ABSTRACT
Since the beginning of the Zika virus epidemic, the Brazilian Ministry of Health has reported over 2000 confirmed cases of microcephaly associated with Zika virus in Brazil, with the cases concentrated in the northeast states. The Zika epidemic reopened a debate in Brazil that has played out in the national newspapers about expanding the abortion law to provide autonomy and legal protection to women. The argument for expanding the abortion law to include microcephaly secondary to Zika virus infection called for autonomy for women and, more broadly, protection of reproductive rights. The argument against expanding the current abortion law was separated into two main moral veins: those citing eugenics and those citing religious beliefs. However, the debate on abortion in the case of microcephaly accomplished more than giving a voice to two different viewpoints; it exposed health disparities that exist in Brazil, which were magnified by Zika virus, and reopened the political arena for discussion of the abortion law.
Subject(s)
Abortion, Induced/psychology , Microcephaly/psychology , Microcephaly/virology , Pregnancy Complications, Infectious/psychology , Zika Virus Infection/complications , Zika Virus Infection/psychology , Abortion, Induced/legislation & jurisprudence , Brazil , Decision Making , Disease Outbreaks , Female , Humans , Newspapers as Topic , Politics , Pregnancy , Pregnancy Complications, Infectious/virology , Reproductive Rights , Zika VirusABSTRACT
INTRODUCTION: The scale of the HIV pandemic - and the stigma, discrimination and violence that surrounded its sudden emergence - catalyzed a public health response that expanded human rights in principle and practice. In the absence of effective treatment, human rights activists initially sought to protect individuals at high risk of HIV infection. With advances in antiretroviral therapy, activists expanded their efforts under international law, advocating under the human right to health for individual access to treatment. DISCUSSION: As a clinical cure comes within reach, human rights obligations will continue to play a key role in political and programmatic decision-making. Building upon the evolving development and implementation of the human right to health in the global response to HIV, we outline a human rights research agenda to prepare for HIV cure access, investigating the role of human rights law in framing 1) resource allocation, 2) international obligations, 3) intellectual property and 4) freedom from coercion. CONCLUSIONS: The right to health is widely recognized as central to governmental, intergovernmental and non-governmental responses to the pandemic and critical both to addressing vulnerability to infection and to ensuring universal access to HIV prevention, treatment, care and support. While the advent of an HIV cure will raise new obligations for policymakers in implementing the right to health, the resolution of past debates surrounding HIV prevention and treatment may inform claims for universal access.
Subject(s)
HIV Infections/drug therapy , Human Rights , HIV Infections/prevention & control , Health Services Accessibility , Humans , Intellectual Property , Patient Acceptance of Health CareSubject(s)
Delivery of Health Care/organization & administration , HIV Infections/drug therapy , HIV Infections/psychology , Sexual Behavior/physiology , Syphilis/drug therapy , Syphilis/psychology , Venereology/organization & administration , Delivery of Health Care/methods , Delivery of Health Care/trends , HIV Infections/epidemiology , HIV Infections/transmission , Humans , Specialization , Syphilis/epidemiology , Syphilis/transmission , Venereology/methods , Venereology/trendsSubject(s)
Antitreponemal Agents/therapeutic use , Arsphenamine/therapeutic use , Delivery of Health Care/history , Drug Discovery/history , Syphilis/drug therapy , Venereology/history , Antitreponemal Agents/isolation & purification , Arsphenamine/isolation & purification , Delivery of Health Care/standards , Health Policy/history , History, 20th Century , Humans , United KingdomSubject(s)
Antitreponemal Agents/therapeutic use , Arsphenamine/therapeutic use , Delivery of Health Care/history , Delivery of Health Care/methods , Syphilis/diagnosis , Syphilis/drug therapy , Venereology/history , Antitreponemal Agents/adverse effects , Arsphenamine/adverse effects , History, 20th Century , Humans , Public Health Administration/history , United KingdomSubject(s)
Anti-Bacterial Agents/therapeutic use , Delivery of Health Care/history , Delivery of Health Care/methods , Drug Discovery/history , Penicillins/therapeutic use , Syphilis/drug therapy , Anti-Bacterial Agents/isolation & purification , History, 20th Century , Humans , Penicillins/isolation & purification , United KingdomSubject(s)
Anti-Bacterial Agents/therapeutic use , Delivery of Health Care/history , Penicillins/therapeutic use , Sexually Transmitted Diseases, Bacterial/drug therapy , Anti-Bacterial Agents/history , Anti-Bacterial Agents/supply & distribution , History, 20th Century , Humans , Incidence , Penicillins/history , Penicillins/supply & distribution , Sexual Behavior , Sexually Transmitted Diseases, Bacterial/epidemiology , Sexually Transmitted Diseases, Bacterial/history , United Kingdom/epidemiologyABSTRACT
Abstract-A moral right to health or health care, given reasonable resource constraints, implies a reasonable array of services, as determined by a fair deliberative process. Such a right can be embodied in a constitution where it becomes a legal right with similar entitlements. What is the role of the courts in deciding what these entitlements are? The threat of "judicialization" is that the courts may overreach their ability if they attempt to carry out this task; the promise of judicialization is that the courts can do better than health systems have done at determining such entitlements. We propose a middle ground that requires the health system to develop a fair, deliberative process for determining how to achieve the progressive realization of the same right to health or health care and that also requires the courts to develop the capacity to assess whether the deliberative process in the health system is fair.
Subject(s)
Decision Making , Health Policy , Immunization, Secondary/economics , Pneumococcal Vaccines/economics , Public Health , Budgets , Cost-Benefit Analysis , Evidence-Based Medicine , Humans , Influenza A Virus, H1N1 Subtype , Influenza Vaccines , Mexico , Pneumococcal Vaccines/administration & dosage , Public Health/ethicsABSTRACT
Three key ethical issues should inform the broader debate about health reform: (1) Why pursue universal coverage? (2) Why is cost containment an ethical issue? (3) What is fairness in financing? After examining these issues, we conclude that the core ethical values underlying each of these goals-including expanding opportunity, sharing burdens equally, and respect for persons-limit the means that can be pursued in health reform. Although national health reform will not accomplish all of the objectives of social justice, true comprehensive reform-even under conditions of political compromise-represents an important step forward.