Vaccine Apartheid: A Human Rights Analysis of COVID-19 Vaccine Inequity

In this paper, we analyse the inequity in current global vaccine distribution through the lens of international human rights law. First, we introduce the currently available COVID-19 vaccines, before discussing causes and consequences of vaccine inequity, as well as efforts to expand global vaccine access. We then turn to explain the relevant obligations of states regarding human rights to health, life, and equitable access to the benefits of technology. In light of those obligations, we assess the human rights compatibility of vaccine procurement and vaccine aid. After a discussion of the possible human rights responsibilities of the pharmaceutical companies that own the vaccines, we focus on whether a proposed waiver of global intellectual property rights in respect of COVID-19 vaccines is demanded under international human rights law. We conclude with a critique of failures in the international legal system, which may have rendered vaccine inequity inevitable

Individual Rights Under State Constitutions in 2018: What Rights are Deeply Rooted in a Modern-Day Consensus of the States?

This Article is actually the third and final article in a series that began with (A) Steven G. Calabresi & Sarah E. Agudo, Individual Rights Under State Constitutions When the Fourteenth Amendment Was Ratified in 1868: What Rights Are Deeply Rooted in American History and Tradition?; and (B) Steven G. Calabresi, Sarah E. Agudo, and Kathryn L. Dore, State Bills of Rights in 1787 and 1791: What Individual Rights Are Really Deeply Rooted in American History and Tradition?. This Article looks at what rights are protected by state constitutions today, in 2018, and compares our findings with the data we collected in our earlier two articles, which looked at rights under state constitutional law in 1868 when the Fourteenth Amendment was ratified, and at what rights were protected in state constitutional law in 1791 when the Federal Bill of Rights with its Ninth Amendment was ratified

The efficacy of behavioural activation treatment for co-occurring depression and substance use disorder (the activate study): a randomized controlled trial

Background Epidemiological studies suggest that compared with the general population, mood disorders are up to 4.7 times more prevalent in substance dependent samples. Comorbid substance use disorder (SUD) and depression has been associated with a more severe and protracted illness course and poorer treatment outcomes. Despite this, the development and assessment of behavioural interventions for treating depression among individuals with SUDs have received little empirical attention. Behavioural Activation Treatment for Depression (BATD-R) is an empirically supported treatment for depression that has shown some efficacy among substance users. This paper describes the study protocol of a parallel, single blind, randomised controlled trial to determine the efficacy and feasibility of a modified version of the BATD-R (Activate) in reducing symptoms of depression and substance dependence among individuals in residential rehabilitation (RR) and opioid substitution therapy (OST). Methods/design A sample of approximately 200 individuals with depressive symptomatology in treatment for SUD will be recruited from RR and OST services in New South Wales, Australia. Dynamic random allocation following minimisation methodology will be used to assign participants to one of two groups. The control group will receive treatment as usual (TAU), which will be the model of care provided in accordance with standard practice at participating RR and OST services. The intervention group will receive Activate, comprising 10 individual 60-min therapy sessions with a psychologist employed on the research team, in addition to TAU. Data collection will occur at baseline (pre-intervention), and 3-months and 12-months post baseline. Discussion The association between depression and substance dependence has been well documented, yet practical and effective treatments are scarce. The findings of the present study will contribute significantly to understanding the types of programs that are effective in treating this comorbidity. Trial registration This trial is registered with the Australian and New Zealand Clinical Trials registry, ACTRN12613000876796. Registered on 7 August, 2013. Electronic supplementary material The online version of this article (doi:10.1186/s12888-016-0943-1) contains supplementary material, which is available to authorized users

The Consensus Hepatitis C Cascade of Care:standardized reporting to monitor progress toward elimination

Cascade-of-care (CoC) monitoring is an important component of the response to the global hepatitis C virus (HCV) epidemic. CoC metrics can be used to communicate, in simple terms, the extent to which national and subnational governments are advancing on key targets, and CoC findings can inform strategic decision-making regarding how to maximize the progression of individuals with HCV to diagnosis, treatment, and cure. The value of reporting would be enhanced if a standardized approach were used for generating CoCs. We have described the Consensus HCV CoC that we developed to address this need and have presented findings from Denmark, Norway, and Sweden, where it was piloted. We encourage the uptake of the Consensus HCV CoC as a global instrument for facilitating clear and consistent reporting via the World Health Organization (WHO) viral hepatitis monitoring platform and for ensuring accurate monitoring of progress toward WHO's 2030 hepatitis C elimination targets.</p

Estimating the number of people who inject drugs in Australia

Abstract Background Injecting drug use is associated with considerable morbidity and mortality. Estimates of the size of the population of people who inject drugs are critical to inform service planning and estimate disease burden due to injecting drug use. We aimed to estimate the size of the population of people who inject drugs in Australia. Methods We applied a multiplier method which used benchmark data (number of people in opioid substitution therapy (OST) on a snapshot day in 2014) and multiplied it by a factor derived from the prevalence of current OST among people who inject drugs participating in the Australian Needle and Syringe Program Survey in 2014. Estimates of the total population of people who inject drugs were calculated in each state and territory and summed to produce a national estimate. We used the sex and age group distribution seen in datasets relating to people who inject drugs to derive sex- and age-stratified estimates, and calculated prevalence per 1000 population. Results Between 68,000 and 118,000 people aged 15–64 years inject drugs in Australia. The population prevalence of injecting drug use was 6.0 (lower and upper uncertainty intervals of 4.3 and 7.6) per 1000 people aged 15–64 years. Injecting drug use was more common among men than women, and most common among those aged 35–44 years. Comparison of expected drug-related deaths based on these estimates to actual deaths suggest that these figures may be underestimates. Conclusions These are the first indirect prevalence estimates of injecting drug use in Australia in over a decade. This work has identified that there are limited data available to inform estimates of this population. These estimates can be used as a basis for further work estimating injecting drug use in Australia

Precursors of the RNA-world in space: Detection of (ZZ)-1,2-ethenediol in the interstellar medium, a key intermediate in sugar formation

We present the first detection of ($Z$)-1,2-ethenediol, (CHOH)$_2$, the enol form of glycolaldehyde, in the interstellar medium towards the G+0.693-0.027 molecular cloud located in the Galactic Center. We have derived a column density of (1.8$\pm$0.1)$\times$10$^{13}$ cm$^{-2}$, which translates into a molecular abundance with respect to molecular hydrogen of 1.3$\times$10$^{-10}$. The abundance ratio between glycolaldehyde and ($Z$)-1,2-ethenediol is $\sim$5.2. We discuss several viable formation routes through chemical reactions from precursors such as HCO, H$_2$CO, CHOH or CH$_2$CHOH. We also propose that this species might be an important precursor in the formation of glyceraldehyde (HOCH$_2$CHOHCHO) in the interstellar medium through combination with the hydroxymethylene (CHOH) radical.Comment: Accepted for publication in The Astrophysical Journal Letter

Observing the Evolution of the Universe

How did the universe evolve? The fine angular scale (l>1000) temperature and polarization anisotropies in the CMB are a Rosetta stone for understanding the evolution of the universe. Through detailed measurements one may address everything from the physics of the birth of the universe to the history of star formation and the process by which galaxies formed. One may in addition track the evolution of the dark energy and discover the net neutrino mass. We are at the dawn of a new era in which hundreds of square degrees of sky can be mapped with arcminute resolution and sensitivities measured in microKelvin. Acquiring these data requires the use of special purpose telescopes such as the Atacama Cosmology Telescope (ACT), located in Chile, and the South Pole Telescope (SPT). These new telescopes are outfitted with a new generation of custom mm-wave kilo-pixel arrays. Additional instruments are in the planning stages.Comment: Science White Paper submitted to the US Astro2010 Decadal Survey. Full list of 177 author available at http://cmbpol.uchicago.ed

A systematic review of the relationship between subchondral bone features, pain and structural pathology in peripheral joint osteoarthritis

Introduction: Bone is an integral part of the osteoarthritis (OA) process. We conducted a systematic literature review in order to understand the relationship between non-conventional radiographic imaging of subchondral bone, pain, structural pathology and joint replacement in peripheral joint OA. Methods: A search of the Medline, EMBASE and Cochrane library databases was performed for original articles reporting association between non-conventional radiographic imaging-assessed subchondral bone pathologies and joint replacement, pain or structural progression in knee, hip, hand, ankle and foot OA. Each association was qualitatively characterised by a synthesis of the data from each analysis based upon study design, adequacy of covariate adjustment and quality scoring. Results: In total 2456 abstracts were screened and 139 papers were included (70 cross-sectional, 71 longitudinal analyses; 116 knee, 15 hip, six hand, two ankle and involved 113 MRI, eight DXA, four CT, eight scintigraphic and eight 2D shape analyses). BMLs, osteophytes and bone shape were independently associated with structural progression or joint replacement. BMLs and bone shape were independently associated with longitudinal change in pain and incident frequent knee pain respectively. Conclusion: Subchondral bone features have independent associations with structural progression, pain and joint replacement in peripheral OA in the hip and hand but especially in the knee. For peripheral OA sites other than the knee, there are fewer associations and independent associations of bone pathologies with these important OA outcomes which may reflect fewer studies; for example the foot and ankle were poorly studied. Subchondral OA bone appears to be a relevant therapeutic target. Systematic review: PROSPERO registration number: CRD 4201300500

Air pollution horizon-scanning:Seven potential risks of relevance to the UK

Horizon scanning is used to help identify potentially significant societal, economic or technological shifts which if they occurred would have major impacts on society. AQEG generally approaches the science and technology of air pollution either through retrospective analyses – what has happened to air quality and why, - or via future projections. These future projections are generally short to medium term and bounded by well-established science, but it is alsoAQEG’s role to identify evidence gaps that include uncertainties. It is valuable to periodically look beyond established evidence, towards emerging science to identify potential perturbations and assess risks that might plausibly lead to unexpected and large future air quality changes, for example those arising from climatological, technological and behavioural shifts. Since atmospheric chemistry is often non-linear in the generation of secondary pollutants and has dependencies on weather and climate, there exists the potential also for chemical and physical tipping points that may amplify changes in air quality (either positively or negatively). Often unanticipated air quality outcomes occur not because of a single large event but instead through the accumulation or interaction of multiple smaller changes.Air quality outcomes are closely linked to policy and regulation but also to hard-to-predict public choices around transport, diet and lifestyle. A possible impact from these types of future changes can be difficult to capture and often requires in-depth knowledge of the science field.Also noteworthy is that the chemical nature of air pollution is not fixed; it changes over time as sources change reflecting wider regulatory, technological and social trends. New perspectives can also arise from new scientific knowledge. The history of air pollution science is littered with events and discoveries that revealed new risks and required rapid evolution of regulation and policy. Examples include the great smog of London in 1952 and the Clean Air Act of 1956, the discovery of the pervasive harm from lead additives in fuel and the measurement campaigns of the 1970s that revealed that photochemical ozone was not just confined to warmer climates but affected air quality in western Europe too. On the health front research from the 1990’s revealed that the health-harm from long-term exposure was far greater than that from short-term smog events laying the foundations for modern air quality regulation. AtAQEG meeting 66 a round-table discussion on the long-term future for air quality in the UK was undertaken. Members each highlighted up to three areas of possibly under- recognised significance in a horizon scanning context. The focus of the discussion was on events, changes and processes that required specialist knowledge of the air pollution science field to discern rather than more generalised high impact and extreme events on air quality such as war and terrorism, chemical, biological, radiological or nuclear releases (CBRN) or major chemical accidents. These latter types of events are already identified in Defra Futures Team horizon scanning activities and more broadly are well-captured in the Cabinet Office National Risk Register. A wide range of issues related to atmospheric emissions, novel materials, human behaviours, monitoring, regulation, atmospheric processes and social factors were discussed. Anumber of consensus themes emerged which are summarised in this short note. 2 It is important to stress that the workshop did not explore the probability or likelihood of individual and/or cumulative outcomes occurring, only that the events or changes to processes were plausible based on current scientific understanding and that if actualised they could lead to large and currently unanticipated impacts on air quality. The existence of a scenario should not be interpreted as meaning it is likely to occur, and the existence of related risk is not a criticism of current technologies, regulations or policies in the relevant sectors. The intended audience for this paper is horizon scanning professionals within Defra, Government Office for Science and related Departments that have responsibilities for sectoral atmospheric emissions. The paper is made accessible publicly since it may be of wider interest and in line with AQEG principles of open and transparent communication of its work. Seven key horizon scan air pollution risks were (in no particular order): • Systemic underperformance of technical and regulatory air pollution abatement. • Multi-causal increases in atmospheric ammonia over the UK. • Increasing concentrations and health impacts of ultrafine particles (UFP). • Emergence of novel airborne materials and health effects • Climate-driven drought effects and increasing PM pollution. • Enhanced emissions of biological particles and antimicrobial resistance (AMR) • Loss of confidence in air pollution science and increasing uncertainty in forecastin