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Disease knows no borders- a discourse on the enforcement of humanitarian and human rights law in conflict settings to successfully contain future pandemic diseases.

Van Hout, MC and Wells, J Disease knows no borders- a discourse on the enforcement of humanitarian and human rights law in conflict settings to successfully contain future pandemic diseases. Public Health. ISSN 0033-3506 (Accepted)

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Abstract

Objectives: The catastrophic effects of armed conflict, particularly prolonged armed conflict, on individual and public health are well-established. The ‘right’ to healthcare during armed conflict and its lack of enforcement despite a range of United Nations mandated requirements regarding health and healthcare provisions is likely to be a significant feature in future conflicts, as zoonotic induced pandemics become a more common global public health challenge. The issue of enforcement of health rights assurance and its implications for the public health management of global pandemics such as COVID-19 in and between countries and regions in conflict is the objective of this Review. Study Design: Narrative Review.
Methods: Referenced to the framework of International humanitarian law (IHL) and International human rights law (IHRL) in order to explore and discuss the deficits in health rights assurances in conflict settings and illustrate how gaps in protection and lack of enforcement compounds the disease response. Both international humanitarian law, and international human rights law can be leveraged to ensure human and health rights are assured in conflict settings. There is a distinct lack of international criteria with regard to standards of health care coverage, infrastructure and service preservation to the civilian population during times of armed conflict. This has far reaching consequences when confounded by a pandemic or even localised disease outbreak.
Results: We illustrate how in a pandemic disease emergency, such as COVID-19, all life is threatened; and how leaving the citizen population exposed to this contagion is a human rights breach and an indirect method of warfare. The consequences of failure to effectively address such pandemic infections, (i.e. COVID-19), in a conflict setting are potentially catastrophic as prevention and containment responses are severely constrained by state insecurity, political instability, terrorism, repression, rights abuses and displacement of citizens. Neglect by State actors potentially constitutes a breach of the universal right to life. States cannot justify their failures to mitigate disease based on claims of lack of resources, even when available resources are minimal. Where discrimination of people with a disease, such as COVID-19, or minority groups at the point of access to health facilities occurs, this further breaches the principle of medical neutrality.
Conclusions: The example of the COVID-19 response may offer a viable route to leverage greater access and coverage of health care in conflict and humanitarian settings. A radicalised partnership approach during these times of emergency is warranted, based on an ethical “humanitarian intervention” approach to provide care to all affected by contagious disease in conflict settings.

Item Type: Article
Uncontrolled Keywords: 1117 Public Health and Health Services
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Public Health Institute
Publisher: Elsevier
Date Deposited: 11 Jan 2021 10:09
Last Modified: 11 Jan 2021 10:15
URI: https://researchonline.ljmu.ac.uk/id/eprint/14246

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