Access to pain treatment as a human right

<p>Abstract</p> <p>Background</p> <p>Almost five decades ago, governments around the world adopted the 1961 Single Convention on Narcotic Drugs which, in addition to addressing the control of illicit narcotics, obligated countries to work towards universal access to the narcotic drugs necessary to alleviate pain and suffering. Yet, despite the existence of inexpensive and effective pain relief medicines, tens of millions of people around the world continue to suffer from moderate to severe pain each year without treatment.</p> <p>Discussion</p> <p>Significant barriers to effective pain treatment include: the failure of many governments to put in place functioning drug supply systems; the failure to enact policies on pain treatment and palliative care; poor training of healthcare workers; the existence of unnecessarily restrictive drug control regulations and practices; fear among healthcare workers of legal sanctions for legitimate medical practice; and the inflated cost of pain treatment. These barriers can be understood not only as a failure to provide essential medicines and relieve suffering but also as human rights abuses.</p> <p>Summary</p> <p>According to international human rights law, countries have to provide pain treatment medications as part of their core obligations under the right to health; failure to take reasonable steps to ensure that people who suffer pain have access to adequate pain treatment may result in the violation of the obligation to protect against cruel, inhuman and degrading treatment.</p

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

Hepatitis C and HIV incidence and harm reduction program use in a conflict setting: an observational cohort of injecting drug users in Kabul, Afghanistan

BACKGROUND: Armed conflict may increase the risk of HIV and other pathogens among injecting drug users (IDUs); however, there are few prospective studies. This study aimed to measure incidence and potential predictors, including environmental events and needle and syringe distribution and collection program (NSP) use, of hepatitis C virus (HCV) and HIV among IDUs in Kabul, Afghanistan. METHODS: Consenting adult IDUs completed interviews quarterly in year 1 and semi-annually in year 2 and HCV and HIV antibody testing semi-annually through the cohort period (November 2007–December 2009). Interviews detailed injecting and sexual risk behaviors, NSP service use, and conflict-associated displacement. Quarters with peak conflict or local displacement were identified based on literature review, and key events, including insurgent attacks and deaths, were reported with simple counts. Incidence and predictors of HCV and HIV were measured with Cox proportional hazards models. RESULTS: Of 483 IDUs enrolled, 385 completed one or more follow-up visits (483.8 person-years (p-y)). All participants were male with a median age of 28 years and a median duration of injecting of 2 years. Reported NSP use among the participants ranged from 59.9 to 70.5 % in the first year and was 48.4 and 55.4 % at 18 and 24 months, respectively. There were 41 confirmed deaths, with a crude death rate of 93.4/1000 p-y (95 % confidence interval (CI) 67.9–125) and overdose as the most common cause. HCV and HIV incidence were 35.6/100 p-y (95 % CI 28.3–44.6) and 1.5/100 p-y (95 % CI 0.6–3.3), respectively. Changing from injecting to smoking was protective for HCV acquisition (adjusted hazard ratio (AHR) = 0.53, 95 % CI 0.31–0.92), while duration of injecting (AHR = 1.09, 95 % CI 1.01–1.18/year) and sharing syringes (AHR = 10.09, 95 % CI 1.01–100.3) independently predicted HIV infection. CONCLUSION: There is high HCV incidence and high numbers of reported deaths among male Kabul IDUs despite relatively consistent levels of harm reduction program use; peak violence periods did not independently predict HCV and HIV risk. Programming should increase awareness of HCV transmission and overdose risks, prepare clients for harm reduction needs during conflict or other causes of displacement, and continue efforts to engage community and police force support

The mens rea of human trafficking: the case of migrant domestic workers

Efforts to eradicate human trafficking continue, with the 2017 Trafficking in Persons Report calling on governments to improve the detection and prosecution of all involved in this crime, with specific reference to recruitment agencies. Yet despite calls to examine the wider scope of potential trafficking perpetrators, an important element remains problematic; namely, establishing that all involved in the recruitment and movement of individuals possess the requisite mental element for this crime. This article examines this mental element and applies it to the different actors commonly involved in the migration and alleged trafficking of migrant domestic workers. The article concludes that establishing such experiences as human trafficking and attributing the mental element of the offense to all people in the supply chain becomes less attainable. The flexibility permitted under the United Nations Trafficking Protocol, as to the national threshold for the crime’s mens rea, has resulted in disparities as to what and who the crime of human trafficking encompasses. The specific intent element of the Protocol is at odds with the constructive knowledge element incorporated in some states, a reality that runs counter to the intentions of the Protocol’s drafters for a unified definition and jeopardizes the prosecution of trafficking cases. In rectifying this, it is pivotal for states to ensure that alternative legal provisions are available to capture those who often pave the way to migrant domestic workers’ exploitation

Drugs and Violence in Afghanistan: A Panel Var With Unobserved Common Factor Analysis

This paper addresses the relationship between the level of violence and the opium market in Afghanistan's provinces. We first provide an overview of the nature and extent of the Afghan drug trafficking. This is followed by a vector autoregressive analysis of the nexus opium-insurgency activities using monthly time-series data on opium prices and the number of security incidents for 15 Afghan provinces over the period 2004-2009. We use a multifactor error structure, the common correlated effect, to include unobservable common factors; Impulse Response functions to describe the time path of the dependent variables in response to shocks; and the mean group estimator to summarize our results across the provinces. Results suggest a conflict-induced reduction in opium prices, while the reverse opium-violence mechanism is mostly negligible. Moreover, unobservable common factors are the main drivers of opium prices and violence

A framework for investigating illegal wildlife trade on social media with machine learning

Peer reviewe