Apr 9, 2020 | Advocacy, News
A joint statement signed by the ICJ and 102 other organizations.
The COVID-19 pandemic and public health crisis is presenting grave challenges for health care systems across Europe.
As European countries work to address the pandemic, protect their populations, and meet the increased demand on health care workers and health care facilities it is vital that they adopt measures to safeguard the health, human dignity, physical and mental integrity, and reproductive autonomy of women and girls in the region.
In many countries the lack of government measures to guarantee individuals’ safe and timely access to essential sexual and reproductive health services, goods, and information during the pandemic is of particular concern.
Women and girls – this statement refers to women and girls, as the majority of individuals who are needing abortion care identify as such but it equally applies to all individuals who may become pregnant and need abortion care or other sexual and reproductive health care – are facing significant restrictions in safely accessing essential sexual and reproductive health services, particularly timely abortion care, post abortion care, and emergency contraception.
Such restrictions disproportionately impact individuals belonging to marginalized groups, including women living in poverty, women with disabilities, Roma women, undocumented migrant women, adolescents, and women at risk or who are survivors of domestic and sexual violence.
These restrictions also create unnecessary risks of exposure to COVID-19 for women and girls and their families as well as for health care providers.
Particularly grave barriers are arising for women and girls living in European countries where abortion care is illegal or severely restricted, and where as a result they must travel to other countries to access legal care or must obtain abortion medication from outside their own jurisdiction.
These issues can also arise in those European countries where individuals are forced to go through burdensome or harmful administrative processes to access abortion care or where they may have difficulty finding doctors in their country willing to provide care.
We applaud those governments that have moved swiftly to safeguard access to essential time- sensitive sexual and reproductive health care during this time, in particular through ensuring access to telehealth and early medical abortion from home.
We call on all other European governments to follow suit and to follow the guidance of medical and public health experts.
We call on the six European countries (Andorra, Liechtenstein, Malta, Monaco, Poland and San Marino) where abortion is illegal or severely restricted to urgently reform these laws, which place women’s health and lives at risk.
Limitations on travel and transport now compound the impact of these highly restrictive laws. Individuals in these countries may no longer be able to travel abroad or to obtain medication for abortion sent by post from medical providers in other countries. As a result, they face heightened risks to their health and wellbeing.
We call on those countries where abortion is legal but where clinical services are unavailable or difficult to access due to a range of barriers, including medically unnecessary requirements that oblige individuals to take multiple or unneeded trips to health care facilities or undergo mandatory hospitalization, to urgently eradicate those barriers and ensure access to services.
Urgent steps should also be taken to ensure that refusals of care because of private beliefs by doctors do not jeopardize timely access to legal abortion care.
In accordance with human rights obligations3 and the recommendations of medical experts4 the following measures should be adopted, and at a minimum remain in place for the duration of the COVID-19 pandemic:
- Ensure that abortion is treated as essential and time-sensitive health care and guarantee access to care in a timely manner.
- Authorize and make available in a timely manner telehealth consultations for anyone who is seeking abortion care or information. Specific measures should be adopted to ensure that telehealth consultations are free or low cost and easily accessible for marginalized groups.
- Guarantee timely access to early medical abortion throughout each jurisdiction and allow doctors to prescribe the necessary medication via telehealth consultation.
- Allow individuals to take all abortion medication at home. Requirements in some European countries that one pill must be taken in the physical presence of a doctor or in a health care facility should be removed.
- Remove mandatory waiting periods prior to abortion as well as mandatory counselling requirements or ensure counselling can be conducted through telehealth consultation.
- Authorize primary care doctors and midwives to provide early medical abortion.
- Adopt health system safeguards to guarantee access to care in cases where early medical abortion is not possible or is contraindicated, for individuals who need abortion care later in pregnancy or post-abortion care, or who may need to visit a health care facility for other reasons. Travel in such cases should be deemed essential and permitted even where governments have otherwise restricted free movement.
- Where a doctor’s authorization is required, this should be limited to one doctor. Requirements for multiple doctors’ approval of an abortion should be removed.
- Guarantee timely access to prenatal testing and psychosocial support where requested.
- Guarantee an adequate number of providers willing and able to provide abortion care throughout the country and widely publicize information on how women can identify health care professionals willing and available to provide abortion care. Urgently ensure that refusals of care by doctors do not jeopardize access to abortion care in a time of crisis.
- Widely disseminate information on those changes to SRHR policies and health care services that are being made in the context of COVID-19 responses.
- Ensure access to contraception including emergency contraception, including through authorizing telehealth consultations and provision of emergency contraception over the counter in pharmacies without a prescription.
Finally, we call on all policy makers across the European region to reject proposals that purport to restrict access to safe abortion care during the COVID-19 pandemic. These disingenuous proposals simply serve to exacerbate the current public health crisis and have negative effects on the health, lives, and wellbeing of women and girls.
Download the full statement with additional information and the list of signatories
Apr 6, 2020 | Feature articles, Multimedia items, News, Video clips
As of 8:00am CET this morning, the Coronavirus COVID-19 Global Cases tracker by the Center for Systems Science and Engineering at Johns Hopkins University in the US recorded 169,049,480 confirmed cases of individuals who had contracted the COVID-19 disease in 192 countries, and 3,513,137 people who had succumbed to the virus. Read all the ICJ articles on the crisis.
Against this background, the aim of this blog is to highlight the necessity of ensuring the consistency of public health policies taken as part of the global responses to the COVID-19 pandemic with human rights law and standards.
As outlined in a prescient 2019 Lancet Commission report – The legal determinants of health: harnessing the power of law for global health and sustainable development – the law, and a firm commitment to the rule of law, play a critical role in the pursuit of global health with justice.
Ultimately, scientifically sound, evidence-based, human rights compliant, transparent and accountable public health policies and practices will also be more effective, as they will, in turn, elicit greater public support, including by prompting greater adherence to public health policy directives imposing restrictive measures on human rights.
As Michelle Bachelet, the UN High Commissioner for Human Rights recently affirmed, ‘COVID-19 is a test for our societies, and we are all learning and adapting as we respond to the virus. Human dignity and rights need to be front and centre in that effort, not an afterthought’.
China, where cases of COVID-19 were first documented, has been questioned from inside and outside for its response to the crisis, at first attempting to shut down information about the virus, leading to arrests and detentions. Outside China, while some COVID-19 health policies have been evidence-based, such as scaled-up, accurate testing for suspected cases, others are ineffective and overly broad, increasing stigmatization and misinformation.
Around the world, people of Asian descent have been subjected to xenophobia, stigmatization and racist attacks. Moreover, many States have now imposed extensive travel restrictions or even blanket travel bans; some have gone as far as using the COVID-19 pandemic as a pretext to promote their xenophobic and anti-asylum agenda and have now shut down their borders to refugee claimants, thereby flouting the right of anyone to seek asylum from persecution in other countries.
In a frontal attack against women’s human rights, in Texas and Ohio, the authorities have moved to ban healthcare providers from performing abortions in most circumstances – purporting to do so to respond to the global COVID-19 crisis. There is also a world of false information on COVID-19. For instance, Indonesia’s health minister suggested that Islamic prayers shielded people from the virus.
To foster scientifically accurate, human rights compliant global health responses – including to events such as the COVID-19 pandemic – it is crucial to enhance dialogue between the public health and human rights sectors. A good place to start framing a productive exchange in this respect is to take a close and simultaneous look at the International Health Regulations (IHR (2005)) – an agreement among 196 WHO Member States to work together for global health security – and to the Siracusa Principles on the Limitation and Derogation Provisions in the International Covenant on Civil and Political Rights (the Siracusa Principles), setting out criteria to determine the lawfulness of measures restricting or otherwise limiting human rights taken by States to respond to – among other things – public health emergencies.
International Health Regulations & Travel Restrictions
Article 3(1) of the IHR (2005), setting out the principles informing the regulations, recalls that, ‘[t]he implementation of these Regulations shall be with full respect for the dignity, human rights and fundamental freedoms of persons’. And, perhaps tellingly, in Article 32, concerning the treatment of travellers, the IHR proclaim, among other things, that, ‘[i]n implementing health measures under these Regulations, States Parties shall treat travellers with respect for their dignity, human rights and fundamental freedoms’.
Notwithstanding the express human rights obligations enshrined in the IHR, current public policy responses to the ongoing crisis – and even public discourses around those responses – make very few, if any, direct references to human rights and, in fact, seem to be oblivious to the impact that measures taken and/or considered in the response to COVID-19 have on human rights.
But the IHR, as noted in a recent piece by Roojin Habibi et al, restrict ‘the measures countries can implement when addressing public health risks to those measures that are supported by science, commensurate with the risks involved, and anchored in human rights. The intention of the IHR is that countries should not take needless measures that harm people or that disincentivise countries from reporting new risks to international public health authorities’.
Siracusa Principles
The 1985 Siracusa Principles provide a good basis to flesh out what a human rights compliant public health response to the COVID-19 pandemic must entail. They detail criteria – by now firmly enshrined in international human rights law and standards – to determine the lawfulness of State measures restrictive of human rights.
According to the Siracusa Principles, for instance, when a State invokes public health as a ground for limiting certain rights, its actions ‘must be specifically aimed at preventing disease or injury or providing care for the sick or injured’. Even in circumstances when it is undeniable that a public health emergency may threaten the life of a nation, the Siracusa Principles reaffirm the obligation of States to ensure that any public health response to such an emergency be rooted in and compatible with human rights law and standards. Importantly, the Principles provide further interpretive guidance to States, proclaiming that restrictions on human rights may be justifiable only when they are:
- provided for and carried out in accordance with the law;
- based on scientific evidence;
- directed toward a legitimate objective;
- strictly necessary in a democratic society;
- the least intrusive and restrictive means available;
- neither arbitrary nor discriminatory in application;
- of limited duration; and
- subject to review.
The final condition – that State action be subject to review – is critical. Analogous requirements can be seen in other areas of international law. In the asylum and refugee context, for example, detention guidelines promulgated by the United Nations High Commissioner for Refugees emphasize that confinement on health grounds beyond an initial medical check must be subject to judicial oversight. Similarly, the Human Rights Committee’s General Comment no. 35 makes clear that the International Covenant on Civil and Political Rights ‘entitles anyone who is deprived of liberty by arrest or detention’ to take their case before a court to decide on ‘the lawfulness of detention’, enshrining the principle of habeas corpus.
The General Comment adds that this right also applies to house arrest, as a form of deprivation of liberty. Of course, whether involuntary home confinement constitutes deprivation of liberty – entitling those subjected to such a measure to challenge the lawfulness of their detention before a court – is a question of fact, depending, in turn, on the degree of the physical confinement imposed. Voluntarily choosing to stay at home in response to State authorities’ exhortation to do so, on the other hand, does not constitute deprivation of liberty.
Furthermore, any State action must comply with the rule of law and should respect the separation of powers. Neither the executive nor public health authorities should be immune from having their actions legitimately scrutinized by other branches of the State, namely, the legislature and the judiciary. Checks and balances are necessary to ensure respect for human rights and for democratic legitimacy.
In conclusion, both the IHR (2005) and the Siracusa Principles remind us of the fact that State responses to global public health emergencies cannot be unfettered, and must comply with States’ human rights obligations. Public responses to health emergencies and human rights need not be in conflict – indeed, grounding States’ public health measures in the human rights framework provides the most effective way to advance global health with justice.
The Lancet Commission report suggests one way to further identify human rights and rule of law compliant measures in the current and future global public health policy response. The report calls for a partnership between ‘legal and health experts to create an independent standing commission on global health and the law’ that would propose ‘evidence-based legal interventions for addressing major global health challenges, reforms of the global health architecture and international law, and strategies to build and strengthen global and national health law capacities’.
We should heed that call.
(Article written by Sam Zarifi and Kate Powers)
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ICJ Director of Media & Communications Olivier van Bogaert talks with ICJ Commissioner Belisário dos Santos Júnior about the COVID-19 pandemic in Brazil and the health, political and judicial crisis that it triggered.
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ICJ Communications Officer Shaazia Ebrahim talks with ICJ Legal Adviser Tim Fish Hodgson about how COVID-19 has impacted socio-economic rights in South Africa:
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Apr 3, 2020 | News
Millions of indigenous people in Guatemala (Mayas, Garífunas and Xincas) are at increased risk of falling victim to COVID-19 unless the government immediately provides them with necessary information and ensures they have access to adequate health care without discrimination, the ICJ said today.
“Guatemala’s indigenous people face an increased risk of suffering during this global pandemic because of the historic and systemic discrimination against them, which means that they don’t have access to proper information needed to protect themselves, nor to health care should they fall ill because of COVID-19,” said Ramón Cadena, ICJ’s Central America Director.
“The most suffering indigenous communities could be those very poor indigenous communities living at the border with México.”
The ICJ called on Guatemalan authorities to ensure that information about public health measures regarding COVID-19 be offered in the languages most used by indigenous communities (mayan languages such as ixil, quiché, mam, q´eqchí, kaqchikel; and garífuna and xinca languages).
During the pandemic the State of Guatemala has not taken into account the difficulties, such as financial, geographical, technological or linguistic barriers, that indigenous people face in accessing information.
On the other side, the ICJ has noticed that the information about the governmental measures to face the pandemic, has been disseminated in a very limited way.
Indigenous communities have been excluded from the official health system because of the discrimination against them and the lack of resources invested in the health system of Guatemala due to processes of privatization of social services, which have been implemented in Guatemala after the signature of the Peace Accords.
“The general weakness of the Guatemalan public health system, historic racism against the indigenous community and the tremendous general social inequality in the country all aggravate the potential impact of the pandemic on the indigenous community,” Cadena said.
The ICJ urges the State of Guatemala to take the necessary legislative, administrative, and judicial measures to protect Indigenous Peoples and preserve their human rights during the current emergency, specifically their right to health, food, and housing.
The ICJ also called on the Guatemalan government to avoid measures that threaten the life and dignity of people, including those from the indigenous community who are generally most subject to violations of their civil and political rights.
“Any measures taken in response to the pandemic must be limited to those that are strictly necessary, legitimate, and proportionate to the risk facing the community, and limited in time and subject to review,” Cadena said.
“There are certain guarantees, such as the right to an effective judicial remedy, that cannot be suspended or repealed and that are vital so that citizens, including indigenous people, can safeguard their rights, and even as the pandemic inevitably affects the legal system the government must do all it can to avoid discrimination against the indigenous community, which already suffers from racism and lack of access to justice.”
Apr 2, 2020 | News, Op-eds
An opinion piece by Shaazia Ebrahim, ICJ Media Officer, and Tim Fish Hodgson, ICJ Legal Adviser on Economic, Social and Cultural Rights, based in South Africa.
The inhumane conditions that most South African residents are subjected to in their daily lives will continue to deepen as the coronavirus spreads.
South Africans are encouraged to take precautionary measures to curb the spread of the pandemic by practising social distancing and intensifying hygiene control. The country will also be under a nationwide lockdown in order to “fundamentally disrupt the chain of transmission across society” from 26 March for 21 days.
The problem is that the recommended measures in South Africa, similarly to those of the World Health Organisation, assume that everyone lives in a house. A house which is at no risk of being destroyed by the state or private owners of the land upon which it is built: a house with access to water, sanitation and other basic services.
But the reality is that millions of South Africans do not live in a house, but in rudimentary structures in poor conditions. In a statement released this week, Abahlali baseMjondolo, a shack dwellers’ movement with members in various provinces across South Africa, articulated this.
Abahali’s frank assessment of the situation is that “it does not seem possible to prevent this virus from spreading when we still live in the mud like pigs”.
It is under the same conditions described by Abahlali baseMjondolo that many of the urban and rural poor in South Africa will be required to live under “lockdown”, commencing from midnight tonight.
Access to basic services: ‘if one person gets infected it’s disastrous’
Speaking before the release of the statement, Abahlali president S’bu Zikode expressed the distress that many around South Africa are currently experiencing. “Abahlali is very concerned about the outbreak of the coronavirus. The reason is, of course, that the conditions that we are subjected [give] us reason to be scared and worried,” he said.
“Social distancing” is difficult for many in South Africa. Government regulations say no more than 100 people should be “gathering” and people are more generally encouraged to keep a distance from one another. In Abahlali’s settlements, Zikode explains, there are thousands living close together under strenuous conditions.
“That on its own is automatically disrespecting the call from the president”, he said.
Abahlali, alongside various other South African movements and organisations, have for years been calling for the state to improve their living conditions and provide them with access to water, sanitation and other basic services.
In 2019 the United Nations Committee on Economic, Social and Cultural Rights noted its concern about “the large number of people living in inadequate housing, including those in informal settlements, without access to basic services; the growing number of informal settlements in urban areas due to rapid urbanisation”.
These calls have not received a sufficiently serious response from the government. Litigation to ensure access to basic services remains commonplace.
In this context, while hygiene has rightly been touted as one of the most important preventatives from spreading Covid-19, it is difficult to imagine how the majority living in South Africa will be able to ensure even basic measures such as handwashing.
Abahlali notes that in many informal settlements “hundreds of people [are] sharing one tap”. In this context, it is easy to see why leaders of Abahlali think that as it stands, preventing the spread of coronavirus is very important, but all but impossible.
“As leaders of Abahlali, we see it as once one person gets infected in the settlements, suddenly the entire settlement will be disastrous,” Zikode said.
A moratorium on evictions: halting evictions ‘will save lives’
Making matters worse, members of Abahlali, like many others in their country, lack security of tenure. As trying as their current circumstances may be, Abahlali warns of the potentially devastating effects of evictions during the pandemic. Another common way to induce evictions is to disconnect existing access to water, electricity and sanitation.
This is why Abahlali demands that “all evictions must be stopped with immediate effect” and that “all disconnections from self-organised access to water, electricity and sanitation must be stopped with immediate effect”. Indeed, it is difficult to see how any eviction during the pandemic could be “just and equitable” in “all relevant circumstances” as is required by South African law.
The call for a “moratorium” on evictions has also been made by a large group of social movements and civil society organisations in South Africa in a letter to the president. It has also received clear support from the UN Special Rapporteur on the Right to Housing, who has called for a “global ban” on evictions worldwide:
“The logical extension of a logical stay-at-home policy is a global ban on evictions. There must be no evictions of anyone, anywhere, for any reason. Simply put: a global ban on evictions will save lives”, she said. The International Commission of Jurists has echoed these calls and the calls for connection of emergency water for all before the nationwide lockdown commences.
Coronavirus, the right to housing and access to land
In February, in giving input to the parliamentary committee contemplating the need to amend the Constitution to expedite land reform, Abahali argued that land is not a commodity and that the Constitution should include a “right to land” which it does not at present.
“Land should be shared and should be viewed as a public good”, Zikode explains.
Abahlali argues that the absence of a right to land in the Constitution undermines the constitutional right to housing: without land there can be no housing. Consistently with this logic, as early as 2000, South Africa’s Constitutional Court held emphatically that:
“For a person to have access to adequate housing all of these conditions need to be met: there must be land, there must be services, there must be a dwelling.”
The current crisis brought on by the coronavirus adds weight to Abahlali’s position on land. Access to land and security of tenure are necessary for access to adequate housing. If people have access to land and secure tenure, evictions are not a constant threat to their well-being.
Without access to housing and basic services, public health is severely compromised on a daily basis. Public health emergencies such as the coronavirus pandemic put even further pressure on an already compromised living environment. They therefore highlight that for many people, the right to adequate housing can only be discharged with full access to land.
The obligations of the South African government
The government of South Africa has rightly been praised for its proactive response to the coronavirus pandemic. The regulations passed in terms of the Disaster Management Act require that measures taken to combat coronavirus are implemented “as far as possible, without affecting service delivery in relation to the realisation of the rights” including the rights to housing and basic services, healthcare, social security and education.
The president’s announcement of a countrywide lockdown included a commitment that “temporary shelters that meet the necessary hygiene standards will be identified for homeless people”. Nevertheless, Abahlali’s members, who are not strictly homeless, might take cold comfort.
Disappointingly, the president failed to announce a moratorium on evictions or make any mention of evictions at all. This not only leaves many more people under the threat of being rendered homeless but may also lead to devastating displacement that will make the further spread of coronavirus possible.
The president did indicate that “emergency water supplies” are “being provided to informal settlements and rural areas”.
However, he did not make mention of whether expedited or emergency provision of other basic services such as sanitation, electricity and waste removal services where they are not currently available would occur. Urgent calls for emergency water connection coming out of Khayelitsha suggest that in many places in major informal settlements such emergency connections have not occurred.
The government of South Africa should be applauded for taking emergency measures. However, in so doing, it is implicitly acknowledging that many — if not most — South African residents have been living on a daily basis in conditions that are insufficient for them to live healthy, dignified lives.
This highlights the government’s existing and continuous failures to respect, protect, promote and fulfil the rights to access to housing and basic services.
The coronavirus, therefore, stands a stark reminder to all in South Africa of the dire impacts of social inequality in the country and the pressing need for government to pursue the realisation of all its obligations in terms of social and economic rights protected in the South African Constitution and the International Covenant on Economic, Social and Cultural Rights. It also lends strong credence to the need for serious consideration of Abahlali’s claim for the need of a constitutionally protected right to land.
As Zikode concludes:
“Abahlali has always been about the land, decent housing, and dignity. Without land, housing is impossible. Without land, dignity is compromised. Land is close to the heart of many mainly black South Africans and it’s very close to the heart of Abahlali.”
Originally published in Daily Maverick
Mar 30, 2020 | News
The ICJ is calling on the Turkish Parliament to extend the planned provision of alternatives to detention in response to the COVID-19 crisis to all those imprisoned for non-violent crimes who do not pose a current threat to members of the public, regardless of the nature of the offences for which they have been charged.
In particular, alternatives to detention should apply to all those detainees who are particularly at risk at losing their life or suffering severe health effects from COVID-19.
Measures to protect the right to life, the right to health and other human rights must apply equally and without discrimination in line with Turkey’s international legal obligations.
The government have announced the tabling of a draft law to reduce the prison population that has been under discussion in recent months. The process has been accelerated with the purported aim of addressing the serious health risk that an outbreak of COVID-19 contagion would pose to the prison population. However, the draft law has not been adapted to address the health crisis and contains several shortcomings.
The new measures would grant alternatives to detention, including house arrest or early parole to an estimated one-third of the prison population.
This welcome move is however limited by the exclusion of those convicted or under trial for terrorism offences or offences against the State.
“In Turkey, terrorism offences and offences against the State have long been abused to arrest, try and jail human rights defenders, lawyers, judges and political opponents,” said Massimo Frigo, Senior Legal Adviser for the ICJ Europe and Central Asia Programme. “The rights to life and health of these groups are now at particular risk.”
The ICJ considers that it is also essential that all detainees who are members of a group whose life or health may be at risk because of COVID-19 have either access to alternatives to detention, if they do not pose a current threat to public safety, or, otherwise, to detention conditions that may preserve them as far as possible from such risk.
“The State has a non-derogable obligation to protect the right to life of all its prison population, without discrimination of any sort,” Massimo Frigo added.
