet, these explanations leave out the central role of two international organizations, the World Trade Organization (WTO) and the World Health Organization (WHO), and particularly their permanent staffs, whose boundary disputes have shaped international IP law at the intersection of trade and global health. Bringing into conversation historical and legal literatures on global health and IP, this article traces how a human rights perspective on IP emerged as a strategy to reconcile the WHO staff’s sociomedical views of health with an increasingly dominant set of global IP rules. It shows how the WHO staff used the language of economics—an analytical frame favored by the WTO—to advance a then unorthodox economic understanding of IP as a type of governmental regulation. This allowed the WHO to argue that states should enjoy regulatory autonomy to curtail IP rights in order to meet broader state objectives, such as human rights protection. Paradoxically, despite their divergent views on the nature of IP, both WTO and WHO engagement with it heralded the emergence of a new technocratic view of global health that focuses on patentable medicines and technologies, and that has ultimately turned away from the WHO’s sociomedical roots.
Monday, July 5, 2021
By Martha F. Davis, Co-Editor
Save the date for a webinar on July 14, 2021, at 10:00-11:30am Eastern US/16:00-17:30pm Central European, on COVID-19 vaccine access through a human rights lens, featuring UN Special Rapporteur Tlaleng Mofokeng, with Amanda Lyons (U Minn), Steven Jensen (Danish Institute), Brook Baker (Northeastern Law), and Morten Kjareum (RWI). Register for the webinar using this link: https://rwi.lu.se/events/covid-19-vaccines-for-the-few-how-to-ensure-the-right-to-health-for-all/.
The webinar marks the publication of the hot-off-the-presses book COVID-19 and Human Rights (Routledge): https://www.routledge.com/COVID-19-and-Human-Rights/Kjaerum-Davis-Lyons/p/book/9780367688035. Topics addressed in the book include racial justice, land rights, access to medicines, the SDGs, rights of disabled persons, and many others, with a must-read introduction by Olivier de Schutter, the UN Special Rapporteur on Extreme Poverty.
Monday, May 10, 2021
Claudio Grossman, Pandemics and International Law: The Need for International Action, Human Rights Brief, Vol. 24, Iss. 3, Art. 2 (2021). Excerpt below.
"This Article argues that, due to the experience of COVID-19, it is important that the ILC of the United Nations considers the adoption of a normative instrument whose purpose would be the regulation of pandemics – before, during, and after they occur. There is a compelling need to act, stressing prevention and common reaction by the international community when these scourges occur, and the existing normative framework has shown its incapacity to organize the type of global mobilization that pandemics require. This Article will first provide a brief background into relevant topics, and then it will summarize key issues noted during the November 18 conference. Lastly, it will conclude by providing a recommendation for further action."
Sunday, May 9, 2021
Please Join the Zolberg Institute on Migration and Mobility at The New School, the Migration and Human Rights Program at Cornell Law School, and the Program on Forced Migration and Health at Columbia University's Mailman School of Public Health, for a symposium on May 18-20th, 2021, revisiting the 14 Principles of Protection for Migrants, Refugees and Other Displaced Persons.
This symposium marks the one year anniversary of the publication of the 14 Principles and will consist of a series of 45-minute sessions will explore how migrants, including refugees, have been particularly impacted by the pandemic and the new and emerging ways in which the human rights of these populations are likely to be challenged going forward.
Monday, May 3, 2021
Oona Hathway et al., The COVID-19 Pandemic and International Law, Cornell International Law Journal, Vol. 54, No. 2 (2021). Abstract below.
How does the COVID-19 pandemic affect States’ obligations under international law? This is a question of not just academic interest but real importance for people’s lives. After all, whether States abide by international law—and whether international law is fit for purpose—is vitally important for everyone from refugees exposed to the virus in unsanitary detention centers to national leaders fighting disinformation campaigns and safeguarding vaccine supply chains. International law has been central to the world’s response to the pandemic from the start—even if the participants did not always realize it. International law, after all, required States to take certain actions to detect and prevent the spread of the novel coronavirus. Some governments responded quickly and effectively, significantly reducing the impact on their populations, but many others were far less successful. Many have made matters worse by responding to the virus in ways that exacerbated the toll on the most vulnerable populations, violating their international law obligations in the process. Moreover, some States have used the pandemic as an excuse for delaying elections or for denying arrested persons adequate legal representation. This Article examines the many ways in which COVID-19 is straining the rules and norms of international law. It considers the five main bodies of international law implicated by the pandemic: international humanitarian law, international human rights law, immigration and refugee law, international cyber law, and the rules and regulations of the World Health Organization. It outlines the obligations each body of law impose on States, and how those obligations apply during the current pandemic. It concludes with several proposals for reform to the international legal system so that the world can prepare to more effectively address the next inevitable pandemic.
Sunday, April 4, 2021
On April 12 and 16, 2021, the University of Miami School of Law International and Graduate Law Programs and Human Rights Clinic, in collaboration with the Human Rights Society, Health Law Association, and University of Miami International and Comparative Law Review —will examine the impact of COVID-19 on international law through a virtual symposium. Speakers include:
- Claudio Grossman, Professor of Law, Dean Emeritus, Raymond I. Geraldson Scholar for International and Humanitarian Law, American University Washington College of Law; Member, UN International Law Commission
- Leilani Farha, former UN Special Rapporteur on Adequate Housing; Global Director, The Shift
- Charles C. Jalloh, Professor of Law, Florida International University College of Law; Member, UN International Law Commission
- Antonia Urrejola Noguera, President, Inter-American Commission on Human Rights
- Nilüfer Oral, Law Faculty, Istanbul Bilgi University; Member, UN International Law Commission
To register and for more information please visit: https://www.law.miami.edu/academics/clinics/human-rights-clinic/international-law-covid19-symposium
Sunday, March 14, 2021
By Khala Turner, 2L at St. Louis University School of Law
Amongst a unification of chaos and denial, society has been able to parse through the racial disparities that should be considered a violation of basic human rights in the aftermath of COVID-19. Human rights that are noted in the Universal Declaration of Human Rights, such as the rights to life, liberty and security of person; just and favorable conditions to work; and a standard of living adequate for the health and wellbeing. These human rights should not only be protected during COVID-19, but also should have been well established protections beforehand. As the number of people in Black communities across the globe who are diagnosed with COVID-19 continues to rise, the acts of disparity towards people of African descents grew rapidly. The ease and comfort of disparate treatment shows that racial inequity has unsuccessfully been challenged.
The risks for contracting COVID for racial and ethnic minority groups are higher due to factors such as occupation, housing, and discrimination as listed by the CDC. Growing and disproportionate unemployment rates for some racial and ethnic minority groups due to COVID-19 may lead to greater risk of eviction and homelessness, as well. When studies show disparities among racial and ethnic minority groups in COVID-19 testing, government officials and institutions should take responsibility to ensure no possible additional disparate treatment will occur.
Racial and ethnic minorities should be concerned with the current approach to vaccine testing as well, considering historical events. During the search for medical knowledge, minorities have been historically exploited to get answers and used as Guinea pigs for testing purposes repeatedly. Consider the cases of Henrietta Lacks and the Tuskegee Syphilis Experiment. Research on Lacks’ cells led to the development of the polio vaccine, cloning, gene mapping, and in vitro fertilization. Unfortunately Lacks never knew that her cells were taken for research purposes and her family wasn’t informed until twenty-five years after her death. Similarly, in the Tuskegee Syphilis Experiment, there was no evidence that researchers informed the subjects of the study or its real purpose. The men were misled and not been given all of the facts required to provide informed consent. Throughout these experiments when consent and transparency were disconnected from subjects, authorities have displayed that all citizens do not have a right to life, liberty and security of person when medical research is involved.
Comparable to HeLa Cells and the Tuskegee Experiment research, COVID-19 has already exploited minority communities by allowing employees to expose themselves by performing essential work and destroying the right to a just and favorable condition to work. In the midst of COVID-19, authorities have released scarce means of financial support; institutions have exposed their foundational contributions to systemic racism as they do not place moratoriums on expenses and plan to send children back to educational facilities and as time progresses, many more issues that highlight racial disparities continue to unravel. While unemployment rates continue to rise, those that are forced to work to ensure that they are not evicted, means for electricity or water are not eliminated and money for food is constant then the exploitation begins to increase.
As minority communities are exploited, lives are lost, families are broken, and diseases run rampant causing more harm than good, and we must consider the generational issues that are the result of future “beneficial” medical research. Black communities have cried for help when it comes to medical treatment due to authorities dismantling trust with the lack of transparency. While looking for a COVID-19 vaccine, there should have been a shift whereas the right to life, liberty and security of person are protected with consent and transparency. The best method to protect minority and low-income communities is to allow community members similar opportunities to actively participate in medical facilities. A portion of the underrepresentation problem stems from the under-supply of minority students from public schools who are academically prepared to succeed as undergraduates and thus are able to apply successfully to medical schools.
The fundamental human rights that need protection are those that are feared by many, such as losing their adequate living standards for health and wellbeing or the possibility of being incarcerated due to truancy laws being broken by not sending their children to mandatory schooling. The fear of survival in communities where many are living paycheck to paycheck should not outweigh the fear of contracting a life-threatening disease that destroys communities much faster due to underlying systemic racist conditions. These human rights efforts should no longer begin when disparate deaths in minority communities and exposure to the virus continue to rise but should begin immediately. Authorities should be willing to review statistics and take proactive steps to ensure that exposure is low, transparency is available, and financial resources are provided.
To eliminate fears and protect society, months ago, governments should have immediately re-implemented mandatory lockdowns, expanded federal and state support for the unemployed to cover living expenses, and eliminated all non-essential travel, business and extracurricular activities. As we have seen in the last few weeks, the Biden Administration has taken small steps towards victory by passing the American Rescue Plan Act. These implementations are all important to the Black family, the minority and low-income communities. In the interim, authorities must work to ensure that healthcare costs, medical needs in all states and expenses related to alleviate COVID-19 through vaccination plans in medical facilitates are affordable or free. The initial perception behind the COVID-19 vaccination was to ensure minority communities were given the opportunity to receive the vaccine as the media questioned the lack of excitement from Black communities to sign up for it. Sadly, the socioeconomic disparities continue across the country as wealthier communities are gaining access to opportunities to vaccinate quicker than others. As people continue to travel from city to city to gain access to the vaccine, the hopes for the Biden Administration’s plan to have every consenting adult vaccinated by May 1st are high. It is imperative that regulations are set in place to guide the actions of all State governments and vaccine locations.
In short, it is now time to continue overseeing actions and implement laws that will protect the human rights of minority communities such as being free from unfair treatment in housing and medical opportunities, and discrimination in education as children return to school. While these laws and policies may be perceived as infringing upon some people’s rights, this has never been the crux of the argument when infringing upon the rights of minorities or any low-income persons. If there is any time to continue to see a positive change in society, now is the time.
Monday, January 6, 2020
An unusual monument to human rights sits in a corner of the Boston Public Garden in downtown Boston.
The 40-foot-tall Ether Monument,installed in 1868, is the oldest monument in the garden. It commemorates the first use of ether as an anesthetic, a pivotal moment in medical history. A few blocks away from the monument, across the Boston Common and downhill toward the Boston harbor, the first public demonstration of ether anesthesia was conducted in the Ether Dome at Massachusetts General Hospital in 1846. Boston dentist William Thomas Green Morton administered the ether, and doctor John Collins Warren then removed a tumor from an unconscious patient.
The Ether Monument depicts this breakthrough through the imagery of two connected figures: the Good Samaritan, holding in his arms an injured stranger he met on the road.
This past human rights day, December 2019, the World Federation of Societies of Anaesthesiologists invited its members to submit essays considering the question: Is anesthesia a human right?
The doctors who responded linked anesthesia not only to the human right to health but also to human dignity.
One doctor working in India wrote: "If healthcare is a human right does that mean anesthesia for surgery is also a human right?" She concluded that "[a]ll of us have the right to life, liberty, and security but we also have the right to safe surgery which is only possible with the provision of safe anesthesia." Another physician, practicing in Burkina Faso, observed that "[a]naesthesia makes it possible to eliminate pain, respect the patient’s dignity and facilitate adequate care."
In the U.S. today, many of us are accustomed to living with little or no pain, and if we do experience pain, we expect it to be addressed. Pain-relieving substances of all kinds are readily available, and medical personnel are often eager to help patients by offering prescriptions. Too much pain relief can be a bad thing if it's not needed, or if it has addictive qualities. But the Ether Monument reminds us how debilitating pain can be, what a momentous event it was when the pain-relieving properties of ether were successfully tested, and how lucky those of us with adequate health care are to have access to the human right to pain relief.
Tuesday, December 3, 2019
This week celebrated World Aids Day. We celebrate that for many HIV/AIDS is a chronic condition that will not result in death from the condition. And we celebrate the latest development that an Indian company has developed a strawberry flavored medicine that will provide infants with palatable, life-saving medication at the cost of only $1.00 per day.
But very real ongoing human costs of AIDS/HIV exist. Approximately 80,000 babies and toddlers die of AIDS yearly and 160,000 children are born with AIDS each year. 37.9 million people worldwide live with HIV or AIDS. 1.1 million of that number live in the United States.
We are fortunate that mortality rates are low and getting lower in the United States, particularly when compared with Africa. But we need to acknowledge the ongoing struggles of those living with HIV/AIDS. Approximately 37,000 new cases of HIV/AIDS diagnosed in 2018 in the US. The increase in opioid use is a particular source of new infections among younger people. AIDS Alabama has announced a planned project that will provide homeless youth with safe shelter in Birmingham. The residence will provide transitional housing, as well. Safe housing will be a powerful tool against opioid use and the spread of AIDS. Some living with HIV have no security of regular medical interventions. Rural America is experiencing an increase in diagnoses, as well, but it is there that helpful resources are fewest.
Stigma still exists for those living with HIV/AIDS and discrimination reveals itself in employment, housing and other areas that impact daily living. And criminalization of HIV/AIDS continues in many states. So while medical advances have improved the lives of those living with HIV/AIDS, in the US we must be mindful of the stressors that impact the day to lives of those living with HIV/AIDS.
We optimistically head toward the day where the conditions will be eliminated. AIDS United projects 2050 as the year for reaching that goal. Until that day we honor those who live with repercussions from discrimination that attaches to an HIV or AIDS diagnosis.
Tuesday, December 5, 2017
December 1st was world AIDS Day.
Over 37,000 people in the US are newly diagnosed with HIV each year. 37 million people world wide are living with HIV or AIDS. The opiod crisis has increased the number of new transmissions. Women in abusive relationships are at increased risk for HIV. Yet many perceive the problem as no longer a crisis in the US because of the effectiveness of treatment (Art). But not everyone has access to treatment. Transportation issues remain a huge barrier to treatment, particularly in rural areas. The gutting of the affordable care act exacerbates the problem. A high percentage of men who have sex with men die from HIV/AIDS.
Those living with HIV experience workplace and housing discrimination, typically following the disclosure of private medical information.
And criminally, those living with HIV are at risk for prosecution if they have sex without disclosing their medical condition to the partner, despite the fact that taking ART as prescribed virtually eliminates any risk of transmission. Arrests and prosecutions under these criminal disclosure statues are disproportionately against people of color.
While the public impression is that HIV and AIDS is no longer a critical problem, those living with HIV and AIDS tell very different stories. For additional information on living with HIV here are just a few sources of information: Positive Women's Network; Center for Disease Control; and AIDS United.
Wednesday, May 24, 2017
The assault on the press continues. Last week we posted about a reporter in North Carolina who was arrested after persistently asking questions about health care to Health Secretary Tom Price.
Health care seems to be a sensitive topic. On Wednesday, a Guardian reporter was body slammed by a Montana congressional candidate on the eve of the election. Ben Jacobs reported that having asked the candidate about the Congressional Budget Office's estimates of over twenty million people who would lack health insurance under Trumpcare, candidate Greg Gianforte slammed the reporter to the floor, breaking his glasses and injuring one of the reporter's elbows.
The lid is off of civil behavior. The press, those charged with the responsibility to seek truth, are one of the first public casualties. The Sheriff's office is investigating. The special election is happening now.
Warning: Reporting can be dangerous to your health.
UPDATE: On election morning Mr. Gianforte was charged with assault. Fox News reporters corroborated Mr. Jacob's account of events.
Tuesday, May 23, 2017
The Yogyakarta Principles for eliminating sexual identity and gender discrimination were written in 2006. In 2010, an Activists Guide to the principles was published. The target audience for the guide is LBGTQ activists, with a secondary audience being academics and others interested in human rights implementation. The principles themselves are directed toward the state, and in particular those creating and implementing policy.
Recently a global conference was held in Bangkok to discuss updating the principles by addressing any existing gaps.
Stephen Leonelli of the Men Who Have Sex with Men Global Forum, seeks to bring more awareness of HIV to the principles. At present, there are only two references to HIV contained in the principles. Leonelli, who was a representative at the Bangkok meeting, has written a critique of the principles from the perspective of what changes might be made in order to appropriately address HIV/AIDS.
One of Leonelli's goals is to bring awareness to the collateral consequences of having HIV. Often acknowledged are the public health concerns HIV raises. But less appreciated are the impacts of criminalization, discrimination, violence and stigma. To read more on Leonelli's suggestions for advancing HIV awareness through the Yogyakarta Principles, click here.
The revisions are scheduled to be completed this fall.
Wednesday, October 5, 2016
Flint Michigan is undergoing an outbreak of infectious disease. Shigellosis is a contagious disease that causes fever, stomach pain and diarrhea. Since the city of Flint and the state of Michigan began sending lead contaminated brown water through the city water pipes, the residents have taken measures to avoid using local water.
Clean water has been distributed at various points for city residents. Along with the water, residents were given "baby wipes". While the wipes have the ability to remove dirt, chlorinated water used with traditional soaps are more effective in eliminating harmful bacteria. The inability of residents to access clean municipal water is seen as the source of the infectious illness. But Flint residents, understandably, do not trust the water being provided by the city. While many residents have filters on their faucets and showers, hot water reduces the life of the filters. The residents' ability to afford frequent filter replacement is limited.
This is the second outbreak of infectious disease experienced in Flint. Two years ago, the residents saw an outbreak of Legionnaires' disease.
The human right to clean water, the most essential ingredient in human survival, remains a low priority in many US cities, with Flint evidencing the consequences.
Monday, July 18, 2016
The connection between domestic violence and mass public killings has not been overlooked. The New York Times published an article on the topic which opened the conversation. While the article could be read to say that the link is casual and not correlative, the connection is supported by FBI data that 57% of mass killings involved a current or former intimate partner or other family member.
Nashville saw a near elimination of domestic violence murders, when, under the leadership of Officer Mark Wynn, every domestic violence call was addressed through a SWAT team response. From the bottom up, our culture needs to shift its focus to take domestic violence as seriously Nashville did. But that is not our culture. For example, not every state requires the surrender of firearms when a restraining order enters against a defendant. Yet federal law makes it a crime for someone subject to a restraining order to be in possession of firearms. When federal gun laws go unenforced, the state is empowering violent men to do further harm. Violence prevention is not a valued path in the U.S.
The failure of civil society to aggressively and effectively address intimate partner violence does, not coincidentally, lead to broader societal violence. Failure to curb gender violence empowers those who are violent. Violent men often hate women, gays, those of different races and others who do not match their limited sex and identity characteristics. Confusion over what it means to be a "man" is a common thread for those who harm both women and those who are gender different. Think Orlando. Religion can be the disguise these men use to execute their hate. Think ISIS and its culture of sexual violence.
As a culture we do very little to intervene when we see concerning behaviors developing in our young men. Ending violence is directly related to how we raise our boys. Traumatized boys are at risk of becoming violent men. Traumatized men who are not given the medical, psycho-therapeutic and other supports they need become dangerous to themselves and many others. Think police killings. We need to rethink our notions of privacy when it comes to children. What is now considered intrusive will later be fundamental as preventative.
What if we organized the restorative and therapeutic equivalent of a SWAT team? Imagine how effective intervention might be if children were diverted from thoughts and conditions that lead to violence by a team of loving, skilled professionals and community members focused only on providing the specific needs of an at-risk child and the child's caregivers. This may sound Utopian, but until we alter our present system of crisis only intervention for children, we should expect violence to continue in more and more dangerous forms.
Thursday, July 7, 2016
On August 4th and 5th Vancouver will host the 18th International Conference on Justice, Security and Human Rights.
The conference has an impressive range of topics including science based presentations on Fish Stock Habitats, business enterprises addressed in Sustainable Entrepreneurship,and Creating Shared Values, medical approaches to Treating Diabetes; and political topics such as Rights of Refugees and Promoting Gender Equality.
For more information, click here.
Tuesday, February 16, 2016
Inga Winkler, a scholar in residence at NYU Law School, is a leading thinker and writer on the human right to water and sanitation. Her definitive book, The Human Right to Water, appeared in 2012. Now, she has contributed a companion analysis of the human right to sanitation: The Human Right to Sanitation, forthcoming in 37 U. Penn J. Int'l L. (2016). The article is currently available on SSRN. Here is the abstract:
The Article provides background on the lack of access to sanitation faced by billions of people and highlights, in particular, inequalities in access to sanitation. It discusses how sanitation has long been, and continues to be, a neglected issue and how it is slowly gaining more and more attention, including in the context of human rights. The Article traces the steps that led to the political recognition of the human right to sanitation, and then discusses the legal status of the right to sanitation: is sanitation a “new” human right? Or has it rather been an implicit component of existing human rights guarantees that has only recently started receiving increasing attention? The Article argues that sanitation has a legal basis in existing human rights law and is best understood as a distinct human right (also distinct from the human right to water) as a component of the human right to an adequate standard of living. It provides clarification on the definition and specification of the right to sanitation through the criteria of availability, accessibility, affordability, quality and hygiene, and acceptability.
Finally, the Article discusses the complexity of realizing the right to sanitation and related human rights combining the aspects of individual dignity and public health. It acknowledges that sanitation is largely a matter of individual responsibility, but argues that states have a significant role to play in creating the environment that enables individuals to practice adequate sanitation as well as in ensuring public health.
Monday, February 15, 2016
This series concludes with an appeal to consider the voices of the most vulnerable and politically powerless of those living with HIV: sex workers. Katherine Hanssens, Executive Director and Founder of the Center for HIV Law and Policy, has called for the inclusion of sex workers in the national discussion of HIV. Sex workers are stigmatized in ways that are usually not encountered by others living with HIV. The disdain and dismissiveness with which sex workers are treated in both U.S. law and culture compounds when HIV is added to the existing stigma experienced through the gender oppression of sex workers. Sex workers also are often poor and experience abuse, both in their personal relationships as well as professionally. In some cases, sex workers are dealing with addictions, as well.
Effective advocacy efforts must include sex workers. As the Center's website states: "Effective advocacy strategies seek to empower, rather than shame or punish, the sex worker community, and are often most successful when led by sex workers themselves."
One of the greatest health risks to sex workers is the policy of many police departments who arrest those in possession of an arbitrary number of condoms. This policy caused sex workers to reduce the number of condoms they carry and engaging in unprotected sex. The policy leaves sex workers as one of the populations left without significant choice in ways to protect themselves from HIV and other sexually transmitted health conditions. The condom possession is then used to make a case of prostitution.
Missing from the discussion of this policy targeted at an unpopular segment of our society are those targeted. But Human Rights Watch changed the discussion by conducting a 2012 study of the effect on condom restriction on sex workers. Most reported that the policy resulted in their having more unprotected sex presenting a serious health risk for them as well as a public health concern.
In 2014, influenced by the study, the New York City police department ended their condom carrying policy in response to pleas from public health advocates. In large part, changes in police policy resulted from the work of Human Rights Watch. Wer eit not for human rights advocates, criminalization of the marginalized expands, if only because those in the criminal justice system are not thinking holistically. In this case, police policy designed to enhance prosecution neglected the public health needs of the general population.
Organizations such as Human Rights Watch provide a service to the marginalized in providing data in order to effect policy change. The next step is, as Hanssens says, is to bring sex workers into the conversation thereby igniting the cultural shift from dismissing the marginalized to respecting their voices.
Thursday, February 11, 2016
According to the Center for HIV Law and Policy, women living with HIV statistically tend to be poor and women of color. These and other women living with HIV, face multiple societal and cultural barriers, and are further stigmatized because of their HIV status. Women face barriers that men with HIV do not.
The interplay of the triple stigma is no more evident than in family court. At least one half of women living with HIV report being in or having been in an abusive relationship. They experience partners controlling their medication. In some cases, their HIV positive partners consume the medication rather then seek medical help on their own. Women who seek civil protection orders must consider the likelihood of the partner's "outing" their medical condition in open court or through public documents. Often women choose not to reveal their HIV status, trading critical testimony for either privacy or the abusive partner's silence. Jane Stover addressed the difficulties of HIV positive battered women in her article Stories Absent from the Courtroom: Responding to Domestic Violence in the context of HIV-AIDS. But not all of the legal challenges originate with abusers.
Mothers living with HIV face challenges in custody matters that HIV positive fathers do not. When women are infected, particularly women of color, courts are concerned with the cause of infection. Consistent with the cultural expectation of the "perfect mother", presumptions are made around women's sexuality, including promiscuity and sex work. Reproductive rights can be impinged by physicians not understanding that for medically treated mothers, transmission between mother and fetus is nearly impossible.
Women also can be encouraged to take PrEP, the relatively new medication that has proven effective in preventing transmission. But the drug's testing was done largely with the men who have sex with men. The research leaves unanswered questions of how the drug will impact women's hormonal systems as well as bone density. Little has been done to ensure the safety of children breastfeeding from mothers who take PrEP. And transgender women need studies separate from other women.
Two organizations that focus exclusively on the needs of women living with HIV are creating change. Positive Women's Network has conducted research on the barriers faced by HIV positive women and SisterLove assists women living with HIV in resolving their health care challenges, including reproductive health. The greatest health care challenge may be how to make health care and research systems gender inclusive when addressing solutions for those living with HIV.
Wednesday, February 10, 2016
This is the first in a series of posts addressing the status of those in the US living with HIV/AIDS.
To varying degrees of culpability, over thirty states in the nation have laws criminalizing having sex while HIV positive. States vary from treating HIV the same as exposing a partner to any STI to intentional infection of a sexual partner. Many of the statutes are based upon outdated science.
Most criminalization statutes originated during the hysteria of the 1980's when thousands, primarily gay men, died of the virus because no stabilizing or preventive medication had been developed. The treatment world has changed. And while a few states amended or invalidated laws designed to punish those living with HIV for having sex without disclosing their status, overall the U.S. has done very little to update laws to reflect the limited likelihood of transmission.
No longer is HIV a terminal condition. Contemporary treatments are effective not only in extending life within normal range, but in prohibiting transmission. Viral loads can be undetectable, making transmission impossible. Aids.gov states that HIV cannot be transmitted through saliva. There is no known case of HIV transmission through spitting, yet many states enhance punishment for those who are HIV positive and spit on a police officer. Bad science makes bad laws.
In 2008, a man in Iowa, Nick Rhoades. was sentenced to 25 years after a one time sexual encounter during which he used a condom but did not disclose his positive status. His viral load was undetectable. After spending over five years in jail, his sentence was reduced to time served after Lambda Legal successfully assumed representation. Prison release happened only after Rhoades spent six weeks in solitary confinement, a traumatizing experience all its own.
While HIV is treatable, this does not diminish anguish felt by those who have been infected through a non-disclosing sexual partner. But the penalty for transmission, even intentional, is often as great or greater for crimes of where the victims are killed. The most recent conviction took place in Missouri last year. Twenty-three year old Michael Johnson was prosecuted for knowingly exposing sexual partners to HIV. Only one of the partners contracted HIV due to the encounter with Johnson. Johnson was sentenced to over 30 years in prison, a sentence far longer than most manslaughter sentences.
According to the Center for HIV Law and Policy nearly two hundred HIV prosecutions have occurred since 2008.
The Global Network of People Living with HIV calls the US one of the world's hotspots for HIV criminalization.
Tuesday, December 8, 2015
Has anti-choice propaganda led to an increase in violence and attacks on abortion clinics? Following last week’s tragic attack on the Colorado Springs Planned Parenthood, the news has focused on the impact of videos released by the Center for Medical Progress and political rhetoric targeting Planned Parenthood. Meanwhile, the New York Times and Washington Post have published pieces trying to figure out what motivated Robert Dear, Jr.
But, regardless of how the media depicts this latest act of violence, it’s clear that there’s a long and well-documented history of attacks on abortion clinics and providers. The Colorado shooting should remind us of the dedication and bravery of abortion providers who daily face intimidation, threats and harassment designed to prevent women from accessing health services and rob them of their right to make their own reproductive rights decisions. For their work, abortion providers are often stigmatized, but they should be acknowledged as human rights defenders.
In an op ed in the New York Times, Dr. Willie Parker describes how he gave up his OB practice in Chicago and moved to Alabama to provide abortions full-time. He explains “[i]n public health, you go where the crisis is. If there is an outbreak and you have the ability to relieve suffering, you rush to the site of the need. This is why, a year and a half ago, I returned to my hometown, Birmingham, Ala., to provide abortions.”
Despite physical threats and threats to their livelihood, abortion providers remain committed to providing care to women. A recent article in Rolling Stone profiled a doctor who was bombarded with harassing calls and “veiled threats online (‘I wonder if someone will shoot the new provider...’).” She eventually gave up her family medicine practice after anti-choice activists picketed her practice and pressured the building where the practice was located. “I wasn't about to let awful tactics like that work, because that would just encourage them to keep doing that to others. So the ultimate effect was that I became a full-time provider of abortion care.”
Mother Jones describes the heroic efforts of abortion providers to keep clinics open in the face of new and frequently arbitrary requirements and regulations imposed on them by anti-choice legislatures each year. And Pro Publica describes the constant barrage of personalized harassment providers face, including picketing of private homes and the targeting of families for harassment. To avoid harassment and threats of violence, providers register their homes in their spouses’ names; they change their path to work; they buy bullet-proof vests. All to ensure that women are able to make their own reproductive health decisions.
The international community has recognized that medial and health services professionals are human rights defenders when they provide services to ensure that women can exercise their reproductive health rights. In 2010 the Special Rapporteur on Human Rights Defenders, a U.N. human rights expert who monitors and speaks out about attacks on human rights defenders, stated that “[i]n certain countries . . . health professionals, as a result of their work, are regularly targeted and suffer harassment, intimidation and physical violence.” The report recognizes that attacks have led to “killings and attempted killings of medical professionals.”
Last month, the Special Rapporteur on Human Rights Defenders, joined by five other human rights experts, issued a statement emphasizing the need to protect sexual and reproductive rights defenders in the Americas. The statement recognized that sexual and reproductive rights defenders “face the same risks as many other activists, but they are further exposed to retaliation and violence because they challenge power structures based on patriarchy and deeply-held gender stereotypes about the role of women in society.”
For their commitment to women’s rights and the challenges that they face to provide services, abortion providers should be recognized as human rights defenders. Let’s change the dialogue and recognize them as the heroes they are.