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Do not violate the International Health Regulations during the COVID-19 outbreak
... They often involve the suspension or modification of ordinary legal processes, allowing for the swift implementation of public health measures. In contrast, existing legislation encompasses the pre-existing laws and regulations that provide a legal basis for introducing public health measures without resorting to emergency powers (Habibi et al., 2020). Sometimes, emergency powers were deemed necessary to respond to the fast-evolving situation, while in others, existing legislation provided sufficient legal authority to implement mask mandates and social distancing measures. ...
... The choice of legal framework depended on the specific circumstances in each country and the perceived need for rapid action. The use of emergency powers has been subject to critique by scholars and civil society organizations, who argue that such powers can lead to the centralization of decision-making, lack of transparency, and potential erosion of civil liberties (Ginsburg & Versteeg, 2021;Habibi et al., 2020). ...
This chapter of the book addresses the most widespread (and controversial) COVID-19 measure: social distancing and wearing of the masks. Social distancing, that is, keeping distance between people in public spaces and decreasing the number of social contacts, was one of the first health-related measures that were introduced in March–April 2020 in most countries. However, the strictness of these measures, as well as government’s understanding of how the virus spreads, varied a lot. In some countries, people were asked to keep their distance at 2 m from each other, in other countries one-meter distance was considered to be enough. Moreover, open and closed spaces were not treated equally; in Switzerland, for example, people were required to keep distance in open spaces like parks, but not in closed spaces like supermarkets. In Belgium, April 2020 legal acts actively discouraged people to wear masks. This chapter aims to present an overview of legal responses to the health requirements, that is, how European governments integrated the medical advice into the exceptional measures. Secondly, this chapter seeks to map and classify these responses against infection levels, death count, as well as country-specific system factors. Finally, it aims to reconstruct the public response to mask wearing, a highly controversial measure in numerous European countries.
... In the longer term, countries that choose which international instruments to comply with may encourage other countries to do the same, which, in turn, undermines the basic tenets of international relations. 13 ...
... Thus, the WHO did not recommend to restrict free movement, arguing that restrictions do more harm than good. 13 In connection with the above, it can be argued that such categories as the coherence of international norms and practices in combating global biological threats and legal certainty in the field of victimological security during quarantine measures are of paramount importance. Legislation should clearly define the terminology of the COVID-19 coronavirus test. ...
The purpose of the study is to consider ways to counter threats in the criminal-legal plane from the perspective of victimology. At the same time, this study aims to justify the need to take comprehensive strategic measures that take into account the victimological threats that became characteristic precisely during the spread of the pandemic and the introduction of quarantine measures. The adoption of a document setting out strategic priorities for a comprehensive pandemic response implies the possibility of adapting it to potential threats of a similar nature. The existence of such a document implies the possibility of developing on its basis a set of narrower, algorithms of actions and measures to ensure the victimological security of citizens in the event of crisis situations due to the threat of pandemics. The research examines current challenges faced by Ukrainian legal system in matters of criminological and victimological security of society during quarantine measures related to COVID-19, against the background of foreign experience.
... The battle against the COVID-19 pandemic suffered prominent effects and impacts on almost all sectors of humanity (Tria, 2020). Due to this pandemic, the progression and development of widespread disturbances such as travel restrictions (Chinazzi et al., 2020), political conflicts (Barrios & Hochberg, 2022), racism (Habibi et al., 2020), misinformation (Enitan et al., 2020), global economic fluctuations (Fernandes, 2020), and closure of schools (Viner et al., 2020) have become sluggish. The extant effects of the COVID-19 pandemic continue to contribute to the suffering of different sectors, especially education. ...
The COVID-19 pandemic has generated a myriad of issues in educational systems across the globe. This community-based study aims to navigate the issues encountered by professors of Mabalacat City College during the pandemic and the interventions employed to address these issues. This study used a descriptive survey research design. In this study, a purposive sampling method was employed to obtain 27 professors. Survey questionnaires were distributed using Google Forms to the participants at Mabalacat City College. The data obtained from the participants were subject to the data privacy act. Thematic analysis and descriptive statistics were used to analyze the participants' data. The results revealed two major themes faced during the pandemic which are "technical problems" and "classroom management". The study found that the installation of DigiHubs provided opportunities for learners experiencing difficulties during the pandemic. These DigiHubs have various means, such as internet connection, gadgets, modules, and learning spaces, that foster a conducive environment. In addition, workshops/training sessions, seminars, and webinar sessions empowered technophobic professors who adhered to traditional modalities. Hence, these findings underscore the critical role of community colleges in the educational system, particularly during times of crisis.
... At the onset of the pandemic, it was widely believed that international travel measures, in particular travel restrictions and border closures, were ineffective as public health measures and their adoption was in violation of international law [3,4]. When the World Health Organization (WHO), upon the advice of the Emergency Committee, declared COVID-19 a public health emergency of international concern (PHEIC) in late January 2020, it did not recommend the adoption of travel or trade restrictions, citing limited scientific evidence of their effectiveness [5]. ...
Objective
To describe the adoption of international travel measures during the first year of the COVID-19 pandemic.
Methods
To comprehensively analyze the measures adopted, we constructed a dataset based on the WHO’s Public Health and Social Measures (PHSM) database, which covered 252 countries, territories, or other areas (CTAs), including all 194 WHO Member States, from December 31, 2019, to December 31, 2020. We examined the adoption of measures by type, over time, and by the implementing and targeted CTA, including their levels of income.
Findings
We identified 11,431 international travel measures implemented during the first year of the pandemic. The adoption of measures was rapid and widespread: over 60% of Member States had adopted a travel measure before the WHO declared COVID-19 a Public Health Emergency of International Concern on January 30, 2020. Initially, health screening and travel restrictions were the most adopted measures; however, quarantine and testing became more widely adopted over time. Although only a small portion of the total measures adopted constituted full border closure, approximately half of all Member States implemented this measure. Many travel measures targeted all CTAs but were unlikely to have been adopted universally enough to provide public health benefits. Low-income countries relied more on more universal measures, including full border closure, and were slower in scaling up testing compared to higher-income countries.
Conclusion
The adoption of international travel measures during the first year of the COVID-19 pandemic varied across jurisdictions and over time. Lower-income countries used a different mix and scaled-up measures slower than higher-income countries. Understanding what measures were used is crucial for assessing their effectiveness in controlling the spread of COVID-19, reviewing the usefulness of the International Health Regulations, and informing future pandemic preparedness and response activities.
... ng malawakang pagkagambala at pagkabahala ang pandemyang COVID-19 sa halos lahat ng sektor ng lipunan. Nagkaroon ng paghihigpit sa paglalakbay (Chinazzi et al., 2020), isinara ang maraming paaralan (Viner et al., 2020), nakaranas ng resesyong pang-ekonomiya ang buong mundo (Fernandes, 2020), umigting ang rasismo (Habibi et al., 2020), at lumaganap ang maraming maling impormasyon at kontrobersiya (Enitan et al., 2020). Ilan lamang ito sa mga negatibong epekto ng COVID-19. ...
... The initial outbreak of the pandemic in China and its global implications have raised persistent doubts on the country's compliance to IHR. Although Habibi, et al (2020) and a great deal of experts have scrutinized Chinese public health policies in the aftermath of the coronavirus pandemic, China's compliance to International Health laws and its implication to global health security remained unclear. It is on the basis of this uncertainty that this article examined China's compliance to the 2005 IHR prior to and during the outbreak of Covid 19. ...
The Covid 19 pandemic presented a defining challenge to public health and global security. The outbreak of the pandemic in China and its global implications raised persistent doubts of states’ compliance to international health laws. The pandemic therefore, provides an opportunity for us to ascertain the extent to which China adhered to the International Health Regulations. Though a great deal of experts have scrutinized Chinese public health policies in the aftermath of the pandemic, China’s compliance to the 2005 International Health Regulation and its implication to global health security remained unclear. The analysis is largely derived from the Global Health Security-GHS Index and other primary legal texts. The GHS Index represents the first comprehensive unit of measurement of global health security across 195 countries that are parties to the 2005 International Health Regulations. The outcome of the analysis exposed significant gaps in China’s compliance to international health laws. It also indicates that, though international health laws provide useful guidance to prevent, respond and manage pandemics, they are implemented in an ad hoc manner and generally have few tools at their disposal to enforce compliance. China’s failure to timely and adequately discharge its duties under the International Health Regulation prior to and in the wake of Covid 19 shows that the international community needs a new legal enforcement mechanism to ensure that states act promptly, transparently and effectively to protect the world’s population against pandemics. The challenge of a lack of statutory enforcement mechanism is insurmountable and it remains uncertain what the future holds for global health security.
... The ongoing struggle against the challenges posed by the COVID-19 pandemic has resulted in profound effects across all aspects of society. Actions like implementing travel restrictions (Chinazzi et al., 2020), closing schools (Viner et al., 2020), experiencing a global economic downturn (Fernandes, 2020), encountering political tensions (Barrios & Hochberg, 2020), witnessing instances of prejudice (Habibi et al., 2020), and facing the spread of misinformation and contentious discussions (Enitan et al., 2020) have collectively led to widespread disruption. Among the sectors significantly impacted, education stands out prominently. ...
Because of the risks posed by COVID-19, most public educational institutions have implemented printed modular distance learning instruction. The purpose of this study was to determine the challenges and alternatives faced by parents as they performed their role as home learning partners during the last two quarters of the school year 2020-2021 using the printed modular distance learning modality. It also sought to investigate the suggestions of parents as home learning partners. The study used an exploratory descriptive qualitative (EDQ) approach. It included fourteen parents from a public elementary school who were purposively chosen. In-depth interviews (IDI) were used to gather information. The different themes were identified through inductive coding. The study found that parents face the following challenges: lack of electronic gadgets, difficulty explaining/teaching, insufficient time, non-conforming modules, and an inconsistent schedule for SLM distribution. To fulfill their responsibilities, parents have employed a variety of coping strategies, such as effective time management, the use of ICT, approaching MKOs, motivation through a reward system, and spoon-feeding. Although parents considered various options for fulfilling their role as home learning partners, most participants preferred to unburden themselves by returning to in-person classes. To reduce their workload, parents suggest the following: (1) a free mobile phone for parents who do not already have one, (2) a free Wi-Fi zone, (3) module updates, and (4) monthly distribution of self-learning modules. Being a home learning partner imposes an additional burden on parents. It is suggested that the government or school work with other government agencies or non-governmental organizations to implement parents’ suggestions. Keywords: challenges, alternatives, home learning partner, modular distance learning
... 30 A group of legal scholars opined that travel restrictions imposed in the wake of this event were a violation of the IHR (2005) because, among other reasons, "evidence belies the claim that illegal (sic) travel restrictions make countries safer". 31 The evidentiary basis cited for such an argument referred to past events, particularly the spread of influenza and of the Ebola virus. ...
... For example, several authors have called for preventative approaches, including the strengthening of environmental governance, better regulation of the illegal wildlife trade or ameliorating other aspects of the human-animal-environment interface. 2 Other scholars have called for adherence to or reform of the present global health law framework, highlighting the need to respect the international health regulations during a pandemic, define key concepts under the law or develop the current legal regime (see, e.g., Habibi et al. 2020;Bartolini 2020;Burci and Eccleston-Turner 2019;Eccleston-Turner 2020;Villarreal 2020;. There is a distinct body of scholarship that promotes the One Health approach, with several scholars highlighting the important role it can play in complementing the present global health framework or guiding reform initiatives and some even arguing that it might amount to a new international constitutional principle (see, e.g., Peters 2021; Garcia and Gostin 2012;Negri and Eccleston-Turner 2022). ...
This article reflects on the proposed pandemic treaty negotiations, the content of the recently published Zero Draft and its prospects for success in preventing future pandemics from emerging at all. It argues that, as presently conceived, the proposed instrument does little to address environmental damage as the primary driver of zoonotic spillover, nor does it make sufficient provision for the implementation and enforcement of legal obligations. In particular, the piece suggests that human rights and rights of nature can and should feature more prominently in efforts to fully realize the One Health agenda and strengthen environmental governance with a view to mitigating the risk of future pandemics. Experience from rights-based approaches in other contexts suggests that they offer a promising conduit for achieving genuine policy reform and accountability regarding environmental degradation. Indeed, human rights and rights of nature can play an important role in mitigating ecological destruction, biodiversity loss and, in turn, preventing disease transmission from the natural world.
... Patients who present with such signs are evaluated by chest radiographs or computed tomography (Russell et al. 2020;Yang et al. 2020;Weiss et al. 2020). Officially, the coronavirus was termed as SARS-CoV-2 or 2019-nCoV Munster et al. 2020;Liu et al. 2020;Habibi et al. 2020;Heymann and Shindo 2020;Wang et al. 2020). ...
The outbreak of COVID-19 has caused great havoc and affected many parts of the world. It has imposed a great challenge to the medical and health fraternity with its ability to continue mutating and increasing the transmission rate. Some challenges include the availability of current knowledge of active drugs against the virus, mode of delivery of the medicaments, its diagnosis, which are relatively limited and do not suffice for further prognosis. One recently developed drug delivery system called nanoparticles is currently being utilized in combating COVID-19. This article highlights the existing methods for diagnosis of COVID-19 such as computed tomography scan, reverse transcription-polymerase chain reaction, nucleic acid sequencing, immunoassay, point-of-care test, detection from breath, nanotechnology-based bio-sensors, viral antigen detection, microfluidic device, magnetic nanosensor, magnetic resonance platform and internet-of-things biosensors. The latest detection strategy based on nanotechnology, biosensor, is said to produce satisfactory results in recognizing SARS-CoV-2 virus. It also highlights the successes in the research and development of COVID-19 treatments and vaccines that are already in use. In addition, there are a number of nanovaccines and nanomedicines currently in clinical trials that have the potential to target COVID-19.
... Specifically, persons of Asian descent have experienced, and continue to experience, COVID-19 scapegoating and prejudice (Adja et al., 2020;Rzymski & Nowicki, 2020a, b). COVID-19 prejudice arose out of the perceived threats posed by the disease itself and were promoted by political rhetoric that attributed blame for COVID-19 to China (Budhwani & Sun, 2020;Dyer, 2020a), leading to COVID-19 xenophobia (Habibi et al., 2020;Rzymski & Nowicki, 2020b). Because prejudice is defined by generally negative attitudes toward targeted groups (Cottrell & Neuberg, 2005) and is theorized to serve as a social mechanism to prompt responses to perceived threats (Cottrell & Neuberg, 2005), prejudicial attitudes can motivate behavior toward mitigating perceived threats (Pirlott & Cook, 2018). ...
Cross-sectional studies have reported that people living with HIV experienced disruptions to social relationships and healthcare during the first year of the COVID-19 pandemic. Furthermore, individuals with less trust in public health sources of COVID-19 information as well as those who held greater COVID-19 prejudicial attitudes experienced greater healthcare disruptions in the early months of COVID-19. To examine changes in trust and prejudicial attitudes in relation to healthcare disruptions during the first year of COVID-19, we followed a closed cohort of 115 men and 26 women ages 18 to 36 living with HIV over the first year of the COVID-19 pandemic. Findings confirmed that a majority of individuals continued to experience disruptions to their social relationships and healthcare over the course of the first year of COVID-19. In addition, trust in COVID-19 information from the CDC and state health department diminished over the year as did COVID-19 prejudicial attitudes. Regression models showed that lower trust in the CDC and health department and greater prejudicial attitudes toward COVID-19 early in the pandemic predicted greater healthcare disruptions over the year. In addition, greater trust in the CDC and health department early in COVID-19 predicted better antiretroviral therapy adherence later in the year. Results support an urgent need to regain and sustain trust in public health authorities among vulnerable populations.
... While border closures in the initial weeks of COVID-19 likely violated Article 43 of the legally-binding International Health Regulations because they were implemented without "available scientific evidence" [42,47,48], our study's evidence of their potential effectiveness in very specific circumstances points toward the need to reconsider past blanket guidance against border closures and take a more nuanced approach to their potential deployment. Most specifically, with increasing evidence that border closures played a moderate role in slowing the initial spread of COVID-19 and buying some additional time to prepare for the oncoming pandemic [8], public health authorities should re-evaluate their guidance so that it is more context-specific and consider global mechanisms to coordinate national decisions on border closures. ...
With over 200 pandemic threats emerging every year, the efficacy of closing national borders to control the transmission of disease in the first months of a pandemic remains a critically important question. Previous studies offer conflicting evidence for the potential effects of these closures on COVID-19 transmission and no study has yet empirically evaluated the global impact of border closures using quasi-experimental methods and real-world data. We triangulate results from interrupted time-series analysis, meta-regression, coarsened exact matching, and an extensive series of robustness checks to evaluate the effect of 166 countries’ national border closures on the global transmission of COVID-19. Total border closures banning non-essential travel from all countries and (to a lesser extent) targeted border closures banning travel from specific countries had some effect on temporarily slowing COVID-19 transmission in those countries that implemented them. In contrast to these country-level impacts, the global sum of targeted border closures implemented by February 5, 2020 was not sufficient to slow global COVID-19 transmission, but the sum of total border closures implemented by March 19, 2020 did achieve this effect. Country-level results were highly heterogeneous, with early implementation and border closures so broadly targeted that they resemble total border closures improving the likelihood of slowing the pandemic’s spread. Governments that can make productive use of extra preparation time and cannot feasibly implement less restrictive alternatives might consider enacting border closures. However, given their moderate and uncertain impacts and their significant harms, border closures are unlikely to be the best policy response for most countries and should only be deployed in rare circumstances and with great caution. All countries would benefit from global mechanisms to coordinate national decisions on border closures during pandemics.
... For example, seeHabibi et al. (2020),,Lee et al. (2020), andWorsnop et al. (2021). For specific recommendations, seeWHO (2021). ...
Effective response to and rapid, reliable detection of infectious disease outbreaks require successful coordination of countries' border policies early on. As threats from diseases are highly salient to the public, researchers agree that a better understanding of domestic politics is crucial. This study investigates a key piece of this question: public demands for border closures. Our experiments in the United Kingdom and the United States show that a greater pandemic threat mildly increases support for border closures, but the World Health Organization's (WHO) guidance against border closures and reminders about international legal obligations to follow the guidance substantially weaken support for border closures. However, during the COVID-19 pandemic, many countries flouted WHO's recommendations and restricted their borders. Examining media attention suggests people's lack of knowledge of the WHO guidance as a crucial reason for those border closures. Our study produces insights into the design of effective global health governance.
... This law, which was enacted in Yogyakarta on June 6, 1946, was clearly based on the desire to make regulations in order to ensure the safety of the country from the threat of danger in the form of attack, danger of attack, rebellion or rioting, so that it was feared that the civilian government would not be able to carry out its work, or natural disasters. In another aspect research by Roojin Habibi et al. (2020) meaning "with findings First, under Article 43.2, countries cannot implement additional health measures exclusively as a precaution but must rather ground their decision making in scientific principles, scientific evidence, and advice from WHO. 13 Second, under Article 43.1, any additional health measures implemented by countries shall not be more restrictive of international traffic and not more invasive or intrusive to persons than reasonably available alternatives, Third. The most importantly, Article 3.1 strictly requires all additional health measures to be implemented with full respect for the dignity, human rights and fundamental freedoms of persons, which in turn must reflect the international law principles of necessity, legitimacy, and proportionality that govern limitations to and derogations from rights and freedoms". ...
Introduction: Legislation in Indonesia has provided a place for regulation in emergency situations, both at the constitutional and statutory levels. There are inconsistencies, both conceptually and practically in the use of the emergency clause in emergency regulations. Through this paper, the author would like to emphasize need for projection of revamping the laws and regulations related to emergency situation in Indonesia.
Purposes of the Research: This study aims to analyze Indonesia’s emergency regulation according to perspective of emergency contitutional law of in the face of a Pandemic. Emergency situations they are Emergency State Law regime Article 12 of the 1945 Constitution, the use of Article 22 of the 1945 Constitution of the Republic of Indonesia, and the meaning of other emergencies in accordance with law.
Methods of the Research: The research methodology used is normative juridical by approaching the laws and regulations (Statute Approach) and conceptual approach. From the approach to legislation, it aims to find out the rules related to emergency regulations. The legal materials were collected by means of a literature study, then the legal materials were analyzed in a qualitative juridical manner.
Results of the Research: Results of his research, emergency option based on constitution which is represented by the phrase state of emergency in Article 12 of the 1945 Constitution gives great powers to emergency authorities, can deviate from democratic procedures in constitution and violate human rights, except for non-derogable rights. Activation of state of danger also results in lack of political and legal oversight.
... Indeed, state behaviour during the COVID-19 pandemic (leading up to and including the response to the Omicron variant), as well as in previous public health emergencies of international concern, persistently demonstrate states' widespread disregard of article 43 of the IHR, despite continued guidance from the international community of legal experts, ethicists and officials at the WHO. [30][31][32][33] We envision two different pathways for moving forward: on the one hand, countries may opt for new and reformed legal instruments with strengthened sanctions in the event of non-compliance or consequences for non-compliance. Alternatively (or additionally), any such rules should be approached with a 'realistic' acknowledgement that if we are to make equity, solidarity, and fairness matter in pandemics, we need both better norms and mechanisms for accountability as well as expanded options to enable strategic resistance by LMIC actors when unjust power differentials impede the advancement of their domestic public health interests. ...
In times of a public health emergency, lawyers and ethicists play a key role in ensuring that government responses, such as travel restrictions, are both legally and ethically justified. However, when travel bans were imposed in a broadly discriminatory manner against southern African countries in response to the Omicron SARS-CoV-2 variant in late 2021, considerations of law, ethics or science did not appear to guide politicians’ decisions. Rather, these bans appeared to be driven by fear of contagion and electoral blowback, economic motivations and inherently racist assumptions about low-income and middle-income countries (LMICs). With a new pandemic treaty and amendments to the WHO’s International Health Regulations (IHR) on the near-term horizon, ethics and international law are at a key inflection point in global health governance. Drawing on examples of bordering practices to contain contagion in the current pandemic and in the distant past, we argue that the current IHR is not adequately constructed for a just and equitable international response to pandemics. Countries impose travel restrictions irrespective of their need or of the health and economic impact of such measures on LMICs. While the strengthening and reform of international laws and norms are worthy pursuits, we remain apprehensive about the transformative potential of such initiatives in the absence of collective political will, and suggest that in the interim, LMICs are justified in seeking strategic opportunities to play the same stark self-interested hardball as powerful states.
... 603 Against this background, it has been argued that the imposition of travel restrictions not recommended by the WHO was in breach of international law. 604 In principle, the IHR apply to any outbreak of a transmissible disease, 605 including such caused by pathogens modified through biotechnology. However, the practical effectiveness of the IHR has recently been called into question, since many developing states lack the necessary resources to implement surveillance systems to early identify outbreaks of transmissible diseases. ...
Who is liable if self-spreading biotechnology causes transboundary harm? With engineered gene drives and similar techniques, the genes of wild-living species, pathogens, and crop plants can soon be modified directly in the environment. This might help address pressing public health, environmental, and food security problems. However, these techniques may also spread across national borders. Looking at both states and private actors, this book studies the rules of international law on the prevention of, and liability for, adverse transboundary effects caused by self-spreading biotechnology. Through an in-depth analysis of the relevant treaties and custom, it shows that international law is not yet equipped to cope with the challenges ahead.
... In addition, States Parties have always undermined the IHR's effectiveness by being non-compliant towards their proposed guidelines in accordance with agreed during previous outbreaks. 59 Hence, the G20 nations should set an example by complying to IHR recommendation as well as to support each other during a crisis by advocating for sharing PPE kits, vaccines, data-sharing technology, and risk-communication channels to curb the spread of disease. Also streamline the regulatory standards and procedures to procure medical countermeasures. ...
Background: Monkeypox has been declared as a Public Health Emergency of International Concern (PHEIC) by the WHO Director General (WHO-DG). Most of the G20 nations have reported Monkeypox outbreak. Policies developed and implemented in G20 countries for the prevention and control of monkeypox preparedness and response have global consequences. This rapid review aimed to map the monkeypox prevention and control policies planned and implemented in G20 nations in line with temporary recommendations issued by the WHO-DG.
Methods: We mapped monkeypox prevention and control policies in G20 nations based on the WHO-DG recommendations. Medline (through PubMed), Scopus, and ProQuest Health and Medical Complete were searched to understand G20 preventative, diagnostic, and therapeutic policies. We also performed an extensive gray literature search through the Ministry of Health websites and newspaper through Google. The documents/ studies that had an information on prevention, control and management guidelines/policies and published through journal, news articles and health ministry websites of G20 nations on monkeypox were included. We excluded the editorials, opinion, and perspective papers and studies published prior to May 6, 2022.
Results: We obtained 671 articles with 10 articles included in the review. Additionally, we identified 55 documents from the gray literature. We included national guidelines of the 18 countries on the control, prevention, and management of monkeypox. National guidelines were compared with the WHO guidelines in terms of implementing coordinated response, engaging and protecting communities, surveillance and public health measures and international travel, clinical management and infection, prevention and control (IPC) measures and medical countermeasures research. Depending on the availability of resources, some recommendations are followed by nations while others are not.
Conclusions: Coordinated response among states is key to contain the transmission of monkeypox. To bring a coordinated response, G20 nations are following temporary recommendations that are context specific to their nation.
... As late as January and February 2020, international health law experts commented on the quarantine measures taken by China as a historical precedent that would be hard to transfer to Western democracies because of the deep infringements on civil liberties (Raposo 2020). Even during a global health emergency, the law of international health regulations applies, according to which all measures must take into account the principle of proportionality (Habibi et al. 2020). ...
What is proportionate? The measures taken worldwide to contain SARS-CoV-2 deeply curtailed the fundamental rights of many citizens. The courts have upheld this course of containment: the protection of life and health takes precedence over individual liberties, even in the case of doubt about scientific evidence for the effectiveness of far-reaching measures. This finding is astonishing and does not automatically follow from the International Health Regulations, according to which interventions in fundamental rights have to be justified by facts. The principle of proportionality is the logical place where facts and normativity meet. Since science has polarized during the pandemic, the court selection and interpretation of scientific expertise is itself a politicized value judgment. Courts, I conclude, base their selection and interpretation on publicly available and legitimate knowledge. I develop this hypothesis on the basis of COVID-19-jurisprudence in Germany.
... 175 However, following the PHEIC declaration on January 30, 2020, states rushed to slow the spread of the virus in ways that directly contradicted IHR (2005) principles and transparency in the deliberations of the Emergency Committee has been a longstanding concern. Eccleston-Turner M, Kamradt-Scott A, "Transparency in IHR Emergency Committee Decision Making: The Case for Reform," BMJ Global Health 4, no. 2 (2019); Richard Horton, "The Politics of PHEIC," 393 Lancet 2470 (2019).WHO guidance -including discriminatory lockdowns, trade restrictions, and travel bans.176 WHO had begun publishing technical guidance for Member States as early as January 10, 2020, addressing recommended approaches and actions to effectively manage this new infectious disease outbreak; 177 yet, states largely ignored WHO guidance in implementing pandemic responses that at times were not grounded in public health evidence, were excessively restrictive of individual liberties, and were in violation of the human rights principles underlying the IHR.178 ...
... The International Health Regulations of 2005 identified that health rights should be protected in any situation which is highly linked with the enjoyment of human rights (Habibi et al., 2020). The health rights of everyone should be ensured equally on human rights grounds (Mykhalovskiy et al., 2020). ...
Purpose
The shipbreaking sector in Bangladesh has spurred extensive academic and policy debates on relations between shipbreaking industries, environmental degradation and the health security of their workers. As shipbreaking is an economically significant industry in Bangladesh, it needs to implement both domestic and global mechanisms for environmental conservation and the protection of the labourers’ health from environmental risks. The purpose of this paper is to primarily explore the environmental and health security issues in shipbreaking activities in Bangladesh. It also identifies the challenges in implementing the rules and regulations for protecting the health of the workers at shipbreaking yards in Bangladesh and preserving the marine environment.
Design/methodology/approach
This is a qualitative paper based on secondary materials, including journal articles, books and national and international reports. It critically reviews the existing literature, rules, regulations and policing on shipbreaking with a particular focus on the environment and health security of the workers.
Findings
This paper finds that the implementation of the rules and regulations in shipbreaking in Bangladesh is complicated because of weak implementation mechanisms, political and economic interests of the yard owners, lack of coordination among different agencies, lack of adequate training and awareness among the workers and workers’ poor economic condition, which contribute to the degradation of marine and local environments and trigger health hazards among the workers. Therefore, degrading the environment and undermining occupational health and safety regulations have become regular; thus, accidental death and injury to the workers are common in this sector.
Originality/value
This paper is an important study on the issues of workers' health and safety and environmental hazards in the shipyard. It reports how the health security of the workers in shipbreaking yards in Bangladesh is vulnerable, and environmental rules are challenged. Finally, this paper frames some policy implications to safeguard the workers’ health rights and the marine environment.
... Before 2002, coronaviruses were assumed not to cause a serious problem. However, in late 2002, with the SARS epidemics in China (2) and some other countries, researchers realized coronaviruses could cause much more severe diseases than the common cold (3). As highly contagious agents, coronaviruses cause severe and deadly problems similar to acute respiratory syndrome (4). ...
Objective: This study aimed to determine the level of post-traumatic stress disorder (PTSD) among nurses and its relationship with occupational burnout.
Method: This online cross-sectional survey was conducted from late November to early January 2020 in six hospitals in Iran. 309 frontline nurses in COVID-19 wards were selected via stratified random sampling and asked to complete a sociodemographic questionnaire, the Impact of Event Scale-revised version (IES-R), and the Maslach Burnout Inventory–Human Services Survey (MBI-HSS) in an anonymous online survey. Data management and analysis were performed in SPSS 25.0 using descriptive and inferential statistics, including Pearson’s correlation coefficient, independent samples t-test, ANOVA, and linear regression.
Results: The majority of the participants were women (81.6%) with a mean ± SD age of 31.56 ± 6.42 years. The mean ± SD of the total PTSD score was 39.2 ± 16.44 years, indicating severe PTSD among nurses. The mean ± SD of the total occupational burnout score was 82.77 ± 19.38, expressing moderate burnout. The findings also demonstrated a significant moderate correlation between PTSD and occupational burnout (r = 0.363, P < 0.001). Univariate analysis revealed a significant relationship of occupational burnout with PTSD, work experience, number of night shifts per month, and employment status (P < 0.05). However, in multivariate analysis, only PTSD had a positive and significant relationship with occupational burnout (P < 0.001; R2 = 160; β = 0.339) and was a predicting factor for it.
Conclusion: We found that both PTSD and burnout are common among nurses. Given the role of PTSD especially as a predictor of burnout and the significant impact of these disorders on occupational and non-occupational activities, immediate and appropriate measures are necessary to monitor and reduce their effects on the nurses who are at the forefront of fighting the pandemic.
... There is nothing in the IHR to delineate what occurs on PHEIC notification, other than the WHO Director-General having the power to make recommendations to governments-recommendations that are frequently ignored, particularly around trade and travel restrictions. 18,19 Before we make broad statements about the importance of the PHEIC or consider the role of the PHEIC in IHR reform or the proposed pandemic treaty, 20 we need to understand what effect the PHEIC has in outbreak response: if this is meaningful or negligible. For a discipline that is so dominated by evidence-based decision making, the fact that such decisions are made ...
... However, many governments have engaged in unnecessary and disproportionate abuses of rights-from implementing selective bans on international travel; to using criminal law to compel compliance with COVID-19 measures; to abusing surveillance technologies to clamp down on civil society. 95 The IHR's invocations of necessity, scientific evidence, proportionality and non-discrimination for implementing various IHR provisions has done little to mitigate overly restrictive public health measures that fail these criteria. The case of travel restrictions under Article 43 illuminates this gap: The WHO has 55 consistently since March 2020 issued practical guidance, guidelines, and statements to assist countries in implementing travel restrictions under this provision in ways that balance the protection of public health and human rights.96 ...
This article examines the influence of human rights law on infectious disease control through the World Health Organization ( who ) International Health Regulations (‘ IHR ’). The who ’s evolving work to mainstream human rights in global health governance strongly influenced the 2005 revision of the ihr , framing a new balance between health and human rights in public health emergencies. The 2005 ihr make respect for human rights a central principle and integrate human rights standards in explicit and implicit ways. Yet these reforms also fail to reflect economic, social and cultural rights, inadequately connect to the UN human rights system, and leave unresolved significant legal issues with major impacts on human rights. These weaknesses have been exposed by the covid -19 pandemic, as national pandemic responses have tested who ’s authority under the ihr and disproportionately and unjustifiably restricted a range of human rights. Resolving these gaps will require both normative and institutional reforms that bring together human rights and global health governance, including through broader rights-based partnerships amongst international organizations.
In December 2021, WHO’s 194 member states began reaching a consensus to start the process of drafting and negotiating a pandemic treaty under the WHO Act. Although there is already a PHEIC system to deal with sudden public health events such as pandemics, the system is not sufficient to deal with global pandemic events. The draft WHO Pandemic Agreement reflects the negotiating process until 24 May 2024. The negotiating team is faced with legal issues such as the treatment of the relationship between the pandemic treaty and the International Health Regulations, the determination of the contracting model, the attribution of the pandemic definition power and the construction of the dispute settlement mechanism. Through a study of the articles of the current draft and a comparative analysis with other treaties, this paper discusses the need to distinguish the functions of the pandemic treaty and the International Health Regulations (IHR), adopt a soft and hard contracting model, establish an open and transparent pandemic determination mechanism, reform the institutional functions of WHO, and establish an effective dispute settlement mechanism in order to solve the above problems. Ultimately, fairness and justice in international public health governance will be achieved.
Целью работы является изучение института ограничения прав человека и основных свобод при чрезвычайной опасности общественному здоровью, а также правовых оснований и пределов таких ограничений в доктрине международного права. Эмпирической основой исследования стали нормы международных договоров и иных правовых актов, а также материалы зарубежных периодических изданий. Институт прав и свобод человека в условиях пандемии COVID-19 подвергается серьезной трансформации, результатом которой может стать появление новой парадигмы прав человека. Многие государства, являющиеся родоначальниками европейского гуманизма, на котором основано современное международное право, под влиянием пандемии постепенно отходят от его базового принципа о признании человека в качестве высшей ценности, реализуемого через идею автономии и универсальности личности. Некоторые современные государства активно культивируют иные по сравнению с европейским гуманизмом ценности и принципы, в которых в качестве приоритета выступает общественное (коллективное) благо, в частности, здоровье всего общества, при ограничении автономии личности и индивидуальных прав. Научная новизна работы состоит в обосновании условий ограничений прав человека и основных свобод при глобальной угрозе общественному здоровью в форме пандемии. Практическое значение исследования состоит в том, что были выявлены существенные противоречия между должным (формальным) порядком по ограничению прав и свобод человека, установленным международным правом, и фактически сложившейся ранее практикой субъектов международного права. Преодоление данных противоречий возможно только путем неукоснительного соблюдения норм и принципов международного права. Автором выявлены существенные изменения политико-правовой сущности современного государства. Констатируется, что модель государства, сложившаяся в период Нового времени, подвергается серьезной трансформации: концепция общественного договора, основанная на ограничении государственной власти в интересах личности, все больше уступает место неограниченному праву вмешательства государства в частную жизнь.Для цитирования: Сквозников А.Н. Ограничение прав и свобод человека в условиях пандемии COVID-19: международно-правовые аспекты // Право. Журнал Высшей школы экономики. 2022. № 3. С. 222–240. DOI:10.17323/2072-8166.2022.3.222.240.
This case study highlights how a looming health crisis was leveraged as drivers for positive change for the health sector, in line with the health security agenda. In Jordan, several authorities are mandated by law to manage health emergencies. Following the declaration of outbreaks of cholera in Iraq, Lebanon and Syria, health authorities in Jordan called for a series of emergency meetings during September 2022 to discuss implications around travel and trade as well as shared waters. WHO was part of the consultations and provided guidance on the application of the International Health Regulations 2005. As the risk for cholera importation persisted, the Ministry of Health assumed its leadership role for the overall health sector response while the Jordanian Center for Disease Control assumed a coordinating function. Roles and responsibilities were enshrined in the National Cholera Preparedness and Response Plan. In consideration of the vulnerability of refugee camps and settlements towards Cholera, the existing Jordan humanitarian coordination platforms such as the Health Sector Working Group were used to share information and to coordinate activities. A whole-of-government risk assessment during December 2022 was complemented by a field visit at Zaatari refugee camp. This helped assess the risk and readiness for a cholera outbreak in Jordan and informed priority activities, such as the establishment of a national risk communication and community engagement working group as well as training on case management.
This article challenges the orthodox view of international law, according to which states have no legal duty to cooperate. It argues for this legal duty in the context of COVID-19, based on the ethical principles of solidarity, stewardship, and subsidiarity. More specifically, the article argues that states have a legal duty to cooperate during a pandemic (as solidarity requires); and while this duty entails an extraterritorial responsibility to care for and assist other nations (as stewardship requires), the legal duty to cooperate still allows states to attend first to the basic needs of those under their own jurisdiction—namely, fellow nationals and residents (as subsidiarity requires). The article provides a definition and philosophical justifications for this legal duty that are lacking in the literature by examining its application to a current COVID-19 controversy: namely, states’ responsibility to assist other countries in greater need by, inter alia, exporting at a discount or donating scarce COVID-19 treatments (including vaccines). In providing a principled tripartite account of pandemic governance, this conceptual and normative article offers a new lens for debating the potential international treaty for pandemic prevention, preparedness, and response that has now been drafted and is under negotiation at the World Health Assembly, by responding to the recent backlash against multilateralism by substantiating global co-responsibilities in times of pandemics and beyond.
Aim
This research was conducted with the aim of examining the health-promoting lifestyles of a specified student population in Iran.
Background
The occurrence of the Coronavirus 2019 (COVID-19) pandemic caused changes in mental health and lifestyle. Clinical students were one of the groups with the most clinical exposure and thus were potentially most affected by the COVID-19 pandemic.
Methods
A cross-sectional study was conducted among students of Jiroft University of Medical Sciences (JMU) in the south of Iran, who were studying in the clinical field in 2021. A consecutive sample of 200 students was used for the study. Data was collected using the Health Promoting Lifestyle Profile (HPLP) Questionnaire of Walker et al., the total score of the questionnaire includes a range of at least 52 points up to a maximum of 208 points. For all statistical analysis, SPSS version 26 was used. The significance level of the p-value was less than 0.05.
Results
The mean score of total students in the lifestyle promotion of health was 129.11 ± 12.11. The highest average score was in the field of spiritual growth (24.97 ± 5.19) and the lowest score was obtained in the field of physical activity (5.17 ± 16.32). The highest average score was in nursing students.
Conclusion
The present study showed that the level of health-promoting lifestyle among clinical students of JMU is at a moderate level indicating that promoting this lifestyle is an urgent global need, especially during the COVID-19 pandemic.
During Public Health Emergencies of International Concern (PHEICs), The International Health Regulations (IHR) require the WHO to issue Temporary Recommendations on the use of international travel and trade measures. During the COVID-19 pandemic, WHO’s initial recommendation against ‘any travel or trade restriction’ has been questioned, and virtually all countries subsequently used international travel measures. WHO’s Recommendations to States Parties also changed over the course of the pandemic. There is a need to understand how WHO’s treatment of this issue compared with other PHEICs and why States Parties’ actions diverged from WHO’s initial Recommendations. This first analysis of WHO’s Temporary Recommendations on international travel and trade measures during all seven PHEICs compares the guidance for clarity and consistency in several areas of substance and process. We find that lack of clarity and inconsistency in WHO guidance makes it difficult to interpret and relate back to IHR obligations. Based on this analysis, we offer recommendations to increase consistency and clarity of WHO’s guidance on this issue during global health emergencies.
Internationally, the pandemic response of states is primarily focussed on protecting health. The article shows that such a narrowly understood protection of the human right to the highest attainable standard of health is too short-sighted. With a focus on the moral nature of human rights, other human rights are identified that are endangered by state regulations. It becomes clear that human rights must not be considered in isolation but in context.This also has implications for the state duties associated with human rights. Specifically for the right to health, this means that it must not only be respected and protected, but also includes the positive claim to fulfilment, that is, it requires equal access to necessary medical services. Such a duty is initially and legally limited to the national level. However, a human rights-based Global Health governance must go beyond this. However, in recent documents of the World Health Organization and in contrast to bioethical weighing, the systematic consideration of human rights outside of health is lacking and a truncated understanding of their moral nature emerges.
The COVID-19 pandemic has affected millions of lives, triggering an unprecedented global health, economic, social and humanitarian crisis. While China aspires to participate in global health governance, WHO also hopes to strengthen global health governance by strengthening cooperation with China on China’s Health Silk Road (HSR). This study uses the critical and comparative analysis method, system analysis method, and literature research method. Analysis is conducted through Chinese and foreign policy documents, official speeches, expert and public surveys, Chinese and other national media publications; the source database for the study from 1949 to 2022 has been collected from the official Chinese government website, think tanks, WHO database for key health indicators, etc. The paper categorizes China’s participation in global health governance into four stages and summarizes the different characteristics of different periods; it reviews China’s position in global health governance and examines the interaction of China’s HSR with the international community on global health governance. COVID-19 accelerates the process of HSR, and the latter helps WHO to strengthen global health governance. China has provided valuable experience in global health governance “with Chinese characteristics” contributing to world health governance during the pandemic.
There is a new public health crisis threatening the world with the emergence and spread of 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as it is now called, is rapidly spreading from its origin in Wuhan City of Hubei Province of China to the rest of the world. Coronaviruses are enveloped positive-sense RNA viruses that are diversely found in humans and wildlife originated in bats ranging from 60 nm to 140 nm in diameter with spike-like projections on its surface giving it a crown-like appearance under the electron microscope, hence the name coronavirus. A total of six species have been identified which are known to infect the neurological, respiratory, enteric, and hepatic systems. The epicenter of infection was linked to seafood and exotic animal wholesale markets in the city. SARS-CoV-2 is highly contagious and has resulted in a rapid pandemic of COVID-19. As the number of cases continues to rise, it is clear that these viruses pose a threat to public health. The disease is transmitted by inhalation or contact with infected droplets and the incubation period ranges from 2 to 14 days. The symptoms are usually fever, cough, sore throat, breathlessness, fatigue, and malaise among others. The disease is mild in most people; in some (usually the elderly and those with comorbidities), it may progress to pneumonia, acute respiratory distress syndrome (ARDS), and multiorgan dysfunction. Many people are asymptomatic. The case fatality rate is estimated to range from 2 to 3%. Treatment is essentially supportive; role of antiviral agents is yet to be established. Prevention entails home isolation of suspected cases and those with mild illnesses and strict infection control measure at hospitals that include contact and droplet precautions. The global impact of this new epidemic is yet uncertain. We conducted a literature review of publicly available information to summarize knowledge about the pathogen and the current epidemic. In this literature review, the causative agent, epidemiology, pathogenesis, diagnosis, and nurses role regarding disease, control, and prevention strategies are all reviewed. It will also provide a means to raise awareness among primary and secondary health-care providers during the current pandemic.
Saat ini, dunia termasuk Indonesia, dihadapkan pada situasi pandemi global Corona Virus Disease (COVID) -19 yang mengancam seluruh aspek kehidupan. Perkembangan ilmu pengetahuan di masa pandemi memiliki peran yang amat penting. Oleh karena itu, Fakultas Kedokteran dan Ilmu Kesehatan, UIN Maulana Malik Ibrahim Malang sebagai institusi pendidikan kedokteran dan kesehatan ingin memberikan sumbangsih dalam pengembangan ilmu pengetahuan terkait COVID-19. Buku The COVIDPEDIA ini merupakan hasil pemikiran dalam bentuk opini, refleksi, reviu, dan praktek baik dari para akademisi, peneliti dan praktisi mengenai COVID-19 dalam berbagai perspektif kesehatan.
A range of public health and social measures have been employed in response to the disproportionate impact of COVID-19 in Latin America and the Caribbean (LAC). Yet, pandemic responses have varied across the region, particularly during the first 6 months of the pandemic, with Uruguay effectively limiting transmission during this crucial phase. This review describes features of pandemic responses which may have contributed to Uruguay’s early success relative to 10 other LAC countries - Argentina, Chile, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Panama, Paraguay, and Trinidad and Tobago. Uruguay differentiated its early response efforts from reviewed countries by foregoing strict border closures and restrictions on movement, and rapidly implementing a suite of economic and social measures. Our findings describe the importance of supporting adherence to public health interventions by ensuring that effective social and economic safety net measures are in place to permit compliance with public health measures.
En este trabajo se analizan, a vista de pájaro, las «cuestiones jurídicas emergentes», y la relación que estas guardan con los Objetivos de Desarrollo Sostenible (ODS) y su realización, especialmente en tiempos de pandemia. En primer lugar, se realizará una descripción básica de los temas que se engloban en dicha categoría de cuestiones jurídicas emergentes: temas que no tienen una regulación completa, que no está clara, o que es insuficiente (o inexistente). Algunos ejemplos serían: a) medio ambiente, cambio climático y desastres; b) regulación científica, derecho y derechos humanos; c) derecho y nuevas tecnologías, y d) cultura y educación. Este es el punto de partida, confrontándolos con los ODS, estudiando los retos que la comunidad internacional tiene ante sí para lograrlos. Los ODS deben ser reinterpretados y adaptados a la realidad que deja el COVID-19, de manera realista. Se requiere la cooperación internacional, más que nunca, para afrontar el reto pospandémico.
Why do some international agreements fail to achieve their goals? Rather than states’ engaging in cheap talk, evasion, or shallow commitments, the World Health Organization's (WHO) International Health Regulations (IHR)—the agreement governing states’ and WHO's response to global health emergencies—point to the unintended consequences of information provision. The IHR have a dual goal of providing public health protection from health threats while minimizing unnecessary interference in international traffic. As such, during major outbreaks WHO provides information about spread and severity, as well as guidance about how states should respond, primarily regarding border policies. During COVID-19, border restrictions such as entry restrictions, flight suspensions, and border closures have been commonplace even though WHO recommended against such policies when it declared the outbreak a public health emergency in January 2020. Building on findings from the 2014 Ebola outbreak, we argue that without raising the cost of disregarding (or the benefits of following) recommendations against border restrictions, information from WHO about outbreak spread and severity leads states to impose border restrictions inconsistent with WHO's guidance. Using new data from COVID-19, we show that WHO's public health emergency declaration and pandemic announcement are associated with increases in the number of states imposing border restrictions.
This study reveals the impacts of the COVID-19 outbreak on the profession of tourist guides and offers possible solutions to the industry. The study draws from the recently published studies and guides’ perspectives from 36 countries. E-mail interview is used to collect data between 25 February and 30 May 2020 when the epidemic is spreading rapidly worldwide. The analysis is performed by using MAXQDA Analytics. The study captures events on COVID-19, as guides experience unemployment and trauma, and provides social and practical implications concerning cooperation and collaboration of stakeholders, the occurrence of inequality, and unfairness in the pandemic.
Non-pharmaceutical interventions (NPIs) were the only viable choice to mitigate or suppress transmission of COVID-19 in the absence of efficient and safe vaccines. In this study, we examined the association between the stringency of containment measures and cumulative incidence of the COVID-19 cases in the first wave of the pandemic across 28 European countries. Our results support the effectiveness of containment measures in the mitigation or suppression of COVID-19 epidemics. Early adoption of stringent containment measures prior to detection of the first confirmed case, together with ramping up containment stringency
during the early days of epidemics, was associated with a lower disease occurrence. The delayed adoption of stringent containment measures did not fully compensate for the lack of early response. Containment measures continue to play a significant role in the control of COVID-19 in the post-vaccination period, when
limited vaccination coverage, the emergence of vaccine resistance, and/or increased mobility enabled further disease transmission.
The COVID-19 Law Lab platform enables quantitative representation of epidemic law and policies in a given country for multiple years, enabling governments and researchers to compare countries, and learn about the impacts and drivers of policy choices. The Law Lab initiative is designed to address the urgent need for quality legal information to support the study of how law and policy can be used to effectively manage this, and future, pandemic(s).
The devastating 2014–16 West African Ebola outbreak challenged the authority of the World Health Organization (WHO) to enforce the legally binding International Health Regulations ( IHR ) that govern pandemic responses. Under Article 43 of the IHR , states parties can only implement additional health measures beyond the WHO’s recommendations if public health rationales or scientific evidence justify such measures. Yet at least fifty-eight states parties enacted additional health measures, mainly travel restrictions to or from Ebola-affected countries. This article explains why Canada’s visa restrictions targeting Ebola-affected countries failed to meet the IHR ’s requirements and therefore violated international law. Specifically, Canada’s response went against public health authorities’ consensus views, the best available scientific evidence on disease transmission, and the WHO’s recommendations. In light of its traditional role as a global health champion, Canada must lead by example and abide by international law, including the IHR , instead of picking and choosing which rules to follow and thereby encouraging other countries to do the same.
Epidemics are among the greatest threats to humanity, and the International Health Regulations are the world's key legal instrument for addressing this threat. Since their revision in 2005, the IHR have faced two big tests: the 2009 H1N1 influenza pandemic and the 2014 Ebola epidemic in West Africa. Both exposed major shortcomings of the IHR, and both offered profound lessons for the future.
The objective of this Article is twofold. First, we seek to compare the lessons learned from H1N1 and Ebola for reforming the IHR in order to test the hypothesis that they are similar. Second, we seek to examine the barriers to implementing these lessons and to identify strategies for overcoming those barriers.
We find that the lessons from H1N1 and Ebola are indeed similar, and that opportunities to act on lessons from H1N1 were woefully missed. We identify many political barriers to global collective action and implementation of lessons for the IHR. On that basis, we describe strategies to overcome these barriers, which will hopefully be deployed now to reform the IHR before the policy window following Ebola closes, and before the inevitable next epidemic comes. The emerging threat of the Zika virus underscores that we have no time to waste.
To assess the effectiveness of internal and international travel restrictions in the rapid containment of influenza.
We conducted a systematic review according to the requirements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Health-care databases and grey literature were searched and screened for records published before May 2014. Data extraction and assessments of risk of bias were undertaken by two researchers independently. Results were synthesized in a narrative form.
The overall risk of bias in the 23 included studies was low to moderate. Internal travel restrictions and international border restrictions delayed the spread of influenza epidemics by one week and two months, respectively. International travel restrictions delayed the spread and peak of epidemics by periods varying between a few days and four months. Travel restrictions reduced the incidence of new cases by less than 3%. Impact was reduced when restrictions were implemented more than six weeks after the notification of epidemics or when the level of transmissibility was high. Travel restrictions would have minimal impact in urban centres with dense populations and travel networks. We found no evidence that travel restrictions would contain influenza within a defined geographical area.
Extensive travel restrictions may delay the dissemination of influenza but cannot prevent it. The evidence does not support travel restrictions as an isolated intervention for the rapid containment of influenza. Travel restrictions would make an extremely limited contribution to any policy for rapid containment of influenza at source during the first emergence of a pandemic virus.
The quick spread of an Ebola outbreak in West Africa has led a number of countries and airline companies to issue travel bans to the affected areas. Considering data up to 31 Aug 2014, we assess the impact of the resulting traffic reductions with detailed numerical simulations of the international spread of the epidemic. Traffic reductions are shown to delay by only a few weeks the risk that the outbreak extends to new countries. © 2014 European Centre for Disease Prevention and Control (ECDC). All rights reserved.
To evaluate the screening measures that would have been required to assess all travellers at risk of transporting A(H1N1)pdm09 out of Mexico by air at the start of the 2009 pandemic.
Data from flight itineraries for travellers who flew from Mexico were used to estimate the number of international airports where health screening measures would have been needed, and the number of travellers who would have had to be screened, to assess all air travellers who could have transported the H1N1 influenza virus out of Mexico during the initial stages of the 2009 A(H1N1) pandemic.
Exit screening at 36 airports in Mexico, or entry screening of travellers arriving on direct flights from Mexico at 82 airports in 26 other countries, would have resulted in the assessment of all air travellers at risk of transporting A(H1N1)pdm09 out of Mexico at the start of the pandemic. Entry screening of 116 travellers arriving from Mexico by direct or connecting flights would have been necessary for every one traveller at risk of transporting A(H1N1)pdm09. Screening at just eight airports would have resulted in the assessment of 90% of all air travellers at risk of transporting A(H1N1)pdm09 out of Mexico in the early stages of the pandemic.
During the earliest stages of the A(H1N1) pandemic, most public health benefits potentially attainable through the screening of air travellers could have been achieved by screening travellers at only eight airports.
The influence of air travel on influenza spread has been the subject of numerous investigations using simulation, but very little empirical evidence has been provided. Understanding the role of airline travel in large-scale influenza spread is especially important given the mounting threat of an influenza pandemic. Several recent simulation studies have concluded that air travel restrictions may not have a significant impact on the course of a pandemic. Here, we assess, with empirical data, the role of airline volume on the yearly inter-regional spread of influenza in the United States.
We measured rate of inter-regional spread and timing of influenza in the United States for nine seasons, from 1996 to 2005 using weekly influenza and pneumonia mortality from the Centers for Disease Control and Prevention. Seasonality was characterized by band-pass filtering. We found that domestic airline travel volume in November (mostly surrounding the Thanksgiving holiday) predicts the rate of influenza spread (r(2) = 0.60; p = 0.014). We also found that international airline travel influences the timing of influenza mortality (r(2) = 0.59; p = 0.016). The flight ban in the US after the terrorist attack on September 11, 2001, and the subsequent depression of the air travel market, provided a natural experiment for the evaluation of flight restrictions; the decrease in air travel was associated with a delayed and prolonged influenza season.
We provide the first empirical evidence for the role of airline travel in long-range dissemination of influenza. Our results suggest an important influence of international air travel on the timing of influenza introduction, as well as an influence of domestic air travel on the rate of inter-regional influenza spread in the US. Pandemic preparedness strategies should account for a possible benefit of airline travel restrictions on influenza spread.
Background:
Attention to global health security governance is more important now than ever before. Scientists predict that a possible influenza pandemic could affect 1.5 billion people, cause up to 150 million deaths and leave US$3 trillion in economic damages. A public health emergency in one country is now only hours away from affecting many others.
Methods:
Using regime analysis from political science, the principles, norms, rules and decision-making procedures by which states govern health security are examined in the historical context of their punctuated evolution. This methodology illuminates the catalytic agents of change, distributional consequences and possible future orders that can help to better inform progress in this area.
Findings:
Four periods of global health security governance are identified. The first is characterized by unilateral quarantine regulations (1377-1851), the second by multiple sanitary conferences (1851-92), the third by several international sanitary conventions and international health organizations (1892-1946) and the fourth by the hegemonic leadership of the World Health Organization (1946-????). This final regime, like others before it, is challenged by globalization (e.g. limitations of the new International Health Regulations), changing diplomacy (e.g. proliferation of global health security organizations), new tools (e.g. global health law, human rights and health diplomacy) and shock-activated vulnerabilities (e.g. bioterrorism and avian/swine influenza). This understanding, in turn, allows us to appreciate the impact of this evolving regime on class, race and gender, as well as to consider four possible future configurations of power, including greater authority for the World Health Organization, a concert of powers, developing countries and civil society organizations.
Conclusions:
This regime analysis allows us to understand the evolution, etiology and eventualities of the global health security regime, which is essential for national and international health policymakers, practitioners and academics to know where and how to act effectively in preparation for tomorrow's challenges.
This volume explores the principle and history of international human rights law. It addresses questions regarding the sources of human rights, its historical and cultural origins and its universality. It evaluates the effectiveness of procedures and international institutions in enforcing and ensuring compliance with human rights. This volume investigates the underlying structural principles that bind together the internationally-guaranteed rights and provide criteria for the emergence of new rights. It also evaluates whether the international human rights project has made a difference in the lives and well-being of individuals and groups around the world.
Oxford Handbook of International Human Rights Law
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