Physicians for Human Rights Statement to the United Nations COVID-19 Special Session

The United Nations Special session of the General Assembly in response to the
coronavirus disease (COVID‑19) pandemic comes at a critically important time. It
provides an opportunity for all Member States to affirm that respect for and promotion
of human rights must be at the core of the global response to the COVID-19 pandemic.

Months ago, Secretary-General António Guterres pronounced the pandemic to be “the
greatest test that we have faced together since the formation of the United Nations.” To
date, this test has not been met. At the end of 2020, health systems are stretched to their
limits, economies are threatened, employment has plummeted, and education is stalled
due to new surges of infections. As humanitarian crises proliferate unchecked and
unattended, as health care workers remain under-supported and – in too many cases –
under attack, as deaths among the most vulnerable skyrocket, and as prominent leaders
peddle disinformation and denial of science, the pandemic has exposed glaring racial
and ethnic disparities, global inequalities, and challenges to the respect for human
rights everywhere.

Working at the intersection of medicine, science, and human rights, Physicians for
Human Rights (PHR) calls for states to adopt rights-based responses to COVID-19,
driven by science and respect for human rights and public health directives. We urge
states to adopt the following measures as areas of priority:

Respect and promote the rights and safety of all health workers

The inadequate supply of personal protective equipment (PPE), including basic surgical masks and N95 respirators, for health workers on the front lines of the COVID-19
emergency remains a global crisis. To ensure effective prevention and treatment, states
must ensure that health workers and facilities are adequately resourced – including
adequate training, PPE, and testing kits – to protect all health workers, ranging from
doctors and nurses to technicians and cleaning staff, who are exposed to SARS-CoV-2,
the virus which causes COVID-19.

In response to inadequate safety conditions, many health workers have spoken out
publicly and then faced threats and retaliation for having expressed their concerns.
States and health systems must actively protect the rights of health workers and offer
them a safe platform to raise concerns. In addition, PHR calls for all health workers to
have access to transparent and accurate information about the coronavirus threat level
and associated health impacts, both in their communities and their workplaces, and to
be guaranteed that they are able to perform their duties safe from physical attacks and
verbal abuse from any source that threatens their work, safety, and well-being.

As vaccine programs launch, it will be critical to monitor and denounce violence and
attacks against public health and all those involved with COVID-19 vaccination efforts.

Ensure that accessible, acceptable, quality health care is available to all, including safe, effective, trusted, and equitable roll-out of vaccines

To ensure an effective, rights-based response to the health threats of coronavirus, states
must ensure that health care and public health responses are available, accessible,
acceptable, and of sufficient quality, particularly for at-risk populations, in keeping with
international human rights standards. The Committee on Economic, Social and Cultural
Rights provides essential guidance on implementation of the right to the highest
attainable standard of health. States must recognize, measure, and actively work to
address disparities in access to health care. To this end, states must collect data
disaggregated by demographics such as gender, age, race, ethnicity, religion, and socioeconomic status. A human rights lens is essential to ensuring an equitable response to the pandemic, including adopting necessary steps to provide equitable access to
treatments, vaccines, and tests.

As safe and effective vaccines begin to be disseminated, it is vital that frontline essential
health care workers receive vaccinations. We must define such workers broadly to
include frontline doctors, nurses, and medical assistants who need to be vaccinated in
order to function safely – but also health care clerks, custodians, food workers, and
workers in social care, such as home health workers.

States must commit to multilateral cooperation, which is required to ensure vaccines are
provided to marginalized, at-risk populations, including migrants in detention,
undocumented workers, people in state custody, those at risk or displaced in conflicts
zones, stateless people, and those fleeing violence or seeking asylum from persecution.
To ensure public and clinician trust in any vaccine that is approved, rigorous scientific
review processes must be completed for all vaccines distributed. Transparency and
communication about the evidence underlying any approved vaccine will be critical.
Such public communication will only be effective with the engagement and full
participation of key community stakeholders and trusted representatives of all sectors of

Abide by humanitarian principles and ensure a robust humanitarian response in conflict settings

A vast number of the world’s population live in conflict-affected areas, and a record 168
million people required humanitarian assistance and protection prior to the COVID-19
pandemic. In the light of the unique dangers to these populations, states, regional, and
multilateral bodies must ensure that their health and broader humanitarian needs are
met at this time. As an immediate priority, attacks on health care – which PHR
has documented across conflict zones – must cease immediately, and belligerents must
commit to abiding by the laws of armed conflict without reservation. All parties must
abide by international humanitarian law and cease all attacks on civilians and civilian
infrastructure. State and local actors must guarantee full, safe, immediate, and
unhindered access for humanitarian and medical personnel, their equipment, and
supplies to areas at high risk.

Recognize and mitigate the adverse impacts of COVID-19 responses on human rights

States have invoked “emergency powers” that can suppress basic human rights. These
include unnecessary use of force, excessive militarization of civilian spaces, draconian
and sweeping application of curfews and quarantines, suppression of freedom of
movement, and undermining of the right to seek asylum. The Siracusa Principles on the
Limitation and Derogation of Provisions in the International Covenant on Civil and
Political Rights (1984) provide essential standards by which states’ responses can be
assessed. When imposing any necessary restrictions on basic freedoms and services,
states must consider and mitigate any subsequent human rights impacts or human
rights violations committed against those at increased risk in this context. For example,
there is an alarming rise in sexual and gender-based violence across the world, including
intimate partner violence, and in violence used to “enforce” curfews and social
distancing measures. Such second order impacts, if unaddressed, may give rise to
serious violations of the human rights of especially marginalized populations.
Emergency situations, particularly in relation to public health, require both the
protection of basic human rights and an enhancement of state reliance on human rights
approaches and frameworks. For countries across the world, effective responses will rest
on commitments to accountability, public oversight, transparency, and cooperation.

Recommendations on COVID-19 in conflict areas

The magnitude of the COVID-19 spread among IDP and refugee camps around the
world, including where PHR and our partners work in Bangladesh, Iraq, Syria, Yemen,
and along the United Sates border, continues to be of tremendous concern. The virus
can exacerbate the existing vulnerabilities of displaced and conflict-affected populations
due to deteriorated health and the humanitarian, economic, and protection systems
available to them. In many of these contexts, the systems for health care provision are
already precarious; restrictions that are necessary to prevent the spread of COVID-19
can further hamper already limited provision of care. The international community
must put the needs of vulnerable populations at the center of any measures that seek to
respond to the outbreak. These populations must have equitable availability and access
to quality public health, humanitarian response measures to suppress and lessen the
impact of this pandemic, and affordable medical care to address COVID-19-related and
ongoing health needs.

It is also essential in post-conflict areas, such as the reconciled areas in Syria, that there
be equitable access to health care and vaccinations with no discrimination based on
political affiliation. A PHR investigation of the health and human rights situation in the
reconciled area of Daraa, Syria found that the right to health of the population has been
severely compromised through discrimination, neglect, failure to allow for humanitarian
assistance, and suppression of vital information about the pandemic. In these and other
such areas, governments must ensure the delivery of aid and the allocation of health
services so the World Health Organization, other UN agencies, international NGOs, and
local actors can reach populations in a neutral, effective, and equitable manner.
Although individual states and multilateral organizations have not yet met the test
posed by the COVID-19 pandemic, it is not too late. The current UN Special session
represents an important opportunity for all UN member states to work together to meet
the current challenges. Integral to these efforts must be the respect for and promotion of
human rights.