An analysis of the impact of minimum core human rights deprivation on under five mortality

This work was supported by the College of Medicine, University of Malawi and the Division of Infection and Global Health at the University of St Andrews, Scotland.Background Most deaths of children under the age of five observed between 1990 and 2010 were due to preventable causes. These causes included poor nutrition, lack of safe water and proper sanitation, lack of access to basic vaccines. Yet, the Universal Declaration of Human Rights (UDHR) protects these rights and the World Health Organisation recognises that the right to health includes the right to these determinants of health. However, the clause ‘progressive realisation’ in the Convention on Economic, Social and Cultural Rights (CESCR) has left a loophole, allowing deferment of access to basic human rights. In 1989 the concept of a minimum core of human rights was introduced to establish a minimum set of protections. Our objective is to study the effect of deprivation of these rights on the chances of children surviving until they are five years of age and thus enjoying their right to life. Method In order to gauge the effect of deprivation of human rights on health status, we employed regression analysis. Specifically, we regressed under-five mortality (U5M) on a set of measures of deprivation of minimum core rights while controlling for other known determinants of U5M. The measures of deprivation used are the proportion of the population deprived of; safe water, improved sanitation, primary education, access to basic vaccines and stunting (as a proxy for food). Results Deprivation of minimum core human rights is associated with increased under-five mortality. All else being equal, a one percentage point increase in the proportion of the population deprived of safe water leads to a 1.5 percentage point increase in under-five mortality rate, while a one percentage increase in the proportion of the population deprived of improved sanitation leads to a 1.3 percentage point increase in under-five mortality rate. A one percentage point increase in the proportion of the population which do not complete primary education and with no access to basic vaccines and leads to, respectively, a 0.6 and 0.3 percent increase in under-five mortality rate. Therefore, where there is reduced access to primary preventative health care services and education, under-five mortality increases. When the proportion of children who are stunted (as a proxy for lack of access to essential food) goes up by one percent, the rate of under-five mortality rises by 0.8 percent. Conclusions Deprivation of minimum core human rights reduces children’s chances of survival and enjoyment of their most fundamental right, the right to life. Therefore, we recommend that the essence approach to minimum core human rights should be adopted by the international community with immediate effect. In addition, since deprivation of these rights reduces chances of survival, these rights are better described as survival rights.Preprin

Cryptococcal meningitis in a previously healthy child

An 8-year-old previously healthy female presented with a 3 weeks history of headache, neck stiffness, deafness, fever and vomiting and was diagnosed with cryptococcal meningitis. She had documented hearing loss and was referred to tertiary-level care after treatment with fluconazole did not improve her neurological signs and symptoms. Her symptoms slowly resolved over two months. This case report illustrates the occurrence of cryptococcal meningitis in a non-immunocompromised patient, as well as the challenges of providing effective care in resource-limited setting

Financing child rights in Malawi

AVAILABILITY OF DATA AND MATERIALS : All data is available on the GRADE website (https:// www. st-​andre ws. ac. uk/ ~grade/ doh/), the Missing Profits (https:// missi ngpro fits. world/), Hidden Wealth (https:// gabri el-​zucman. eu/ hidden-​wealth/), Who Owns the Wealth in Tax Havens? (http:// gabri el-​zucman. eu/ offsh ore/) websites, and the Tax Justice Network’s website (https:// iff. taxju stice. net/).BACKGROUND : Nearly all countries have ratified the United Nations Convention on the Rights of the Child and, therefore, support children having access to their rights. However, only a small minority of children worldwide have access to their environmental, economic, and social rights. The most recent global effort to address these deficits came in 2015, when the United Nations General Assembly agreed to a plan for a fairer and more sustainable future by 2030 and outlined the Sustainable Development Goals (SDGs). One remediable cause is the lack of revenue in many countries, which affects all SDGs. However, illicit financial flows from low-income to high-income countries, including international tax abuse, continue unabated. METHODS : Using the most recent estimates of tax abuse perpetuated by multinational companies and tax evasion through offshore wealth, and precise econometric modelling, we illustrate the potential regarding child rights (or progress towards the SDGs) if there was an increase in revenue equivalent to tax abuse in Malawi, a low-income country particularly vulnerable to climate change. The Government Revenue and Development Estimations model provides realistic estimates of government revenue changes in developmental outcomes. Using panel data on government revenue per capita, it models the impact of increased revenue on governance and SDG progress. RESULTS : If cross-border tax abuse and tax evasion were curtailed, the equivalent increase in government revenue in one country, Malawi, would be associated with 12,000 and 20,000 people having access to basic water and sanitation respectively each year. Each year, an additional 5000 children would attend school, 150 additional children would survive, and 10 mothers would survive childbirth. CONCLUSIONS : More children would access their economic and social rights if actions were taken to close the gap in global governance regarding taxation. We discuss the responsibility of duty bearers, the need for a global body to arbitrate and monitor international tax matters, and how the Government of Malawi could take further domestic action to mitigate the gaps in global governance and protect itself against illicit financial flows, including tax abuse.The Global Challenges Research Fund, the Scottish Funding Council, and the Professor Sonia Buist Global Health Research Fund, the MRC Impact Acceleration Award. Wellcome Trust Institutional Strategic Support fund of the University of St Andrews.https://bmcpublichealth.biomedcentral.comam2024TaxationSDG-16:Peace,justice and strong institution

Public money creation to maintain fundamental human rights during the COVID-19 pandemic

As governments around the world respond to the COVID-19 pandemic with a range of policies aimed at mitigating the economic fallout, we argue that low- and middle-income countries (LMICs) should prioritize public money creation over foreign borrowing. Experience shows that the cost of servicing foreign debt diverts resources from public services and can undermine fundamental economic, social and cultural rights, such as the rights to clean water, sanitation, basic education and health care. Moreover, the conditions attached to any subsequent debt restructuring can make matters worse

Public money creation to maintain fundamental human rights during the COVID-19 pandemic

As governments around the world respond to the COVID-19 pandemic with a range of policies aimed at mitigating the economic fallout, we argue that low- and middle-income countries (LMICs) should prioritize public money creation over foreign borrowing. Experience shows that the cost of servicing foreign debt diverts resources from public services and can undermine fundamental economic, social and cultural rights, such as the rights to clean water, sanitation, basic education and health care. Moreover, the conditions attached to any subsequent debt restructuring can make matters worse.https://www.hhrjournal.orghj2020Economic

Public Money Creation to Maintain Fundamental Human Rights during the COVID-19 Pandemic

As governments around the world respond to the COVID-19 pandemic with a range of policies aimed at mitigating the economic fallout, we argue that low- and middle-income countries (LMICs) should prioritize public money creation over foreign borrowing. Experience shows that the cost of servicing foreign debt diverts resources from public services and can undermine fundamental economic, social and cultural rights, such as the rights to clean water, sanitation, basic education and health care. Moreover, the conditions attached to any subsequent debt restructuring can make matters worse

Higher-income countries and global child health

Social and economic factors, acting via communities and households, impact child health. These are the social determinants of health. An array of international forces can affect the availability of these health determinants; this is especially important in lower-income countries. Government revenue is critical to funding the public services which provide child health determinants, such as water, sanitation, healthcare, and education. Global actors play a significant role in the availability of resources to provide these services and, thus, global child health. Important global actors: upper-middle and high-income countries, multinational corporations, and international organisations (such as the International Monetary Fund and other banks), impact policies and the availability of government revenue within lower-income countries. This short review considers the potential impacts of these actors. Understanding these dynamics is essential for advocacy, and paediatricians and healthcare professionals have a critical role. Child health advocates could critically analyse the impact of global actors and use these to advocate for children's right to health.PostprintPeer reviewe

Higher-income countries and global child health

Social and economic factors, acting via communities and households, impact child health. These are the social determinants of health. An array of international forces can affect the availability of these health determinants; this is especially important in lower-income countries. Government revenue is critical to funding the public services which provide child health determinants, such as water, sanitation, healthcare, and education. Global actors play a significant role in the availability of resources to provide these services and, thus, global child health. Important global actors: upper-middle and high-income countries, multinational corporations, and international organisations (such as the International Monetary Fund and other banks), impact policies and the availability of government revenue within lower-income countries. This short review considers the potential impacts of these actors. Understanding these dynamics is essential for advocacy, and paediatricians and healthcare professionals have a critical role. Child health advocates could critically analyse the impact of global actors and use these to advocate for children's right to health

Financing child rights in Malawi

BackgroundNearly all countries have ratified the United Nations Convention on the Rights of the Child and, therefore, support children having access to their rights. However, only a small minority of children worldwide have access to their environmental, economic, and social rights. The most recent global effort to address these deficits came in 2015, when the United Nations General Assembly agreed to a plan for a fairer and more sustainable future by 2030 and outlined the Sustainable Development Goals (SDGs). One remediable cause is the lack of revenue in many countries, which affects all SDGs. However, illicit financial flows from low-income to high-income countries, including international tax abuse, continue unabated.MethodsUsing the most recent estimates of tax abuse perpetuated by multinational companies and tax evasion through offshore wealth, and precise econometric modelling, we illustrate the potential regarding child rights (or progress towards the SDGs) if there was an increase in revenue equivalent to tax abuse in Malawi, a low-income country particularly vulnerable to climate change. The Government Revenue and Development Estimations model provides realistic estimates of government revenue changes in developmental outcomes. Using panel data on government revenue per capita, it models the impact of increased revenue on governance and SDG progress.ResultsIf cross-border tax abuse and tax evasion were curtailed, the equivalent increase in government revenue in one country, Malawi, would be associated with 12,000 and 20,000 people having access to basic water and sanitation respectively each year. Each year, an additional 5000 children would attend school, 150 additional children would survive, and 10 mothers would survive childbirth.ConclusionsMore children would access their economic and social rights if actions were taken to close the gap in global governance regarding taxation. We discuss the responsibility of duty bearers, the need for a global body to arbitrate and monitor international tax matters, and how the Government of Malawi could take further domestic action to mitigate the gaps in global governance and protect itself against illicit financial flows, including tax abuse.</div