Why We Need Anthropologists During Public Health Emergencies

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Image courtesy of NPR.

Image courtesy of NPR

Anthropologists play a key role in responding to public health emergencies, particularly infectious disease outbreaks. However, in the early stages of the recent Ebola outbreak in West Africa, many of the response teams sent by Doctors Without Borders, the World Health Organization (WHO), the U.S. military, etc. failed to include anthropologists. In the face of resistance to treatment and prevention measures (as well as distrust of the people implementing those measures) by the affected communities, anthropologists could have collaborated with public health professionals to ensure that efforts to contain the outbreak were both culturally sensitive and appropriate.

Fortunately, the international community has made a more concerted effort to include anthropologists as part of the teams that are formulating and implementing the response to the current Zika outbreak. Here are 3 examples of how anthropologists are contributing to these important efforts:

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Posted in Global Health, Human Rights, Uncategorized, WHO; Tagged: , , , , , .


Let the Games Begin: Legal and Health Dramas Off-field Risk Overshadowing Rio

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This week has been an interesting week in the world of international sports and health law. The Court of Arbitration for Sport (CAS) announced today that it will uphold the suspension of the Russian track and field team originally imposed by the International Association of Athletics Federations (IAAF) from the upcoming games in Rio in a month’s time. Russia was originally suspended from track and field events by the IAAF in November 2015 after an independent publication by the World Anti-Doping Agency (Wada) alleged systematic and state-supported doping and recommended lifetime doping bans against a number of athletes and coaches. Russia accepted this ban without requesting a hearing and the Russian sports minister apologized at the time for not having identified that doping was taking place without directly admitting state involvement.

The allegations against Russia worsened this week with the publication of another Wada-report called the McLaren Independent Investigations Report into Sochi Allegations that reviewed Russian activities across a range of sports on numerous international sporting events, from roughly 2011 up to and including the 2014 Sochi Olympic Games. The Report suggests that Russian systemic doping of athletes extends well beyond the track and field team, and was directly overseen by the Ministry of Sport and may have involved active participation by members of the Russian secret service who assisted with sample swapping. The International Olympic Committee (IOC) responded to this report in a statement where they called this a “shocking and unprecedented attack on the integrity of sports and on the Olympic Games” and said that they would “not hesitate to take the toughest sanctions available against any individual or organization implicated”. These allegations have led to calls to have the entire Russian Olympic and Paralympic teams banned from the Rio Games, a process that is currently underway through the international sporting tribunal system.

Despite the ban, it may be possible for some Russian athletes to compete if they are nominated by the Russian Olympic Committee and pass numerous drug tests, but their participation would have to do so under the banner of the IOC and not under their home flag of Russia. It remains to be seen what will happen to the secondary challenge against the wider Russian teams and opinions about the correctness of the findings are mixed. Many athletes have come forward praising the decision as being a strong warning for those who would seek to cheat through doping methods, while others have argued that a blanket ban runs contrary to the principles of justice for the clean Russian athletes who have qualified for the Rio Games without having undertaken doping.

With the Olympic torch on day 80 of 95 on its way to Rio, this is just one more dramatic piece to what has already shaped up to be an incredibly dramatic event with political overthrows, violence in the city’s favelas, fears about Rio’s water quality and the ever present threat of the Zika virus, all of which have somewhat overshadowed enthusiasm for the Games themselves and have left some calling to have the Games cancelled. Despite these difficulties, the Games are set to start in just 15 days time and will undoubtedly be exciting however, let us hope that the excitement on the field far exceeds any excitement off the field!

Posted in Uncategorized;


Strengthening Immunization in Conflict-Affected Countries

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Nicholas J. Diamond, J.D., LL.M., M.B.E.

Woman with Immunization Kit

Source: UNICEF

Earlier this month, the World Health Organization (WHO) and the United Nation Children’s Emergency Fund (UNICEF) released the latest data on global immunization coverage. While the data showed evidence of improvement in global immunization coverage, progress remains short of global immunization targets set by the Global Vaccine Action Plan (GVAP), a framework adopted by 194 Member States of the World Health Assembly in 2012 to address vaccine-preventable diseases and advance equitable access to existing vaccines. For instance, the recent data showed that 67 States have not yet been able to reach and sustain GVAP coverage targets and that coverage for newer vaccines (e.g., rotavirus) lagged in middle-income countries.

Most troubling, however, is the fact that immunization in conflict-affected countries remains a significant global concern. Immunization rates in conflict-affected countries, such as Somalia, have hovered at very low levels (less than 50 percent) across basic vaccines for a number of years. Immunization rates in conflict-affected countries, such as Ukraine, which has experienced sustained conflict in recent years, has resulted in significant declines in immunization rates across basic vaccines from higher rates (over 90 percent) in the early 2000s. Still other conflict-affected countries, such as Guatemala and Iraq, have experienced recent declines in immunization rates due to an under-investment in national immunization programs and vaccine stock-outs, among other factors, in addition to conflict. Read More

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Big Tobacco’s Challenge Goes Up In Smoke, Public Health Breathes Easy

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This post was written by Neiloy Sircar, J.D.-LL.M Global Health Law Candidate 2017 and summer research assistant at the O’Neill Institute for National and Global Health Law and Sarah Roache, Institute Associate. Any comments or questions about this post can be directed to nrs53@georgetown.edu.

The July 8 rulinUruguay tobacco packageg in favor of the government of Uruguay in the case of Philip Morris Brands v. Uruguay is an historic victory that clearly establishes the primacy of public health measures over companies’ rights to profit from dangerous products. The 6-year-long legal challenge launched by tobacco giant Philip Morris against Uruguay’s strong tobacco control laws ended in abject failure for the multinational. Governments all over the world considering
strengthening their own tobacco control efforts should be encouraged and emboldened that they too can overcome tobacco industry threats and legal challenges.

Uruguay’s World-Leading Tobacco Control Strategy

Since 2006, Uruguay has established itself as a global leader in tobacco control, adopting multiple measures to protect its population from the dangers of tobacco use in compliance with its obligations under the Framework Convention on Tobacco Control. Two key components of Uruguay’s tobacco control strategy emerged in 2008 and 2009: a “single presentation requirement” and an “80/80 Regulation.” The single presentation requirement effectively limits tobacco producers to one variant of their brand for sale, while the 80/80 Regulation imposes a warning label on all tobacco packaging comprising 80% of the package’s surface area.

Philip Morris Brought Fire…

Having failed to strike down the single presentation requirement and the 80/80 Regulation in Uruguayan administrative and constitutional courts, in 2010 Philip Morris challenged Uruguay’s tobacco control measures as a violation of a bilateral investment treaty between Uruguay and Switzerland, where Philip Morris is based. The case was heard by the World Bank’s International Centre for Settlement of Investment Disputes (ICSID). Philip Morris’ primary argument was that Uruguay’s measures expropriated Philip Morris’ investments, resulting in substantial economic losses. This case was more than a legal dispute, it was part of Philip Morris’ efforts to intimidate other governments seeking to adopt strong tobacco control measures in accordance with the FCTC.

…and Got Burned

The ICSID’s binding ruling constitutes a powerful rejection of Philip Morris’ legal challenge. The ICSID tribunal rejected the tobacco giant’s arguments in their entirety, reaffirming Uruguay’s sovereign right to exercise regulatory powers in the interest of public health. In the 300-page decision, one line may be quoted in future writing more than any other:

“The responsibility for public health measures rests with the government and investments tribunals should pay great deference to governmental judgments of national needs in matters such as protection of public health…”

In addition to finding in Uruguay’s favor, the ICSID also ordered Philip Morris to pay Uruguay’s legal costs. The decision comes as the latest in a string of major defeats for Philip Morris and the tobacco industry more broadly. Philip Morris lost a 2012 case in which it sued the government of Norway in respect of a ban on the display of tobacco products at in retail establishments as well as a legal challenge against Australia’s landmark “plain packaging” legislation.

A Victory With Global Resonance

Philip Morris Brands v. Uruguay will likely have a profound influence on global efforts to reduce tobacco use, to the benefit of public health and those who champion it. Uruguay’s victory will not only help protect its population from the dangers of tobacco, it sends a powerful message that public health measures will not be trumped by well-resourced and unrelenting industry litigants seeking profits at all costs.

Posted in FCTC, Global Health, Non-communicable diseases, Tobacco;


Reflections on Indifference and Human Rights

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24 Jan 2005, New York City, New York, USA --- Nobel Prize winner and Holocaust survivor Elie Wiesel speaks at a special session of the United Nations General Assembly in New York, January 24, 2005. Those who incite hatred and mass murder are not always extremists but men of culture, UN Secretary General Kofi Annan told world leaders in opening the first-ever General Assembly commemoration of the World War Two Holocaust. The UN held a special memorial to the 60th anniversary of the liberation of Auschwitz, the largest Nazi Germany death camp. --- Image by © JEFF ZELEVANSKY/Reuters/Corbis

Elie Wiesel speaks at a UN General Assembly special session in 2005 commemorating the Holocaust. © Jeff Zelevansky/Reuters/Corbis

Indifference. In a word, that was the enduring evil against which Elie Wiesel – the Nobel Peace Laureate and Auschwitz survivor who died earlier this month – struggled, indifference to avoidable anguish. In a 1999 White House address raising the perils of indifference, Elie Wiesel offered these reflections:

Of course, indifference can be tempting – more than that, seductive. It is so much easier to look away from victims. It is so much easier to avoid such rude interruptions to our work, our dreams, our hopes. It is, after all, awkward, troublesome, to be involved in another person’s pain and despair. Yet, for the person who is indifferent, his or her neighbor are of no consequence. And, therefore, their lives are meaningless. Their hidden or even visible anguish is of no interest. Indifference reduces the Other to an abstraction….

[I]ndifference is always the friend of the enemy, for it benefits the aggressor – never his victim, whose pain is magnified when he or she feels forgotten. The political prisoner in his cell, the hungry children, the homeless refugees – not to respond to their plight, not to relieve their solitude by offering them a spark of hope is to exile them from human memory. And in denying their humanity, we betray our own.

The depth of the harm of indifference comes from how easy, and thus how pervasive, it is. I expect that is why other great advocates for human rights have emphasized the danger of indifference. In a 1965 speech, Martin Luther King, Jr., called “the greatest tragedy of this period…not the vitriolic words and other violent actions of the bad people but the appalling silence and indifference of the good people.”

Perhaps the greatest cause of indifference in today’s world, the normalization of terror – whether the terror of another terrorist attack, another mass casualty bombing, or the terror of a mother and her family as she hemorrhages uncontrollably after childbirth, soon to become one of a quarter million-plus women who die from pregnancy- or childbirth-related complications every year, with almost all such deaths preventable. Read More

Posted in Global Health, Human Rights; Tagged: , , , , , , .


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