More than 13,500 asylum seekers remain trapped on the Greek islands in deplorable conditions as winter begins on December 21, 2017. Greece, with support from its European Union partners, should urgently transfer thousands of asylum seekers to the Greek mainland and provide them with adequate accommodation and access to fair and efficient asylum procedures.

Author: Human Rights Watch, Human Rights Watch
Posted: January 1, 1970, 12:00 am

(New York) – The latest revisions to China’s Criminal Law impose up to seven years in prison for “spreading rumors” about disasters, Human Rights Watch said today. The revised law, which took effect November 1, 2015, does not clarify what constitutes a “rumor,” heightening concerns that the provision will be used to curtail freedom of speech, particularly on the Internet.

“The revised Criminal Law adds a potent weapon to the Chinese government’s arsenal of punishments against netizens, including those who simply share information that departs from the official version of events,” said Sophie Richardson, China director at Human Rights Watch. “The authorities are once again criminalizing free speech on the Internet, which has been the Chinese people’s only relatively free avenue for expressing themselves.”

The National People’s Congress Standing Committee approved the addition of a provision to article 291(1) of the Criminal Law (Criminal Law Amendment Act (9)), which states that whoever “fabricates or deliberately spreads on media, including on the Internet, false information regarding dangerous situations, the spread of diseases, disasters and police information, and who seriously disturb social order” would face prison sentences – with a maximum of seven years for those whose rumors result in “serious consequences.” The vagueness of the provision means that individuals doing nothing more than asking questions or reposting information online about reported local disasters could be subject to prosecution.

In the past, the Chinese government has detained netizens who questioned official casualty figures or who had published alternative information about disasters ranging from SARS in 2003 to the Tianjin chemical blast in 2015, under the guise of preventing “rumors.”

The revision was made in the context of a wider effort to rein in online freedom since President Xi Jinping came to power in 2013:

  • In August 2013, the authorities waged a campaign against “online rumors” that included warning Internet users against breaching “seven bottom lines” in their Internet postings, taking into custody the well-known online commentator Charles Xue, and closing popular “public accounts” on the social media platform “WeChat” that report and comment on current affairs;
  • In September 2013, the Supreme People’s Court and the Supreme People’s Procuratorate (the state prosecution) issued a judicial interpretation making the crimes of defamation, creating disturbances, illegal business operations, and extortion applicable to expressions in cyberspace. The first netizen who was criminally prosecuted after this took effect was well-known blogger Qin Huohuo, who was sentenced to three years in prison in April 2014 for allegedly defaming the government and celebrities by questioning whether they were corrupt or engaged in other dishonest behavior;
  • In July and August 2014, authorities suspended popular foreign instant messaging services, including KakaoTalk, claiming the service was being used for “distributing terrorism-related information”;
  • In 2015, government agencies such as the State Internet Information Office issued multiple new directives, including tightening restrictions over the use of usernames and avatars, and requiring writers of online literature in particular to register with their real names;
  • In 2015, the government has also shut down or restricted access to Virtual Private Networks (VPNs), which many users depend on to access content blocked to users inside the country and also help shield user privacy;
  • In March 2015, authorities also deployed a new cyber weapon, the “Great Cannon,” to disrupt the services of GreatFire.org, an organization that works to document China’s censorship and facilitate access to information;
  • In July 2015, the government published a draft cybersecurity law that will requires domestic and foreign Internet companies to increase censorship on the government’s behalf, register users’ real names, localize data, and aid government surveillance; and
  • In August 2015, the government announced that it would station police in major Internet companies to more effectively prevent “spreading rumors” online.
     

Activists in China are regularly prosecuted for speech-related “crimes,” Human Rights Watch said. The best known of these crimes is “inciting subversion,” which carries a maximum of 15 years in prison. But authorities have also used other crimes such as “inciting ethnic hatred,” as in the case of human rights lawyer Pu Zhiqiang, who has been detained since May 2014 for a number of social media posts questioning the government’s policies towards Uighurs and Tibetans.

While providing the public with accurate information during disasters is important, the best way to counter inaccurate information would be to ensure that official information is reliable and transparent, Human Rights Watch said.

Above all, journalists should have unimpeded access to investigate and inform the public about these events, and the wider public should have the freedom to debate and discuss disaster response.

“The casualties of China’s new provision would not be limited to journalists, activists and netizens, but the right of ordinary people and the world to know about crucial developments in China,” Richardson said. “The best way to dispel false rumors would be to allow, not curtail, free expression.”

Posted: January 1, 1970, 12:00 am

Imports sit destroyed in a damaged warehouse at the port in Hodeida city, Yemen.

© November 2016 Kristine Beckerle / Human Rights Watch

(Beirut) – All parties to the conflict in Yemen should minimize civilian harm during military operations against the western port city of Hodeida, Human Rights Watch said today. The Saudi-led coalition, backed by the United States, and Yemeni government-aligned forces, backed by the United Arab Emirates, stepped up attacks on Houthi forces controlling the port in June 2018.

About 70 percent of Yemen’s aid and commercial imports enter through Hodeida and the nearby Saleef port, providing food, fuel, and medicine that the population needs for survival. To comply with international humanitarian law, or the laws of war, warring parties should take immediate steps to provide safe passage and adequate support to civilians fleeing fighting and facilitate the flow of aid and commercial supplies to the broader population and access by humanitarian agencies.

“The coalition and Houthi forces now fighting for Hodeida have atrocious records abiding by the laws of war,” said Sarah Leah Whitson, Middle East director at Human Rights Watch. “The UN Security Council should urgently warn senior officials on both sides to provide civilians access to desperately needed aid.”

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Up to 600,000 civilians remain in the vicinity of densely populated Hodeida, which the Houthis took over in late 2014. On June 9, the UAE, which has led coalition operations along Yemen’s western coast, informed humanitarian organizations that they had three days to evacuate the city. The United Nations and other humanitarian organizations withdrew many of their staff, but the UN aid chief, Mark Lowcock said, “It is our plan, intention and hope to stay and deliver.”

The parties to the conflict are bound under the laws of war to take all feasible precautions to minimize civilian casualties and damage to civilian structures. Since the coalition began its military campaign in Yemen in March 2015, coalition forces have committed numerous unlawful airstrikes and used inherently indiscriminate cluster munitions. The Houthis have unlawfully carried out indiscriminate missile strikes, used anti-personnel landmines, and deployed children in combat, as have pro-government Yemeni forces.

The UN has referred to Yemen as the world’s worst and largest humanitarian crisis. As of January 2018, at least eight million Yemenis were on the brink of famine, which is linked directly to the armed conflict. Hodeida’s port is the “single most important point of entry for the food and basic supplies needed to prevent famine and a recurrence of a cholera epidemic,” the UN has said.

UN Security Council Resolutions 2140 and 2215 established a sanctions regime that authorizes the Yemen Sanctions Committee to designate those responsible for serious abuses, including obstructing humanitarian assistance, for travel bans and asset freezes. The Security Council should announce that it will impose these penalties on individuals who commit offenses during the Hodeida offensive that meet the sanctions committee’s designation criteria, Human Rights Watch said.

The US became a party to the Yemen conflict soon after fighting began by providing intelligence and refueling for coalition bombing missions. In 2017, the US sent special forces to assist in locating and destroying Houthi caches of ballistic missiles and launch sites, according to the New York Times. The US has also sold thousands of advanced bombs and rockets to Saudi Arabia, which leads the coalition. The US could become complicit in violations of the laws of war by assisting coalition forces during the Hodeida offensive. The United Kingdom, France and other countries have also sold weapons to coalition forces. US and other foreign officials may be exposed to potential legal liability by selling weapons likely to be used in unlawful attacks.

“The battle for Hodeida could have a devastating impact on civilians both in the city and elsewhere in Yemen,” Whitson said. “Both sides need to seek to minimize civilian harm at all times, whether in carrying out attacks or by allowing families to flee to safety.”

A worker is pictured in a government hospital's drug store in Sanaa, Yemen August 16, 2017. 

© 2017 Reuters/Khaled Abdullah

Facilitate Humanitarian Access
Health professionals and humanitarian workers in Yemen have described how parties to the conflict have restricted access to aid and essential goods and the impact on the civilian population. This includes repeatedly failing to abide by laws-of-war requirements to facilitate the delivery of aid to civilians, exacerbating Yemen’s humanitarian crisis.

Further disruption of humanitarian and commercial imports through Hodeida and Saleef will have predictably devastating consequences for civilians, Human Rights Watch said. The inability of essential supplies to reach their final destinations, including to areas under Houthi or Yemeni government control, would also be disastrous.

On June 8, Lise Grande, Yemen’s UN humanitarian coordinator, said: “In a prolonged worst case, we fear that as many as 250,000 people may lose everything – even their lives.… Cutting off imports through Hodeidah for any length of time will put Yemen’s population at extreme, unjustifiable risk.”

The coalition has imposed a naval and air blockade on Yemen since the current conflict began that has severely and disproportionately restricted the flow of food, fuel, and medicine to civilians in violation of international humanitarian law. The coalition closed all of Yemen’s entry points in response to a Houthi missile strike on Saudi’s Riyadh airport on November 4, 2017, keeping Hodeida and Saleef ports closed for several weeks. The closures immediately and predictably exacerbated existing food shortages. The port of Aden in the south, which is controlled by the Yemeni government, does not have the capacity to receive the hundreds of thousands of metric tons of food, fuel, medicine, and other imported goods Yemenis depend on for survival.

Houthi forces have blocked and confiscated food and medical supplies and denied access to civilians in need. They have imposed onerous restrictions on aid workers, interfered with aid delivery, and restricted the movement of ill civilians. The cumulative impact of Houthi obstruction and interference with humanitarian assistance has significantly harmed the civilian population.

Parties to the conflict must facilitate the rapid passage of humanitarian aid for civilians in need and not arbitrarily interfere with it. They must also ensure the freedom of movement of humanitarian workers, which can only be restricted temporarily for reasons of imperative military necessity. Warring parties are also prohibited from carrying out attacks on objects that are indispensable to the civilian population, such as food stores or drinking water installations intended for civilians. The laws of war prohibit using starvation as a method of warfare, and require parties to a conflict not to “provoke [starvation] deliberately” or deliberately cause “the population to suffer hunger, particularly by depriving it of its sources of food or of supplies.”

All parties to the conflict should:

 

  • Take all necessary steps to keep Hodeida and Saleef ports open and operational without interruption to humanitarian and essential commercial goods;
  • Take all necessary steps to ensure that aid and essential commercial imports can be taken in at ports and can be transported to civilians throughout Yemen;
  • Cease targeting, damaging or destroying objects indispensable to the survival of the civilian population; and
  • Ensure the safety and security of humanitarian workers at all times.

 

Provide Safe Passage to Fleeing Civilians

Thousands of civilians have been displaced as fighting moved up Yemen’s western coast. In Aden in February, families displaced from their homes said they fled because they did not trust the warring parties to distinguish between civilians and combatants in their attacks. They described their fear when “the war came” and that the next mortar attack or airstrike would hit their or their neighbors’ homes. Some said that Houthi or UAE-backed fighters had restricted their flight.

A three-story house in Souq al-Hinood, a crowded residential area in Hodeida city, that was hit by an airstrike on the evening of September 21, 2016. A single bomb killed at least 28 civilians, including 8 children.

© 2016 Priyanka Motaparthy / Human Rights Watch

One man, “Talal,” said that after pro-government fighters pushed the Houthis out of Khawka in late 2017, about a dozen Houthi fighters deployed in the woods near his farm. He was worried that coalition forces would attack, but for two weeks the Houthis refused to allow his family to leave. “They said, ‘We will live together or we will die together.’ It was an order,” said Talal. “We heard the sound of airplanes all the time, stuck between the coalition and the Houthis.” His 4-year-old son “would wake up at night, crying, and yell, ‘The airplanes are coming!’” In December, after the Houthis had retreated to the woods, coalition airstrikes hit the family vehicle and their home. Eleven family members, including Talal’s nine children, were at the farm, and his 12-year-old son was severely wounded. They fled on motorbikes to the city of Hays.

Thousands of people displaced from fighting on the western coast have fled to Aden. “Ahmed,” 27, said UAE-backed forces at checkpoints occasionally refused entry to Aden or sought bribes from displaced people. His brother said, “Some of the people who are coming pay at the checkpoint, but it depends where you are from.” People from Houthi areas in the north pay larger bribes, he said. When Ahmed traveled from Taizz to Aden in early 2018, UAE-backed forces held him and a family traveling on the same bus at a checkpoint overnight with nothing to eat – the soldiers took their food and water. The soldiers let Ahmed go in the morning, but the family from the northern city of Saada, whom the soldiers accused of being Houthis, were still being interrogated when he left.

The laws of war require parties to the conflict to take all feasible steps to evacuate civilians from areas of fighting or where fighters are deployed and not to block or impede the evacuation of those wishing to leave. The creation of “humanitarian corridors” and the issuance of effective advance warnings of attack to the civilian population do not relieve attacking forces of their obligation to distinguish at all times between combatants and civilians and to take all feasible precautions to protect civilians.

Deliberately using the presence of civilians to protect military forces from attack is the war crime of “human shielding.”

The parties to the conflict should:

 

  • Remove civilians to the extent feasible from areas in the vicinity of military targets;
  • Allow civilians to flee areas of fighting for safety and to obtain aid; and
  • Never use civilians as “human shields.”

 

Avoid Civilian Casualties and Damaging Civilian Structures
Human Rights Watch and others have documented dozens of indiscriminate or disproportionate airstrikes by coalition forces and missile attacks by the Houthis that have caused thousands of civilian casualties. Coalition airstrikes have killed civilians in attacks on markets, homes, schools, hospitals and mosques. In March, the UN human rights office said that coalition airstrikes caused 61 percent of verified civilian casualties in Yemen.

The coalition has repeatedly hit infrastructure critical to the civilian population, including damaging essential port infrastructure in Hodeida. The coalition has carried out airstrikes using explosive weapons with wide-area effect in densely populated areas, including in Hodeida city.

The coalition has repeatedly pledged to minimize civilian harm in its aerial campaign, but has continued to carry out unlawful attacks. In April, the coalition bombed a wedding in Hajjah, killing 22 civilians and wounding at least another 54, about half of whom were children. As in 23 other apparently unlawful coalition airstrikes that Human Rights Watch has documented, the coalition used a US weapon – a Joint Direct Attack Munition (JDAM) satellite guidance kit.

Houthi and government-aligned forces have carried out indiscriminate artillery attacks that have struck populated neighborhoods, killing and wounding civilians. The Houthis have repeatedly fired artillery indiscriminately into Yemeni cities, including after withdrawing from city centers. They have failed to take all feasible precautions against harming civilians by deploying military forces in civilian facilities – including a school and a civilian detention facility.   

A so-called dual-use object – one that normally has both civilian and military purposes – is a valid military target so long as the expected concrete and direct military advantage from the attack is greater than the anticipated loss of civilian life and property. Any coalition attacks on Hodeida and Saleef port facilities, which serve a military purpose, will need to take into account the extreme importance of those facilities to the civilian population and the anticipated impact of their destruction, Human Rights Watch said.

 

All parties to the conflict should:

 

  • Take all feasible measures to ensure the protection of civilians and civilian objects during military operations;
  • Act to ensure that attacks on military targets do not cause disproportionate harm to civilians and civilian objects;
  • Take all feasible steps, when operating in areas where civilians and combatants are comingled, to minimize the harm to civilians and civilian objects, including by selecting weapons and specific munitions to minimize civilian casualties; and
  • Cease use of munitions with wide-area destructive effect in heavily populated areas.

 

Cease Use of Landmines; Increase Efforts to Clear Explosive Remnants of War

Landmines have killed and maimed civilians, disrupted civilian life, hindered humanitarian access, and prevented civilians’ safe return home in affected areas in Yemen. In any battle for Hodeida, the Houthis, as well as pro-government forces, should not use antipersonnel mines, which pose a threat to civilians long after a conflict ends.

Houthi forces have repeatedly laid antipersonnel, antivehicle, and improvised mines, as they withdrew from areas in Aden, Taizz, Marib and, more recently, along Yemen’s western coast. In February, the Yemen Executive Mine Action Center’s southern branch found antipersonnel mines, antivehicle mines and other types of explosive ordnance, including improvised antipersonnel mines, near the towns of Mokha, Khawka and Hays. One deminer said that, “Areas that have been mined have never been signed [marked with warning signs].” Three years after the Houthis withdrew from Aden, mine survey and clearance operations continue.

Use of antipersonnel landmines violates the laws of war, and those involved are committing war crimes. The indiscriminate use of antivehicle mines and failure to minimize civilian casualties also violate the laws of war. Yemen suffers from a shortage of equipped and trained personnel who can systematically clear landmines and explosive remnants of war.

All parties to the conflict should:

 

  • Cease using antipersonnel mines, destroy any antipersonnel mines in their possession, and appropriately punish those using them;
  • Raise awareness among the displaced about the threat of mines, including improvised mines, and develop capacity to rapidly clear homes and residential areas of mines and remnants of war to facilitate the return of the civilian population; and
  • Direct international assistance to equip, train, and assist clearance personnel to systematically survey, clear, and destroy Yemen’s mines and explosive remnants of war. International donors should provide assistance for landmine victims, including medical care, prosthetics, and ongoing rehabilitation.

 

Ensure that No Children Take Part in Fighting

Houthi forces, pro-government forces, and other armed groups have used child soldiers, an estimated one-third of the fighters in Yemen. By August 2017, the UN had documented 1,702 cases of child recruitment since March 2015, 67 percent of which were attributable to formerly aligned Houthi-Saleh forces. About 100 of the verified cases included recruiting children younger than 15, the recruitment or use of whom is a war crime.

The Houthis have recruited, trained, and deployed children in the current conflict. “Yasser,” 20, said that the fear of forced recruitment drove him and two of his close friends to flee Sanaa in 2017. The Houthis had recruited his younger brother, 15 or 16, who then patrolled neighborhoods, worked at checkpoints, and received training. “He takes our father’s weapon when he goes.” The Houthis provided him with food and qat, but no pay. “He goes with seven of his friends around the same age,” Yasser said. Houthi supporters came to their neighborhood almost daily and talked to young men and boys about becoming fighters.

“Salem,” who was displaced by fighting on the western coast, said that children as young as 13 “were ruling us, they have the guns,” while his family remained in Houthi-controlled Mafraq. His family was first displaced to Houthi-controlled Ibb, but they fled to Aden in early 2018 after a local leader warned them the Houthis might forcibly recruit their children.

The local leader, who was also trying to send his children away to protect them, said the Houthis were going around to people’s homes, asking how many men and boys lived there, and registering names for fighting. Their neighbors said families had to provide either money or a person to fight, often a child: “They paid, or they take the kids, so they paid… They would take people who were 16, 17, if they can carry a weapon.” His relative, “Ali,” 16, said that in December 2017 Houthi men on a truck came to his secondary school. “I saw three Houthis with guns trying to take the kids… some of the kids were crying.” He and his friend scaled the school’s wall and ran away. Salem, Ali and about 70 other members of 13 related families were staying together in an abandoned school in Aden when Human Rights Watch interviewed them.

International law sets 18 as the minimum age for participation in direct hostilities, which includes using children as scouts, couriers, and at checkpoints. Under Yemeni law, 18 is the minimum age for military service.

Forces that capture child soldiers should treat them as victims of rights violations, not simply as captured fighters, and abide by international standards. The Paris Principles on Children Associated with Armed Forces or Armed Groups states: “The release, protection and reintegration of children unlawfully recruited or used must be sought at all times, without condition and must not be dependent on any parallel release or demobilization process for adults.”

All parties to the conflict should:

 

  • Ensure that no children take part in fighting in Hodeida;
  • Clarify to affiliated forces that recruiting children is unlawful even if they are not serving a military function;
  • Appropriately investigate and punish officers who allow children in their units or are responsible for the war crime of recruiting or using children under 15; and
  • Provide former child soldiers all appropriate assistance for their physical and psychological recovery and social reintegration.

 

Investigate Unlawful Attacks

None of the countries that make up the Saudi-led coalition have publicly clarified which alleged unlawful attacks their forces participated in. The investigative body the coalition created in 2016 does not meet international standards and has absolved coalition forces of responsibility in the vast majority of attacks investigated. The coalition has not compensated victims of unlawful strikes or their families, as far as Human Rights Watch has been able to determine.

In response to Human Rights Watch letters in 2016 and 2017, the Houthi-controlled Foreign Affairs Ministry expressed a willingness to investigate reports of landmine use, but not until the conflict ended. Human Rights Watch has not been able to identify any concrete steps the Houthis have taken to investigate potentially unlawful attacks or hold anyone to account for violations.

Countries that are parties to the armed conflict should:

 

  • Impartially and transparently investigate credible reports of alleged violations of the laws of war and make public their findings. Individuals implicated in war crimes should be appropriately prosecuted;
  • Conduct investigations using a full range of tools, including interviews with witnesses, surveillance and targeting videos, and forensic analyses. Public findings should include accountability measures taken against individual personnel, redress provided to victims or their families, and an explanation of the process used;
  • Provide compensation for wrongful civilian deaths, injuries and harm. The coalition should develop effective systems for civilians to file claims for condolence or ex gratia payments and to evaluate the claims; and
  • The US, UK, and France should cease all weapons transfers to Saudi Arabia because of Saudi Arabia’s widespread violations of the laws of war, and weapons transfers to other coalition members that are likely to use them unlawfully.
Posted: January 1, 1970, 12:00 am

A medic looks on during a demonstration near the separation fence with Israel in southern Gaza, May 18, 2018.

© 2018 Reuters

According to the Gaza Ministry of Health, an Israeli sniper fatally shot 21-year-old paramedic Razan al-Najjar inside Gaza near the separation fence on June 1, 2018. According to a medical volunteer with al-Najjar when she was shot, al-Najjar was clearly identifiable as a medical volunteer and aiding injured demonstrators. The Israeli army has said “no shots were deliberately or directly aimed towards her.”

On May 14, 2018, an Israeli sniper shot Dr. Tarek Loubani in the leg near the separation fence. He is one of 25 medical workers and first-responders injured by live fire in demonstrations in Gaza between March 30 and June 2, according to Gaza’s Health Ministry. Loubani wrote that, when shot, he too was clearly identifiable as a doctor, and that most paramedics were wearing bright, fluorescent jackets. He said there were no protests, fire, or smoke in his immediate vicinity, and he and his colleagues were standing still and talking. According to Loubani, one hour later, the paramedic who had rushed to his aid, Musa Abuhassanin, was shot in the chest and killed by Israeli fire while assisting in another rescue.

These shootings take place during an overall health crisis in Gaza, worsened by its decade-long closure by Israel.

The closure, exacerbated by Egypt’s usually sealed border to the south, as well as disputes between the Palestinian Authority and Hamas, has left medical facilities struggling to operate due to severe lack of electricity and shortages of medicines. Hospitals rely on generators to get them through power cuts, but they are prone to malfunction. Israel blocks many critically ill residents from accessing care outside Gaza, leaving them few options but to seek care at overstretched hospitals and clinics in Gaza.

Shooting at medical workers adds further strain to a system already struggling to cope.

Before he was shot, Loubani attended a Human Rights Watch event in Toronto and discussed the humanitarian impact of the decade-long closure. When discussing the bleak situation in Gaza, Loubani was asked if he had hope. He said, “Working in a hospital without electricity, sutures, or supplies, all you can have is hope. Hope that this will, one day, get better.”

Lifting Israel’s closure of Gaza and the accompanying indiscriminate restrictions on the movement of people and goods would mark a major step in that direction. Accountability for serious abuses would be another; the Commission of Inquiry set up by the United Nations Human Rights Council to examine the killings in Gaza should investigate the attacks on medical workers.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

World Health Organization (WHO) workers prepare a center for vaccination during the launch of a campaign against an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo, May 21, 2018.

© 2018 Kenny Katombe/Reuters

On May 8, 2018, the Democratic Republic of Congo’s health minister declared an outbreak of Ebola, the highly deadly disease that killed more than 11,000 people in West Africa between 2014 and 2016. The first cases were reported in the remote town of Bikoro, in northwestern Equateur province. However, by early June three out of four confirmed Ebola patients have died in Mbandaka, the Equateur provincial capital, a city of more than 1 million and a transport hub to Congo’s capital, Kinshasa. The World Health Organization (WHO) called news of Ebola’s spread to Mbandaka a “game-changer” that makes the risk of an international spread of the disease “particularly high.” As of late May, 55 cases had been reported, of which 37 have been confirmed. Twenty-five people have died so far; 12 deaths are directly attributed to Ebola.

Authorities and international aid organizations have vaccinated more than 1000 people so far. Nine confirmed Ebola patients have reportedly been cured already.

The following questions and answers look at the human rights implications of the Ebola outbreak in Congo.

What is the Ebola virus?

The Ebola virus was first discovered in 1976 near the Ebola River in Zaire, which is now known as the Democratic Republic of Congo. It causes a rare disease that can affect primates and humans and is believed to be carried by bats. Since the 1970s, it has caused occasional outbreaks in humans in several African countries, with by far the largest in Guinea, Liberia, and Sierra Leone in 2014-2016. More than 800 people have died during eight previous outbreaks in Congo since 1976.

The virus is transmitted between humans through contact with bodily fluids of a person who is sick with the virus or has died from it. It causes a range of symptoms, including fever, severe headaches, muscle pain, fatigue, diarrhea, vomiting, and hemorrhage, usually between 2 and 21 days after exposure.

There is no known cure so medical care focuses on alleviating symptoms, including providing fluids and electrolytes, oxygen, and medications to support blood pressure, reduce vomiting and diarrhea, and manage fever and pain. The United States Centers for Disease Control and Prevention says that these basic measures, if taken early, can significantly increase survival rates. An experimental vaccine has shown significant promise in clinical trials in West Africa, and it is now being used in Congo.

A World Health Organization (WHO) worker administers a vaccination during the launch of a campaign against an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo, May 21, 2018.

© 2018 Kenny Katombe/Reuters

Why is Ebola so dangerous?

Ebola is highly lethal, especially in settings with weak healthcare systems, such as Congo. In the 2014-2016 outbreak in West Africa, more than 28,000 people are believed to have fallen ill with the disease and more than 11,000 of them reportedly died.

As the 2014 outbreak showed, Ebola can spread rapidly when no adequate measures are taken to contain it. A lack of information about the virus, cultural practices such as ritual washing of bodies before burial, and a lack of adequate protective equipment for health workers can facilitate the virus’ spread.

What obligations does the Congolese government have under international human rights law with respect to the Ebola outbreak? What role should the international community play?

The International Covenant on Economic, Social and Cultural Rights, which Congo ratified in 1976, recognizes that everyone has the right to the highest attainable standard of health. Governments are obligated to take effective steps for the “prevention, treatment and control of epidemic, endemic, occupational and other diseases.” This includes containing the outbreak, providing protections to people who are at especially high risk of contracting the virus, and ensuring adequate treatment to those who contract the disease. Any measures taken to protect the population from the virus that limit people’s rights and freedoms, such as quarantines, must be lawful, necessary, and proportionate.

While the Congolese government is the primary guarantor of human rights in the country, the international community has an important role to play “through international assistance and co-operation.” Placing the burden on the government alone to address the obstacles to the fulfillment of the right to health would be to ignore the political and economic difficulties that the country faces. Despite an abundance of natural resources, Congo is one of the poorest countries in the world, with weak infrastructure, poor governance, and widespread corruption without accountability. 

To promote the right to health, the United Nations Committee on Economic, Social and Cultural Rights (CESCR) and the special rapporteur on the right to health have observed that, “States should ensure that their actions as members of international organizations take due account of the right to health.” The committee also has determined that “international assistance and cooperation, especially economic and technical,” should enable developing countries to fulfill their core and other obligations. The special rapporteur has indicated that governments should pay particular attention to helping other countries achieve minimum essential levels of health.

Congolese Health Ministry officials carry the first batch of experimental Ebola vaccines in Kinshasa, Democratic Republic of Congo, May 16, 2018.

© 2018 Kenny Katombe/Reuters

Are quarantines appropriate to contain the Ebola outbreak?

After the outbreak of the Ebola crisis in West Africa in 2014, the governments of Guinea, Liberia, and Sierra Leone all imposed quarantines, restricting people’s rights to liberty and freedom of movement as well as their livelihoods and access to health care and other rights. The quarantines were imposed on individual houses, neighborhoods, villages, and, in a few cases, entire administrative districts.

International human rights law, notably the International Covenant on Civil and Political Rights, requires that restrictions on human rights in the name of public health or a public emergency meet requirements of legality, evidence-based necessity, and proportionality. Restrictions such as quarantine or isolation of symptomatic people must, at a minimum, be provided for and carried out in accordance with the law. They must be strictly necessary to achieve a legitimate objective, the least intrusive and restrictive available to reach the objective, based on scientific evidence, neither arbitrary nor discriminatory in application, of limited duration, respectful of human dignity, and subject to review. When quarantines are imposed, governments have absolute obligations to ensure access to food, water, and health care.

The quarantines imposed during the 2014-2016 epidemic did not always meet these standards. They were often not based on scientific evidence, were applied arbitrarily, and were overly broad in implementation. The quarantines were not adequately monitored, making them ineffective from a public health perspective and disproportionately affecting people unable to evade the restrictions, including older people, the poor, and people with chronic illness or disability.

A resident speaks to a medical worker through a cordon ribbon, near the isolation facility prepared to receive suspected Ebola cases, at the Mbandaka General Hospital, in Mbandaka, Democratic Republic of Congo, May 20, 2018.

© 2018 Kenny Katombe/Reuters

What alternatives are there to forcible quarantine or isolation to contain Ebola?

Social mobilization efforts that expand understanding of Ebola and appeals for voluntary limits on movement combined with social support – including home-based care and food aid – can be as effective as measures that restrict rights and can be achieved through community engagement and attention to the special needs of disadvantaged groups.

Congo and its international partners should ensure that people have access to health information and care and should restrict liberty or movement only if and when absolutely needed and with the protections outlined under international human rights law. As part of government’s obligation to take all necessary steps for the “prevention, treatment and control of epidemic ... diseases,” the International Covenant on Economic, Social and Cultural Rights regards as a “core obligation” providing “education and access to information concerning the main health problems in the community, including methods of preventing and controlling them.” The Congolese government and international partners should step up support for groups engaging in public health education.

Why should Congo prioritize protection of health workers?

During the 2014-2016 Ebola epidemic, domestic and international health workers repeatedly raised concerns about the lack of personal protective equipment for health workers treating actual and suspected Ebola patients, including rubber gloves, safety goggles, and protective suits. Janitors, cleaning staff, drivers, and burial staff who may come in contact with infected people or contaminated material also require protection and preventive measures. Lack of appropriate protection resulted in numerous cases of Ebola infection in health workers. Liberia, for example, lost 8 percent of its doctors, nurses, and midwives to Ebola. In the current outbreak, 3 of the 45 reported cases of Ebola in Congo by mid-May affected health workers, suggesting that Congolese health workers may face the same risks as their counterparts in West Africa in 2014-2016.

While health workers have an ethical obligation to care for their patients, even if doing so involves some degree of risk, the government has an important obligation to provide health workers and others involved in the response with appropriate training in infection control and with protective gear. The Congolese government, with the support of international donors, needs to ensure that health professionals and others involved in the response are promptly paid, and that social protection programs are in place for the families of government workers who die or become ill as a result of their work in addressing the crisis. In Congo, health workers are often poorly paid, or receive their salaries late or not at all, which has led to numerous strikes in recent years.

In 2014, fear of Ebola also led to attacks on health workers. In April 2014, an angry crowd attacked an Ebola treatment center in Macenta, 425 kilometers southeast of Guinea’s capital, Conakry, run by Doctors Without Borders (Medecins Sans Frontieres or MSF), which it accused of bringing Ebola to the city. In August 2014, people in N’Zérékoré, Guinea’s second largest city, protested spraying a market with disinfectant that they believed was infected with the Ebola virus and rioted, injuring over 50 people, including security forces. Law enforcement agencies in Congo should ensure that they can quickly, adequately, and appropriately respond if similar attacks occur.

A Congolese health worker is sprayed with chlorine after visiting the isolation ward at Bikoro hospital, which received a new suspected Ebola case, in Bikoro, Democratic Republic of Congo, May 12, 2018.

© 2018 Jean Robert N’Kengo/Reuters

Do women need special attention in the Ebola response?

In the 2014 Ebola epidemic and earlier outbreaks, women had greater exposure to the virus and were thus at greater risk of becoming ill. The higher exposure rate among women appears to have been the result of the roles women traditionally or disproportionately occupy – including cross-border traders, health workers, and traditional birth attendants – which put them at greater risk of coming into contact with the virus. Furthermore, women more often cared for the sick and in the case of death, traditionally wash and prepare a body for burial.

Pregnant women may be at increased risk because of increased contact with health workers, and the Ebola virus persists for months in the semen of men who have recovered from Ebola, endangering female sexual partners.

There are concerns that women will also bear the brunt of the epidemic in Congo, as they tend to fill some of the same roles.

The government of Congo and international partners responding to the crisis need to ensure that prevention efforts address the particular vulnerability of women, that women are able to get information about how to prevent and respond to the epidemic, that any obstacles to obtaining care – including financial and cultural – are removed, and that they are engaged at the community and national level in shaping the response to the crisis.

A Congolese health worker records medical data of passengers at the airport in Mbandaka, Democratic Republic of Congo, May 19, 2018.

© 2018 Kenny Katombe/Reuters

Oversight and monitoring of the Ebola response 

If Congo institutes emergency measures that restrict basic rights and freedoms – including freedom of association, assembly, and movement –, as Guinea, Liberia and Sierra Leone each did in 2014, the government should ensure that restrictions on public health or public emergency grounds meet the requirements of legality, evidence-based necessity, and proportionality. Any restrictions should be clearly defined, well publicized, and subject to monitoring through public hearings before the Congolese parliament, by the national human rights commission, and by independent groups operating without unnecessary restrictions.

Over the past three years, the Congolese government has brutally repressed dissent and curtailed basic civil and political rights as President Joseph Kabila has remained in power beyond the end of his constitutionally mandated two-term limit. Security forces have killed more than 300 people during largely peaceful protests since 2015 and arrested hundreds of others, while the government has cracked down on media and civil society groups. The government should not use the Ebola crisis as a pretext to further clamp down on people’s fundamental rights.

To enhance public confidence in the Ebola response, the government should ensure transparency in the receipt and use of donations and other assistance. In 2014, Sierra Leone initially made a meaningful effort to do this by creating an Emergency Operations Center (EOC), which centralized donations, regularly published lists of donations received, and independently monitored the EOC’s “Ebola Account.” However, subsequent studies concluded that major corruption concerns marred the Ebola response.

Posted: January 1, 1970, 12:00 am

Congolese Health Ministry officials carry the first batch of experimental Ebola vaccines in Kinshasa, Democratic Republic of Congo, May 16, 2018.

© 2018 Kenny Katombe/Reuters

(Kinshasa) – The government of the Democratic Republic of Congo should ensure human rights protections in controlling the recent Ebola outbreak, Human Rights Watch said today in releasing a question-and-answer document about the response to the virus. Since 1976, more than 800 people have died in Congo during eight previous Ebola outbreaks.

The government and international partners should take effective steps to contain the Ebola virus, protect people at high risk of infection, and ensure treatment for those affected.

“Protecting human rights is key to responding to the Ebola outbreak,” said Diederik Lohman, health and human rights director at Human Rights Watch. “Limits on freedom of movement and other measures restricting basic rights should be lawful, necessary and proportionate.”

The Congolese government should limit the use of quarantines, make protection of health workers and women a priority, and ensure effective oversight and monitoring, Human Rights Watch said.

Under international human rights law, quarantines should be imposed only in accordance with the law, should be demonstrated to be necessary to contain the virus, and be the least intrusive possible. Human Rights Watch noted that quarantines imposed during the 2014-2016 epidemic in West Africa did not always meet these standards, as they were often not based on scientific evidence, were applied arbitrarily, and were overly broad in their application.

The response of the government and its international partners should be based on social mobilization focused on expanding knowledge of Ebola and voluntary limitations on movement, combined with social support for the people affected, Human Rights Watch said.

Health workers in Congo are most likely at increased risk of Ebola infection, as the healthcare system is under-resourced and health workers are often underpaid if paid at all. During the earlier West Africa epidemic, numerous health workers died of the disease, impeding efforts to contain it.

Fear of Ebola also resulted in multiple attacks on health workers in West Africa. The government and its international partners should ensure that local health workers are adequately equipped and protected against Ebola as well as potential physical attacks.

Because of traditional roles as caregivers, birth attendants, and health workers, women are also likely to be at increased risk of Ebola in Congo, as they were in the West Africa epidemic. Specific steps should be taken to address these particular vulnerabilities, including through inclusion of women in developing the response.

International partners should take steps to monitor the response. In recent years, the Congolese government has brutally repressed dissent and curtailed basic civil and political rights. Security forces have killed more than 300 people during largely peaceful protests since 2015 and arrested hundreds of others, while the government has cracked down on media and nongovernmental groups.
 

Posted: January 1, 1970, 12:00 am

People walk around the neighboring streets around the Fred Jordan Mission, in Los Angeles, California, U.S. May 12, 2018.

© 2018 Reuters

Philip Alston, the United Nations’ special rapporteur on extreme poverty and human rights, did not mince words when he issued his recent report on poverty in the United States.

Recent policies under the Trump administration “seem designed to remove basic protections from the poorest, punish the poor and make even basic health care a privilege to be earned rather than a right of citizenship.”

Alston’s damning assessment is a stark reminder of the consequences of the US government’s failure to recognize the right to health under international law. Articulated in the Universal Declaration of Human Rights in 1948, the right was then codified by the International Covenant for Economic, Social and Cultural Rights (ICESCR). 166 countries have ratified that treaty, including most developed nations of the world – but not the United States.

The right to health does not guarantee the right of everyone to be healthy. What it does do is oblige governments to enact policies that promote the availability and affordability of basic healthcare services, without discrimination against those most likely to face obstacles gaining access – the poor, minorities, persons with disabilities, women and children among others.

So far, many of the Trump administration’s signature policies have pulled in exactly the opposite direction. Most notably, it has embarked on an all-out effort to repeal the Affordable Care Act. That repeal failed in Congress, but many of the Affordable Care Act’s key components are still under attack.

Women, especially Black women, Indigenous women, and those living in rural areas, face particular challenges in accessing health care in the US. Black women die at higher rates than white women from preventable cervical cancer and maternal mortality. Reproductive healthcare is also under siege, from attempts to defund Planned Parenthood to the recently proposed domestic “gag rule” affecting all public family planning grantees that would prohibit even discussion or referral to other providers for abortion services.

Amid an epidemic of overdose deaths, the right to health for people who use drugs has been dealt crushing new blows by efforts, led by the Department of Justice, to return to punitive approaches that have proven disastrous and are incompatible with public health solutions to the crisis.

It is not enough to push back against the Trump administration’s harmful policies. It’s high time US political leaders realized that by failing to embrace the right to health under international law, they’ve made it easier for these terrible policies to take root. 

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

 

The Honorable Chuck Grassley 
135 Hart Senate Office Building
Washington, D.C. 20510 

The Honorable Dianne Feinstein
331 Hart Senate Office Building
Washington, D.C. 20510

Dear Chair Grassley and Ranking Member Feinstein: 

We, the undersigned, write to you today to urge you to reject any efforts to reduce the fentanyl and analogue quantities in 21 U.S.C. §§ 841 and 960, or to increase the lengths of these mandatory minimum sentences, as you consider opioid legislation in the committee. We oppose any effort to amend S. 2645, S. 2535, S. 2789, S. 207, S. 2838, or S. 2837 by adding S. 2635, the Ending the Fentanyl Crisis Act of 2018, or any other legislation similar to S. 2635.

We understand and share the deep concern about the opioid overdose crisis and fentanyl in particular. Over 63,000 people died from opioid overdoses in 2016. State opioid overdose death rates range from 6.4 per 100,000 people in Nebraska to 52 per 100,000 in West Virginia.[1] With such startling statistics, it is crucial that Congress pass evidence-based policies that work – and mandatory minimums do not. Lowering the statutory weight thresholds for fentanyl and its analogues, or increasing current penalties, will fail to curb fentanyl supply or demand and will give lengthy, expensive prison sentences to more low-level sellers and individuals who struggle with addiction.

If anything demonstrates the failure of mandatory minimums, it is the opioid overdose crisis. We have had harsh five-, 10-, 20-year, and life without parole mandatory minimum sentences for fentanyl and fentanyl analogues for 30 years, and they did not prevent and have not stopped the manufacture, traffic, or use of these drugs. Reducing fentanyl quantities and applying their lengthy penalties to more people with less drugs will not reverse this. Instead, Congress should invest more resources into alternatives that are proven to reduce drug use, addiction, and overdoses, like effective treatment and overdose prevention programs in our communities.

Making current mandatory penalties harsher will not deter drug trafficking or use or reduce drug supply, either. The Department of Justice’s National Institute of Justice has found that the length and severity of a punishment does not deter crime. Rather, it is the certainty of being caught and swiftly punished that deters criminal behavior.[2] The Pew Charitable Trust released a 50-state report that found no statistically significant relationship between drug sentencing and three key indicators of drug problems: drug use, drug overdoses, and drug arrests.[3] These findings reinforce what we already know: study after study shows that incapacitation does little to slow the drug trade because low-level dealers (the ones who would certainly be impacted if drug thresholds are reduced) are easily replaced. Furthermore, incapacitating suppliers does nothing to curb demand; effective treatment does.

Lowering fentanyl quantities will also produce counterproductive and unintended consequences. First, it may cause some illicit manufacturers to make this drug even more potent and fatal in even smaller quantities – a product no one wants on the streets. Second, it will apply mandatory minimum penalties that Congress intended for major traffickers to low-level drug offenders, people who use drugs, and individuals who struggle with addiction.

The U.S. Sentencing Commission has repeatedly found that current mandatory minimum sentences apply mostly to those who play low-level roles in drug conspiracies, such as mules, couriers, or street-level sellers – and this holds true in fentanyl cases.[4] It is true that a very small amount of fentanyl may prove fatal if misused. Nonetheless, the current fentanyl quantities do seem reasonably targeted at mid-level or major dealers or importers. Reducing fentanyl quantities will misapply mandatory minimums to more low-level sellers and people who use drugs, wasting prison cells and taxpayer resources on people who pose less threat to public safety, are easily replaced in the drug trafficking chain, or need treatment.

Third, smaller fentanyl quantities will punish many people who use drugs and people who struggle with addiction for drugs they may not even be aware they have in their possession. Because fentanyl is usually added to drugs before they get to the streets for sale, street-level sellers or people who use drugs often do not even know that their drugs contain fentanyl. People who use heroin or cocaine and share drugs with friends or sell to support their own addictions may not know that they are sharing drugs laced with fentanyl, but under S. 2635, they would face a five-year mandatory minimum for having a mere two grams of a mixture of a substance containing a detectable amount of fentanyl. A person who unknowingly possesses 1.999 grams of baking soda with 0.001 grams of fentanyl mixed in would face this mandatory minimum sentence. The same five-year mandatory minimum sentence would apply to someone with five grams of 100-percent pure fentanyl. Additionally, fentanyl can be trafficked in many forms, including pills. For example, a 10 milligram dose of hydrocodone weighs approximately 0.65 grams.[5] Using a reduced threshold of two grams, it would take only four hydrocodone pills laced with fentanyl to trigger the five-year mandatory minimum. These results would not be just, cost-effective, or make the public safer.

Congress was wise to pass the Comprehensive Addiction and Recovery Act (CARA) and the Fair Sentencing Act (FSA), a bill that increased drug quantities to more appropriately target the mid- and high-level sellers for whom Congress intended mandatory minimum sentences. Proposals to reduce fentanyl and fentanyl analogue thresholds are antithetical to CARA and the FSA and waste money with no corresponding public safety increase. We understand fully the crisis that our country is currently facing. The rise in drug overdose deaths is not a problem we take lightly. However, we cannot afford to fall back on failed policies of the past as lives continue to be lost to these powerful drugs.

Thank you for your time and consideration. We are happy to provide more assistance to your offices as you consider this important issue.

Sincerely,

AIDS Alabama (AL)
Aleph Institute 
American Civil Liberties Union
Blacks in Law Enforcement of America
BOOM!Health (NY)
Broken No More
The Brotherhood/Sister Sol (NY)
Charles Hamilton Houston Institute for Race & Justice, Harvard Law School
Church of Scientology National Affairs Office
Clergy for a New Drug Policy
The Community Health Outreach Work (CHOW) Project (HI)
The Connecticut Bail Fund (CT)
Criminal Justice Policy Foundation
#cut50
The Daniel Initiative
Due Process Institute
Drug Policy Alliance
Drug Policy Forum of Hawai’i (HI)
Drug Policy Forum of Texas (TX)
Empire State NORML (NY)
Families Against Mandatory Minimums
FedCURE
FreedomWorks
Friends Committee on National Legislation
GRASP (Grief Recovery After a Substance Passing)
Harm Reduction Coalition
Harm Reduction Michigan (MI)
HIPS (DC)
Health Equity Alliance
Hep Free Hawaii (HI)
Human Rights Watch
Justice Strategies
Karen Garrison, President of Mommieactivist and Sons
Law Enforcement Action Partnership
The Leadership Conference on Civil and Human Rights
Legal Action Center
Life for Pot
Life Foundation (HI)
MomsRising
NAACP
National African American Drug Policy Coalition, Inc.
National Alliance for Medication Assisted Recovery
National Association of Criminal Defense Lawyers
National Council of Churches
National Immigration Project of the National Lawyers Guild
National Urban League
November Coalition
One Million Americans (CT)
Peer Network of New York (NY)
Project Inform
Protect Families First
Public Justice Center
QC Harm Reduction (IA)
Reentry Central (CT)
Safe Streets Arts Foundation
San Francisco Drug Users Union (CA)
San Francisco Safety and Wellness Coalition (CA)
Sex Workers and Allies Network (CT)
Sonoran Prevention Works (AZ)
St. Ann’s Corner of Harm Reduction (NY)
StoptheDrugWar.org
Students for Sensible Drug Policy
Supernova Women
The Prison Consultants
The Sentencing Project
Tray Johns, Executive Director of Fedfam4life
Treatment Communities of America
Unitarian Universalist Association
Van Jones, President of The Dream Corps
VOCAL-NY (NY)
WOLA - Washington Office on Latin America
Witness to Mass Incarceration
Women’s Alliance for Theology, Ethics and Ritual (WATER)
Women Who Never Give Up

cc: Members of the Senate Judiciary Committee


[1] “Drug Overdose Death Data” Center for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/data/statedeaths.html  

[2] “Five Things about Deterrence” National Institute of Justice, May 2016. https://www.ncjrs.gov/pdffiles1/nij/247350.pdf

[3] “More Imprisonment Does Not Reduce State Drug Problems,” The Pew Charitable Trust, March 2018. http://www.pewtrusts.org/~/media/assets/2018/03/pspp_more_imprisonment_does_not_reduce_state_drug_problems.pdf

[4] U.S. Sentencing Comm’n, Public Data Presentation for Synthetic Cathinones, Synthetic Cannabinoids, and Fentanyl and Fentanyl Analogues Amendments (Jan. 2018) (showing that a majority of defendants sentenced for fentanyl offenses are low-level dealers; of the 51 persons convicted of a fentanyl-related offense in FY 2016, 29 served “street-level dealer,” “courier/mule,” and “employee/worker” functions).

[5] “Opinions Are Mixed About Sentencing Laws for Painkiller Trafficking” The Florida Legislature Office of Program Policy Analysis and Government Accountability, January 2012. http://www.oppaga.state.fl.us/MonitorDocs/Reports/pdf/1202rpt.pdf

Posted: January 1, 1970, 12:00 am

Students receive free condoms at an event organized by the United Nations Population Fund in Metro Manila, July 11, 2014.

© 2014 Reuters

The Philippine Senate passed a bill on Monday that would amend the country’s 20-year-old AIDS law, and which promises to improve the government’s response to the HIV epidemic, the fastest-growing in the Asia-Pacific region. The draft law, which still needs to be harmonized with the version the House of Representatives passed in December, outlines a rights-based response to the epidemic.

The proposed law will provide more resources to the Philippine National AIDS Council, the government’s main policymaking body on HIV/AIDS. It lowers the age young people can be tested for HIV without parental consent from 18 to 15 years. It prohibits discrimination against people with HIV in the workplace and other settings. It makes it unlawful to disclose the HIV status of an individual without their consent. And it makes age-appropriate sex education in schools compulsory.

In short, the draft law is a marked improvement over its antiquated predecessor. But like its predecessor, the measure does not include specific provisions directing the government to promote condom use. This is a big mistake.

An improved official response to the epidemic is crucial. The government itself has declared the HIV epidemic a national emergency. The United Nations program on HIV/AIDS, known as UNAIDS, has determined that over the past six years, the Philippines has had a 140 percent increase in the number of new infections. Low condom use has been identified as the main reason HIV has exploded in the Philippines in the past decade. A 2016 Human Rights Watch report documented the government’s failure to conduct national campaigns to promote condom use. In February, the new UNAIDS country director for the Philippines announced that advocating condom use and comprehensive sex education were key planks in the agency’s strategy.

The failure to make promotion of condom use an official government priority reflects a damaging defeat by the ideological biases of conservative lawmakers and the Catholic Church over proper public health practice. Condoms, when used properly, are scientifically proven to be one of the best methods to prevent HIV transmission. Unless that message is integrated into the new AIDS law – perhaps during the harmonizing of the two congressional versions, or during the drafting of implementing rules and regulations – the struggle to contain the epidemic will get even tougher.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

May 17, 2018

Office of the United Nations High Commissioner for Human Rights
United Nations Office at Geneva (c/o Zaved Mahmood)
CH 1211 Geneva 10
Switzerland

Re: Report of the Office of the High Commissioner for Human Rights on the implementation of the UNGASS joint commitment to effectively addressing and countering the world drug problem with regard to human rights

To the Office of the High Commissioner for Human Rights:

Thank you for the opportunity to submit our comments to feed into your upcoming report on the implementation of the outcome document of the UN General Assembly Special Session (UNGASS) on Drugs, adopted by the General Assembly in April 2016. We believe that respect for human rights needs to be a central element of national and global drug strategies and that your contribution to the UNGASS is of critical importance. For there to be an effective policy to tackle the world drug problem, there should be a stronger engagement of Geneva health mandate-holders, including the WHO and UNAIDS, together with the human rights expertise of the Human Rights Council, and civil society organizations.

Below, we draw on recent Human Rights Watch work on drug policy issues in several countries to highlight challenges and some progress with the implementation of the UNGASS outcome document.

Re: Operational recommendations on ensuring the availability of and access to controlled substances exclusively for medical and scientific purposes, while preventing their diversion

In its 2016 outcome document, UNGASS called on countries to consider reviewing “unduly restrictive” regulations governing access to controlled substances for medical and scientific purposes. Human Rights Watch has repeatedly documented how needlessly restrictive national drug policies make it difficult for people needing palliative care, pain treatment, and drug treatment to access morphine, methadone, and other medicines.

In 2017, Armenia took significant steps to address the limited availability of palliative care medicines, in line with the UNGASS recommendation. In February, it adopted a national palliative care strategy;[1] in March, it registered two forms of liquid oral morphine, considered by WHO to be fundamental to cancer pain treatment;[2] and in November, it adopted new drug regulations that remove many barriers to access to morphine for patients with pain.

However, many countries have yet to implement the UNGASS recommendation. In Guatemala, for example, Human Rights Watch found that at least 5,000 Guatemalans with cancer and HIV/AIDS live and die in pain per year because they cannot get morphine or other opioid analgesics due to regulatory barriers.[3] To prescribe an opioid analgesic, physicians must use a special prescription pad that only contains 25 scripts and can only be purchased one at a time at one location in the country. Physicians can only prescribe a maximum eight-day supply of morphine. For a longer supply, the physician must issue a second prescription form with a special stamp that they can only buy at one location in Guatemala City. Only 50 to 60 of the 14,000 doctors in Guatemala have special prescription pads, all in Guatemala City. Patients also need to get their prescription authorized in-person by the Ministry of Health, which can only be done at one office in Guatemala City. Only three pharmacies in the country, all in Guatemala City, consistently carry opioid analgesics.

Re: Operational recommendations on drugs and human rights

The 2016 UNGASS outcome document also recommended that states promote “proportionate national sentencing policies, practices and guidelines for drug-related offences”; enhance “access to treatment of drug use disorders for those incarcerated”; and promote effective responses to drug-related crimes that “ensure legal guarantees and due process safeguards.” Yet, our work in the Philippines has found that the government continues to pursue “war on drugs” policies that have resulted in numerous extrajudicial executions. Our work in Georgia has found that the government continues to prioritize arrest and incarceration over human rights and a public health-based approach to drugs.

Philippines

Since taking office on June 30, 2016, Philippine President Rodrigo Duterte has carried out a “war on drugs” resulting in the deaths of more than 12,000 suspected drug dealers and users by January 2018.[4] The government has attributed an estimated 4,000 killings to the Philippine National Police, and the remainder to “unidentified gunmen.”[5] Media and rights groups investigations have determined that many of these killings were unlawful executions by police or agents of the police acting as “death squads.”[6]

Authorities have likewise used “drug watch lists” not only to target alleged drug suspects but, by releasing these to the media without charges filed in court, also to demonize local politicians they accused – without presenting evidence – of involvement in illegal drugs.[7] So-called “drop boxes” have also been set up in communities and police stations to encourage residents to report alleged drug suspects.[8] These boxes are prone to abuse as anyone can potentially be listed and put at risk.[9]

The government, with China’s assistance, has built so-called “mega rehab centers,” where alleged drug users are arbitrarily detained, ostensibly for drug treatment.[10] It has also initiated a police-run drug rehabilitation program, also detention-based.[11] These programs are not in accordance with internationally accepted standards on drug rehabilitation. More recently, the government has agreed to consider UN-backed programs that are community-based and voluntary.[12]

Poor conditions of detention facilities are also an issue, particularly in police precincts where most of those arrested or surrendered spent a considerable amount of time before being transferred to regular jails for trial or drug rehabilitation facilities.[13]

Georgia

Georgia’s fight against the use and sale of illicit drugs prioritizes arrest and incarceration over drug prevention and treatment. Georgian authorities aggressively pursue drug prosecutions, which often lead to long sentences and prohibitive fines. People convicted for drug-related felonies often are deprived of several civil rights after they have served their sentences, including the rights to operate motor vehicles and to work in certain professions for certain periods, depriving many of their livelihoods and contributing to further stigmatization of drug users.

Drug users are vulnerable to police abuse, including ill-treatment and forced drug testing. Police have and use broad powers to stop individuals in the street and compel them to undergo drug testing, so long as there are “sufficient grounds” for assuming they are under the influence of drugs.[14] Police can detain a person who refuses a drug test for up to 12 hours in a forensic lab, during which time they can be deprived of fundamental rights afforded to a detainee in a criminal case.

First-time illegal drug consumption or possession of small quantity for personal use is a misdemeanor offense, but repeated use or possession within a year of a first offense results in criminal liability.[15] Approximately three-quarters of controlled substances – including commonly used substances like amphetamine, methamphetamine, and desomorphine – do not have established thresholds for small and medium quantities.[16] Thus, possession of any amount of those substances automatically qualifies as a large quantity, triggering criminal liability and prison terms ranging from five to eight years. Possession of more than one gram of these substances is considered an “extremely large amount” and can result in life imprisonment.[17]

Georgia imposes mandatory minimum sentences for drug-related offenses. As a result, a person charged with a drug-related offense are essentially compelled to agree to a plea deal to avoid long prison terms.[18] Plea bargaining in drug-related offenses often lead not only to prison sentences but also to prohibitive fines, which can financially devastate the accused and his/her family.

 

[1] Human Rights Watch, “Armenia Has New Strategy to Help Terminally Ill: Legal Changes Are Next Step to Get Treatment to Those in Need,” October 12, 2017, https://www.hrw.org/news/2017/10/12/armenia-has-new-strategy-help-termin....

[2] Human Rights Watch, “All I can Do Is Cry”: Cancer and the Struggle for Palliative Care in Armenia, July 2015, https://www.hrw.org/report/2015/07/14/all-i-can-do-cry/cancer-and-strugg....

[3] Human Rights Watch, “Punishing the Patient”: Ensuring Access to Pain Treatment in Guatemala, May 2017, https://www.hrw.org/report/2017/05/17/punishing-patient/ensuring-access-....

[4] Human Rights Watch, “Philippines: Duterte’s ‘Drug War’ Claims 12,000+ Lives,” January 18, 2018, https://www.hrw.org/news/2018/01/18/philippines-dutertes-drug-war-claims....

[5] ABS-CBN News, “Drug war death toll nears 4,000,” says PNP, January 23, 2018, http://news.abs-cbn.com/news/01/23/18/drug-war-death-toll-nears-4000-say....

[6] Reuters, “Duterte’s War: Inside the bloody drug crackdown in the Philippines,” June 2017, https://www.reuters.com/investigates/section/philippines-drugs/.

[7] Rappler, “PDEA drug list: More than 200 barangay officials linked to illegal drugs,” April 30, 2018, https://www.rappler.com/nation/201401-list-names-barangay-officials-link....

[8] Philippine Daily Inquirer, “‘Drop boxes’ help gather intel for Duterte’s drug war,” Jul 30, 2017, http://newsinfo.inquirer.net/918727/drop-boxes-help-gather-intel-for-dut...

[9] Human Rights Watch, “Deadly Drop Boxes Fuel Philippine’s ‘War on Drugs’,” September 25, 2017, https://www.hrw.org/news/2017/09/25/deadly-drop-boxes-fuel-philippines-w...

[10] Human Rights Watch, “Japan: Don’t Fund Abusive Philippine Drug Rehab Services,” May 17, 2017, https://www.hrw.org/news/2017/05/17/japan-dont-fund-abusive-philippine-d...

[11] ABS-CBN, “PNP chief 'Bato' opens Laguna drug rehab center,” January 14, 2017, http://news.abs-cbn.com/video/news/01/14/17/pnp-chief-bato-opens-laguna-...

[12] BusinessWorld, “UN offers assistance to Philippines’ rehab program for drug users,” April 3, 2018, http://bworldonline.com/un-offers-assistance-to-philippines-rehab-progra...

[13] Human Rights Watch, “Philippines' 'War on Drugs' Worsens Jail Miseries,” August 2, 2016, https://www.hrw.org/news/2016/08/02/dispatches-philippines-war-drugs-wor....

[14] Police intelligence is considered “sufficient grounds.” See Joint order No1244–No278/n of the Minister of Internal Affairs and of the Minister of Labour, Health and Social Affairs of Georgia “On Approval of Rule of Determination of Administrative Offences Related to Consumption of Narcotic drugs and psychotropic substances”, October 24, 2006.

[15] Article 45 of Administrative Offences Code of Georgia.

[16] Georgian Law on Drugs, Psychotropic Substances, Precursors and Narcological aids, Annex 2. Out of 203 illegal drugs/psychotropic listed by the law, 156 do not have determined small amounts, and amounts enough to start criminal prosecution.

[17] Criminal Code of Georgia, Article 260.

[18] According to data provided by the Georgia’s Supreme Court, 60 percent of all drug-related cases heard by first instant courts in 2016 ended in a plea deal. Letter of Supreme Court of Georgia Np-42-17, February 2, 2017, in response to Human Rights Watch’s request of public information.

Posted: January 1, 1970, 12:00 am

An illustration depicts a transgender woman housed in a men's immigration detention facility.

© 2016 Brian Stauffer for Human Rights Watch

The Trump administration’s decision to change the policy of the federal Bureau of Prisons (BOP) for housing transgender prisoners is dangerous, wrongheaded, and unnecessary.

Because being transgender is a known risk for being sexually victimized in confinement, the Prison Rape Elimination Act (PREA) and Department of Justice guidance issued in 2016 called for individual determinations of housing, program, and other assignments in correctional facilities. That means an individual assessment must be made, taking many factors into account, including the person’s own views about their gender and safety. It also made assigning a transgender prisoner to housing, programs, or other services based solely on their sex assigned at birth a violation of federal law.

But last week, the BOP announced that while it will continue to make these determinations on a case by case basis as is required, “biological sex” will be used as the basis for the initial determination, and transgender prisoners will be assigned to facilities conforming to their gender identity only “in rare cases.”

At highest risk are transgender women who have reported alarming rates of assault in federal and state prisons and local jails: more than 1 in 3 have been sexually victimized according to PREA data. In a national survey of transgender adults, respondents who were incarcerated reported physical and sexual assault rates six to 10 times higher than non-transgender prisoners.

This latest decision is part of a pattern of actions taken by the Trump administration that includes an attempt to ban transgender persons from military service; disavowing protections for transgender persons in both employment and education under the Civil Rights Act of 1964; and green-lighting discrimination in health care by expanding religious and moral objections in health care settings.

As with the change to BOP policy, there is no defensible basis for these decisions. Indeed, Attorney General Jeff Sessions was a leading co-sponsor of PREA when he was in the Senate. BOP’s decision to weaken protections will place transgender people at immediate risk of physical and sexual assault. In light of overwhelming evidence of severe risks in confinement, it should be reversed immediately.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

An anti-gay rights activist shows a badge during a flash mob organized by gay rights protesters in St. Petersburg May 17, 2012.

©2012 Reuters/Interpress/Valentia Svistunova

Earlier this week, Roskomnadzor, Russia’s federal agency responsible for overseeing online and media content, took steps to shutter ParniPlus, a website raising awareness about the exploding HIV epidemic among men who have sex with men.

The shuttering of ParniPlus marks at least the eighth case of outright censorship under Russia’s 2013 federal “gay propaganda” law that effectively prohibits any positive information about “non-traditional sexual relations” from public discussion.

Children-404, an online group that offers psychological support, advice, and a safe community for lesbian, gay, bisexual and transgender (LGBT) children, has repeatedly been censored and subject to attempts by the government to shut the group down since 2013.

“You can easily imagine a young guy somewhere in a Siberian town for which closed sites [such as] ‘Children 404,’ which have been repeatedly subjected to judicial and other pressure, have become invaluable evidence that he is not a monster and should not be afraid,” ParniPlus administrators wrote.

The purported rationale behind Russia’s “gay propaganda” ban is that portraying same-sex relations as socially acceptable supposedly threatens the intellectual, moral, and mental well-being of children. The law has rightly been condemned by the United Nations Committee on the Rights of the Child, the European Court of Human Rights, the Organization for Security and Co-operation in Europe, and the Council of Europe.

And, ParniPlus leaders point out, their site does more than promote awareness about sexual orientation, gender identity, and human rights; for the past decade, it has “vividly explained about the growing HIV epidemic in Russia every month and tells readers about the need for HIV prevention.”

The head of Moscow’s Federal AIDS Center has called Russia’s HIV epidemic a “national catastrophe,” and prevalence rates among men who have sex with men have increased dramatically in recent years – a trend some leading epidemiologists link closely with the anti-gay propaganda law’s stifling of sexual health information.

Cases like these clearly demonstrate that Russia’s “gay propaganda” law is just a flimsy excuse to discriminate against LGBT people and is abjectly harmful to public health in the process. Factual, positive, and affirming information about sexuality and health is essential for adults and children, including for HIV prevention.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

Rohingya refugees try to take shelter from torrential rain as they are held by the Border Guard Bangladesh (BGB) after illegally crossing the border, in Teknaf, Bangladesh, August 31, 2017.

© 2017 Reuters
When I last visited the Rohingya refugee camps in Bangladesh at the end of last year, a new sort of everyday life was taking shape. No longer were countless desperate people milling about by the road, on paddy fields, and in public buildings. Instead, I watched refugees line up for plastic, tarpaulin, and bamboo to help construct rows upon rows of shelters.

But these rickety structures won’t be able to withstand the storms and heavy rains of the imminent monsoon season. And as dry earth turns to sludge in the coming weeks and months, there will be danger of both mudslides and disease.

A short but severe storm on Monday portends future disaster. Anxious activists began to call us in the afternoon. One sent a video recorded by 18-year-old Shafiq on his cell phone. The storm ripped into about 900 dwellings, some of which essentially fell apart and blew away.

The head of the International Committee of the Red Cross in Myanmar posted a video on Twitter from Maungdaw town, just across the border from the camps, expressing his concerns: “A reminder about the potential impact of the upcoming monsoon.” The United Nations refugee agency said it was accelerating its delivery of sturdier shelter kits, but the challenge is daunting.

Various UN agencies and humanitarian organizations on the ground in Bangladesh are seeking to address the situation. Their concerted efforts will hopefully get the refugees through this monsoon, but the difficulties they face, including the desire of many to return home to Myanmar when it’s safe to do so, will remain. 

Resolving that issue will require concerted international pressure, including by the UN Security Council, so that Myanmar puts in place the necessary economic, political, and security measures so that the approximately one million Rohingya refugees in Bangladesh and those that remain in Myanmar will be able to one day soon resume their lives in safety and dignity.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

Doctors in the United States continue to perform medically unnecessary surgeries that can inflict permanent harm on intersex children. 

I testified before California’s senate judiciary committee today to support Senate Concurrent Resolution 110, which supports the autonomy of intersex Californians to decide if and when their bodies get surgically altered. The resolution, authored by Senator Scott Wiener and co-sponsored by interACT Advocates for Intersex Youth and Equality California, says the medical community should establish long-overdue evidence- and rights-based standards of care for children born with atypical sex characteristics.

Intersex children— born with chromosomes, gonads, internal or external sex organs that don’t match typical social expectations of male or female—are born perfectly healthy in most cases. However, since the 1960s, doctors in the US and around the world have routinely performed surgery to “normalize” their bodies, long before they are old enough to decide for themselves whether they want these procedures. The surgery is medically unnecessary, irreversible, often traumatizing, and carries a risk of lifelong harm.

While some surgical intervention is undisputedly medically necessary, some surgeons perform risky cosmetic surgery on intersex children, often before they are even able to talk. The results are often catastrophic and the supposed benefits largely unproven.

A poster by intersex activist Pidgeon Pagonis

© 2017 Human Rights Watch

Resolution 110 in no way seeks to interfere with legitimate medical practice, but rather “to protect children born with variations of sex characteristics from nonconsensual, medically unnecessary surgeries.

Nonetheless, some medical professional associations oppose intersex children’s rights. Some surgeons have proposed deeply problematic amendments to this resolution. These convey the idea that the thousands of intersex children across the state cannot be functioning members of society without cosmetic surgery.

To quote these proposed edits: “It should be considered negligent to not offer to parent’s all options including...surgical reconstruction of their child...as the inherent desire of any responsible parent is that their child be raised as a functioning member of society.”

As I told the senators today, the implicit idea that surgery is often necessary in order for intersex people to be functioning members of society has no factual or scientific basis, and most of the doctors I’ve interviewed on this issue would find it objectionable.

Medically unnecessary surgery on intersex children has been condemned by the World Health Organization, the American Medical Association board of trustees, three former US surgeons-generalPhysicians for Human Rights, the AIS-DSD Support GroupAmnesty InternationalUnited Nations expertsLambda Legal, the ACLU, pediatrics professional bodies, and intersex-led organizations worldwide.

California should join these ranks.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

This submission focusses on the topics of girls’ right to access a safe abortion, accountability for past abuses against children, and the protection of students, teachers, and schools during time of armed conflict.
 
Access to Abortion (Articles 2, 6, 14, 16, 24, 37)

Abortion is illegal in Argentina, except in cases of rape or when the life or health of the woman or girl is at risk. But even in such cases, women and girls are sometimes subject to criminal prosecution for seeking abortions, and often have trouble accessing reproductive health services, such as contraception and voluntary sterilization. 
 

In 2016, the Committee on the Elimination of Discrimination Against Women urged Argentina to legalize abortion not only in cases of rape and risk to the life or health of the pregnant woman but also other circumstances such as incest and when there is a risk of severe fetal impairment. 
 
In this year’s State of the Union, President Mauricio Macri said that, despite his personal views on the matter, he supported Congress’ inclusion of abortion as an issue to be debated in 2018. 
 
Human Rights Watch recommends the Committee ask the government of Argentina:
  • What is the government doing to ensure that all adolescent girls and boys, both in and out of school, are provided with, and not denied, accurate and appropriate information on how to protect their health and development and practise healthy behaviors, including information on safe sexual behavior, and accurate information on contraception?
  • During the reporting period, how many arrests and prosecutions have been carried out of either providers or recipients of abortion services?

 
Human Rights Watch recommends that the Committee:

  • Welcome the statement by President Mauricio Macri as it opens the door to a candid, long-overdue debate.
  • Recommend that Argentina decriminalize abortion in all circumstances and take all necessary steps, both immediate and incremental, to ensure that women and girls have informed and free access to safe and legal abortion services, and postabortion care, as an element of their exercise of their reproductive and other human rights.

 
Accountability for child abductions and disappearances (Articles 6, 8, 16)

Argentina has made significant progress in identifying children of the disappeared who were illegally taken from their families during the dictatorship and bringing those responsible to justice. As of March 2018, 127 people who were illegally taken from their parents as children during the 1976-1983 dictatorship had been located. Many were reunited with their biological families.
 
Human Rights Watch recommends that the Committee:

  • Ask the delegation from Argentina to provide updated information on the status of prosecutions and the government’s policies to move forward with the identification of children who were abducted during the dictatorship.
  • Recommend that Argentina prioritizes these prosecutions to avoid unnecessary delays that could undermine the pursuit of justice. 

Protecting Students, Teachers, and Schools During Armed Conflict (Articles 28, 38, 39)

Since 2014, Argentina has taken a leading role in promoting the protection of students, teachers, schools, and universities during times of armed conflict, through its championing of the Guidelines for Protecting Schools and Universities from Military Use during Armed Conflict and the Safe Schools Declaration. 
 
The Guidelines were drawn up with the aim of better protecting schools and universities from use by armed groups for military purposes, and to minimize the negative impact that armed conflict has on students’ safety and education. They provide concrete guidance to states and non-state armed groups for the planning and execution of military operations. They may also serve as a tool for organizations engaged in monitoring, programming, and advocacy related to the conduct of armed conflicts. A draft version of the Guidelines were prepared based on consultations with representatives from governments—including Argentina—as well as militaries, UN agencies, and intergovernmental and nongovernmental organizations. They were finalized through a state-led process headed by Norway and Argentina in December 2014.
 
The Safe Schools Declaration is an inter-governmental political commitment that was opened for endorsement by countries at an international conference held in Oslo, Norway, on 28 May 2015. The Safe Schools Declaration was developed through consultations with states led by the ministries of foreign affairs of Norway and Argentina between January and May 2015.
 
In March 2017, Argentina hosted the Second International Safe Schools Conference in Buenos Aires, with representatives from more than 80 countries in attendance. 
 
Human Rights Watch recommends that the Committee:

  • Commend Argentina for its leadership role on the Safe Schools Declaration and the Guidelines for Protecting Schools and Universities from Military Use during Armed Conflict.
  • Encourage Argentina to continue to develop and share examples of its implementation of the Declaration’s commitments with other countries that have endorsed the Safe Schools Declaration and with the Committee as examples of good practice in protecting students, teachers, and schools during armed conflict.
Posted: January 1, 1970, 12:00 am