The Right to Health and the Climate Crisis: The Vital Role of Civic Space

Under the United Nations Framework Convention on Climate Change and its protocols, states have legal obligations to address the climate crisis. The principle of participation is increasingly acknowledged as central to the protection and promotion of human rights, including the right to health. This paper explores states' obligations to address the climate crisis-and concomitant health crises-from a right to health perspective. The right to health lens provides a valuable opportunity for engaging diverse civil society constituencies in the response to the climate crisis. However, civic space must be protected if these actors are to participate meaningfully. The climate crisis discourse has lacked an explicit recognition of the interconnected nature of the right to health, environmental degradation and climate change, and civic space. There is also concern that restrictions on civic space will continue after the COVID-19 pandemic. While the public health community is an important constituency in the design and implementation of laws, policies, and programs to address climate change, the human rights literacy of this community remains to be strengthened. This paper addresses these lacunae within the context of the right to health as enshrined in United Nations human rights treaties and related international law.

Legal and human rights-based approaches to healthy diets and sustainable food systems

Issue

Malnutrition in all its forms poses daunting challenges to global health and development. The agriculture sector is a significant contributor to global warming. COVID-19 has pushed many people into poverty, including food poverty. A radical rethink of business models, food systems, civil society involvement, and national and international governance is required to address the interlinked crises of COVID-19, obesity, undernutrition, and climate change. International human rights law, institutions and mechanisms provide important opportunities for norm setting, advocacy and accountability. Yet these pathways are under-utilised by both governments and civil society.

Description

The global AIDS response demonstrated the power of a human rights-based approach. United Nations' HIV/AIDS and Human Rights Guidelines greatly influenced the global consensus for effective, evidence-based approaches. The Guidelines also informed resolutions of the UN General Assembly and its Human Rights Council, contributing to more affordable medicines, an unprecedented increase in people on treatment, less stigmatising health services, the empowerment of marginalised groups, and the institutionalisation of norms, including “no one left behind.” Human rights-based approaches have also been successfully utilised in tobacco control.

Results

In 2019, 180 experts from 38 countries published an open call on WHO and the UN Office of the High Commissioner for Human Rights (OHCHR) to initiate an inclusive process to develop guidelines on human rights, healthy diets and sustainable food systems. Most signatories were from the health and development sectors, demonstrating the increasingly broad interest in using human rights mechanisms to address global health challenges.

Lessons

Opportunities exist to transform food systems and create healthier food environments and a healthier planet by clarifying existing international obligations to progressively realise the right to food and the right to health.

Key messages

Market forces, alone, are failing to deliver healthy diets and sustainable food systems. International legal frameworks and accountability mechanisms provide opportunities for engagement and action.

Human rights guidelines can help mobilize multisectoral action, strengthen State and private sector accountability, and deepen community engagement in the urgent task of achieving Agenda 2030.

A comparison of the National Center for Health Statistics and new World Health Organization growth references for school-age children and adolescents with the use of data from 11 low-income countries

BACKGROUND

In 2007 new World Health Organization (WHO) growth references for children aged 5-19 y were introduced to replace the National Center for Health Statistics (NCHS) references.

OBJECTIVE

This study aimed to compare the prevalence of stunting, wasting, and thinness estimated by the NCHS and WHO growth references.

DESIGN

NCHS and WHO height-for-age z scores were calculated with the use of cross-sectional data from 20,605 schoolchildren aged 5-17 y in 11 low-income countries. The differences in the percentage of stunted children were estimated for each year of age and sex. The z scores of body mass index-for-age and weight-for-height were calculated with the use of the WHO and NCHS references, respectively, to compare differences in the prevalence of thinness and wasting.

RESULTS

No systematic differences in mean z scores of height-for-age were observed between the WHO and NCHS growth references. However, z scores of height-for-age varied by sex and age, particularly during early adolescence. In children for whom weight-for-height could be calculated, the estimated prevalence of thinness (WHO reference) was consistently higher than the prevalence of wasting (NCHS reference) by as much as 9% in girls and 18% in boys.

CONCLUSIONS

In undernourished populations, the application of the WHO (2007) references may result in differences in the prevalence of stunting for each sex compared with results shown when the NCHS references are used as well as a higher estimated prevalence of thinness than of wasting. An awareness of these differences is important for comparative studies or the evaluation of programs. For school-age children and adolescents across all ranges of anthropometric status, the same growth references should be applied when such studies are undertaken.

Neuroanatomy of the human affective system

We provide a brief overview of the structures associated with the limbic system using fixed human material. Although the review is by no means intended to be exhaustive, its purpose is to provide a tutorial on the primary structures that are involved in the experience, expression, and regulation of emotion and their anatomical location so that the reader can use this as a "pedagogical guide" for orientation and understanding of the many papers that appear in this Special Issue.

Non-Hodgkin's lymphoma disguised as odontogenic pain

A patient was treated for infraorbital swelling, nonvital teeth and a periapical lesion. Suspected malignancy, confirmed with an early biopsy, resulted in diagnosis of non-Hodgkin's lymphoma.