Saturday, November 2, 2024

Human Rights, Covid-19 & Adolescent consent to vaccination

It has been reported by (Guterres, 2021) as well as other global reports that the cataclysmic impact of COVID-19 and COVID-19 responses on human rights worldwide cannot be overstated.  UN Secretary-General Antonio Guterres is decrying “a pandemic of human rights abuses in the wake of COVID-19”.

This piece dear reader looks at the human rights impacts of COVID-19 and the COVID-19 response. It is intended to give us a perspective in the country to take stock and offer guidance as to what is that must be done, how it should be done and why it must be done.  It was reported by (UNAIDS, 2020), that: “rather than a public health response and a rights-based response being opposing poles, public health responses are only fully effective if they are absolutely grounded in human rights”.

The 1945 UN Charter elevated human rights as a principal foundation of the post-war international system, with the UN holding a foundational role in “promoting and encouraging respect for human rights and for fundamental freedoms for all” (UN, 1945). The 1948 Universal Declaration of Human Rights (UDHR), proclaimed by the General Assembly as “a common standard of achievement for all peoples and all nations,” recognized the human rights that underlying health: Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control (UNGA, 1948).

Drawing from the declaration of the right to health in the 1946 WHO Constitution, this expansive vision of health in the UDHR saw the fulfilment of necessary medical care and the realization of underlying determinants of health as a basis for public health, recognizing separately that some individual rights may be limited in order to protect the general welfare (UNGA,1948),States thereafter codified the human rights proclaimed in the UDHR in a set of core international human rights treaties, including:

International Covenant on Civil and Political Rights (UNGA, 1966a),  International Covenant on Economic, Social and Cultural Rights (UNGA, 1966b),  International Convention on the Elimination of All Forms of Racial Discrimination (UNGA, 1965) , Convention on the Elimination of All Forms of Discrimination against Women (UNGA, 1979), Convention on the Rights of the Child (UNGA, 1989), International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families (UNGA, 1990).

These treaties which have near universal ratification, are complemented by regional human rights treaties in Africa, the Americas and Europe, and the incorporation of human rights in national constitutions and other legislation, (Guterres, 21). As a legal and normative foundation for human rights-based responses to COVID-19, these treaties provide binding obligations under the right to health and other human rights that underlie health and define the scope of permissible limitations of civil and political rights to protect public health.

Grounded in international law, human rights constitute a universal, normative and legally binding foundation to prevent, protect against and control public health threats, and a basis for an equitable, participatory, transparent, accountable and effective public health response. Since the outbreak of COVID-19, the Office of the UN High Commissioner for Human Rights (OHCHR), international human rights accountability mechanisms including Treaty Bodies and Special Procedures, and the WHO and other international organizations have been united in robust commitment to human rights and have responded through extensive guidance on international human rights law in the context of COVID-19, (Guterres, 21).

For their part, it is expected that States must fully engage with, and improve support to, domestic and international human rights accountability procedures and comply with their recommendations. International organizations can also do more to support human rights-based responses to COVID-19. There is significant potential for collaboration between the WHO with OHCHR and international human rights procedures, including within a Framework of Cooperation of the WHO and OHCHR since 2017, to ensure that human rights are supported at WHO including at country level, and that the WHO supports international human rights mechanisms. Building on its Constitutional protection of the right to health and human rights mainstreaming work carried out over more than three decades, the WHO has an opportunity to strengthen its human rights policies, programmes, and practices, including within its emergencies team, (Guterres, 21).

Various scholars have acknowledged that since the unprecedented outbreak of Covid-19, its responses have been marred by controversy resulting to in human rights obstacles and violations in the following areas:  Equality and non-discrimination: Social inequalities and discrimination have caused differential impacts of COVID-19 and COVID-19 responses in terms of health, livelihoods, education, stigma and violence. Marginalized and vulnerable groups, including racial and ethnic minorities, older persons, persons with disabilities, women, children, and LGBTI+ persons have experienced multiple and intersecting human rights violations and obstacles.

 The Rights to Life and the Highest Attainable Standard of Health: The scale and distribution of infections and deaths are grounded in right to health obstacles predating the pandemic, including weak health systems and neglect of social determinants of health. They also reflect failures in States’ COVID-19 responses to uphold their right to health obligations for the “prevention, treatment and control” of infectious diseases, and to guarantee “medical care and assistance in the event of sickness” (UNGA, 1966).

Economic, Social and Cultural Rights: Sweeping restrictions to control disease transmission have disrupted education; removed sources of income; increased hunger; interrupted social care; and increased poverty, and disproportionately impacted vulnerable populations in countries with limited social protection.

Civil and Political Rights: International human rights law permits limitations of some civil liberties to protect public health so long as those limitations are proportionate, grounded in law, nonarbitrary and non-discriminatory.

Global health policy is essential in framing national responses to globalized threats of infectious disease, yet the IHR (2005), which seeks to promote global health security while safeguarding human rights, has proven ineffective in supporting states in balancing public health imperatives and human rights obligations. As this international legal framework is revised to meet future global health threats, it is crucial that states renew their commitment to human rights and accountability in global governance to control infectious disease and strengthen human rights assessments of state disease control efforts.

It has been provided that States have obligations under international law to respect, protect and fulfil human rights. Guided by COVID-19 human rights guidance from UN treaty bodies, Special Procedures and the OHCHR, and recommendations issued to individual States by international or domestic human rights bodies, States must comply with their international human rights obligations in the following:  laws, regulations and policies for the prevention, treatment and control of COVID-19, socio-economic responses and recovery policies and future pandemic preparedness.

Amongst others, States’ obligations under international human rights law require them to, Collect and disaggregate data on COVID-19 infections and deaths on grounds including gender, race, ethnicity, disability, age, language, religion, national or social origin, birth, health status (including HIV/AIDS), LGBTI+ status. Enhance public health systems capacities to ensure COVID-19 testing, treatment and vaccines are available and freely accessible to all especially to the most vulnerable groups.

It has been argued by (Morgan L et al 2021) that an oft repeated public health mantra is that “vaccines do not save lives, vaccinations save lives.  As a result of that Adolescent COVID-19 vaccination has become politicized, further hampering efforts by clinicians to promote COVID-19 vaccination among adolescents. Although Covid-19 illness is generally less severe in younger people the disease has nonetheless caused substantial morbidity among children and adolescent globally as noted by (Mahase E, 2021).

According to various scholarly publications on adolescent vaccination and consent indicates that In May 2021, the PFIZER BioNTech Covid-19 vaccine received emergency use authorization from the US Food and Drug Administration in adolescent aged 12 to 15 years, with authorization for younger children expected to increase by the end of the year 2021, (Mahase E ,2021). Despite clinical trial data indicating that the vaccine is safe and 100% efficacious for this age range, some parents and guardians may remain hesitant or outright opposed to vaccinating their children, politically and culturally conservative community (Heueman E, 21).

According to WHO reports, most confirmed Covid-19 cases in minors have been asymptomatic, creating an opportunity for minors to spread the virus unknowingly. The reduction of asymptomatic transmission is essential to slowing the spread of the virus and growing evidence suggesting that vaccination provides substantial public health benefits by decreasing transmission in addition to its direct, individual benefits (US, CDC21). For these reasons there is an urgent need for increasing immunization in younger age groups. Vaccinating minors is critical to protecting them from the virus, reducing transmission especially in higher risk populations and continuing progress toward herd immunity (WHO,21).

*Thabo Lucas Seleke is a researcher and scholar, Global Health Policy Analysis (LSHTM)

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