The Boogeymen of HIV that Never Were

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In the 30 plus years since HIV was first described, there’s been an omnipresent desire to identify the “bad actors” that are responsible for HIV becoming an epidemic. This is true nowhere more than in sub-Saharan Africa (SSA). Much blame over the years has been laid at the feet of those who are perceived as morally inferior rather than dealing with the reality that the reason HIV in SSA has become more prevalent than in other parts of the globe are complex and not fully understood.

In the scientific and planning literature, the language of moral judgment has shifted over time towards calling out groups as “drivers of the epidemic” on whom the blame can be heaped. In large part, these “drivers” are nothing of the sort and are merely boogeymen that can conveniently be utilized to justify a sexual morality that has little to do with public health. As our knowledge of HIV has expanded and as more scientific research has been conducted, it’s unfortunate that many of these same “drivers” remain core parts of the prevention agenda and continue to divert prevention resources away from interventions that have a proven evidence base and effectiveness outcomes.  Read More

Posted in Global Health, Human Rights;


Universal Health Coverage Should Be Universal: An Analysis of a World Health Organization/World Bank Proposal

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Universal health coverage (UHC). It is an ambitious, historic goal. At least in its strongest form, it entails enabling all people to receive the health services they need. Not long ago, it seemed that UHC would be included in the Sustainable Development Goals (SDGs), which will replace the Millennium Development Goals after 2015. While no longer the clear frontrunner for the health-specific goal in the SDGs, it will likely be an important pathway towards achieving the health SDG(s). Independent of the SDG process, UHC has become a centerpiece of many countries’ health agendas.

There is wide recognition that the SDGs must focus much more directly on equity. Universal health coverage must having equity as a focus from the start, rather than as an afterthought, with the rest that the people traditionally with the least access to health services will be the last to benefit. Accordingly, when WHO and the World Bank recently proposed a set of targets for UHC in the post-2015 sustainable development agenda, they assumed a clear equity focus. One, aimed at ensuring a focus from the start on the poorer segments of the population, was that by 2030, the health services available through universal health coverage initiatives would be available to 80% of the poorest 40% of the population. Read More

Posted in Human Rights, WHO; Tagged: , , .


The ACA’s Contraception Coverage Mandate: Constitutional Limits On Exempting Employers

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20120215 NHS_0018This post was written by John D. Kraemer, Assistant Professor in the Department of Health Systems Administration at Georgetown University and O’Neill Institute Scholar.  It was originally published in the Health Affairs Blog on March 20, 2014, and the summary is posted here with permission of the author.  The views presented here are his own. Any questions or comments can be directed to jdk32@georgetown.edu.

Next week, the Supreme Court will consider legal challenges to the Affordable Care Act’s requirement that most employers provide contraception coverage at no cost to employees. Whereas most analyses of these cases have focused on whether the Free Exercise Clause or Religious Freedom Restoration Act require religious exemptions from the contraception mandate, this post considers whether such exemptions would violate a different constitutional provision: the Establishment Clause. The Establishment Clause forbids religious accommodations if they would substantially burden third parties’ interests. In this instance, exempting for-profit, secular employers from the contraception mandate would impose significant limits on female employees’ health and autonomy and would be unconstitutional.  Constitutional precedents protect religious freedom, but not always when in tension with important public health interests.

The full post can be found here.

Posted in Uncategorized; Tagged: , , , , , .


O’Neill Institute: Accepting Applications for 2014-2015 Fellows

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The O’Neill Institute for National and Global Health Law is seeking exceptionally qualified candidates to serve as O’Neill Institute Law Fellows. Housed at Georgetown University Law Center in Washington, D.C., the O’Neill Institute is a leading research institute for health law. For more details about O’Neill and its ongoing work please visit www.oneillinstitute.org.

Law Fellows are based at the O’Neill Institute and report to the O’Neill Executive Director and Faculty Director.  Fellows work on academic legal research and scholarly projects.  Duties include working closely with faculty to produce scholarly works for publication, in some cases leading to joint publication.  Allocation of time is primarily determined by O’Neill Institute faculty needs; additionally, limited time may be allocated to independent research and O’Neill Institute projects. 

Fellowship terms are one year, with possible extension to two years, and will begin in Fall 2014.  Fellows receive an annual salary of $65,000 with outstanding benefits.

Candidates must have a J.D. degree (or the equivalent), exceptional academic credentials including publications, and health law-related research interests in areas like public health law, global health law, domestic health care law, empirical studies, regulatory impacts on health, health and human rights.  Successful candidates will have knowledge and/or experience in aspects of national and/or global health law and ethics.  A post-graduate degree (M.P.H., LL.M.) or significant work experience is preferred.

Applications should be submitted electronically here  and must include: CV, cover letter, writing sample, professional references, official law school transcripts and other graduate school transcripts (if applicable).

Applications must include: CV, cover letter, writing sample, professional references, unofficial law school transcripts (official transcripts may be requested at a later time), and other graduate school transcripts (if applicable).  The application deadline is Friday, April 25, 2014.  Any questions about the position should be directed to oneillinstitute@law.georgetown.edu.

APPLICATION DEADLINE: Friday, April 25, 2014

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“Uganda Be Kidding Me”: Anti-Homosexuality Bill Becomes Law

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On February 24, 2014, Uganda President Yoweri Museveni signed the infamous anti-homosexuality bill into law. He signed it despite threats of losing economic aid from the United States (Uganda’s largest donor). Now, a number donors have suspended aid to Uganda, including the United States and the World Bank. The European Parliament passed a resolution just yesterday calling for targeted sanctions against “the key individuals responsible for drafting and adopting” the law.

It is one of the harshest anti-gay laws in the region. The new law imposes a life sentence for acts of “aggravated homosexuality,” seven years in prison for those “aiding and abetting homosexuality,” and criminalizes the “promotion of homosexuality.” It also subjects any person charged with “aggravated homosexuality” to an HIV test and criminalizes consensual same-sex sexual activity among adults where one is a person living with HIV.

On March 11, 2014, the Civil Society Coalition on Human Rights and Constitutional Law (representing approximately 50 groups) filed a petition before the Constitutional Court. It claims violations of a number of fundamental human rights, including non-discrimination and equality. Read More

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


Is obesity the ticket to fighting antibiotic resistance?

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Research points to the possibility that taking antibiotics could lead to weight gain. Could this reality be the necessary catalyst to change the way we use antibiotics in general?Antibiotic overuse is a public health crisis. For decades, scientists have supported changing antibiotic prescribing practices in response to the alarming consequences of their overuse – most notably, the increasingly common presence of superbug infections.  A report by the Centers for Disease Control, Antibiotic resistant threats in the United States, 2013, found that at least 2 million people become infected with antibiotic resistant bacteria every year, of whom 23,000 die from this infection (note this statistic does not include those who will die from complications of an antibiotic-resistant infection). In reporting for a PBS Frontline documentary, Hunting the Nightmare Bacteria, David E. Hoffman challenges Americans to “jump out of their complacency” and not to view superbugs as “someone else’s problem, some other time.”

 Antibiotics unequivocally remain one of the greatest achievements of modern medicine. But doctors must be more judicious about prescribing the pills and consumers should be more wary of readily taking them.  Director-General of the World Health Organization, Margaret Chan, warns that antibiotic resistance could mean “in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill.”

 Hoffman supports the creation of a broad collaboration of scientists, clinicians, hospitals, regulators and the pharmaceutical industry, to fight this crisis. Right now the federal government has a task force in place to address antimicrobial resistance, but it only meets once a year. Hoffman emphasizes that the “government can light a spark and galvanize people toward a result that each could not achieve acting alone in the face of a real threat.” Read More

Posted in FDA, Global Health, National Healthcare, Uncategorized; Tagged: , .


Arcing Toward Justice: Three Reasons the Fight for Access to Medicines Is Far from Over, But Can Be Won

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“The arc of the moral universe is long, but it bends towards justice.” – Dr. Martin Luther King, Jr.

The past few years have produced a flurry of films documenting (e.g. Fire in the Blood and How to Survive a Plague) and dramatizing (e.g. Dallas Buyers Club) the fight for access to medicines during the early days of the AIDS pandemic. These popular films provide an excellent entry-point into one of public health’s great triumphs. The courage of individuals and unprecedented mobilization of transnational civil society saved millions of lives and transformed the political landscape, helping to reverse the course of a disease once thought to be unstoppable. 

However, these films—always set in the past—risk leaving the public with a perception of the campaign for access to medicines as an historical phenomenon. This post attempts to rectify this misconception, showing that, despite the enormous strides made in providing more affordable medicines for those living with HIV/AIDS, much remains to be done. While campaigners have won several strategically significant battles, the war continues unabated. Read More

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


Cartes, Tobacco’s President: With a Tobacco Executive in Paraguay’s Top Office, the Country is Doing Little to Implement the FCTC

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This post was written by Juan Miguel Litvachkes, O’Neill Institute Research Assistant and National University of Cordoba Abogado (JD Equivalent) Candidate ’14. It was edited by Daniel Hougendobler. For more information about this post, please contact jl1875@law.georgetown.edu.

Tobacco PostThe Framework Convention on Tobacco Control (hereinafter FCTC) was adopted by the 56th World Health Assembly in May 2003. Two years later, on 27 February 2005, the FCTC entered into force. It was sponsored by the World Health Organization (WHO) and, in the ten years since its creation, has been ratified by 177 countries, making it one of the most ratified treaties in the world.

Read More

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Sounding the Alarm: CTE Risks Evident in Many Sports

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soccerIn the days leading up to Super Bowl XLVIII, I wrote about chronic traumatic encephalopathy (CTE) in football and the role that law and policy may play in reducing concussions and protecting the health of athletes. Last week, concussions were back in the news as a groundbreaking study revealed that athletes in other sports – including those that are traditionally perceived as “safe,” such as soccer and baseball – are not immune to the danger of concussion-related degenerative brain diseases. Read More

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You’re Invited – O’Neill Institute 2014 Summer Programs!

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O'Neill Save the Date Email_bothThe O’Neill Institute for National and Global Health Law at Georgetown University invites you to our 2014 Summer Programs.  Now in our third year, we are excited to present two programs this summer: (1) Emerging Issues in Food and Drug Law and (2) US Health Reform – The Affordable Care Act. 

Our Summer Programs convene leading practitioners, policymakers, advocates and academics in food and drug law and US healthcare reform for a series of interactive lectures, panel discussions, and case studies.  Held during consecutive weeks, July 14-18 (Emerging Issues in Food and Drug Law) and July 21-25 (US Health Reform – The Affordable Care Act), interested participants may attend one or both programs. Invited speakers include current and former officials from HHS, the FDA, the FTC, the EPA, as well as former U.S. Congressional staff involved in the adoption and implementation of the Affordable Care Act.

Additional details, including schedule, speakers, online application, and program fees may be found here.  Questions may be directed to oneillsummer@law.georgetown.edu.

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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.

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