Smokes and mirrors at the United Nations’ universal periodic review process

Purpose: In 2006, the United Nations’ Human Rights Council was tasked to establish a new human rights monitoring mechanism: the Universal Periodic Review Process. The purpose of this paper is to examine the nature of discussions held in the process, over the two cycles of review in relation to women’s rights to access health care services. Design and Methodology: This investigation is a documentary analysis of the reports of 193 United Nations’ state reports, over two cycles of review. Findings: The primary findings of this investigation reveal that despite an apparent consensus on the issue, a deeper analysis of the discussions suggest the dialogue between states is superficial in nature, with limited commitments made by states under review in furthering the protection of women’s right to access health care services in the domestic context. Practical Implications: Considering the optimism surrounding the UPR process, the findings reveal that the nature of discussions held on women’s rights to health care services is at best a missed opportunity to make a significant impact to initiate, and inform, changes to practices on the issue in the domestic context; and at worst, raises doubts as to whether the core aim of the process, to improve the protection and promotion of all human rights on the ground, is being fulfilled. Originality/Value: Deviating from the solely technocratic analysis of the review process in the existing literature, this investigation has considered the UPR process as a phenomenon of exploration in itself, and will provide a unique insight as to how this innovative monitoring mechanism operates in practice, with a particular focus on women’s right to access health care services

Exploring synergies between human rights and public health ethics: A whole greater than the sum of its parts

<p>Abstract</p> <p>Background</p> <p>The fields of human rights and public health ethics are each concerned with promoting health and elucidating norms for action. To date, however, little has been written about the contribution that these two justificatory frameworks can make together. This article explores how a combined approach may make a more comprehensive contribution to resolving normative health issues and to advancing a normative framework for global health action than either approach made alone. We explore this synergy by first providing overviews of public health ethics and of international human rights law relevant to health and, second, by articulating complementarities between human rights and public health ethics.</p> <p>Discussion</p> <p>We argue that public health ethics can contribute to human rights by: (a) reinforcing the normative claims of international human rights law, (b) strengthening advocacy for human rights, and (c) bridging the divide between public health practitioners and human rights advocates in certain contemporary health domains. We then discuss how human rights can contribute to public health ethics by contributing to discourses on the determinants of health through: (a) definitions of the right to health and the notion of the indivisibility of rights, (b) emphasis on the duties of states to progressively realize the health of citizens, and (c) recognition of the protection of human rights as itself a determinant of health. We also discuss the role that human rights can play for the emergent field of public health ethics by refocusing attention on the health and illness on marginalized individuals and populations.</p> <p>Summary</p> <p>Actors within the fields of public health, ethics and human rights can gain analytic tools by embracing the untapped potential for collaboration inherent in such a combined approach.</p

Imprisoned and imperiled: access to HIV and TB prevention and treatment, and denial of human rights, in Zambian prisons

<p>Abstract</p> <p>Background</p> <p>Although HIV and tuberculosis (TB) prevalence are high in prisons throughout sub-Saharan Africa, little research has been conducted on factors related to prevention, testing and treatment services.</p> <p>Methods</p> <p>To better understand the relationship between prison conditions, the criminal justice system, and HIV and TB in Zambian prisons, we conducted a mixed-method study, including: facility assessments and in-depth interviews with 246 prisoners and 30 prison officers at six Zambian prisons; a review of Zambian legislation and policy governing prisons and the criminal justice system; and 46 key informant interviews with government and non-governmental organization officials and representatives of international agencies and donors.</p> <p>Results</p> <p>The facility assessments, in-depth interviews and key informant interviews found serious barriers to HIV and TB prevention and treatment, and extended pre-trial detention that contributed to overcrowded conditions. Disparities both between prisons and among different categories of prisoners within prisons were noted, with juveniles, women, pre-trial detainees and immigration detainees significantly less likely to access health services.</p> <p>Conclusions</p> <p>Current conditions and the lack of available medical care in Zambia's prisons violate human rights protections and threaten prisoners' health. In order to protect the health of prisoners, prison-based health services, linkages to community-based health care, general prison conditions and failures of the criminal justice system that exacerbate overcrowding must be immediately improved. International donors should work with the Zambian government to support prison and justice system reform and ensure that their provision of funding in such areas as health services respect human rights standards, including non-discrimination. Human rights protections against torture and cruel, inhuman or degrading treatment, and criminal justice system rights, are essential to curbing the spread of HIV and TB in Zambian prisons, and to achieving broader goals to reduce HIV and TB in Zambia.</p

Using smart pumps to help deliver universal access to safe and affordable drinking water

It is estimated that broken water pumps impact 62 million people in sub-Saharan Africa. Over the last 20 years, broken handpumps have represented US$1·2–1·5 billion of lost investment in this region, with 30–40% of rural water systems failing prematurely. While the contributory factors are complex and multi-faceted, the authors consider that improved post-construction monitoring strategies for remote water projects, which rely on smart pumps to monitor operational performance in place of physical site visits, may address some of these problems and help reduce the heavy time and resource demands on stakeholders associated with traditional monitoring strategies. As such, smart pumps could play a significant role in improving project monitoring and might subsequently help deliver universal access to safe and affordable drinking water by 2030, which constitutes one of the key targets of United Nations sustainable development goal 6 and is embedded in some national constitutions

‘Repeal the 8th’ in a Transnational Context: The Potential of SRHRs for Advancing Abortion Access in El Salvador

This article undertakes a discursive feminist reading of citizenship and human rights to understand, through the cases of Ireland and El Salvador, domestic abortion rights movements as part of a transnational women’s rights movement. While abortion has been partially decriminalised in Ireland, approximately 42 per cent of the world’s women1 of reproductive age still live in a country where abortion is prohibited entirely or only permitted to save a woman’s life or health (Singh et al., 2018, p. 4). In El Salvador, abortion is illegal and those suspected of having the procedure are prosecuted. As in Ireland, since 2012/2013 numerous controversies have brought the issue to wider public attention and have further galvanised the feminist movement to campaign for reform. Feminist abortion rights campaigns in both countries have connected important sites of activism and contestation: civil society, national parliaments, regional human rights systems and the United Nations

Disparities in diabetes care: role of the patient's socio-demographic characteristics

<p>Abstract</p> <p>Background</p> <p>The commitment to promoting equity in health is derived from the notion that all human beings have the right to the best attainable health. However, disparities in health care are well-documented. The objectives were to explore disparities in diabetes prevalence, care and control among diabetic patients. The study was conducted by Maccabi Healthcare Services (MHS), an Israeli HMO (health care plan).</p> <p>Methods</p> <p>Retrospective study. The dependent variables were diabetes prevalence, uptake of follow-up examinations, and disease control. The independent variables were socio-economic rank (SER), ethnicity (Arab vs non Arab), supplementary voluntary health insurance (SVHI), and immigration from Former Soviet Union (FSU) countries. Chi Square and Logistic Regression Models were estimated.</p> <p>Results</p> <p>We analyzed 74,953 diabetes patients. Diabetes was more prevalent in males, lower SER patients, Arabs, immigrants and owners of SVHI. Optimal follow up was more frequent among females, lower SERs patients, non Arabs, immigrants and SVHI owners. Patients who were female, had higher SERs, non Arabs, immigrants and SVHI owners achieved better control of the disease. The multivariate analysis revealed significant associations between <it>optimal follow up </it>and age, gender (males), SER (Ranks 1-10), Arabs and SVHI (OR 1.02, 0.95, 1.15, 0.85 and 1.31, respectively); <it>poor diabetes control </it>(HbA1C > 9 gr%) was significantly associated with age, gender (males), Arabs, immigrants, SER (Ranks1-10) and SVHI (OR 0.96, 1.26, 1.38, 0.72, 1.37 and 0.57, respectively); significant associations with <it>LDL control </it>(< 100 gr%) were revealed for age, gender (males) and SVHI (OR 1.02, 1.30 and 1.44, respectively).</p> <p>Conclusion</p> <p>Disparities in diabetes prevalence, care and control were revealed according to population sub-group. MHS has recently established a comprehensive strategy and action plan, aimed to reduce disparities among members of low socioeconomic rank and Arab ethnicity, sub-groups identified in our study as being at risk for less favorable health outcomes.</p

Cross-Sector Review of Drivers and Available 3Rs Approaches for Acute Systemic Toxicity Testing

Acute systemic toxicity studies are carried out in many sectors in which synthetic chemicals are manufactured or used and are among the most criticized of all toxicology tests on both scientific and ethical grounds. A review of the drivers for acute toxicity testing within the pharmaceutical industry led to a paradigm shift whereby in vivo acute toxicity data are no longer routinely required in advance of human clinical trials. Based on this experience, the following review was undertaken to identify (1) regulatory and scientific drivers for acute toxicity testing in other industrial sectors, (2) activities aimed at replacing, reducing, or refining the use of animals, and (3) recommendations for future work in this area

Avoiding the internet of insecure industrial things

Security incidents such as targeted distributed denial of service (DDoS) attacks on power grids and hacking of factory industrial control systems (ICS) are on the increase. This paper unpacks where emerging security risks lie for the industrial internet of things, drawing on both technical and regulatory perspectives. Legal changes are being ushered by the European Union (EU) Network and Information Security (NIS) Directive 2016 and the General Data Protection Regulation 2016 (GDPR) (both to be enforced from May 2018). We use the case study of the emergent smart energy supply chain to frame, scope out and consolidate the breadth of security concerns at play, and the regulatory responses. We argue the industrial IoT brings four security concerns to the fore, namely: appreciating the shift from offline to online infrastructure; managing temporal dimensions of security; addressing the implementation gap for best practice; and engaging with infrastructural complexity. Our goal is to surface risks and foster dialogue to avoid the emergence of an Internet of Insecure Industrial Things