1. The right to health, public health and COVID-19: a discourse on the importance of the enforcement of humanitarian and human rights law in conflict settings for the future management of zoonotic pandemic diseases
- Author
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Van Hout, M.C. and Wells, J.S.G.
- Subjects
enforcement ,Public administration ,Ebola Virus Disease, (EVD) ,Health Services Accessibility ,0302 clinical medicine ,medical personnel ,RA0421 ,Zoonoses ,Health care ,Disease ,Democratic Republic of the Congo, (DRC) ,030212 general & internal medicine ,International Humanitarian Law, (IHL) ,health care economics and organizations ,media_common ,Review Paper ,education.field_of_study ,Human rights ,Personal Protective Equipment, (PPE) ,030503 health policy & services ,public health ,World Health Organization, (WHO) ,General Medicine ,international humanitarian law (IHL) ,Humanitarian intervention ,Corona Virus Disease, (COVID-19) ,International Human Rights Law, (IHRL) ,right to healthcare ,Committee on Economic, Social and Cultural Rights, (CESCR) ,Universal Declaration of Human Rights, (UDHR) ,0305 other medical science ,International humanitarian law ,Geneva Convention IV, (GC IV) ,medicine.medical_specialty ,Health Personnel ,zoonotic induced pandemics ,media_common.quotation_subject ,International Covenant on Civil and Political Rights, (ICCPR) ,Population ,human rights ,United Nations, (UN) ,03 medical and health sciences ,Right to Health ,Political science ,medicine ,Animals ,education ,Pandemics ,armed conflict ,Right to health ,SARS-CoV-2 ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,COVID-19 ,Altruism ,International Covenant on Economic, Social and Cultural Rights, (ICESCR) ,International human rights law ,Health Facilities ,Emergencies ,business - Abstract
Objectives The catastrophic effects of armed conflict, particularly prolonged armed conflict, on individual and public health are well-established. The ‘right’ to healthcare during armed conflict and its lack of enforcement despite a range of United Nations mandated requirements regarding health and healthcare provisions is likely to be a significant feature in future conflicts, as zoonotic induced pandemics become a more common global public health challenge. The issue of enforcement of health rights assurance and its implications for the public health management of global pandemics such as COVID-19 in and between countries and regions in conflict is the objective of this Review. Study Design Narrative Review. Methods Referenced to the framework of International humanitarian law (IHL) and International human rights law (IHRL) in order to explore and discuss the deficits in health rights assurances in conflict settings and illustrate how gaps in protection and lack of enforcement compounds the disease response. Both international humanitarian law, and international human rights law can be leveraged to ensure human and health rights are assured in conflict settings. There is a distinct lack of international criteria with regard to standards of health care coverage, infrastructure and service preservation to the civilian population during times of armed conflict. This has far reaching consequences when confounded by a pandemic or even localised disease outbreak. Results We illustrate how in a pandemic disease emergency, such as COVID-19, all life is threatened; and how leaving the citizen population exposed to this contagion is a human rights breach and an indirect method of warfare. The consequences of failure to effectively address such pandemic infections, (i.e. COVID-19), in a conflict setting are potentially catastrophic as prevention and containment responses are severely constrained by state insecurity, political instability, terrorism, repression, rights abuses and displacement of citizens. Neglect by State actors potentially constitutes a breach of the universal right to life. States cannot justify their failures to mitigate disease based on claims of lack of resources, even when available resources are minimal. Where discrimination of people with a disease, such as COVID-19, or minority groups at the point of access to health facilities occurs, this further breaches the principle of medical neutrality. Conclusions The example of the COVID-19 response may offer a viable route to leverage greater access and coverage of health care in conflict and humanitarian settings. A radicalised partnership approach during these times of emergency is warranted, based on an ethical “humanitarian intervention” approach to provide care to all affected by contagious disease in conflict settings.., Highlights • The catastrophic effects of armed conflict on individual and public health are well-established. • Zoonotic induced pandemics (COVID-19) are a growing public health challenge in conflict settings. • International humanitarian law and human rights law can be leveraged to ensure health rights are assured in conflict settings. • In a pandemic disease emergency life is threatened; and leaving citizens exposed to contagion is a human rights breach and an indirect method of warfare. • States cannot justify their failures to mitigate disease based on claims of lack of resources. • Breaches of medical neutrality occur where discrimination of people with COVID-19 at the point of access to health facilities occurs. • COVID-19 responses may offer a viable route to leverage greater access and coverage of health care in conflict settings.
- Published
- 2021