On November 13, Paris experienced the worst terrorist attack in the city’s history. In coordinated attacks across the city, terrorists detonated suicide vests and gunned down concertgoers. In the end 130 people were killed and more than 350 wounded—many seriously.
Mass casualty, multi-site terror attacks pose an extraordinary challenge to health system capacity. An influx of severely wounded people requires a coordinated response including a surge of medical personnel and first responders as well as complex coordination and triage. Most of all it requires careful preplanning.
Today, the Lancet released first-hand account of the medical response to the Paris attacks. Doctors who were directly involved in the aftermath detailed the mechanisms that were triggered by the attacks and how they worked in practice. As the authors note, “it is too early to report . . . the lessons that can be learned from this event.” Nonetheless, the article provides a fascinating look into how public health emergency preparedness.
This week several members of the O’Neill Institute attended and participated in the World Bank’s Law, Justice and Development Week program. On Tuesday morning, members of the Institute led a session on “Law's Power to Safeguard Global Health.” I moderated the session, and was fortunate to be joined by one of the Co-Chairs of The Lancet - O’Neill Institute, Georgetown University Commission on Global Health and the Law, John Monahan, and one of the Commissioners, Alicia Yamin. Read More
On November 2-4, Oscar Cabrera, Executive Director of the O'Neill Institute, and I participated in the IV Latin American Legal Conference on Reproductive Rights in Lima, Peru. The Conference takes place every two years, bringing together academics, judges and other judicial officers, legislators, activists and civil society representatives. This year, the Conference focused on the intersections between violence against women and reproductive rights in Latin American.
Posted in Human Rights; Tagged: Adolescent Health, Colombia, human rights, justice, latin america, maternal mortality, O'Neill Institute, Reproductive Rights, right to health, sexual and reproductive rights, United Nations, violence against women.
This post was written by Janelle Langan, a Global Health Law LL.M. student at Georgetown Law. Any questions or comments about this post can be directed to email@example.com.
Recent emphasis upon diet through consumer education, media coverage, and mobile food journaling applications has brought healthy eating to the forefront of the minds of consumers. A healthy diet is a preventative measure that can help combat various diseases and conditions. In response to consumer focus upon diet, the market for healthy foods expanded from its’ niche origins into a prevalent force in the mainstream food marketplace.
By Bruno Ramdjee and Fernanda Alonso
In December of last year, an FDA advisory panel met to discuss whether or not the federal government should reverse its policy banning gay men from donating blood. If the FDA had lifted the ban, gay men would have been allowed togive blood if they abstained from sexual encounters with men for 12 months, a posture that was analyzed in this blog. However, the federal government in the US did not change its policies and men who have sex with men (MSMs) are still banned from blood donation. Luckily, this is not the case in Europe, were countries such as Portugal and the UK have authorized donations, limiting their deferral periods for sexually active MSMs to a year. Other countries like Spain and Italy have gone even further, preferring individual risk assessment approaches instead of discriminatory measures based on sexual orientation.
On November 9th, France joined this list of countries, when French Minister of Health Marisol Tourraine ended the lifetime ban for gay and bisexual men, authorizing MSMs to donate blood, with the one-year deferral period. This new regulation will be tested during one year, and if no new risks are identified, MSMs will be allowed to donate their blood under the same conditions as the rest of the population. Although French Health Ministers had been announcing that they wanted to end the discriminatory banfor more than ten years, they hadn’t been able to do it do to an HIV contaminated blood transfusion that took place in the 1980s. The health crisis that occurred because of this event brought the Prime Minister and the Minister of Health before the High Court of Republic for the first time in French history, making the topic a taboo matter in the government. Read More
A colleague, Aliza Glasner, recently asked a fundamental question about the move towards food labeling that not only tells you about what nutrients are in the food, but also provide warnings about unhealthy food: What is healthy food? What is unhealthy food?
That got me thinking. What about people for whom “healthy” is not the same as for most people, certainly most Americans, two-thirds of whom are overweight or obese? What is healthy for people who are underweight or even anorexic, and need more food, not less? How might food labels that seek to deter the central American eating problem, eating too much not particularly healthy food, affect them?
Several countries have recently required nutrition labels to rate foods, making clear – such as through warnings, color coding (e.g., red for danger), or a star system – which foods have high levels of nutrients that are considered unhealthy at those levels. Chile, with the first such law, in 2012, will require that labels for foods that exceed certain levels of calories, saturated fat, sugar, and sodium include the appropriate warning inside a stop sign. Other such food warning labeling schemes, both mandatory and voluntary, are getting underway.
Limiting intake of such foods is sound advice for most people. But for a small minority, those stop signs should be green lights instead – at the very least, for calories. Some people are underweight, even severely so, with eating habits that may lead to malnutrition (and as a result, illnesses including osteoporosis and anemia) and weakened immune systems.
A concern about food labels and people who are underweight, and in particular people with eating disorders, is not new; in 2008, Harvard's dining service stopped posting calories for this reason.
Finally, after years of negotiation, speculation, anticipation and/or trepidation, the full text of the Trans-Pacific Partnership (TPP) has been released. Undoubtedly, lawyers around the world will be pouring over the details over the next weeks and months, as will the US congress in order to decide whether to approve or reject the agreement in its current form.
As I’ve written about before, many people working in public health and tobacco control have been concerned about how tobacco will be treated under the agreement. Particularly, whether Big Tobacco will be able to continue to use trade and investment lawsuits to bully and intimidate countries that try to enact tobacco control laws. Laws that are trying to address the horrifying reality that tobacco kills six million people every year – more people than alcohol, AIDS, car accidents, illegal drugs, murders and suicides combined.
After much negotiation and lobbying by health, human rights and tobacco control organizations, a provision excluding tobacco claims from investor-state disputes has been included in Chapter 29 of the TPP. It’s contained in Article 29.5 and states that a “Party may elect to deny the benefits of [investor-state dispute resolution] with respect to claims challenging a tobacco control measure of the Party.” Parties can elect to deny benefits before or after such claims are have been initiated. A tobacco control measure is defined very broadly and applies to a wide range of tobacco control interventions, possibly even the regulation of e-cigarettes.
This kind of tobacco-specific carve-out is certainly unprecedented in the history of trade and investment agreements and sets a strong precedent for tobacco control and public health. An international trade treaty expressly recognizing tobacco products as uniquely harmful and tobacco control measures as requiring specific protection is an incredibly important step which, ideally, would set a floor for future agreements. But is it enough? Read More
A fundamental purpose of the law is to provide individuals with the tools and means to achieve the highest possible standard of life and to empower those least able to enforce their rights. Individuals make numerous permanent and life-changing decisions everyday without interference and indeed, many of us gauge our notion of freedom on our ability to make choices and navigate avenues of self-determination without the interference of government. One avenue where this balance between self-determination and government intervention is particularly called into question is the discussion around end of life choices, particularly physician assisted death (PAD).
PAD broadly encompasses two terms, physician assisted suicide (PAS), where a doctor gives a patient a prescription for life-ending medications that they can take in their own time, and euthanasia, where the doctor directly administers the life ending medication at the patient’s request. Whatever your views on PAD, the issue has domestic and global momentum with recent polls showing that the majority of U.S. doctors and general public are in favor of PAD along with the majority of the general population in Western Europe and physicians in the U.K. Following two Supreme Court decisions in the 90’s, PAD is at the discretion of the States and a recent wave of legislation is following this cultural shift with California becoming the 5th state to explicitly allow PAS in 2015 and bills and/or legal cases being discussed in 25 legislatures and the District of Colombia in the 2015 legislative session. Starting in 2016 almost 1 in 10 American’s will live in a state where they can choose assisted death. Internationally, parliamentary discussions are slated to occur around PAD in Brittan, South Africa, Germany and Scotland in 2015/16.
This post was written by O’Neill Institute Executive Director, Oscar Cabrera and O’Neill Institute Faculty Director, Lawrence O. Gostin. Any questions about this post can be directed to firstname.lastname@example.org or email@example.com.
A prior O’Neill Institute blog by Aliza Glasner reported on the criminal convictions and sentencing of food company executives in the United States for knowingly selling contaminated peanut butter. Bringing criminal charges against any corporations or executives that knowingly or recklessly break the law by selling contaminated or defective products that cause significant risks or harms to consumers certainly makes sense. Indeed, successful criminal prosecutions of corporations and their executives typically focus on harmful actions that directly violate specific statutes or otherwise go well beyond accepted business practices (e.g., bribery) or normal market competition (e.g., fraud).
Yesterday, the World Health Organization (WHO) made waves with meat-eaters around the world by classifying processed meat as carcinogenic, and red meat as probably carcinogenic:
Processed Meat: Processed meat was classified as carcinogenic to humans based on sufficient evidence in humans that the consumption of processed meat causes colorectal cancer.
Red meat: After thoroughly reviewing the accumulated scientific literature, a Working Group of 22 experts from 10 countries convened by the IARC Monographs Programme classified the consumption of red meat as probably carcinogenic to humans (Group 2A), based on limited evidence that the consumption of red meat causes cancer in humans and strong mechanistic evidence supporting a carcinogenic effect. This association was observed mainly for colorectal cancer, but associations were also seen for pancreatic cancer and prostate cancer.
The significance of the science behind WHO’s findings needs more explanation. For example, we need better understanding of the actual statistical significance of the findings. Still, the news is hardly a surprise. Correlations between red meat and health issues have been drawn for years. The study’s public conclusions open another door for regulators to make meaningful strides in improving dietary choices negatively impacting public health. To save lives, reduce rates of cancer, and protect children, regulation of carcinogenic food is probably necessary, and likely inevitable.
The question is, how?
Should hot dogs come with a warning label about their propensity to cause cancer? Should we focus on portion control? Issue a deterring sales tax? Should Congress give FDA the authority to regulate processed meats like other carcinogenic products, namely tobacco?
The memory of NYC’s soda wars is fresh. A measure as simple as portion control caused tremendous strife, lawsuits and public outrage. If New Yorkers got that upset about soda, imagine how this nation might respond to a perceived threat to hot dogs? Bacon?? Lunchmeat???
Much remains to be understood about WHO’s findings and there is not an obvious path forward. We have many years of regulatory precedents, both successes and failures, from which to draw. We wear seatbelts in cars and trans-fats are being banished from our food. On the flip side, we failed to limit marketing sugary foods to children and we are still drinking soda with abandon.
WHO's report affords the public health community an opportunity to make meaningful change in the diets of people around the world, but we must tread carefully to maximize its potential. Dialogue and consensus are going to be key ingredients in devising a plan to turn these findings into meaningful regulation. I am optimistic. If the public health community figured out how to prohibit smoking on airplanes, surely there is hope for reducing the incidence of bacon-related cancers.
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The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.