Since my last post on the Ebola virus merely one week ago, the death toll in West Africa has risen from approximately 600 to close to 1,000, it has reached one more African country (Nigeria), and the first European to contract the virus was admitted to a hospital only yesterday. There are currently over 1,700 cases, and if not contained soon, Ebola will spread to even more countries and continents. Only today, the World Health Organization (WHO) declared the outbreak a “public health emergency of international concern” (PHEIC) in order to “[alert] the world to the need of high vigilance for possible cases of Ebola virus disease.”
“There are no nations! There is only humanity.” — Isaac Asimov (in I, Asimov: A Memoir)
In a tragedy born of gang violence in Honduras, Guatemala, and El Salvador, compounded by poverty, tens of thousands of children, many unaccompanied by an adult, are risking the treacherous journey across Mexico and to the United States.
What would our response be if we were to let human rights, including the right to health, be our primary policy guide? (I leave aside the fact that the United States has signed, but not ratified, the main international treaty containing the right to health, the International Covenant on Economic, Social and Cultural Rights.)
Françoise Barré-Sinoussi, co-chair of the recently concluded 20th International AIDS Conference, believes that “[a]nti-gay laws in Russia, Uganda, Nigeria and other countries around the world will have ‘consequences’ for the continued spread of HIV around the world, potentially dashing hopes of eradicating the virus in the early 21st century.”
Apropos to the theme of the conference, activists, researchers, policymakers, donors, and celebrities challenged the rest of the world to “pick up the pace” to combat discrimination, stigma, and sustain momentum – political and financial – to fight HIV. While scientific, technical, infrastructural, and financial capacity were discussed and deliberated, little attention was paid to issue of legal capacity.
For the most part, lawyers are viewed as extraneous to conversations on health; they are relegated to some shadow world of paper, words, and bureaucracy that at turns frustrates and mystifies all others to no end. Yet, in this instance – where legalized discrimination is not just an active barrier, but also perhaps the greatest barrier to positive health outcomes – more science, more activism, and more money are not enough. A cure for AIDS could be found tomorrow, but the laws and policies that discriminate against gays, criminalize sex work, and prohibit harm reduction programs will ensure that the most vulnerable populations, concurrently the most at-risk populations, will never realize the end of AIDS. Read More
West Africa is currently experiencing the worst Ebola outbreak since the disease’s first appearance in humans in 1976. This time around, what began as one outbreak in Guinea in February has spread to 60 outbreak sites to date. Since then, it has already killed over 600 people and infected nearly 1,100 in Guinea, Liberia, and Sierra Leone combined (although the numbers are thought to be higher than what has been reported). Only a couple of days ago, the head doctor in Sierra Leone, who has treated more than 100 people and has been leading the fight against the disease since it first appeared in the country, has contracted the disease and is currently being treated by Doctors Without Borders (MSF). Only a few days earlier, three of the nurses working with him died from the disease.
Ebola does not necessarily pose the type of global threat that H1N1 represented back in 2009. It is simply not as contagious—it is transmitted through extended direct contact with the infected person’s bodily fluids and the person only becomes contagious when she or he begins to exhibit the symptoms). It is highly fatal (90% mortality rate), and it kills the infected (if left untreated) in an average of ten days. Nevertheless, given that the incubation period (period of time that it takes for symptoms to develop since first being exposed to the virus) can range from two to 21 days, it is possible that a person could hop on a plane and get to another corner of the world before developing any symptoms. Read More
This post originally appeared on Out2Enroll. To learn more please visit www.out2enroll.org or contact Katie Keith at firstname.lastname@example.org. Katie is a former Research Fellow at Georgetown University’s Center on Health Insurance Reforms. She is currently Director of Research at Trimpa Group and a Steering Committee Member of Out2Enroll.
Yesterday, Out2Enroll—a nationwide campaign dedicated to connecting LGBT people with their coverage options—released a new report exploring the extent to which this year’s outreach and enrollment efforts met the needs of the lesbian, gay, bisexual, and transgender (LGBT) community. The report, Key Lessons for LGBT Outreach and Enrollment under the Affordable Care Act, reflects Out2Enroll’s experience as well as interviews with key stakeholders such as navigators, state equality organizations, national membership organizations, and marketplace officials in the District of Columbia, New York, and Washington.
The US Centers for Disease Control and Prevention (CDC) has come under fire this past month for a series of biosafety problems reported by the country’s top government labs. Last week, the CDC released a report reviewing an incident that occurred in early June that involved the unintentional exposure of CDC personnel to potentially viable anthrax. Additional biosafety violations were also disclosed, including the discovery of smallpox vials in a Food and Drug Administration lab and a transfer from a CDC lab to a US Department of Agriculture lab of an avian influenza cross-contaminated with a highly dangerous influenza strain, H5N1. As a result of these incidents, the CDC issued a moratorium on the transfer of biological specimens from the agency’s highest-level biosafety labs, the closure of the two labs involved in the recent breaches, and the appointment of a senior scientist to be the single point of responsibility for lab safety going forward. The CDC has also established an external advisory group to review the incidents and make recommendations for strengthening biosafety in its labs. Read More
Posted in Global Health;
In my last post, I discussed seven things individual consumers can do to stop the spread of antibiotic resistant superbugs. I left out one important element: the need to lobby our government’s leaders to make this issue a priority. This summer, combating antibiotic resistance is making headlines on both the national and international level. On June 25-26, the Netherlands hosted an international conference on antibiotic resistance as a follow-up to a World Health Organization (WHO) report on antimicrobial resistance. On July 1, British Prime Minister David Cameron announced the creation of a new review panel to investigate antibiotic overuse and explore why new drugs are not being developed. And here in the states, the President’s Council of Advisors on Science and Technology (PCAST) will meet tomorrow to discuss its work on antibiotic resistance.
Momentum is building. Pressure from constituents will further influence government to give the threat of antibiotic resistance the attention it deserves. The following list provides six things constituents should nudge government officials at the local, national and international level to consider among their top priorities. Read More
Sometimes I fantasize about research before the Internet. I would’ve walked to the library to find cases in physical copies of the law reports, and read books made out of actual trees. Sure, it would’ve been slow and time consuming, but perhaps more manageable than the constant onslaught of facts and figures bombarding today’s researchers.
Most days I realize how lucky I am to have access to such a wealth of information. What’s more, there are a wide range of tools to help us manage research in the digital era. But using these tools effectively means customizing content to your interests. Remember: rubbish in = rubbish out. Read More
Posted in Resources;
Last Monday, five justices of the Supreme Court handed down a decision in Burwell v. Hobby Lobby Stores. The basic outline of the case was already briefly discussed on this blog as well as in many many other locations. In short, Hobby Lobby (and others) sued Health and Human Services (HHS) over the contraception mandate established under regulations to the Affordable Care Act (ACA). Five members of the Supreme Court decided that the mandate violated statutory law, and is thus null and void as relates to closely held corporations whose owners object on religious grounds. This leaves all women working for such closely held corporations in limbo in terms of whether they will be able to access a full range of contraceptive options for both family planning and health related concerns.
Importantly – and insufficiently discussed – is that this case does not concern the Constitution. Although Constitutional claims were brought by some of the parties, the Court didn’t consider them. In fact, the First Amendment’s free exercise clause jurisprudence would have found against Hobby Lobby. Instead, this case is purely about a statutory provision that created an enhanced accommodation protection for religious beliefs in the Restoration of Religious Freedom Act of 1993 (RFRA). As such, this decision will remain in place only so long as Congress chooses to keep it by not repealing or amending RFRA. If this were a First Amendment Case, seemingly these words from Justice Scalia in Employment Div. v Smith would be dispositive: Read More
This morning the Supreme Court handed down its most anticipated decision of the term.Burwell, Secretary of Health and Human Services, et al. v. Hobby Lobby Stores, et al. dealt with the application of the Religious Freedom Restoration Act (RFRA) to the contraceptive mandate established under regulations promulgated by HHS under the Affordable Care Act (ACA).
The Supreme Court’s decision that closely-held corporations could not be compelled to provide contraceptives to their employees against the corporation’s religious beliefs may have far-reaching impacts on access to birth control, and could open the door for a wide range of corporate claims to religious exemptions. It also deals a symbolic blow to the ACA in the run-up to the contentious mid-term elections. This post summarizes the decision and its context. Watch the O’Neill Institute Blog this week for further analysis of the decision.
Hobby Lobby in Context
The ACA mandates that all employers with more than 50 full-time employees offer health insurance to these workers or pay a tax penalty. As part of this mandate, HHS established rules defining the basic package of services that must be provided as part of employer-provided health insurance. A required element of that package is coverage without any co-pay for all FDA-approved contraceptive devices, including intrauterine devices (IUDs) and emergency contraceptives (e.g. Plan B). Read More
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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.