Professor Leonard Rubenstein - A Global System for Protection of Health Care

8/2/2019 Professor Leonard Rubenstein - A Global System for Protection of Health Care

1/14

Leonard Rubenstein, JDCenter for Public Health and Human Rights

Johns Hopkins Bloomberg School of Public Health


2/14

Mutually reinforcing mechanisms to

promote adherence -- human

rights model

1. Establishing norms

2. Documentation of violations

3. Prevention strategies

4. Accountability


3/14

Where we are today:

1. Norms Powerful and explicit in

internationalhumanitarian law

In non-conflict context,human right to access tohealth care

Norms reinforce and

respect ethical obligationto provide impartial care

But


4/14

NormsAnti-terror law

criminalizes medicalcare for terrorists

Serbia prosecuti0ns

for assistance to KLA USAmaterial support

Claims based onassymetrical warfare

Other norms rarelyincorporated in domesticlaw


5/14

Where we are today:

2. Documentation Only episodic reporting by human rights

groups

Reports on attacks on health included inreports of Special Representative of SecretaryGeneral on Protection of Children in ArmedConflict, but not a priority

Limited sharing of internal securityinformation among humanitarianorganization.

41 22 791 2316


6/14

Documentation promising

developments Health Care Danger report by ICRC multi-country

study

US Department of State now collecting data for annualCountry Reports on Human Rights Practices onattacks on health and humanitarian access

Executive Board of WHO adopts resolution to provide

leadership at global level on systematic collection anddissemination of data on attacks on health in complexhumanitarian emergencies

Will be taken up by World Health Assembly


7/14

Where we are today:

3. Prevention Little study of causes, motives, even

what works

Information that exists not widely shared Little study of impacts on health services

Sense of inevitability and powerlessness

Lack of constituent engagement


8/14

Prevention promising

developments ICRC training of military and insurgent groups,

negotiation activities to promote access

Health Care in Danger Campaign pragmaticstrategies to address potential points of attack

Military workshops

Increasing sophistication on NGO security matters

Increased discussion at international level

Attempts at coordination


9/14

Where we are today:

4. Accountability Occasional diplomatic condemnation, but no

teeth

Little sustained advocacy Prosecutions for violations rare

Most attention on humanitarian providers, notindigenous health workers and facilities


10/14

Accountability promising

developments UN Security Council includes attacks on hospitals

and health personnel in mechanism forprotection of children in armed conflict (2011)

Perpetrators listed in report

Action plan for promoting adherence required

Increased documentation increases potential for

diplomatic leverage Safeguarding Health Coalition to mobilize civil society

www.safeguardinghealth.org

Medical and nursing associations

Human rights, development and humanitarian NGOs
http://www.safeguardinghealth.org/http://www.safeguardinghealth.org/


11/14

A way forward: global solutions

through inter-governmental

organizationsPredicates

Vision of integrated approach norms, prevention,documentation, accountability

Develop constituency through Health Care in Dangerand Safeguarding Health Coalition


12/14

A global approach1. Reinforcement of norms

Integrate human rights and humanitarian law values

Reflection in national law Rejection of anti-terror exceptions to adherence;

resolution of Human Rights Council?

2. Prevention

Robust program of discussion and research on causesand what works, with donor and foundation support

Dissemination of findings

Pressure for adherence via Human Rights

Council/Security Council


13/14

A global approach3. Documentation

Unified, coordinated approach

Collaboration between WHO and otheragencies -- OCHA, UNICEF, SpecialRepresentative on Children, HighCommissioner for Human Rights

Collaboration with humanitarian NGOs ondata


14/14

A global approach4. Accountability

UN system: Security Council should Condemn and call for the cessation of attacks or interference

Call for compliance by parties to conflict with international law Apply targeted measures against perpetrators

Authorize commissions of inquiry and/or refer such situations to the ICC

Action by Human Rights Council/ OHCHR

Prosecutions, domestically and internationally Bi-lateral and regional mechanisms of accountability

Diplomatic pressures

Sanctions and related measures

Professor Leonard Rubenstein - A Global System for Protection of Health Care

Documents