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The Guardian - UK
The Guardian - UK
World
Nicola Kelly

‘Toxic combination’ of issues threaten world’s health and human rights – BMA

A mural in Sao Paulo, Brazil.
A mural in Sao Paulo, showing Brazil’s president Jair Bolsonaro and Covid pulling against health workers, asks: ‘Which side of the rope are you on?’ Photograph: Nelson Almeida/AFP/Getty Images

Health-related human rights are under intense threat across the globe with devastating consequences for the public and healthcare professionals, a new report from the British Medical Association warned.

The study, which examines the links between human rights and healthcare, identifies a “toxic combination” of emerging issues that have undermined human rights standards, putting renewed stress and pressure on populations around the world. BMA researchers say climate change, disinformation, neoliberalism, populism and socioeconomic inequalities are threatening “the vulnerable, the foreign, the marginal, the displaced, the ‘other’.”

“This is a really critical moment to think through whether we’re serious about equalities in healthcare and basic universal provision,” said Dr Julian Sheather, one of the authors of the report. “We’ve got rising costs of healthcare, rising needs of healthcare and real challenges about how health goods can be distributed around the world. Globally, we’re at a turning point.”

Inequalities were brought into sharp focus by the pandemic with the more powerful, wealthy countries given greater access to vaccines and personal protective equipment, the BMA said. Researchers found global cooperation had a direct impact on health outcomes, with resource-poor countries more exposed to Covid infections.

Social media and other new technologies allowed governments to deliver public health messaging around the pandemic, including monitoring and interventions such as test and trace, but it also gave rise to the spread of health misinformation and increased state surveillance encroaching on the privacy of its citizens. This misinformation “undermines and undercuts” trust in the health authorities and medical opinion, Sheather said.

Hospital staff sit in a basement, used as a bomb shelter, during an air raid alarm in Brovary, Ukraine, March 2022.
Hospital staff sit in a basement, used as a bomb shelter, during an air raid alarm in Brovary, Ukraine, March 2022. Photograph: Felipe Dana/AP

“Populist politicians of a particular ilk have shown themselves adept at channelling their [citizens’] fears for short-term political advantage. The potential effects of these populist appeals on health-seeking behaviour can be extremely damaging,” Sheather said in the report, pointing to the example of Brazilian president Jair Bolsonaro’s public discourse on Covid, who called the virus a “little flu”, which should be faced “like a man, not a boy”.

Conflict has also had an adverse effect on global human rights and health. The protection of medical staff and facilities during conflict are of particular concern, with hospitals and medics targeted, as seen most recently in Russia’s invasion of Ukraine.

“Medical professionals and facilities should be sacrosanct, yet we see them deliberately and systematically attacked,” Sheather said. “We need to be moving to a time of restraint and respect for international humanitarian law.”

Populations who have been displaced and sought asylum in neighbouring countries or farther afield are at greater risk of poor mental and physical health, and face significant challenges accessing healthcare.

The report sets out the effects forced displacement of the Roma population have had on living standards and healthcare. It shows that one in three Roma are living in housing without running water and that Roma women are 4.5 times more likely to have a low birth-weight baby than a non-Roma woman, with their babies 2.8 times more likely to be born prematurely.

Approximately 4,300 Roma live in the Lunik IX district of Kosice, Slovakia, most of them in abject poverty in crumbling high-rise apartment buildings.
Approximately 4,300 Roma live in the Lunik IX district of Kosice, Slovakia, most of them in abject poverty in crumbling high-rise apartment buildings. Photograph: Sean Gallup/Getty Images

Research also highlights the plight of the 600,000 Myanmar Rohingyas trapped in the country, confined to camps with inadequate food, healthcare and education, and routinely subjected to state violence. Those who have fled over the border to refugee camps in Bangladesh have limited access to healthcare, and inadequate resources to support the hundreds of thousands of people living there.

Climate change and its links to more prevalent diseases and virus strains, as well as the transfer of infections on migration routes, was also found to be a major contributing factor to human rights imbalances between countries. Sheather says the transfer of viruses from non-human to human hosts, as seen during the pandemic, will “continue to be a feature of climate change”.

The BMA makes urgent recommendations to policymakers, including the removal of barriers for migrants to access healthcare systems and greater support from wealthier countries to displaced and migrant populations. Clear recording of human rights violations during war, with a specific list of those that relate to health and healthcare were also urged, with health professionals calling for a strengthening of the international criminal court.

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