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HIV criminalization laws may discourage HIV testing. We tested whether California's 2018 HIV criminalization law reform increased the likelihood of past-year HIV testing compared to Nevada, which did not reform its HIV criminalization law. We fitted two difference-in-differences logistic regression models: one for all respondents reporting behaviors that increase the chances of getting or transmitting HIV, and one for male respondents reporting these behaviors. All analyses accounted for the complex survey design of BRFSS. HIV criminalization reform was significantly associated with an increased likelihood of past-year HIV testing. After reform, the predicted marginal probability of past-year HIV testing increased by six percentage points. By comparison, probabilities of a past-year HIV test decreased in Nevada. HIV criminalization law reform may increase the likelihood of getting tested by individuals who engage in behaviors that increase the chances of getting or transmitting HIV. [ABSTRACT FROM AUTHOR]

Background: In the last decades all health systems have experienced a lack of resources. Against this background, the idea of ​​applying personal responsibility of the patient as a criterion for allocation of resources (PRCAR) is gaining increasing attention. Bulgarian healthcare reform has been marked by the implementation of many new strategies, that grounded our scientific interest towards investigating PRCAR in Bulgarian public health law and social legislation. Methods: Through a search of national legal databases 7 documents were selected and subjected to content analysis. Results: Prospective responsibility was found in two and retrospective responsibility - in three documents, two of which imposed explicit penalties on the patient. Two documents did not distinguish between the types of patient responsibility. PRCAR was found to be controversial through the prism of the social justice principle. The discussion was conducted through the perspectives of evidence translation of research to law, particularities of social cohesion in Bulgaria, and the interpretation of principles of public health ethics. Conclusion: Although PRCAR was traceable in Bulgarian legislation, no supporting arguments for its introduction were deduced. The applicability of PRCAR should be further studied and wider public debate should be initiated. Key points: • In the context of insufficient healthcare resources experienced by all healthcare systems, the idea of ​​applying the personal responsibility of the patient as a criterion for the allocation of resources (PRCAR) is appealing. • If striving for a common European vision on PRCAR, then each European country's view on the subject would be of key importance, and studies in this direction are necessary. • Our manuscript offers an in-depth expert analysis of the presence of PRCAR in public health law and social regulation in Bulgaria, which is one of the more recent EU member states but experiences the same developmental trends as other European healthcare systems. • As PRCAR is still an under-researched concept, our results will be of particular interest to other public health researchers. [ABSTRACT FROM AUTHOR]

Abstract Background In the last decades all health systems have experienced a lack of resources. Against this background, the idea of ​​applying personal responsibility of the patient as a criterion for allocation of resources (PRCAR) is gaining increasing attention. Bulgarian healthcare reform has been marked by the implementation of many new strategies, that grounded our scientific interest towards investigating PRCAR in Bulgarian public health law and social legislation. Methods Through a search of national legal databases 7 documents were selected and subjected to content analysis. Results Prospective responsibility was found in two and retrospective responsibility - in three documents, two of which imposed explicit penalties on the patient. Two documents did not distinguish between the types of patient responsibility. PRCAR was found to be controversial through the prism of the social justice principle. The discussion was conducted through the perspectives of evidence translation of research to law, particularities of social cohesion in Bulgaria, and the interpretation of principles of public health ethics. Conclusion Although PRCAR was traceable in Bulgarian legislation, no supporting arguments for its introduction were deduced. The applicability of PRCAR should be further studied and wider public debate should be initiated.

Child care access shapes parental involvement in the workforce, and inherently families' economic security. Given the well-supported relationships between family economic stress and child maltreatment, we hypothesize financially accessible child care subsidies will reduce the risk of maltreatment by reducing parental stress and improving families' ability to provide for children's basic needs. States' policy components shaping financial access to child care subsidies are explored here in terms of their relationship to child maltreatment. The National Child Abuse & Neglect Data System was used to derive states' annual rates of child maltreatment (maltreatment, abuse, neglect, physical abuse, and sexual abuse). These act as the dependent variable in a generalized estimator equation (GEE) series. The explanatory variables in this series are four policy component variables derived from the Child Care and Development Fund Policy Database. These include: the income eligibility level for a family with three children, whether asset tests are used to determine eligibility, whether families living in poverty are exempt from copayments, and the number of sources of public support that are counted towards a family's income when determining their eligibility. Together, these policies serve as a state-year measure for financial accessibility of child care subsidies. The GEE models predict higher expected rates of maltreatment in states whose policies make it more difficult to qualify for child care subsidies (i.e., lower income eligibility levels, applying asset tests, lacking copay exemptions for families in poverty, and counting a greater number of public support sources towards a family's income). [ABSTRACT FROM AUTHOR]

Balancing on a tightrope twenty feet above the ground is outside the comfort zones of many health law professors. Being there forces you to consider in new ways yourself, your skills, and your surroundings. Fears arise, and yet you must still act. And you must trust that the person who offered you this opportunity cared about you and your well-being, and that they would ensure there was a way to get from where you began to the other side. [ABSTRACT FROM AUTHOR]

Union activism, medical lobbying and occupational health and safety prosecutions led to a major public health initiative in Australia - the banning from 1 July 2024 of work with engineered/artificial stone, including manufacturing, supplying, processing and installing it. This editorial contextualises within the history of regulation of workers' exposure to risks of contracting silicosis the growing international awareness of the dangers posed by working with engineered stone, particularly in relation to making and installing kitchen and bathroom benchtops made from engineered stone. It argues that the Australian initiative is an important public health decision that has a sound justification, is likely to save many lives and should be emulated internationally. [ABSTRACT FROM AUTHOR]

Abstract Context Public health law is an important tool in non-communicable disease (NCD) prevention. There are different approaches available for achieving policy objectives, including government, co-, quasi- and self-regulation. However, it is often unclear what legal design features drive successes or failures in particular contexts. This scoping review undertakes a descriptive analysis, exploring the design characteristics of legal instruments that have been used for NCD prevention and implemented and evaluated in OECD countries. Methods A scoping review was conducted across four health and legal databases (Scopus, EMBASE, MEDLINE, HeinOnline), identifying study characteristics, legal characteristics and regulatory approaches, and reported outcomes. Included studies focused on regulation of tobacco, alcohol, unhealthy foods and beverages, and environmental pollutants. Findings We identified 111 relevant studies evaluating 126 legal instruments. Evaluation measures most commonly assessed implementation, compliance and changes to the built and lived environment. Few studies evaluated health or economic outcomes. When examining the design and governance mechanisms of the included legal instruments, government regulation was most commonly evaluated (n = 90) and most likely to be reported effective (64%). Self-regulation (n = 27) and quasi-regulation (n = 5) were almost always reported to be ineffective (93% and 100% respectively). There were few co-regulated instruments evaluated (n = 4) with mixed effectiveness. When examining public health risks, food and beverages including alcohol were more likely to be self- or quasi-regulated and reported as ineffective more often. In comparison, tobacco and environmental pollutants were more likely to have government mandated regulation. Many evaluations lacked critical information on regulatory design. Monitoring and enforcement of regulations was inconsistently reported, making it difficult to draw linkages to outcomes and reported effectiveness. Conclusions Food and alcohol regulation has tended to be less successful in part due to the strong reliance on self- and quasi-regulation. More work should be done in understanding how government regulation can be extended to these areas. Public health law evaluations are important for supporting government decision-making but must provide more detail of the design and implementation features of the instruments being evaluated – critical information for policy-makers.

The article focuses on the legal functions of public health professionals and their sort of training need to do that work. Topics include how law pervades public health practice and research, 5 essential public health law services (5EPHLS) framework that serves to specify the skills and knowledge that public health professionals need to carry out their law-related work, and skills and expertise that graduates of public health programs should have to manage legal matters in public health.

Physician advocates for sexual and reproductive health (SRH) care have been active in the United States for decades. Despite such activism, access to SRH services has been fraught with persistent restrictions, particularly for abortion care. We sought the perspectives of key stakeholders on what makes for an effective SRH physician advocate and thoughts about the successes, failures, and needs of the abortion advocacy movement. We interviewed 15 SRH key informants (KIs) in sectors with expertise in organizational policy and advocacy (n = 6); clinical leadership and education (n = 3), media (n = 3), and reproductive justice (n = 3). The analytic team coded repeating ideas and conducted a thematic analysis, organizing findings within KI perspectives on the role of physician advocates in the field of abortion and contraception; successes, failures, and needs in abortion and contraception advocacy; and recommendations on the composition and components of an ideal clinician advocacy training program. KIs relayed that skill building related to communication, developing relationships with changemakers, and understanding political systems was critical for effective advocacy. They felt clinician advocacy training programs should include providers other than physicians and be designed for trainees to build relationships with one another over time. KI perspectives can be valuable in informing advocacy training programs and for contributing strategic approaches to increasing equitable and widespread access to SRH services. [ABSTRACT FROM AUTHOR]

Public health laws and policies are uniquely able to mitigate the adverse and inequitable health impacts of climate change. This article summarizes some key considerations in developing such laws and policies and a variety of approaches local public health departments are using to increase climate resilience and health equity. [ABSTRACT FROM AUTHOR]

This paper summarizes key shifts in judicial decisions relating to public health powers during the pandemic and the implications of those decisions for public health practice. Then, it gives a preview and call for partnership in developing a legal framework for authority that guides public health to better activities, processes, and accountability in service of the public's health. [ABSTRACT FROM AUTHOR]

Abstract Background Despite the discovery of vaccines, the control, and prevention of Coronavirus disease 2019 (COVID-19) relied on non-pharmaceutical interventions (NPIs). This article describes the development and application of the Public Health Act to implement NPIs for COVID-19 pandemic control in Uganda. Methods This is a case study of Uganda’s experience with enacting COVID-19 Rules under the Public Health Act Cap. 281. The study assessed how and what Rules were developed, their influence on the outbreak progress, and litigation. The data sources reviewed were applicable laws and policies, Presidential speeches, Cabinet resolutions, statutory instruments, COVID-19 situation reports, and the registry of court cases that contributed to a triangulated analysis. Results Uganda applied four COVID-19 broad Rules for the period March 2020 to October 2021. The Minister of Health enacted the Rules, which response teams, enforcement agencies, and the general population followed. The Presidential speeches, their expiry period and progress of the pandemic curve led to amendment of the Rules twenty one (21) times. The Uganda Peoples Defense Forces Act No. 7 of 2005, the Public Finance Management Act No. 3 of 2015, and the National Policy for Disaster Preparedness and Management supplemented the enacted COVID-19 Rules. However, these Rules attracted specific litigation due to perceived infringement on certain human rights provisions. Conclusions Countries can enact supportive legislation within the course of an outbreak. The balance of enforcing public health interventions and human rights infringements is an important consideration in future. We recommend public sensitization about legislative provisions and reforms to guide public health responses in future outbreaks or pandemics.

Law and the legal environment are important factors in the epidemiology and prevention of sexually transmissible infections (STIs) and blood-borne viruses (BBVs). However, there has been no sustained effort to monitor the legal environment surrounding STIs and BBVs. This article presents the first data on the incidence and impacts of unmet legal needs for those affected by an STI or BBV in Australia using a survey administered to a sample of the Australian sexual health and BBV workforce. Migration, Housing, Money/Debt, Health (including complaints about health services), and Crime (accused/offender) were reported as the five most common legal need areas, with 60% of respondents describing these legal problems as generating a "severe" impact on health. These results indicate that unmet legal needs generate significant negative impacts in terms of individual health, on public health, and the ability to provide sustainable services such as testing and treatment to those facing unmet legal needs. [ABSTRACT FROM AUTHOR]

The tobacco endgame is rapidly moving from aspirational and theoretical toward a concrete and achievable goal and, in some cases, enacted policy. Endgame policies differ from traditional tobacco control measures by explicitly aiming to permanently end, rather than simply minimize, tobacco use. The purpose of this paper is to outline recent progress made in the tobacco endgame, its relationship to existing tobacco control policies, the challenges and how endgame planning can be adapted to different tobacco control contexts. Examples of implemented policies in three cities in the United States and national policies in the Netherlands and New Zealand are outlined, as well as recent endgame planning developments in Europe. Justifications for integrating endgame targets into tobacco control policy and the need to set concrete time frames are discussed, including planning for ending the sale of tobacco products. Tobacco endgame planning must consider the jurisdiction-specific tobacco control context, including the current prevalence of tobacco use, existing policies, implementation of the World Health Organization’s Framework Convention on Tobacco Control, and public support. However, the current tobacco control context should not determine whether endgame planning should happen, but rather how and when different endgame approaches can occur. Potential challenges include legal challenges, the contested role of e-cigarettes and the tobacco industry’s attempt to co-opt the rhetoric of smoke-free policies. While acknowledging the different views regarding e-cigarettes and other products, we argue for a contractionary approach to the tobacco product market. The tobacco control community should capitalize on the growing theoretical and empirical evidence, political will and public support for the tobacco endgame, and set concrete goals for finally ending the tobacco epidemic.

Background: Despite the discovery of vaccines, the control, and prevention of Coronavirus disease 2019 (COVID-19) relied on non-pharmaceutical interventions (NPIs). This article describes the development and application of the Public Health Act to implement NPIs for COVID-19 pandemic control in Uganda. Methods: This is a case study of Uganda's experience with enacting COVID-19 Rules under the Public Health Act Cap. 281. The study assessed how and what Rules were developed, their influence on the outbreak progress, and litigation. The data sources reviewed were applicable laws and policies, Presidential speeches, Cabinet resolutions, statutory instruments, COVID-19 situation reports, and the registry of court cases that contributed to a triangulated analysis. Results: Uganda applied four COVID-19 broad Rules for the period March 2020 to October 2021. The Minister of Health enacted the Rules, which response teams, enforcement agencies, and the general population followed. The Presidential speeches, their expiry period and progress of the pandemic curve led to amendment of the Rules twenty one (21) times. The Uganda Peoples Defense Forces Act No. 7 of 2005, the Public Finance Management Act No. 3 of 2015, and the National Policy for Disaster Preparedness and Management supplemented the enacted COVID-19 Rules. However, these Rules attracted specific litigation due to perceived infringement on certain human rights provisions. Conclusions: Countries can enact supportive legislation within the course of an outbreak. The balance of enforcing public health interventions and human rights infringements is an important consideration in future. We recommend public sensitization about legislative provisions and reforms to guide public health responses in future outbreaks or pandemics. [ABSTRACT FROM AUTHOR]

The current pandemic of COVID-19 has brought forth issues salient to the epidemic diseases act of India, 1897 like ambiguous terminology, lack of defined criteria for its application, and dearth of features regarding adequate response to threats arising due to communicable diseases for public health. The public health law has an important role in the control of communicable diseases. Constraining individual rights is inherent to public health law which necessitates striking a balance between the coercive aspect of public health law and the common good. Adhering to ethical principles relevant to public health law and valid limitations on human rights as per international covenants is imperative for public health law. A tabular summary of articles published about the epidemic diseases act, of 1897 highlights the need for urgent reform in the legislation. Suggestions to achieve congruence between the epidemic diseases act of India, 1897, and ethical principles for public health law are provided.

The article discusses the importance of integrating legal education into public health continuing education to equip practitioners with essential competencies to navigate the complex legal landscape and enhance public health practice. By incorporating legal principles into ongoing professional development, practitioners can better identify and address systemic barriers contributing to health disparities. Various initiatives and frameworks are highlighted to support the integration of law into public health education, emphasizing the need for a structured and cohesive approach to address gaps in legal training for public health professionals. [Extracted from the article]

As teen dating violence (TDV) has gained attention as a public health concern across the United States (US), many efforts to mitigate TDV appear as policies in the 50 states in the form of for programming in K-12 schools. A keyword search identified 61 state-level school-based TDV policies. We developed an abstraction form to conduct a content analysis of these policies and generated descriptive statistics and graphic summaries. Thirty of the policies were original and 31 were additions or revisions of policies enacted by 17 of the 30 states previously. Of a possible score of 63, the minimum, mean, median, and maximum scores of currently active policies were 3.0, 17.7, 18.3, and 33.8, respectively. Results revealed considerable state-to-state variation in the presence and composition of school-based TDV policies. Opportunity for improving policies was universal, even among those with most favorably scores. [ABSTRACT FROM AUTHOR]

The power afforded to the administrative state is heavily reliant on public trust and the perception of evidence-based agency decision-making. Organizational reputation is key to preserving regulatory power. However, recent investigations reveal that existing scientific integrity policies may not be sufficient to preserve the credibility of many federal agencies. In fact, a significant number of career scientists across various entities – including the FDA – have observed unreported incidents of political interference. While political influence exerted by the executive branch to set policy goals and determine agency priorities can be beneficial, political pressures must not undermine public trust in scientific agencies. Recently, public perception regarding the FDA's COVID-19 response threatened to weaken the agency's longstanding reputation as the gold standard of review. The COVID-19 pandemic publicized vulnerabilities that exist across agencies, as well as those that are unique to the FDA. The FDA's evolution as an increasingly public health-focused agency that must function in the landscape of politicized science exposes the agency to a greater risk of political interference. After all, the FDA's involvement in public health requires increased participation in non-ideal, value-based decision-making. Throughout its history, the FDA has managed to maintain its reputation through its firm responses to scandal. The COVID-19 pandemic provides a platform for the FDA to – once again – look introspectively and institute safeguards addressing vulnerabilities that plagued the agency's pandemic response. This Article examines the FDA's early COVID-19 response to propose reforms that promote meaningful transparency, public accountability, and scientific integrity. [ABSTRACT FROM AUTHOR]

Intimate partner homicides (IPHs) often occur in the context of violent relationships, and firearms often facilitate lethal outcomes. Accordingly, policies have been implemented to reduce firearm access among individuals with histories of intimate partner violence (IPV) or violent propensities. There is considerable variation, however, in the enactment and implementation of such state-level firearm protection laws. Some states fail to extend IPV-related firearm related protections to dating partners, creating what has been referred to elsewhere as the "boyfriend loophole", or what will be referred to here as the "partner loophole". The goal of this analysis was to examine trends in National Violent Death Reporting System (NVDRS) data to assess the relationship of IPHs among unmarried victims in association with state partner loopholes. State policies were abstracted to identify partner loopholes. A series of negative binomial generalized estimating equations were performed using lagged policy variables, year fixed-effects, robust standard errors, and errors clustered by state. Model findings suggest that increased firearm access is related to higher rates of unmarried IPH victimization, however, the associations between the presence of a partner loophole and IPH rates amongst unmarried victims varied between racial subgroups. Significant, protective relationships with closed partner loopholes were identified for the IPH rates amongst white unmarried victims, however, not amongst victims of color. The partner loophole policies considered here, and other individual IPV-related and/or firearm-related policies may be an important component of protections, however, our findings suggest they are not independently sufficient to equitably reduce the burden of IPH. Continuing to develop public health and policy evaluation literature will be essential to progressing towards a policy landscape and cultural environment that are equitably protective. [ABSTRACT FROM AUTHOR]

The mutual influences of social epidemiology and ideas of justice, each on the other, have been seminal in the development of public health ethics and law over the past two decades, and to the prominence that these fields give to health inequalities and the social—including commercial, political, and legal—determinants of health. General and political recognition of injustices in systematised health inequalities have further increased given the crushingly unequal impacts of the COVID-19 pandemic; including impacts of the legal and policy responses to it. However, despite apparent attention from successive UK governments to injustices concerning avoidable inequalities in health opportunities and outcomes, significant challenges impede the creation of health laws and policy that are both effective and ethically rigorous. This article critically explores these points. It addresses deficiencies in a UK health law landscape where health care contexts and medico-ethical assumptions predominate, to the great exclusion of broader social and governmental influences on health. The article explains how a public health framing better serves analysis, and engages with a framework of justice-oriented questions that must be asked if we are to understand the proper place and roles of law and regulation for the public's health. [ABSTRACT FROM AUTHOR]

Previous research has shown that patients who are older, less educated, or have lower income are less likely to lodge complaints about health care. This variation may reflect less wish to complain or inequitable access to complaint channels or remedies. We aimed to investigate associations between sociodemographic characteristics and health users' wish to complain. This was a randomized case vignette survey among 6756 Danish men aged 45–70 years (30% response rate). Assuming they received the care in vignettes about prostate cancer (prostate-specific antigen) testing, participants rated their wish to complain on a 5-point Likert scale. Information on sociodemographic characteristics was obtained through self-reports and municipality-level information from national registries. Lower education was associated with an increased wish to complain (mean Likert difference 0.44 [95% CI 0.36–0.51]; P <.001). The wish to complain was higher among unemployed men (difference 0.16 [95% CI 0.04–0.28]; P <.011) and those with a chronic illness (difference 0.06 [95% CI 0.02–0.10]; P <.004). Given the same healthcare scenarios, there was no difference in wish to complain among health users who were retired, living rurally, or from lower income groups. Health users who are less educated, lower income, elderly, or from rural or minority communities appear to be as likely, or more likely, to wish to complain about health care as others. Yet, younger, well-educated, and higher income citizens are overrepresented in actual complaint statistics. The finding suggests persisting inequalities in the suitability or accessibility of complaint processes for some groups of patients. [ABSTRACT FROM AUTHOR]

Australian, New Zealand, English and Canadian courts have made a number of orders, often in the context of parenting disputes, requiring children to be vaccinated. Complementary therapy options have generally not been permitted as an alternative to mainstream vaccination. Debates about parental entitlements to make decisions about such matters have taken place in the context of contested family law litigation during the COVID-19 era. However, by contrast with Ontario Superior Court of Justice decisions in 2022, a series of Australian decisions, including the judgment of Sutherland CJ in Clay & Dallas [2022] FCWA 18, have developed the law further, having regard to both the capacity of a minor to consent to vaccination and reviewing a variety of factors going to children's best interests at different junctures during the pandemic, finding it generally to be in the best interests of children to receive COVID-19 vaccinations. This is likely to flow back into curial decision-making about vaccinations more broadly, as well as cognate matters. [ABSTRACT FROM AUTHOR]

Digital contact-tracing systems have been widely implemented worldwide with different system designs and implementation policies for the purpose of tracking potentially exposed individuals. The use of a digital contact-tracing app in Hong Kong has been mandated for visiting certain premises by legislations. This paper reviewed the regulations promulgated specifically for the prevention and control of COVID-19 and identified those associated with the digital contact-tracing system. A comprehensive search in newspaper databases was performed to explore the enforcement of the mandated use of the digital contact-tracing app. The three facets of regulations in relation to digital contact tracing were examined: duty to disclose information, requirements and directions to businesses, and compulsory testing. The use of digital contact-tracing data for non-public health purposes was also reported. Our analyses showed that prosecution of non-use or the use of fraudulent digital contact-tracing apps was not limited to COVID-19-specific legislations. The flexible approach ensured the enforcement of the use of the digital contact-tracing app, but the judiciary's test must be passed in future cases. [ABSTRACT FROM AUTHOR]

A debate is developing in Italy on the reform of the employment status of general practitioners. The dispute was prompted by the extraordinary resources the European Union has allocated to Italy on the condition of several structural reforms, among which lies the renewal of the primary care system. One of the most debated questions is whether general practitioners should become civil servants or remain autonomous workers. The issue is not only relevant to the quality and efficiency of primary care but is propitious for improving the legal certainty of this "hybrid figure" in Italian health law. The commentary suggests that, from a public law point of view, the employment status of civil servants better agrees with the foreseeable conditions of general practitioners working in Community Houses. In any case, national and regional policymakers must take into consideration possible controversies and litigation arising from an inappropriate qualification of the legal status of general practitioners in building the new system of Italian primary care. [ABSTRACT FROM AUTHOR]

COVID-19 brought havoc in the world with its high infectivity and virulence. Many countries were caught unprepared in public health capacity and socio-economic parameters. In this trying time, public health ethics remain an unanswered question on many fronts of treatment and control of novel coronavirus. The objective of the paper is to analyse the significant ethical challenges faced during the COVID-19 pandemic. The pre-defined thematic areas based on critical issues are identified to understand the ethical concerns of prevention and control of COVID-19. Secondary sources of literature have been consulted, and pieces of evidence gathered to strengthen the arguments. The article also provides a recommendation on ethical measures for the preservation of human dignity and ethical practices. The human rights aspects of regulations during the pandemic of the coronavirus are discussed to understand various nuances of justice and liberty.

This article explores the importance of integrating legal education into public health curricula. It argues that understanding public health law goes beyond simply summarizing statutes or court decisions. The article suggests that the Council on Education for Public Health should revise its competencies to include law explicitly and advocates for hiring faculty with legal training to effectively teach legal concepts and skills. Lawyers can support faculty members in incorporating law into their courses and contribute to research projects examining the relationship between law and health outcomes. However, there are challenges to hiring lawyers, such as salary differences and tenure expectations. SPPHs can utilize resources and partnerships to enhance their capacity to teach legal concepts and skills. [Extracted from the article]

The COVID-19 Law Lab platform enables quantitative representation of epidemic law and policies in a given country for multiple years, enabling governments and researchers to compare countries, and learn about the impacts and drivers of policy choices. The Law Lab initiative is designed to address the urgent need for quality legal information to support the study of how law and policy can be used to effectively manage this, and future, pandemic(s). [ABSTRACT FROM AUTHOR]

Tourism industry plays a very important role in the global economy contributing to 5 % gross domestic product (GDP), 30% of service export and accounts for 235 million jobs. The industry is the third largest export sector of the global economy (Signe and Johnson, 2018). Africa is endowed with great potential for tourism. The continent has a variety of natural resources and richness of cultural heritage. Tourism in Africa provides livelihoods to millions of people and allows more to appreciate their own culture. The Coronavirus Disease of 2019 (COVID-2019) pandemic has adversely impacted on the economies, livelihoods, public services and great opportunities in Africa. After the pandemic outbreak went global, regulations to contain it were affected in many countries of the World. These included and not limited to:-Transport; cross border movement; closure and regulations on public gatherings (Social distance); guidance on testing; quarantine and isolation; and vaccination. A lot of changes have occurred due to COVID 19 pandemic and especially on international travelling, tourism sector and hospitality industry. This study is guided by Public health law as authored by Gostin (2007). It is therefore important to investigate the existing opportunities crucial on the recovery opportunities and sustainability of the industry after the COVID-19 pandemic. This study was done online and desktop search done through thematic google search engines. Published and relevant research sources from seven African Countries were selected for analysis, interpretation and way forward. [ABSTRACT FROM AUTHOR]

COVID-19 brought havoc in the world with its high infectivity and virulence. Many countries were caught unprepared in public health capacity and socio-economic parameters. In this trying time, public health ethics remain an unanswered question on many fronts of treatment and control of novel coronavirus. The objective of the paper is to analyse the significant ethical challenges faced during the COVID-19 pandemic. The pre-defined thematic areas based on critical issues are identified to understand the ethical concerns of prevention and control of COVID-19. Secondary sources of literature have been consulted, and pieces of evidence gathered to strengthen the arguments. The article also provides a recommendation on ethical measures for the preservation of human dignity and ethical practices. The human rights aspects of regulations during the pandemic of the coronavirus are discussed to understand various nuances of justice and liberty. [ABSTRACT FROM AUTHOR]

The Global Health Security Agenda (GHSA) is a multilateral, multisectoral partnership comprised of more than 70 countries, international organizations, foundations, and businesses to strengthen global health security. [ABSTRACT FROM AUTHOR]

This contribution marks a dual milestone at the intersection of public health law and JLME : my 50th publication of a substantive manuscript in the 50th anniversary of the Journal in 2022. In recognition of these coinciding landmarks, this installment of the Public Health Law column for JLME features observations and reflections of the field based largely on prior publications. [ABSTRACT FROM AUTHOR]

Involuntary commitment links the healthcare, public health, and legislative systems to act as a "carceral health-service." While masquerading as more humane and medicalized, such coercive modalities nevertheless further reinforce the systems, structures, practices, and policies of structural oppression and white supremacy. We argue that due to involuntary commitment's inextricable connection to the carceral system, and a longer history of violent social control, this legal framework cannot and must not be held out as a viable alternative to the criminal legal system responses to behavioral and mental health challenges. Instead, this article proposes true alternatives to incarceration that are centered on liberation that seeks to shrink the carceral system's grasp on individuals' and communities' lives. In this, we draw inspiration from street-level praxis and action theory emanating from grassroots organizations and community organizers across the country under a Public Health Abolition framework. [ABSTRACT FROM AUTHOR]

This article analyzes the Supreme Court's "shadow docket" Free Exercise cases relating to COVID-19. The paper highlights the decline of deference, the impact of exemptions, and the implications of the new doctrine for vaccine and other public health laws. [ABSTRACT FROM AUTHOR]

In 2019, the Council of Europe agreed to urge member states to take steps toward total abolition of psychiatric coercive measures. To test if this aspiration is perceived as realistic and what the alternative would be in the event of a total abolition, we surveyed members of the European FOSTREN network of mental health practitioners and researchers, which is specifically dedicated to exchanging knowledge on reducing psychiatric coercion to its minimum. Web-based survey. Categorical responses were analyzed using frequencies, and free text responses were analyzed through thematic analysis. In total, out of 167 invitations to FOSTREN network members, 76 responded to the survey (Response Rate 45.5%). A minority (31%) of participating experts dedicated to the reduction of psychiatric coercive measures believed a total abolition to be an achievable goal. A commonly held belief was that total abolition is not achievable because mental health disorders are difficult to treat and may cause violence, necessitating coercion, and there is a need to protect the involved persons from harm. Those responding that complete abolition is achievable argued that the consequences of coercion outweigh any gains and indicated that use of advance directives are sufficient as alternatives to coercion. Of a European group of experts specifically dedicated to the reduction of psychiatric coercion who participated in this questionnaire study, a minority believed a total abolition be an achievable goal. The study adds to the empirical evidence of the feasibility of the aspiration to totally abolish involuntary measures in the mental health services from the perspective of experts. [ABSTRACT FROM AUTHOR]

A cross-sectional analysis of human papillomavirus (HPV) vaccine statutes and regulations from states and the District of Columbia in the United States (U.S.) was conducted from September–November 2018 to advance analyses of policy impact on HPV vaccination uptake. A search was conducted using WestlawNext, a legal research database. Statutes and regulations relevant to the study were analyzed and coded based on their legal attributes into ten broad coding questions and several sub-questions. Of the 212 laws identified by the initial search string, 93 (43.9%) reference HPV vaccination in statute or regulation. An additional three laws were added following subsequent review. There was a total of 52 statutes and 44 regulations from 34 states and the District of Columbia. Most laws were related to developing and distributing HPV vaccination materials for parents, and mechanisms to fund and reimburse for the vaccination. This study can be used by policymakers in jurisdictions that are considering establishing HPV vaccination promotion interventions in state law and highlighting the limited statutory and regulatory efforts that have been implemented to promote HPV vaccination. Importantly, this study can also be used to conduct evaluations of the efficacy of statutory and regulatory strategies in increasing HPV vaccination rates.

Abstract Background A resilient health system is inevitable in attaining the health-related Sustainable Development Goals (SDGs). One way of strengthening health systems is improving the coverage of public health laws for better health governance. The aim of this study is to describe the public health law situation in the Western Pacific Region and analyse the association of public health law coverage with health-related SDGs statistics. Methods A total of 33 Western Pacific countries were selected and analysed using a multi-group ecological study design. Public health law coverage was measured from April 2013 to October 2016 based on the public health law coverage module in the ‘Tool to Assess Health Law’ developed by the WHO Western Pacific Regional Office and Asian Institute for Bioethics and Health Law of Yonsei University. The health-related SDGs status were examined using health statistics data from World Health Statistics 2017 and 2018 by WHO and SDGs index scores of previous research. Results Countries with high public health law coverage were Vietnam, Republic of Korea, Hong Kong, and Singapore. Low coverage countries were mainly Pacific Island countries. High public health law coverage issues were health care organisation, communicable diseases, and substance abuse, whereas those of low coverage were human reproduction, family health, and oral health. Public health law coverage was associated with health-related SDGs statistics such as life expectancy at birth (r = 0.47, p = 0.03), health life expectancy at birth (r = 0.47, p = 0.04), health-related SDGs index (r = 0.43, p = 0.05). Among the SDG 3 indicators, maternal mortality ratio (r = − 0.53, p = 0.01), neonatal mortality rate (r = − 0.44, p = 0.02), new HIV infections (r = 0.78, p = 0.04), total alcohol consumption (r = 0.45, p = 0.02), adolescent birth rate (r = − 0.40, p = 0.04), UHC service coverage index (r = 0.50, p = 0.02), and IHR average core capacity score (r = 0.54, p = 0.004) were statistically meaningful. However, there was no association of public health law coverage with health statistics in other SDGs. Conclusions This study proved the importance of public health law in supporting the attainment of health-related SDGs. These results should be used as the basis for review and action at country level in improving public health law for better health systems, consequently achieving health-related SDGs.

This article critically examines the Supporting Ontario's Recovery Act, 2020 ('SORA') and the civil immunity it extends, inter alia, to Ontario's long-term care facilities ('LTCFs') in the wake of the novel coronavirus ('COVID-19') pandemic. It concludes that tort law is a necessary vehicle for accountability and systemic change and should not be proscribed. Part I examines the manner in which increasing reliance on privatization and insufficient regulation of Ontario's long-term care system left residents and workers particularly vulnerable to the pandemic. Part II illustrates the imprudence of granting civil immunity to LTCFs on the contention that any supposed public benefit it yields is outweighed by the harm it portends to both victims and the public at large. Analysis reveals that the aim of SORA's civil immunity is not the furtherance of public health interests in a time of crisis, but rather the preservation of the economic interests of LTCFs (insofar as SORA applies to them). Construed accordingly, the benefits of this civil immunity do not justify its negative consequences, which are explored as three interrelated concepts: the denial of corrective justice; the inequity in bailing out the potential tort liabilities of LTCFs; and the removal of a key incentive for institutional change. [ABSTRACT FROM AUTHOR]

Background: In Georgia, recent measures have expanded public access to naloxone-containing products like Narcan® to combat opioid-related overdose deaths. Although laypersons may legally purchase naloxone products without a prescription for use during opioid-related overdose events, barriers may remain. Methods: We conducted an anonymous telephone survey to investigate three potential barriers to purchasing naloxone (Narcan®) in Georgia: availability, price, and working knowledge of legal requirements among pharmacy representatives. We surveyed pharmacy representatives in select Georgia counties with high volumes or high rates of poisoning deaths compared with other counties. We also compared responses among chain and non-chain representatives. Descriptive statistics are presented concerning the availability, price, and required documentation to purchase Narcan®. Results: Representatives from all 120 pharmacies contacted completed the survey, comprising 6.8% of eligible pharmacies. Availability of Narcan® varied among counties categorized by poisoning deaths: High Rate Counties (50%; n=40), High Volume Counties (66%; n=38), and Comparison Counties (64%, n=42). Narcan® was more available in chain pharmacies (76.7%; n=73) than in non-chain pharmacies (34.0%; n=47). Mean prices for Narcan® were similar among county type: High Volume ($131.46); High Rate ($134.19); and Comparison ($124.50). However, the mean price was much lower in chain versus non-chain pharmacies ($120.91 vs. $149.72). Representatives in chain pharmacies were more likely to state that a prescription was not required to purchase Narcan® (58.9 % vs. 30.0%). Conclusions: In Georgia, barriers related to availability, price, and dispensing requirements for Narcan® persist, decreasing the likelihood of purchase by those who may need a safe, easily administered form of naloxone. Narcan® was generally more available and cost less in chain pharmacies. Representatives in non-chain pharmacies were more likely to require a non-legally necessary prescription to sell Narcan®. Training/intervention opportunities targeting pharmacy staff may help increase layperson access to naloxone products and could ultimately prevent opioid-related overdose deaths.

The Basic Healthcare and Health Promotion Law 2019 became the new constitution of China's health system in June 2020, giving legal effect to ambitious health reform programmes like Healthy China 2030. The concurrent outbreak of coronavirus disease 2019 must not distract us from appreciating the fact that this Law will comprehensively overhaul the health regulatory framework of the world's most populous country during the coming decade, if not beyond. This article offers an original evaluation of the Law in its political context. The Law commendably promises to safeguard the right to health, assist citizens to live a 'complete cycle of life', and promote health using the resources of the public health system. However, it is also deeply politicised, guaranteeing extensive and penetrative political control in health campaigns, digitalised health data, the governance of health institutions, and the resolution of medical disputes. This can be explained by the consequential roles played by epidemics in China's historical dynastic cycles, but even more so by powerful tendencies of centralisation on the part of the Leninist Party-state. The Law's potential is thus subject to the overriding caveat that the Party-state's existence and influence over law and public health must be secured. [ABSTRACT FROM AUTHOR]

Copyright of Jadara Journal of Research & Studies is the property of Association of Arab Universities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Histories of medicine and vaccinology routinely reference the Ottoman Empire with regard to Lady Mary Wortley Montagu, her children's variolation, and the transmission of this knowledge throughout Britain and thereafter Europe. Few, however, follow the empire's ongoing relationship with vaccination after the Montagu family's departure. This article examines this aspect of Ottoman medical history by noting how Jenner's advances diffused back into the empire and then presenting and analyzing how imperial, medical, and even community leaders began to both educationally condition the population and gradually enact legislation that mandated vaccination. Owing to severe infrastructural, personnel, and financial deficits, instability, and popular fears and trepidation, the empire's aspirations to achieve universal vaccination were far from realized by the time of its early 1920s demise—especially throughout largely rural Anatolia. Ottoman institutional, educational, and legislative advances, however, collectively prepared the ground for the succeeding Turkish republic and its public health agenda. Given the republic's promotion of its efforts to modernize Turkey amid its mutual initiatives of nation-building, the empire's histories of providing this foundation are also sometimes overlooked.

Abstract Background The detection of wild poliovirus in Israeli sewage in May 2013 led the health authorities to vaccinate children with OPV (Oral Polio Vaccine). Shelly Kamin-Friedman explored the legal and ethical dimensions of this policy. This commentary makes three claims: (1) Mandatory vaccination is a valid exercise of the state’s police powers to protect the common good. (2) A disease eradication campaign is a sufficient ground for the exercise of those powers. (3) The state is obliged to use the least restrictive/invasive measure to achieve community-wide vaccine coverage, but need not use less effective measures; further, determining which measure is most effective is a fact-specific determination. Goals This commentary offers grounds to support state powers to protect the public’s health and safety. It shows why governments have both the duty and power to safeguard the collective good. State powers also have limits, whose boundaries are determined by the public health necessity. If the state is reasonably using the least restrictive intervention to achieve an important public health objective, it is well within the limits of its authority. Method The commentary uses legal and ethical norms and evidence to support its conclusions. Main findings and conclusion Governments have a duty and power to achieve population-based vaccine coverage sufficient to stem the spread of infectious diseases, including in isolated geographical areas with high numbers of individuals claiming religious and/or conscientious exemptions to vaccine requirements. Governments are obliged to reasonably seek the least restrictive/invasive measure to achieve valid public health objectives; and governments are not obliged to use less effective measures simply because they are voluntary or less invasive. Finding the most effective, least invasive intervention is fact-specific. The essence of public health law is to recognize the state’s power and duty to safeguard the public’s health and safety, and to establish and enforce limits on those powers when the government overreaches—that is, adopts a measure more invasive/restrictive than needed to achieve a valid public health objective.

In early February of 2020, attention was drawn to the increased number of deaths and the new cases of coronavirus infection. The epicentre of the outbreak was Wuhan in the People's Republic of China. In order to control the outbreak, Chinese leaders called on the city authorities in Wuhan to set up mass quarantine centres for infected people. The Chinese government took this step to protect the public against infectious disease. This is an example of the conflicts between public health and civil liberties/individual rights. Government authority is the pillar of the public health law. The government retains the power to achieve and maintain common good by restricting -- within solid international and national limits -- individual rights concerning autonomy, privacy, association, and liberty. Public health agencies have the right to collect, use, and disclose a considerable amount of personal health information and to enforce certain vaccinations, medical examinations, and treatments. In addition to the power to isolate individuals to protect the public against the spread of infectious disease, their powers can be used to control businesses and professions. There are several legal interventions to prevent injury and disease and promote the public's health. Among these tools are taxing policies, which encourage engaging in beneficial behaviour (fruit consumption) and disincentives to engage in high-risk activities (smoking). [ABSTRACT FROM AUTHOR]

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The public health laws are passing through a process churning in the COVID-19 pandemic in India. The effectiveness of quarantine law under 160 years old Indian Penal Code, 1860, and 123 years old Epidemic Diseases Act, 1897 proved short-lived euphoria in controlling horrendous COVID-19 pandemic. The nation-wide Lockdowns on the ground of Sections 6, 10, 38, and 72 of the Disaster Management Act, 2005, provided significant assistance in dealing with formidable challenges of COVID-19. The execution of these laws revealed the safety and security of public health professionals and the delivery system to high vulnerability. Therefore, the President of India promulgated the Epidemic Diseases (Amendment) Ordinance, 2020 declaring 'act of violence' cognizable and non-bailable with high deterrent value. The paper explores the range of normative choices in refurbishing the public health laws beyond the command and control approach evidenced in Epidemic Diseases (Amendment) Ordinance, 2020, to therapeutic perception public health and equity in India. [ABSTRACT FROM AUTHOR]

As countries face public health emergencies, building public health capacity to prevent, detect, and respond to threats is a priority. In recent years, national public health institutes (NPHIs) have emerged to play a critical role in strengthening public health systems and to accelerate and achieve implementation of the International Health Regulations (IHR 2005). NPHIs are science-based government institutions that provide national leadership and expertise for the country's efforts to protect and improve health. Providing a Legal Framework for a National Public Health Institute is a recently released Africa CDC publication intended to support NPHI development throughout Africa. Here we present a legal mapping analysis of sampled legal domains for 5 countries, using the "Menu of Considerations for an NPHI Legal Framework." The analysis delineates the types of legal authorities countries may use to establish or enhance NPHIs and demonstrates how legal mapping can be used to review legal instruments for NPHIs. It also demonstrates variability among legal approaches countries take to establish and enable public health functions for NPHIs. This article examines how the legal framework and menu of considerations can help countries understand the nuances around creating and implementing the laws that will govern their organizations and how countries can better engage stakeholders to identify or address potential areas for opportunity where law may be used as a tool to strengthen public health infrastructure. [ABSTRACT FROM AUTHOR]

• We used publicly available data from 2010 to 2012 to predict which counties in the US would allow legal cannabis sales in 2014 using multiple methods. • The ensemble method produced the best results, as measured by a macro f1 average score of 0.61. • The main factors associated with legalizing county-level recreational cannabis sales were the prevalences of past-month cannabis use and past-year cocaine use. There is substantial geographic variability in local cannabis policies within states that have legalized recreational cannabis. This study develops an interpretable machine learning model that uses county-level population demographics, sociopolitical factors, and estimates of substance use and mental illness prevalences to predict the legality of recreational cannabis sales within each U.S. county. We merged data and selected 14 model inputs from the 2010 Census, 2012 County Presidential Data from the MIT Elections Lab, and Small Area Estimates from the National Surveys on Drug Use and Health (NSDUH) from 2010 to 2012 at the county level. County policies were labeled as having recreational cannabis legal (RCL) if the sale of recreational cannabis was allowed anywhere in the county in 2014, resulting in 92 RCL and 3002 non-RCL counties. We used synthetic data augmentation and minority oversampling techniques to build an ensemble of 1000 logistic regressions on random sub-samples of the data, withholding one state at a time and building models from all remaining states. Performance was evaluated by comparing the predicted policy conditions with the actual outcomes in 2014. When compared to the actual RCL policies in 2014, the ensemble estimated predictions of counties transitioning to RCL had a macro f1 average score of 0.61. The main factors associated with legalizing county-level recreational cannabis sales were the prevalences of past-month cannabis use and past-year cocaine use. By leveraging publicly available data from 2010 to 2012, our model was able to achieve appreciable discrimination in predicting counties with legal recreational cannabis sales in 2014, however, there is room for improvement. Having demonstrated model performance in the first handful of states to legalize cannabis, additional testing with more recent data using time to event models is warranted. [ABSTRACT FROM AUTHOR]

Abstract Medical law and public health law have both served extensively as instruments of health protection and promotion—yet both are limited in their effect and scope and do not sufficiently cover nor supply a remedy to systematic, rather than anecdotal, mistreatments in the health care system. A possible solution to this deficiency may be found in the human rights in patient care legal approach. The concept of human rights in patient care is a reframing of international human rights law, as well as constitutional thought and tools, into a coherent approach aimed at the protection and furthering of both personal and communal health. It applies human rights discourse and human rights law onto the patient care setting while moving away from the narrow consumeristic view of health care delivery. By applying human rights in patient care approach, both national and international courts may and should serve as policy influencing instruments, protecting the rights of the most vulnerable and prejudiced against groups, which are want of a remedy through traditional patients’ rights legal schemes.