Research > Research Strength: Health Ethics and Human Rights
Research Strength: Health Ethics and Human Rights
Health Ethics and Human Rights research at the School of Public Health and Community Medicine
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Introduction
Public health researchers are increasingly confronted by new opportunities and challenges associated with emerging issues of the new millennium, including: economic globalisation, conflicts and natural disasters, widening health disparities among populations, ageing, emerging epidemics, climate change and the widespread movements of people through labour and forced migration. In addition, the planning and delivery of health services within populations and communities poses considerable logistical and ideological challenges. The UNSW SPHCM has a number of experts who examine these critical issues from a health ethics and human rights perspective. Researchers at the SPHCM use health ethics as a framework to reflect on issues ranging from clinical trials, health care treatment and health care relationships to the larger macro issues of health care systems, and even further to the broader societal issues of health and social structure. In addition, the SPHCM has a strong base of health and human rights expertise as it hosts the cross-faculty
UNSW Initiative for Health and Human Rights. The Initiative is committed to working across disciplines and borders to develop innovative approaches and solutions to real-world problems. Our researchers confront some of the most pressing health and human rights issues today by strengthening the capacity of governmental, non-governmental and academic institutions to apply health and human rights principles to policy, programmes and practice. Improving the health and wellbeing of people in Australia, the Asia-Pacific and globally requires building on best public health practice and tools and universally established human rights norms and standards as they relate to such critical issues as: HIV/AIDS, pandemic influenza, indigenous health, climate change, refugee and Internally Displaced Persons health, gender inequality and ageing.
Health & Human Rights Research
HIV/AIDS and rehabilitation centres in Vietnam: Sexual and reproductive health needs, care and choices of current and former detainees and their sexual partners
– Prof. Daniel Tarantola and A/Prof. Anna Whelan
It is increasingly being recognised that sexual and reproductive health is a critical need for people living with HIV (PHIV) and populations at greatest risk of acquiring HIV infection. Information and education, complemented by access to services in a supportive environment, determines the capacity of PHIV and those at greatest risk to make informed reproductive choices, adopt and sustain healthy protective behaviours and practices, and protect their sexual partners against HIV and other sexually transmitted infections. Women and men who are current sex workers or injecting drug users (IDUs) are especially at-risk of acquiring HIV, particularly if they have a co-existent sexually transmitted infection. This AusAID-funded project aims to determine how policies, programmes and practices are responding to the sexual and reproductive health needs and choices of current and former detainees of rehabilitation centres and their sexual partners. The project will incorporate a gender and right-based approach analysis to the study findings. In addition, this project will develop a preliminary model for enhanced access to and delivery of sexual and reproductive health information and services, which will guide the development and trialling of resource materials and capacity building interventions for local service providers in 1-2 districts in Hanoi. It will also offer relevant national institutions with precious information on how vulnerable populations can best be served. The project outcome to develop practical applications, approaches and instruments will entail providing capacity building within research and intervention methods for policy makers and practitioners to improve the sexual and reproductive health of the targeted population.
Rights-based approach to cataract care services in Pakistan – Dr. Khabir Ahmad, Supervisors: Profs. Daniel Tarantola and Anthony Zwi
Under a grant award from The Fred Hollows Foundation, the Postgraduate Research Scholarship explores Rights-based approaches to blindness and cataract care services in Pakistan and other developing countries. The project aims to explore cataract-related policies, services and outcomes in Pakistan from the perspective of equality/non-discrimination, participation, and accountability. It also examines cataract care from the perspective of availability, accessibility, acceptability and quality of health facilities, goods and services.
HIV and mental illness in Vietnam
– Ms. Catherine Esposito; Supervisors: Prof. Daniel Tarantola and Dr. Zac Steel (Psychiatry)
People living with HIV and a mental disorder often face social isolation and high levels of stigma. They experience discrimination of their basic rights such as the right to employment, education and health care and can be deprived of their civil rights in the absence of any legal protection from improper treatment. Whilst the expansion of HIV programs has provided an opportunity for integrating mental health care into such programs in high income countries, very limited studies or interventions have been carried out within Asia to determine the prevalence and linkage between HIV and mental disorders such as anxiety or depression or the current capacity and response to manage such illness. This research program will bridge this gap by determining the prevalence of mental health disorders among people with HIV and provide recommendations for policy and programmatic interventions for the target group. International and national human rights standards will be used to incorporate a moral dimension to public health solutions and help ensure people living with HIV and mental disorders can access the highest standard of physical and mental health in such a manner that they are protected from discrimination and afforded their individual dignity.
HIV, sex work and human rights in China (2007 – 2010)
– Ms. Jinmei (Alice) Meng (NCHSR); Supervisors: Dr. Heather Worth (NCHSR) and Prof. Daniel Tarantola
This project aims to explore the decriminalisation of sex work in China in the context of
human rights and the human immunodeficiency virus (HIV) epidemics. The conceptual framework for the study draws from both the theory of universality of human rights and the theory of HIV and human rights reflected in the UNAIDS International Guidelines on HIV / AIDS and Human Rights. The study combines qualitative research and legal research methodologies.
An analysis of selected psychological, social and cultural factors that impact maternal and child health outcomes in urban slums in Bangladesh – Dr. Mohammad Shamsul Arafeen; Supervisors: Dr. Susan Priest and Prof. Daniel Tarantola
For every 100,000 live births taking place in Bangladesh, 380 mothers lose their lives as a result of pregnancy. The research is investigating the roles played by psychological, social and cultural factors in this highly adverse outcome. To this end, concepts and tools were drawn from existing epidemiological and public health research, models for integrated perinatal care and a health and human rights framework. The project has two phases. Phase One will include mapping and analyzing existing maternal and child health care systems; defining the epidemiology of mothers and child mortality and morbidity in the study population; and evaluating current policies and programs relevant to perinatal maternal and child care within a health and human rights framework. Phase Two will develop and test a locally relevant, culturally suitable and potentially sustainable system of perinatal psychosocial assessment and referral.
Refugee health and access to care
- Dr Mohamud Sheikh, Prof Raina MacIntyre
Refugees and Internally Displaced Persons(IDPs)endure conditions of social disconnection, displacement, isolation, famine, war and overcrowding, and are regarded as being among the most poor and marginalised members of the Australian community. They suffer a high rate of social, physical, emotional and mental health problems, many of which are treatable or preventable. Studies suggest that resettled refugees have poor access to diagnostic and therapeutic intervention services. The need for the development of high level management guidelines and cross-cutting intervention to improve their access to healthcare services requires extensive research.
Recent publications on Health and Human Rights:
Tarantola D, Byrnes A, Johnson M, Kemp L, Zwi AB, Gruskin S ‘Human Rights, Health and Development’ Australian Journal of Human Rights, [accepted April 2008]
Tarantola D ‘A perspective on the history of health and human rights: from the Cold War to the Gold War’ J Public Health Policy 2008;29(1).
Hallgath L and Tarantola D ‘A rights-based approach to the assessment of global health initiatives’ Australian Journal of Human Rights. [accepted Feb 2008]
Klinken Whelan A (2008) Culture, health and inequities: new paradigms, new practice imperatives. J Research in Nursing 13(2):149-150
Matthews C, Klinken Whelan A, Johnson M, Noble C (2008) A piece of the puzzle – the role of ethnic health staff in hospitals. Australian Health Review
Garrett PW, Forero R, Dickson HG, Klinken Whelan A (2008) Communication and Healthcare Complexity in People with Little or No English: The Communication Complexity Score. Ethnicity and Health
Tarantola D (2007) ‘The interface of mental health and human rights in Indigenous populations: triple jeopardy and triple opportunity’ Australasian Journal of Psychiatry, 15(Suppl):S10-S17
Gruskin S, Mills EJ, Tarantola D (2007) ‘History, principles and practice of health and human rights’ Lancet (Health and Human Rights Series 1), 370(9585):449-55
Nelson CB, Birmingham M, Costa A, Daviaud J, Perea W, Tarantola D et al (2007) ‘Public-private partnership to develop an affordable vaccine for an emergent threat: the trivalent Neisseria meningitides ACW135 Polysaccharide vaccine’ Am J Public Health, 97(Suppl 1):S15-22
Tarantola D (2007) ‘Global justice and human rights: health and human rights in practice’ Global Justice: Theory, Practice, Rethoric, 1:11-26
Tarantola D, Macklin R, Reed ZH, Osmanov S, Stobie M, Hankins C and Kieny MP (2007) ‘Ethical considerations related to the provision of care and treatment in vaccine trials’ Vaccine, 25:4863-74
Gruskin S and Tarantola D ‘Global issues: health and human rights, overview’ in: Heggenhougen K (ed) Encyclopedia of Public Health Elsevier [accepted Sept 2007]
Tarantola D and Gruskin S ‘Policy: human rights approach to public health policy’ in: Heggenhougen K (ed) Encyclopedia of Public Health Elsevier [accepted Oct 2007]
Whelan A. & Blogg J (2007) Halfway People: Refugee Views of Reproductive Health Services” Global Public Health vol 2 (4):373-394
Sheikh-Mohammed M. Macintyre CR. Wood NJ. Leask J. Isaacs D. Barriers to access to health care for newly resettled sub-Saharan refugees in Australia. Medical Journal of Australia. 185(11-12):594-7, 2006 Dec 4-18.
Leask J. Sheikh-Mohammed M. Macintyre CR. Leask A. Wood NJ. Community perceptions about infectious disease risk posed by new arrivals: A qualitative study. Medical Journal of Australia. 185(11-12):591-3, 2006 Dec 4-18.
Grove N, Zwi AB, Silove D, Tarantola D. Psychosocial health and human rights: Fair weather friends? Examining post-Tsunami interventions in conflict-affected areas. Australian Journal of Human Rights, 2006; Vol 11 (2)
Whelan A and Matters P, (2002) Pacific Solution: part of the problem,
Intouch vol 19 (6) July/August:4-5. Public Health Association of Australia, Canberra
Whelan A (2002) Refugees and Population Policy: a new language and ethical base is needed,
Intouch vol 19 (2) March:10-11. Public Health Association of Australia, Canberra
Health Ethics Research
Publishing ethics
– Prof. Raina MacIntyre
Prof Raina Maclntyre has an interest in the ethics of publication, publication bias, industry influence on publishing and editorial independence. She is a member of the World Association of Medical Editors which regularly discusses such issues. She also has an interest in doctors and dual loyalty, and in introducing more extensive teaching for medical students and postgraduate students in this area.
Ethics of the Detention of Asylum Seekers
- Dr Mohamud Sheikh, Prof Raina MacIntyre
Dr Mohamud Sheikh and Professor MacIntyre have an interest in the ethics of detention of asylum seekers and other people.
Recent publications on Health Ethics
Sheikh-Mohammed M, Perera S, MacIntyre CR. Preventive detention: the ethical ground where politics and health meet. Focus on asylum seekers in Australia. Journal of Epidemiology and Community Health. In Press 2008.
Liyanage SS, MacIntyre CR. Do financial factors such as author page charges and industry funding impact on the nature of published research in infectious diseases? Health Information & Libraries Journal, Volume 23 Page 214 - September 2006
MacIntyre CR. King CL. Isaacs D. Ethics and access to teaching materials in the medical library: the case of the Pernkopf atlas. Medical Journal of Australia. 184(5):254-5, 2006 Mar 6.
Asante AD, Zwi AB. Public-private partnerships and global health equity: prospects and challenges. Indian Journal of Medical Ethics 2007; Vol IV (4): 176-180.
Zwi AB, Grove NJ, Pittaway E, Mackenzie C, Zion D, Silove D, Tarantola D. Placing ethics in the centre: negotiating new spaces for ethical research in conflict situations. Global Public Health 2006; 1 (3) : 264-277.