Oscar A. Cabrera

Human Rights and the Framework Convention on Tobacco Control: Mutually Reinforcing Systems

This article explores the connection between human rights and tobacco control, and in particular, the Framework Convention on Tobacco Control (FCTC). We address rights-based arguments used by the tobacco industry to argue against tobacco regulation. We demonstrate the weakness of these arguments, and that tobacco control and human rights are, in fact, not in conflict, but are mutually reinforcing. We also offer counter-arguments in favour of tobacco regulation based on international human rights obligations. Moreover, we argue that international human rights law and human rights bodies can provide tobacco control advocates with avenues for international monitoring and enforceability, which are lacking in the FCTC.

Human rights as a tool for tobacco control in Latin America

T tobacco epidemic is one of the most dangerous and pervasive public health concerns the world faces today. Tobacco consumption is an epidemic that spreads not by infection, but by promotion and advertisement, and, more importantly, lack of effective regulation. In other words, it is an epidemic that can be controlled if governments implement appropriate tobacco control measures. Integrating a human rights approach in tobacco control has many advantages. Human rights law is one of the most powerful legal tools that can be used both domestically (in-country) and internationally. Moreover, human rights are also widely used in political discourse and they usually influence policy debates. As an area of discourse that is used globally, human rights law has a reach similar to the global dimension of the tobacco epidemic. Despite its utility, a human rights approach to advance tobacco control policies has not been widely used by the tobacco control movement. In fact, one could argue that the tobacco industry has been more proactive in using human rights law to attack tobacco control policies.1 This article addresses the connections between human rights law and tobacco control. Providing concrete examples from Latin America, we demonstrate the potential of a human rights approach to tobacco control, while at the same time we aim to explain how such approach can be used. This paper is divided into three sections. The first section provides background on human rights law and Human rights as a tool for tobacco control in Latin America

Public Health Measures to Control Tuberculosis in Low-Income Countries: Ethics and Human Rights Considerations

In low-income countries, tuberculosis (TB) control measures should be guided by ethical concerns and human rights obligations. Control programs should consider the principles of necessity, reasonableness and effectiveness of means, proportionality, distributive justice, and transparency. Certain measures-detention, infection control, and treatment to prevent transmission-raise particular concerns. While isolation is appropriate under certain circumstances, quarantine is never an acceptable control measure for TB, and any detention must be limited by necessity and conducted humanely. States have a duty to implement hospital infection control to the extent of their available resources and to provide treatment to health care workers (HCWs) infected on the job. HCWs, in turn, have an obligation to provide care unless conditions are unreasonably and unforeseeably unsafe. Finally, states have an obligation to provide adequate access to treatment, as a means of preventing transmission, as broadly as possible and in a non-discriminatory fashion. Along with treatment, states should provide support to increase treatment adherence and retention with respect for patient privacy and autonomy. Compulsory treatment is almost never acceptable. Governments should take care to respect human rights and ethical obligations as they execute TB control programs.