Matthew M Kavanagh

Georgetown University | GU

The “right to health” is increasingly enshrined in national constitutions around the world—present today in a slight majority of written constitutions. Whether this trend is good, bad, or meaningless is considerably debated. Contrary to skeptics’ worries, this study finds empirical evidence of a positive role of the right to health in the productio...

Introduction Despite international commitment to achieving the end of HIV as a public health threat, progress is off‐track and existing gaps have been exacerbated by COVID‐19's collision with existing pandemics. Born out of models of political accountability and historical healthcare advocacy led by people living with HIV, community‐led monitoring...

Achieving the global HIV, tuberculosis, and malaria targets will require innovative strategies to deliver high quality and person-centered health services. Community-led monitoring (CLM) is a rapidly proliferating health systems strengthening intervention for improving healthcare services and documenting human rights violations, through social empo...

Background Failure to retain people living with HIV (PLHIV) in care remains a significant barrier to achieving epidemic control in Haiti, with as many as 30% lost from care within one year of starting treatment. Community-led monitoring (CLM) is an emerging approach of improving healthcare and accountability to service users, through a cycle of mon...

Background We assessed if women and girls on the move living with or at high risk of HIV faced increased health inequity and socioeconomic inequalities during the COVID-19 pandemic compared with other vulnerable women and girls. Methods We used data collected through a survey conducted in Nigeria between June and October 2021. Women and girls livi...

Objectives Assess the relationship between income inequality and HIV incidence, AIDS mortality and COVID-19 mortality. Design Multicountry observational study. Setting 217 countries for HIV/AIDS analysis, 151 countries for COVID-19 analysis. Participants Used three samples of national-level data: a sample of all countries with available data (gl...

Across multiple pandemics, global health governance institutions have struggled to secure the compliance of states with international legal and political commitments, ranging from data sharing to observing WHO guidance to sharing vaccines. In response, governments are negotiating a new pandemic treaty and revising the International Health Regulatio...

Context: To facilitate the manufacturing of COVID-19 medical products, in October 2020, India and South Africa proposed a waiver of certain WTO intellectual property (IP) provisions. After 18 months, a narrow agreement that did little for vaccine access passed the ministerial, despite the pandemic's impact on global trade, which the WTO is mandate...

International mechanisms failed to achieve equitable distribution of COVID‐19 vaccines—prolonging and deepening the pandemic. To understand why, we conduct process tracing of the first year of international policymaking on vaccine equity. We find that, in the absence of a single venue for global negotiation, two competing law and policy paradigms e...

Background: Few assessments of associations between structural-level factors and HIV among gay men and other men who have sex with men (MSM) have been conducted, especially in sub-Saharan Africa. Our objective was to examine HIV testing history, HIV status, and stigmas among MSM living in ten countries with heterogeneous legal environments. Metho...

The philanthropist’s life-saving ideas need insights from political science. The philanthropist’s life-saving ideas need insights from political science. People cheer and hold up signs at a mask and Covid-19 vaccination mandates protest People cheer and hold up signs at a mask and Covid-19 vaccination mandates protest

There is growing recognition that health and well-being improvements have not been shared across populations in the Americas. This article analyzes 32 national health sector policies, strategies, and plans across 10 different areas of health equity to understand, from one perspective, how equity is being addressed in the region. It finds significan...

How do choices in criminal law and rights protections affect disease-fighting efforts? This long-standing question facing governments around the world is acute in the context of pandemics like HIV and COVID-19. The Global AIDS Strategy of the last 5 years sought to prevent mortality and HIV transmission in part through ensuring people living with H...

Most countries have implemented restrictions on mobility to prevent the spread of Coronavirus disease-19 (COVID-19), entailing considerable societal costs but, at least initially, based on limited evidence of effectiveness. We asked whether mobility restrictions were associated with changes in the occurrence of COVID-19 in 34 OECD countries plus Si...

Why do some countries rapidly adopt policies suggested by scientific consensus while others are slow to do so? Through a mixed methods study, we show that the institutional political economy of countries is a stronger and more robust predictor of health policy adoption than either disease burden or national wealth. Our findings challenge expectatio...

How does the use of criminal law affect disease-fighting efforts, particularly in a pandemic? This longstanding question for governments around the world is felt acutely in the context of the COVID-19 and HIV pandemics. Many countries have laws and policies that criminalise behaviours, making same-sex relationships, illicit drug use, and sex work i...

There is growing recognition that health and well-being improvements have not been shared across populations in the Americas. This article analyzes 32 national health sector policies, strategies, and plans across 10 different areas of health equity to understand, from one perspective, how equity is being addressed in the region. It finds significan...

It is necessary to look at WHO from at least two perspectives: (1) its role as a scientific, technical, and humanitarian organization and (2) as an international organization and venue for international political negotiation, diplomacy, and policy-making. These two different, at times conflicting, missions leave WHO in a precarious position and hav...

Objectives To determine the impact of restrictions on mobility on reducing transmission of COVID-19. Design Daily incidence rates lagged by 14 days were regressed on mobility changes using LOESS regression and logit regression between the day of the 100th case in each country to August 31, 2020. Setting 34 OECD countries plus Singapore and Taiwan...

Mathew Kavanagh and co-authors discuss law reform in the global tuberculosis response.

Throughout the world, laws play an important role in shaping population health. Law making is an intervention with measurable effects yet often unfolds without evaluation or monitoring. Policy surveillance—the systematic, scientific collection and analysis of laws of public health significance—can help bridge this gap by capturing important feature...

Law and policy differences help explain why, as HIV-related science has advanced swiftly, some countries have realised remarkable progress on AIDS while others see expanding epidemics. We describe the structure and findings of a new dataset and research platform, the HIV Policy Lab, which fills an important knowledge gap by measuring the HIV-relate...

The COVID-19 pandemic has challenged governments around the world. It has also challenged conventional wisdom and empirical understandings in the comparative politics and policy of health. Three major questions present themselves: First, some of the countries considered to be the most prepared—having the greatest capacity for outbreak response—have...

With the novel coronavirus disease COVID-19 reaching pandemic proportions and U.S. President Donald Trump declaring a national emergency, now is a critical moment to learn from countries’ responses thus far and rapidly implement effective strategies to limit the impact of the virus. Yet Americans are at risk of learning the wrong comparative lesson...

Better data on health disparities and commitment to interventions focused on the determinants of inequality are essential, argue Eric Friedman and colleagues.

Abstract: Every U.S. President in recent decades has had to respond to at least one pandemic disease. Political leadership has proven decisive. In the coming years, U.S. foreign policy will face at least three inter-related issues: today’s major pandemics of AIDS, TB, and Malaria; future outbreaks with the potential to become pandemics; and rising...

Background: The Global Fund to Fight AIDS, Tuberculosis and Malaria has proven highly effective at fighting the world's major killers. Strong governance and robust development institutions are necessary, however, for improving health long-term. While some suggest that international aid can strengthen institutions, others worry that aid funding wil...

Efforts to improve the effectiveness of global health aid rarely take full account of the micro-politics of policy change and implementation. South Africa's HIV/AIDS epidemic is a case in point, where the US President's Emergency Plan for AIDS Relief (PEPFAR) has provided essential support to the national AIDS response. With changing political cont...

The Ebola epidemic in the Democratic Republic of Congo (DRC) is exceptionally dangerous, occurring within active armed conflict and geopolitical volatility, including a million displaced persons. With 421 cases, 240 deaths, and the numbers increasing, this Ebola outbreak is the second deadliest in history.¹ Recent spread to Butembo, home to 1.2 mil...

Widespread public health surveillance efforts focused on key populations (men who have sex with men, sex workers, people who inject drugs, and others) gather data on population sizes, HIV prevalence, and other information for planning and resource allocation. Biometric identification might improve this data gathering. However, in the context of ext...

This year marks the 70th anniversary of both the birth of human rights law through the Universal Declaration of Human Rights (UDHR) and the birth of global health governance through the World Health Organization (WHO). Over the past 70 years, human rights have developed under international law as a basis for public health, providing a foundation fo...

Purpose of review: Civil society demand for accountability has long been a critical component of the AIDS response. In the age of 90-90-90 HIV treatment goals, civil society advocacy has continued, but often in new forms. In particular, civil society accountability at the intersection of national policy and global health financing has taken on inc...

Establishing Principles of Stakeholder Engagement in Global Health Implementation Science and Research. https://www.heardproject.org/resources/establishing-principles-of-stakeholder-engagement-in-global-health-implementation-science-and-research/

Introduction: Key populations bear a disproportionate HIV burden and have substantial unmet treatment needs. Routine viral load monitoring represents the gold standard for assessing treatment response at the individual and programme levels; at the population-level, community viral load is a metric of HIV programme effectiveness and can identify "h...

In recent decades there has been an increasing trend toward “constitutionalizing” health—identifying health as a right in national constitutions. Today more than half of written constitutions in the world contain such a right. Whether that is good, bad, or immaterial for the production of population health, however, is much debated. Does constituti...

Introduction: The scale of the HIV pandemic - and the stigma, discrimination and violence that surrounded its sudden emergence - catalyzed a public health response that expanded human rights in principle and practice. In the absence of effective treatment, human rights activists initially sought to protect individuals at high risk of HIV infection...

In 1996, the global HIV community gathered in Vancouver, Canada, for the XI International AIDS Conference and shared the clear evidence that triple-combination antiretroviral treatment held the power to stem the tide of deaths from AIDS. The HIV treatment era had begun. As we gathered again in Vancouver in July, 2015, it was clear that a new transf...

Recent years have seen significant advances in the science of using antiretroviral medicines (ARVs) to fight HIV. Where not long ago ARVs were used late in disease to prevent sick people from dying, today people living with HIV can use ARVs to achieve viral suppression early in the course of disease. This article reviews the mounting new scientific...

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has been one of the most effective foreign aid programmes in history. It reached 6.7 million people with antiretroviral therapy in 2013, and has also strengthened country health systems, provided billions of dollars in aid to prevention programmes, and helped to drive substantial declines...

PEPFAR South Africa has been among the world's most successful foreign aid efforts, taking antiretroviral treatment to scale in a time of South African government inaction. Political change in South Africa and the United States is now restructuring that relationship just as scientific advance shows the opportunity for significant incidence and mort...

In the last decade, there has been a rapid funding scale-up for global health initiatives. However, global health needs continue to outpace funding commitments. The global financial crisis, the recent decision by the US to flat-fund PEPFAR, and uncertainty about funding increases for the Global Fund for AIDS, TB and Malaria have driven global healt...