The COVID-19 pandemic raises many human rights challenges and concerns, reports public health researcher Alison Barrett in her latest COVID-19 wrap.
Human rights must be the foundation of any COVID-19 response
Meier, B & Gostin, LO, Oxford University Press Blog, 17 August 2020
As stated in the 1966 International Covenant on Economic, Social and Cultural Rights, everyone has the right to the highest standard of health; and steps should be taken to prevent, treat and control epidemic, endemic, occupational and other diseases. Everyone should also be assured that medical services and attention are available in the event of illness.
In the context of the current coronavirus pandemic, this means that governments and policymakers need to make decisions to control the spread of the virus, whilst also ensuring medical care is available, accessible, acceptable and culturally appropriate to treat both infected individuals and other patients requiring medical attention.
The right to health also requires that health goods, facilities and services are of good quality, non-discriminatory, and respectful of gender and medical ethics. This includes, among other things, ensuring that those infected with COVID-19 have access to appropriate healthcare, such as ventilators and oxygen; personal protective equipment (PPE) is available for healthcare workers; and routine healthcare services are not disrupted.
Examples where these rights to health have not been met during the pandemic include inadequate supplies of PPE, diagnostic test kits, ventilators and oxygen; and disruptions to routine immunisation programs.
“The COVID-19 pandemic has been exacerbated by human rights failures, yet the right to health can provide a framework for assuring that the COVID-19 response serves to realise the right to the highest attainable standard of physical and mental health for all,” Dainius Puras and colleagues wrote in The Lancet.
In controlling the spread of the COVID-19 virus, individual human rights and freedoms have been limited.
Travel and the right to move freely have been reduced; privacy violated in some nations; and mandatory mask wearing, contact tracing, lockdowns and curfews all restrict aspects of individual freedoms.
But these measures are important for public health and in controlling the virus. Under public health acts, such as the Victorian Public Health and Wellbeing Act (2008), they are permissible in a state of emergency.
“Where it is necessary to limit individual freedoms to address this public health emergency, governments must ensure that any human rights limitations are reasonable, proportionate, non-discriminatory, and grounded in law,” Meier and Gostin wrote.
Governments and policymakers need to ensure they are following principles and guidelines to ensure that human rights are not being restricted without legitimacy.
Summarised in this article, the Siracusa Principles, adopted in 1984, clarified that the restriction of human rights in the context of a crisis, such as the coronavirus pandemic, should only be done when, among other things, the restrictions are:
responsive to a pressing public need (for example, protecting public health);
deemed necessary and proportionate to a legitimate aim;
prescribed by law and not imposed arbitrarily; and
applied as a last resort using the least restrictive means available.”
With respect to the pandemic in Victoria, Australia, the Victorian Equal Opportunity and Human Rights Commission has identified six key principles that should guide the Victorian Government’s response to the pandemic.
Restrictions and limitations to people’s rights should be:
- Necessary, proportionate and based on evidence;
- Time-bound and remain in place only as long as necessary; reviewed regularly, updated accordingly and clearly communicated;
- Transparent; not only should restrictions be clearly communicated, but accessible, comprehensive and timely for people from all backgrounds. People need to be able to understand the measures and reasons why they’re being implemented;
- Scrutinised; the government needs to facilitate accountability and individuals should have knowledge of review processes should they wish to voice any concerns; and,
- Inclusive of additional safeguards and supports to minimise the limitation on human rights, prevent abuse of new government powers and protect vulnerable people.
A PDF of the six key principles can be found here.
Source: © State of Victoria (The Victorian Equal Opportunity and Human Rights Commission) 2020.
Marginalised populations, such as those experiencing homelessness or those living in aged care, are most vulnerable to infection. In responding to the pandemic, it is important to consider the population-level impacts of the virus and ensure attention is given to those who face disproportionate risks.
Physical distancing measures have highlighted “inequitable challenges” during the pandemic. For example, access to basic food and nutrition, safe housing, water, sanitation and hygiene are basic social determinants of health, central to the right to health, and are nearly impossible to achieve in some living conditions.
Physical distancing and lockdown measures also exacerbate access to health care for people living with disability, keep children from school, make it a challenge for people to buy basic necessities, increase gender-based violence, and therefore widen health inequities.
While these measures are important for public health and in controlling the spread of the virus, attention must be given to vulnerable populations by providing adequate shelter to people experiencing homelessness, additional support to those living in violent situations, adequate financial support to those who have lost income, by providing food and medication delivery to people living with disability.
In a human rights-based approach to health, governments and policymakers need to “pursue equality, support participatory engagement and facilitate accountability for rights violations,” Meier wrote.
Importantly, and to reiterate what has already been outlined, any response to the pandemic must be communicated clearly by governments and policymakers, in an equitable and timely fashion, justified with evidence, and open to review.
Independent reviews into COVID-19 responses enable assessments by courts, human rights institutions and governments to ensure accountability and also improvements to future pandemic responses and health systems. In Australia, examples include an independent review into the outbreak at Newmarch House, in New South Wales, and an inquiry currently underway into the hotel quarantine program.
Croakey’s #JusticeCOVID series has also highlighted wide-ranging concerns about the rights of people in detention and prisons during the pandemic, as well as the importance of reforms to address ongoing systemic problems with policing and incarceration in Australia.
In conclusion, as health and human rights are so strongly linked, it is imperative the pandemic response follows a human rights framework and minimises the impact on basic health needs, with a particular focus on vulnerable populations.
Alison Barrett is a Masters by Research candidate and research assistant at University of South Australia, with interests in public health, rural health and health inequities. Follow on Twitter: @AlisonSBarrett. Croakey thanks her for providing this column as a probono service to our readers.
See previous editions of the COVID wrap.
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