Framing COVID-19 as a health and human rights issue

The United States has administered 321 million doses of COVID-19 vaccines, with about 67 percent of adults expected to be partly vaccinated by July 4.

But vaccine distribution and access are a different story in other parts of the world, posing a threat to our success against COVID-19, according to an article published in The Lancet by Sofia Gruskin, JD, MIA, professor of preventive medicine and law, and her fellow commissioners on the International AIDS Society-Lancet Commission on Health and Human Rights.

"Inequitable access to COVID-19 vaccines is a reckless public health practice," Gruskin and her colleagues wrote in "Human Rights and Fair Access to COVID-19 vaccines." "Allowing that kind of injustice is not only legally, politically, and morally unacceptable, but it also undermines all of our humanity."

Headshot of Sofia Gruskin, professor of preventive medicine and law, and director of the USC Institute on Inequalities in Global Health

Sofia Gruskin, JD, MIA

Gruskin, who is also director of the USC Institute on Inequalities in Global Health, talked about the commission's work in the years to come.

Q: Countries and regions with the highest incomes are getting vaccinated more than 30 times faster than those with the lowest, according to Bloomberg. In its article, the commission cited the successful smallpox vaccine effort in the 1970s as an example to follow.

A: Yes, we wrote that in the 1970s, the global community understood that smallpox anywhere was smallpox everywhere. A successful vaccine effort happened despite huge international tensions between Russia and the United States. As was done with smallpox, we should ensure that a substantial portion of vaccines manufactured for high-income countries are made available to lower- and middle-income countries. In addition, efforts are needed to ramp up vaccine production and broaden distribution, share vaccine manufacturing technology and intellectual property, temporarily waive intellectual property barriers, and expand voluntary contracting between manufacturers. We need a major effort to create a comprehensive system for COVID-19 vaccine production, funding, allocation, distribution, and deployment, based on true global solidarity.

Q: How will the commission help address this problem?

A: There are 22 scholars and thought leaders on the commission representing 19 educational institutions and organizations around the world from Beirut to Kuala Lumpur to Los Angeles. We first met virtually early this year and will publish our first full report in 2022. We meet every two weeks at 6:30 a.m. our time dialoguing as a group to establish the larger conceptual focus and specifics of what we want to do. That's where we decided to write about vaccine access as our first product and to announce the commission. We've formed smaller groups organized around different thematic areas. Each of us will be holding public talks to make people aware of our ideas. For example, several of us will be doing a large-scale virtual event on the July 20 to draw attention to these issues. We'll also be doing work with local and national governments and civil society in terms of operationalizing these ideas.

Q: The International AIDS Society is co-sponsoring this Lancet commission. Can you elaborate on the commission's focus in addition to COVID?

A: There are a lot of similarities between what happened in the early years of AIDS and what is happening now with COVID-19. And HIV continues to serve as an entry point for clarifying links between health and rights. The implication is that we will be doing some work around HIV, but we're equally trying to hit broader themes at the health and rights nexus, such as climate change and the global refugee crisis. We will explore the evidence base in relation to each topic In order to be able to shape some overarching recommendations to propose a way forward that draws on what a health and human rights framework can offer in its current form; where it needs to be revitalized and reinvigorated; and what are immediate steps for ensuring robust health systems and universal access to prevention and care moving forward.

Q: What can be achieved by framing health in a human rights framework?

A: The health and human rights framework has been key to much of the work that happens at the global level, and within many countries of the world. Much less in the United States than outside of the U.S. With COVID, there seems to be more people listening. There's an opportunity right now for more attention to social justice and to addressing inequality and the bigger issues it raises about the use and misuse of law as it impacts health; the responsibilities of governments to their most vulnerable communities and to people beyond their borders; and to the mechanisms of accountability.

Q: Why is it important for USC to be involved at this level?

A: USC has the opportunity to play a prominent role in setting the global health agenda. It's important as well because Los Angeles is part of the globe, and this means we can use the processes connected to the commission interrogate and engage our own space and to learn from the good practice happening in other parts of the world.

In this moment, it's about trying to put together and engage with a paradigm that ensures justice and fairness in terms of the way we think about health and the delivery of health care as much in Los Angeles as in the rest of the world.

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