Recent Trends in International Criminal Law: Perspectives from the U.N. International Criminal Tribunal for Rwanda

This article appraises recent developments in international criminal law, with an emphasis on the jurisprudence engendered by the U.N. International Criminal Tribunal for ( ICTR or Tribunal ) during 2007. It evaluates trends in the ICTR\u27s jurisprudence during the year 2007 in relation to substantive, procedural and evidentiary aspects of international criminal law. It is noteworthy that over the course of 2007, by and large, the ICTR did not break much new ground in the arena of international criminal law. Nevertheless, the ICTR addressed some critical issues that deserve evaluation. Some of the decisions reached by the ICTR provide important elaboration as to the position of international criminal law, while others raise controversies. Moreover, a number of decisions reached by the ICTR\u27s Appeals Chambera chamber also shared by the ICTY, and the only appellate and highest courtwere not unanimous. Many of these decisions generated important dissents, thus pointing to conflicting signals from the ICTR. While absence of unanimity by the judges raises challenges as to the current status of international law, arguably it equally creates some room for the possibility of remedying some questionable positions in the future, and thus may lead to the improvement of international criminal jurisprudence. In appraising the issues addressed by the ICTR over the course of 2007, this Article is arranged as follows: Part II evaluates the ICTR\u27s approach to the elements, participation in, and proof of the crime of rape, as well as issues arising from the Tribunal\u27s approach. The issues raised include the status of circumstantial evidence, and its application to the crime of rape, the scope of commission as a mode of criminal participation, and the status in the Tribunal\u27s jurisprudence of the concepts of \u27lesser included or subsumed crimes or modes of liability\u27 and \u27re-qualification\u27 of crimes. Part III deals with the ICTR\u27s approach to extermination as a crime against humanity, while the crimes of direct and public incitement to commit genocide, conspiracy to commit genocide, and persecution as crime against humanity are covered in Parts IV, V and VI respectively. These are followed by some procedural and evidentiary aspects of the Tribunal\u27s jurisprudence, namely, specificity in pleading and the status quo of hearsay evidence. They are addressed in Parts VII and VIII respectively. Concluding the analysis is Part IX, which also comments, in brief, on other issues addressed by the Tribunal, including the notion of \u27witness proofing;\u27 the scope of the rights of the accused, such as the right to be tried in one\u27s presence and the right to compensation; joint criminal enterprise liability; the powers of Trial Chambers to control proceedings, and issues arising from the Tribunal\u27s plea of guilty jurisprudence

Recent Trends in International Criminal Law: Perspectives from the U.N. International Criminal Tribunal for Rwanda

This article appraises recent developments in international criminal law, with an emphasis on the jurisprudence engendered by the U.N. International Criminal Tribunal for ( ICTR or Tribunal ) during 2007. It evaluates trends in the ICTR\u27s jurisprudence during the year 2007 in relation to substantive, procedural and evidentiary aspects of international criminal law. It is noteworthy that over the course of 2007, by and large, the ICTR did not break much new ground in the arena of international criminal law. Nevertheless, the ICTR addressed some critical issues that deserve evaluation. Some of the decisions reached by the ICTR provide important elaboration as to the position of international criminal law, while others raise controversies. Moreover, a number of decisions reached by the ICTR\u27s Appeals Chambera chamber also shared by the ICTY, and the only appellate and highest courtwere not unanimous. Many of these decisions generated important dissents, thus pointing to conflicting signals from the ICTR. While absence of unanimity by the judges raises challenges as to the current status of international law, arguably it equally creates some room for the possibility of remedying some questionable positions in the future, and thus may lead to the improvement of international criminal jurisprudence. In appraising the issues addressed by the ICTR over the course of 2007, this Article is arranged as follows: Part II evaluates the ICTR\u27s approach to the elements, participation in, and proof of the crime of rape, as well as issues arising from the Tribunal\u27s approach. The issues raised include the status of circumstantial evidence, and its application to the crime of rape, the scope of commission as a mode of criminal participation, and the status in the Tribunal\u27s jurisprudence of the concepts of \u27lesser included or subsumed crimes or modes of liability\u27 and \u27re-qualification\u27 of crimes. Part III deals with the ICTR\u27s approach to extermination as a crime against humanity, while the crimes of direct and public incitement to commit genocide, conspiracy to commit genocide, and persecution as crime against humanity are covered in Parts IV, V and VI respectively. These are followed by some procedural and evidentiary aspects of the Tribunal\u27s jurisprudence, namely, specificity in pleading and the status quo of hearsay evidence. They are addressed in Parts VII and VIII respectively. Concluding the analysis is Part IX, which also comments, in brief, on other issues addressed by the Tribunal, including the notion of \u27witness proofing;\u27 the scope of the rights of the accused, such as the right to be tried in one\u27s presence and the right to compensation; joint criminal enterprise liability; the powers of Trial Chambers to control proceedings, and issues arising from the Tribunal\u27s plea of guilty jurisprudence

Prevalence of non-fatal injuries and associated factors in Mbarara Municipality, Western Uganda, December 2016-June 2017

Background: Injuries are a significant public health problem but poorly quantified especially in low and middle-income countries. In Uganda, the burden of injuries is poorly quantified with most of the data reported being facility and mortality based. Many non-fatal injuries, therefore, remain unreported in communities. We conducted a household survey in Mbarara Municipality to identify and describe all non-fatal injury events and the associated factors. Methods: We conducted a cross-sectional study of non-fatal injuries among 966 household members in Mbarara Municipality, from May to June 2017. The most recent non-fatal injury (within a six-month recall period; December 2016 to June 2017) resulting in loss of at least one day of usual daily operating activity was considered. We conducted a descriptive statistical analysis to estimate the counts and frequencies of non-fatal injuries. We identified factors associated with non-fatal injuries using a modified Poisson regression model. Results: The prevalence of non-fatal injuries was 18.2% (176/966) with 92% (162/176) of the non-fatal injuries being unintentional. Falls 27.3% (48/176) were the most common cause of injury followed by road traffic injuries (RTI), 26.7% (47/176), burns 16.5% (29/176) and the least being poisoning 2.8% (5/176). Occupation as casual laborer (Adjusted PR=2.1, 95% CI: 1.2 - 3.7), urban residency (Adjusted PR=1.5, 95% CI: 1.1 - 1.9) and being a non-native of the study area (Adjusted PR=1.7, 95% CI: 1.3 - 2.3) were independently associated with non-fatal injuries. Conclusion: Almost one out of five people had suffered a non-fatal injury in the past six months in Mbarara Municipality. Majority of the non-fatal injuries were unintentional, caused by falls and RTIs, and were amongst casual labourers and urban residents. These findings reveal a gap in injury prevention in Uganda that needs to be addressed to improve the quality of life

Enhanced infection prophylaxis reduces mortality in severely immunosuppressed HIV-infected adults and older children initiating antiretroviral therapy in Kenya, Malawi, Uganda and Zimbabwe: the REALITY trial

Meeting abstract FRAB0101LB from 21st International AIDS Conference 18–22 July 2016, Durban, South Africa. Introduction: Mortality from infections is high in the first 6 months of antiretroviral therapy (ART) among HIV‐infected adults and children with advanced disease in sub‐Saharan Africa. Whether an enhanced package of infection prophylaxis at ART initiation would reduce mortality is unknown. Methods: The REALITY 2×2×2 factorial open‐label trial (ISRCTN43622374) randomized ART‐naïve HIV‐infected adults and children >5 years with CD4 <100 cells/mm3. This randomization compared initiating ART with enhanced prophylaxis (continuous cotrimoxazole plus 12 weeks isoniazid/pyridoxine (anti‐tuberculosis) and fluconazole (anti‐cryptococcal/candida), 5 days azithromycin (anti‐bacterial/protozoal) and single‐dose albendazole (anti‐helminth)), versus standard‐of‐care cotrimoxazole. Isoniazid/pyridoxine/cotrimoxazole was formulated as a scored fixed‐dose combination. Two other randomizations investigated 12‐week adjunctive raltegravir or supplementary food. The primary endpoint was 24‐week mortality. Results: 1805 eligible adults (n = 1733; 96.0%) and children/adolescents (n = 72; 4.0%) (median 36 years; 53.2% male) were randomized to enhanced (n = 906) or standard prophylaxis (n = 899) and followed for 48 weeks (3.8% loss‐to‐follow‐up). Median baseline CD4 was 36 cells/mm3 (IQR: 16–62) but 47.3% were WHO Stage 1/2. 80 (8.9%) enhanced versus 108(12.2%) standard prophylaxis died before 24 weeks (adjusted hazard ratio (aHR) = 0.73 (95% CI: 0.54–0.97) p = 0.03; Figure 1) and 98(11.0%) versus 127(14.4%) respectively died before 48 weeks (aHR = 0.75 (0.58–0.98) p = 0.04), with no evidence of interaction with the two other randomizations (p > 0.8). Enhanced prophylaxis significantly reduced incidence of tuberculosis (p = 0.02), cryptococcal disease (p = 0.01), oral/oesophageal candidiasis (p = 0.02), deaths of unknown cause (p = 0.02) and (marginally) hospitalisations (p = 0.06) but not presumed severe bacterial infections (p = 0.38). Serious and grade 4 adverse events were marginally less common with enhanced prophylaxis (p = 0.06). CD4 increases and VL suppression were similar between groups (p > 0.2). Conclusions: Enhanced infection prophylaxis at ART initiation reduces early mortality by 25% among HIV‐infected adults and children with advanced disease. The pill burden did not adversely affect VL suppression. Policy makers should consider adopting and implementing this low‐cost broad infection prevention package which could save 3.3 lives for every 100 individuals treated