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please summarize each article into 1-2 paragraphs and combine all of them into one paper. thank you!
Since I cannot attach all articles, I have copy pasted one here:
“
Not Every Pandemic Needs Someone to Blame
May 21, 2023
Credit…Nash Weerasekera
By Daniela J. Lamas
Dr. Lamas, a contributing Opinion writer, is a pulmonary and critical-care physician at Brigham and Women’s Hospital in Boston.
You’re reading The Next Pandemic newsletter. Insights and guidance for preparing for future outbreaks. Get it sent to your inbox.
Three years ago, as I stood at the bedside of my first patient with the coronavirus, I struggled to understand why someone relatively young and healthy had become so sick. The unknown of the virus was frightening enough — to think that severe illness could strike at random was untenable. Even in my personal protective equipment, I held my breath, suddenly aware of my own vulnerability. The air itself felt dangerous.
A couple of months ago, my father called me to let me know that he had tested positive for the virus. I barely reacted — until I realized that a positive test meant that he would not travel to visit my infant as planned. He had been vaccinated and boosted, so I was not worried about his health, but I was frustrated. Quickly I felt my disappointment turn to judgment. He could have been more careful.
As I reflected on my reaction — and on the shift from the coronavirus as mortal threat to inconvenience — I found myself thinking not just about the early days of the pandemic in the intensive care unit, but also about how this virus has become intertwined with morality.
From the earliest reports, the public conversation has so often assigned blame for the spread of the coronavirus, based on ethnicity or underlying health conditions or political party. It is tempting to believe that health care workers are immune to such reactions. After all, we care for all patients, regardless of their culpability in their own illnesses. But looking forward to the inevitability of another pandemic, we must acknowledge that when faced with fear and uncertainty, those of us working at the bedsides are not entirely different.
Disease has long been weaponized against those who are perceived as “other.” From the bubonic plague of the 14th century to tuberculosis and H.I.V., the examples echo throughout the history of medicine. When people are frightened, they seek someone to blame, to create a narrative — even if that narrative is false — in which disease is punishment rather than a random unlucky event.
Of course, health care workers frequently care for patients who are suffering, either directly or indirectly, as a result of actions they have taken. We transplant organs for those with liver failure after cirrhosis after years of alcohol abuse, with heart failure after decades of poor diet and little exercise. So much of what we do in the hospital is about second chances, about care without judgment.
And yet the idea of culpability, whether our patients are blameless in their diseases, is still present. When we see patients with lung cancer, for instance, we mention whether they had a history of cigarette smoking. The young mother with a lung mass who has never smoked represents a tragedy; an older man who develops cancer after 50 years of smoking elicits a different response. That’s not to say that the medicine we offer is different, not in any way that’s measurable. But the distinction matters. It affects the way we frame the story, the way we understand the world.
Disease that has no explanation in behavior is terrifying. It is a reminder that no matter what we do, no matter how careful we are, any of us could fall ill and die. It is a reminder that none of us are safe. Which is one reason the coronavirus was so frightening to those of us in health care. The disease did not just break through the boundaries between doctor and patient, it decimated them. We were all vulnerable. And at first I thought that vulnerability might increase empathy, but then, as time went on, that empathy waned. And we, too, began to find an “us” and a “them.”
It happened first with masks. Patients who did not wear masks were, in some ways, responsible for their own illness. We became even more frustrated, and more comfortable with openly discussing that frustration, when it came to patients who were not vaccinated. There were health care workers who railed against the idea of offering advanced and scarce resources like a lung bypass or transplantation to unvaccinated patients with life-threatening disease.
Even when there was no question of medical resources, the stigma of the unvaccinated was clearly present in the way we discussed a case. When we talked about patients on rounds, we would mention in the first sentence whether they had been vaccinated. As in the case of the patient with lung cancer, this knowledge would not affect treatment, but it did change the way we framed the story. The people in front of us had made a choice, and they were sick and even dying as a result. They were not blameless, and so perhaps they were deserving of less of our sympathy.
This pandemic is waning, but there will be another one. I want to say that we will learn and we will be different, both at the bedside and out in the world. I want to say that we will give grace, that we know how assigning blame only tears us further apart, but then I look at history. I think about our perception of the unvaccinated. I think of the stigma that so many diseases bring with them, how little we want to acknowledge the role of luck and random chance. And I have to wonder: When the next pandemic comes, who will we blame?
Daniela J. Lamas (@danielalamasmd), a contributing Opinion writer, is a pulmonary and critical-care physician at Brigham and Women’s Hospital in Boston.“
Unformatted Attachment Preview
HHr
Health and Human Rights Journal
perspective
The Trojan Horse: Digital Health, Human Rights, and
Global Health Governance
HHR_final_logo_alone.indd 1
10/19/15 10:53 AM
sara l. m. davis
The COVID-19 pandemic has massively accelerated a global shift toward new digital technologies in health,
a trend underway before the crisis. In response to the pandemic, many countries are rapidly scaling up the
use of new digital tools and artificial intelligence (AI) for tasks ranging from digital contact tracing, to diagnosis, to health information management, to the prediction of future outbreaks. This shift is taking place
with the active support of numerous private actors and public actors. In particular, United Nations (UN)
development agencies, such as the World Health Organization (WHO), are actively encouraging this trend
through normative guidance and technical cooperation aimed at helping the governments of low- and middle-income countries to assess their needs for digital health, develop national digital health strategies, and
scale up digital interventions.1 At the same time, global health financing agencies, such as the Global Fund
to Fight AIDS, TB and Malaria, are financing these technologies through aid to national health programs
and through their own public-private partnerships. But in this major effort to spur low- and middle-income
countries to race toward the digital future, are UN development agencies adequately considering the risks?
In 2019, UN Special Rapporteur on Extreme Poverty and Human Rights Phillip Alston cautioned that
digital technologies could be a “trojan horse” for forces that seek to dismantle and privatize economic and
social rights, undermining progress toward the Sustainable Development Goals (SDGs) instead of speeding
it.2 Similarly, in 2020, UN Special Rapporteur on Racism Tendayi Achiume warned that technology is
shaped by and frequently worsens existing social inequalities.3
As this article explores, these and other serious social effects may be accelerated by the rapid scaleup of digital technologies in health. An enabling policy and legal environment that confronts these risks
and judiciously plans for them should be a precondition to the scale-up of digital technologies, not an
afterthought. As part of its normative and technical advice to governments on digital technologies and AI
in health, WHO should be supporting governments in assessing risks and needs and in ensuring that these
governments also receive the advice they need to put in place laws, policies, and governance mechanisms to
protect and uphold human rights. But to date, the main equity and human rights risk that WHO and other
UN development agencies appear to view with real urgency is the need to overcome the “digital divide”—
inequitable access to digital technologies and internet connectivity that might undermine access to digital
health for impoverished and marginalized populations. In June 2020, the UN Secretary-General warned
Sara (Meg) Davis, PhD, is a research fellow at the Graduate Institute of International and Development Studies, Geneva, Switzerland.
Please address correspondence to the author. Email: [email protected].
Competing interests: None declared.
Copyright © 2020 Davis. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial
License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted noncommercial use, distribution, and reproduction.
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that closing the digital divide is now “a matter of life
or death.”4 While addressing the digital divide is a
legitimate concern in an increasingly digital age,
a disproportionate focus on this issue could itself
become a trojan horse, a poisoned gift to low- and
middle-income countries that legitimizes sweeping
access for private actors and state power, while rolling back hard-won human rights protections.
This article explores four risks in particular:
the expansion of state surveillance, the risk of malicious targeting, numerous challenges linked to the
management of partnerships with powerful private
companies, and the risks of scaling up digital interventions for which scientific evidence is weak.
A trojan horse for state surveillance
In 2013, the UN General Assembly adopted a resolution expressing concern over the negative impact
of technological surveillance on human rights.5 A
series of reports by UN Special Rapporteur on the
Right to Freedom of Opinion and Expression David
Kaye highlighted the systematic use of technologies
to violate privacy rights.6 The COVID-19 response
has intensified these concerns, as some states expand systems of surveillance that could later be
utilized for political purposes.
Function creep has been highlighted as a risk
whenever personal data is gathered.7 The Global
Commission on HIV and the Law has particularly
warned of the risk of digitally collected biometric
information being used by the police.8 The proposed
gathering of biometric data (such as fingerprints or
iris scans) for an HIV study sparked specific concerns for marginalized and criminalized groups
in Kenya—namely, sex workers, men who have sex
with men, transgender people, and people who use
drugs—about the use of the data to target individuals for arrest.9
China offers a cautionary example of this
targeted use of biometric data. To manage the coronavirus, the Chinese government requires citizens
to download an app from Alibaba, a US$500 billion
e-commerce company. The app was developed in
partnership with the police and uses a color code
to identify those free to travel, at risk, or in need of
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immediate quarantine, based on data that includes
travel history and time spent in proximity to others
with the virus.10 Subway stations use thermal scanners to check for high temperatures, incorporating
facial recognition technology.11
These tools were developed by some of the
same companies responsible for developing AI systems used to profile millions of Uighur Muslims.12
The systems track individual communications, police records, patronage at mosques, and individual
movements to identify people considered high risk
and place them in forced labor camps.
Beijing now actively exports these surveillance technologies, through its Belt and Road
Initiative, to over 60 countries as a form of development assistance.13 In August 2020, the International
Telecommunication Union’s AI for Good Global
Summit tweeted a promotional video praising
China’s use of artificial intelligence without mentioning related abuses.14 WHO has also praised
China’s response to COVID-19 without mentioning
related rights abuses.15
Some humanitarian aid agencies, such as the
International Committee of the Red Cross, have
developed policies strictly limiting the gathering
and use of biometric data, aiming to prevent state
and nonstate actors using data gathered for humanitarian purposes to target people for harm.16
However, there is currently no agreed approach
to the governance and use of biometrics and other
sensitive data among normative agencies, such as
WHO, and funding agencies, such as the Global
Fund, which often provide advice to the same
countries. In fact, WHO’s draft digital strategy,
approved in 2020, appears to contravene its own
data protection policy, according to an analysis
by the Third World Network.17 To promote consistent and rights-respective governance, agencies
that normally work together to provide technical
support and funding to low- and middle-income
countries on health interventions should also work
together to establish a common bottom line with
regard to privacy, surveillance, and policing in the
name of health, including policies on biometrics
(potentially using the the International Committee
of the Red Cross’s policy as a starting point); and
Health and Human Rights Journal
s. l. m. davis / perspective, big data, technology, artificial intelligence, and the right to health, 41-47
certainly, they should deplore China’s use of technology and AI for abusive policing, not extoll it on
social media as a model.
A trojan horse for malicious targeting
Security experts have documented the growing use
of AI systems for malicious purposes, including
to attack both digital security (through phishing attacks, speech synthesis for impersonation,
automated hacking, and data poisoning) and physical security (attacks using autonomous weapons
systems, using micro-drones, and subverting cyber-physical systems).18 UN High Commissioner for
Human Rights Michele Bachelet has warned of the
abuse of digital technologies to attack individuals
and groups.19 There are now growing cyber attacks
against medical facilities which take advantage of
hospitals’ growing dependence on digital systems.20
Even where states do not retain the data, data
gathered by digital contact tracing apps could
enter the public domain, exposing women, girls,
and other vulnerable groups such as LGBTI+
people or stigmatized groups to risks of stalking,
extortion, or violence.21 In South Korea, for example , digital contact tracing app data was used
to create a “coronamap” website showing the
travel histories of anonymous confirmed patients
and identifying them by gender and age; as this
information was publicly accessible, individuals
were accused of infidelity, fraud, and sex work,
and some were the targets of online witch hunts
aimed at identifying individuals who had spread
the virus. Moreover, individual businesses were
associated with COVID-19 transmission after they
were identified through contact tracing, and some
were targeted for extortion.22 Privacy International
has documented data-exploitative tactics used by
some organizations to target women with misinformation about contraception and abortion.23 The
International Committee of the Red Cross and Privacy International have further found that mobile
technologies leave digital trails that could be used
to target individuals.24
The growing dependence of health systems on
digital technologies and AI thus creates many new
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vulnerabilities, and as Achiume has noted, due to
inequalities that already exist in our societies, the
risks are greater for some groups than for others.
Incidents such as those documented in South Korea could undermine public trust and make many
people reluctant to download or use mobile health
apps. This may even have been the case in Singapore, where early downloads of the coronavirus
app TraceTogether flatlined at just 20% of the population, leading the government to step back from
promoting its use.25
A trojan horse for the private sector
Public-private partnerships may significantly
benefit private actors, raising questions about the
appropriate use of taxpayer funds.
Shoshana Zuboff has shown how tech giants
such as Facebook and Google have turned data
into a source of profit through “surveillance capitalism.”26 Today, private companies of all sizes
race to locate big datasets that they can either sell
for profit or use to train and improve algorithms,
developing profitable tools. However, the supply of
big data in the Global North is not enough to meet
the demand, and privacy regulations in Europe
and North America are growing stricter, thanks to
the European General Data Protection Regulation.
Health systems in low-resource settings offer potentially vast, as-yet-untapped reserves of big data
in countries with weaker regulatory controls.
Thus, the private sector has a strong interest
in partnering with health agencies to roll out new
AI-enabled digital health tools in low- and middle-income countries, thereby accessing big data
that would be harder to access in countries with
stronger regulation, a form of “data colonialism.”27
Private companies may benefit significantly from
partnerships in which there is no immediate obvious financial gain.
These partnerships sometimes include companies with problematic track records. In 2018, the
World Food Programme’s five-year partnership
with data-mining firm Palantir was criticized by
civil society due to Palantir’s history of collaboration with Cambridge Analytica, the Los Angeles
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and New York Police Departments, Immigration
and Customs Enforcement, and US intelligence
agencies.28 One internal Immigration and Customs
Enforcement report revealed that Palantir data
had been critical in locating and prosecuting the
parents of immigrant children.29 The World Food
Programme issued a statement affirming that it
would place controls on the use of data by Palantir, but critics continue to raise concerns about
the risks for refugees and persons in displacement
and to call for clearer standards for humanitarian
programs.30 In response to COVID-19, Palantir is
now offering its services to public health agencies
to track and analyze the spread of the coronavirus.31
A trojan horse for unsupervised
experimentation
WHO’s draft digital strategy argues that it hopes
to “[build] a knowledge base … enabl[ing] testing,
validating and benchmarking artificial intelligence
solutions and big data analyses across various
parameters and settings.”32 But is it ethical to promote the testing, validating, and benchmarking
of unproven health interventions in developing
countries?
WHO’s systematic literature reviews of
evidence for new digital technologies tend to be
consistent in praising the promise these offer, while
also highlighting the need for further implementation research.33 WHO has acknowledged in its
guidelines that the quality of evidence for digital
health interventions is sometimes weak, yet it
nonetheless recommends them.34
The Committee on Economic, Social and
Cultural Rights’ General Comment 14 on the right
to health asserts that health facilities, goods, and
services must be scientifically and medically appropriate and of good quality.35 The rapid scale-up of
new digital technologies, even those with promising
pilots, should be promoted by WHO and financed
by publicly funded agencies only if the evidence
base is sufficient to justify bringing new tools to
scale. Financing unproven digital interventions
may leach resources away from interventions for
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which the evidence base is stronger—for example,
harm reduction services, which are proven to work
but are chronically underfunded.36
Conclusion
The digital strategies and guidance currently
emerging from global health agencies unfortunately make only minimal reference to these and other
human rights concerns.37 The report from the UN
Secretary-General’s high-level panel on digital
technologies set the tone with its emphasis on
addressing the digital divide, recommending that
“by 2030, every adult should have affordable access
to digital networks, as well as digitally-enabled
financial and health services, as a means to make
a substantial contribution to meeting the SDGs.”38
The panel’s recommendations on human rights
protection were far less precise, calling only for
“an agencies-wide review of how existing human
rights accords and standards apply to new and
emerging digital technologies.”39 A year later, the
“agencies-wide review” has yet to be published.
Similarly, WHO’s draft digital strategy and
normative guidance to countries focus overwhelmingly on the promise, with little discussion
of the risks discussed above.40 The strategy’s four
principles focus on urging countries to commit
to digital health, recognizing the need for an integrated strategy, promoting the appropriate use of
digital technologies for health, and recognizing the
need to address impediments faced by the least-developed countries, and they make little reference to
the concerns raised by UN human rights experts.41
The strategy was approved by the WHO Executive
Board in February 2020 and was on the agenda for
approval by the World Health Assembly in November 2020.42
Recognizing that trust and respect for human
rights are critical to upholding the right to health
and that it is crucial to ensure that the public feels
secure in accessing health care, global health agencies such as WHO and the Global Fund should,
following the Ruggie Framework, “know and
show” that they have done due diligence in order to
Health and Human Rights Journal
s. l. m. davis / perspective, big data, technology, artificial intelligence, and the right to health, 41-47
identify, prevent, and address human rights abuses
linked to digital technologies in health.43 This includes the following:
evolve, it is critical that respect for human rights
move to the center of digital health governance and
not be left as an afterthought.
• developing a common position across WHO, the
Global Fund, and other UN development agencies on the risks linked to these technologies, and
clearly committing to making respect for human
rights standards a core principle of all strategies
and guidance;
Acknowledgments
• integrating consideration of the above risks into
normative guidance by WHO and UNAIDS and
developing risk assessment tools for countries
and donor agencies;
• integrating a robust approach to due diligence
into ongoing technical assistance provided to
low- and middle-income countries by such agencies as UNDP, UNAIDS, French 5%, and others
to enable states to fully assess the track records of
companies with which they do business;
• developing biometrics and data management
policies that share consistent principles across
UN health agencies and global health funders:
commiting to and recommending the minimal
use of biometrics, setting out legitimate uses of
health and biometric data, committing to impact
assessments for data processing, and setting out
constraints on private sector access to health
data; and
• consulting with civil society—particularly affected communities—to ensure their involvement in
the development and rollout of these policies.
Ultimately, states bear the responsibility to protect human rights; but UN development agencies
and global health financing agencies, through the
evidence-based normative guidance and technical cooperation they provide and the power they
exercise as funders of health interventions, have
signficant influence on state decisions, and they
cannot afford to be naiive. As holders of the purse
strings for billions in taxpayer contributions, they
must do all they can to ensure that international
cooperation does more good than harm. Given that
technologies used in health will only continue to
DECEMBER 2020
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The research for this article was supported in part
by a consultancy with the Joep Lange Institute. I
am grateful for input from Joe Amon, Christoph
Benn, Erika Castellanos, Kene Esom, Tabitha Ha,
Allan Maleche, Bruna Martinez, Mike Podmore,
Tony Sandset, Peter van Rooijen, Akarsh Venkatasubramanian, Nerima Were, Carmel Williams, and
two reviewers.
References
1. See, for example, World Health Organization, Draft
global strategy on digital health 2020–2025 (Geneva: World
Health Organization, 2020); World Health Organization
and International Telecommunication Union, Be he@
lthy, be mobile (Geneva: International Telecommunication
Union, 2014); Global Fund, “Private sector partners step up
the fight to end AIDS, TB and malaria” (press release, October 9, 2019). Available at https://www.theglobalfund.org/en/
news/2019-10-09-private-sector-partners-step-up-the-fightto-end-aids-tb-and-malaria.
2. United Nations General Assembly, Report of the Special Rapporteur on Extreme Poverty and Human Rights,
UN Doc. A/74/493 (2019).
3. Office of the United Nations High Commissioner for
Human Rights, “Emerging digital technologies entrench
racial inequality, UN expert warns” (press release, July 15,
2020). Available at https://www.ohchr.org/EN/NewsEvents/
Pages/DisplayNews.aspx?NewsID=26101&LangID=E.
4. United Nations, “Digital divide ‘a matter of life and
death’ amid COVID-19 crisis, SecretaryGeneral warns
virtual meeting, stressing universal connectivity key for
health, development” (press release, June 11, 2020). Available
at https://www.un.org/press/en/2020/sgsm20118.doc.htm.
5. United Nations General Assembly, Res. 68/147, UN
Doc. A/RES/68/167 (2014).
6. Human Rights Council, Report of the Special Rapporteur on the Promotion and Protection of the Right to
Freedom of Opinion and Expression, UN Doc. A/HRC/41/35
(2019).
7. S. Davis and A. Maleche, “Everyone said no: Key populations and biometrics in Kenya,” Health and Human Rights
Journal (July 4, 2018).
8. Global Commission on HIV and the Law, Risks, rights
and health: Supplement (New York: UNDP, 2018); p. 8.
NUMBER 2
Health and Human Rights Journal
45
s. l. m. davis / perspective, big data, technology, artificial intelligence, and the right to health, 41-47
9. KELIN and the Key Populations Consortium, “Everyone said no”: Biometrics, HIV and human rights, a Kenya
case study (Nairobi: KELIN, 2018).
10. A. Holmes, “China is reportedly making people download an Alibaba-backed app that decides
whether they’ll be quarantined for coronavirus,” Business Insider (March 2, 2020). Available at https://www.
businessinsider.nl/alibaba-coronavirus-chinese-app-quarantine-color-code-2020-3?international=true&r=US.
11. S. Yuan, “How China is using AI and big data to fight
the coronavirus,” Al Jazeera (March 1, 2020). Available at
https://www.aljazeera.com/news/2020/03/china-ai-big-data-combat-coronavirus-outbreak-200301063901951.html.
12. M. Gira Grant, “The pandemic surveillance state,”
New Republic (May 8, 2020).
13. S. Feldstein, The global expansion of AI surveillance
(New York: Carnegie Endowment for International Peace,
2019).
14. AI for Good Global Summit (@ITU_AIForGood),
“What is #China’s digital #health strategy? #AI #AiforGood” (August 19, 2020). Available at https://twitter.com/
ITU_AIForGood/status/1296031059948318720.
15. World Health Organization, Report of the WHO-China joint mission on coronavirus disease 2019 (COVID-19)
(February 16–24, 2020). Available at https://www.who.int/
docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf.
16. B. Hayes and M. Marelli, “Faciliting innovation,
ensuring protection: The ICRC biometrics policy,” Humanitarian Law and Policy (October 18, 2019). Available at https://
blogs.icrc.org/law-and-policy/2019/10/18/innovation-protection-icrc-biometrics-policy.
17. Third World Network, “WHO: Draft global strategy
on digital health threatens data sovereignty” (press release,
February 6, 2020). Available at https://www.twn.my/title2/
health.info/2020/hi200203.htm.
18. M. Brundage, S. Avin, J. Clark, et al., The malicious
use of artificial intelligence: Forecasting, prevention and
mitigation (Future of Humanity Institute, University of Oxford, Centre for the Study of Existential Risk, University of
Cambridge, Center for a New American Security, Electronic
Frontier Foundation, and Open AI, February 2018), p. 4.
Available at https://arxiv.org/pdf/1802.07228.pdf.
19. M. Bachelet, “Human rights in the digital age” (speech
to the Japan Society, October 17, 2019). Available at https://
www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=25158&LangID=E.
20. Oxford Institute for Ethics, Law and Armed Conflict, Oxford statement on the international law protections
against cyber operations targeting the health-care sector
(May 2020). Available at https://law.yale.edu/sites/default/
files/documents/pdf/Faculty/circulation_oxfordstatement_
internationallawprotections_cyberoperations_healthcare.
pdf.
46
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21. S. Davis, “Contact tracing apps: Extra risks for women
and marginalized groups,” Health and Human Rights Journal (April 29, 2020).
22. Corona map: COVID-19 status map. Available
at https://coronamap.site; N. Kim, “‘More scary than
coronavirus’, South Korea’s health alerts expose private
lives,” Guardian (March 6, 2020). Available at https://www.
theguardian.com/world/2020/mar/06/more-scary-than-coronavirus-south-koreas-health-alerts-expose-private-lives.
23. Privacy International, A documentation of data
exploitation in sexual and reproductive rights (April
21, 2020). Available at https://privacyinternational.org/
long-read/3669/documentation-data-exploitation-sexual-and-reproductive-rights.
24. International Committee of the Red Cross,
Digital trails could endanger people receiving humanitarian aid, ICRC and Privacy International find (December
7, 2018). Available at https://www.icrc.org/en/document/
digital-trails-could-endanger-people-receiving-humanitarian-aid-icrc-and-privacy.
25. G. Goggin, “COVID-19 apps in Singapore and Australia: Reimagining healthy nations with digital technology,”
Media International Australia (August 14, 2020). Available
at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429912.
26. S. Zuboff, The age of surveillance capitalism (London:
Profile Books, 2019).
27. N. Couldry and U. Mejias, “Data colonialism: Rethinking big data’s relationship to the colonial subject,”
Television and New Media (April 20, 2018).
28. G. Greenleaf, “Global data privacy laws 2019: 132
national laws and many bills,” Privacy Laws and Business
International Report 157 (2019), pp. 14–18.
29. “Palantir played key role in arresting families for
deportation, document shows,” Mijente (press release, May
2, 2019). Available at https://mijente.net/2019/05/palantir-arresting-families.
30. N. Raymond, L. Walker McDonald, and R. Chandran, “Opinion: The WFP and Palantir controversy should
be a wake-up call for humanitarian community,” Devex
(February 14, 2019). Available at https://www.devex.com/
news/opinion-the-wfp-and-palantir-controversy-shouldbe-a-wake-up-call-for-humanitarian-community-94307.
31. Palantir, Responding to COVID-19 (November 15,
2020). Available at https://www.palantir.com/covid19.
32. World Health Organization (2020, see note 1), para. 17.
33. H. Abaza and M. Marschollek, “mHealth application
areas and technology combinations: A comparison of literature from high and low/middle income countries,” Methods
of Information in Medicine 56/7 (2017), pp. e105–e122; C.
Agbo, Q. Mahmoud, and J. Eklund, “Blockchain technology
in healthcare: A systematic review,” Healthcare (Basel) 7/2
(2019), p. 56; B. Bervell and H. Al-Samarraie, “A comparative
review of mobile health and electronic health utilization
in sub-Saharan African countries,” Social Science and
Health and Human Rights Journal
s. l. m. davis / perspective, big data, technology, artificial intelligence, and the right to health, 41-47
Medicine 232 (2019), pp. 1–16; G. Fontaine, S. Cossette, M.
Maheu Cadotte, et al., “Efficacy of adaptive e-learning for
health professionals and students: A systematic review and
meta-analysis,” BMJ Open 9/8 (2019), p. e025252; K. Henry,
A. Wilkes, C. McDonald, et al., “A rapid review of eHealth
interventions addressing the continuum of HIV care
(2007–2017),” AIDS Behavior 22/1 (2018), pp. 43–63; C. Kemp
and J. Velloza, “Implementation of eHealth interventions
across the HIV care cascade: A review of recent research,”
Current HIV/AIDS Reports 15/6 (2018), pp. 403–413; N.
Konduri, G. Bastos, K. Sawyer, and L. Reciolino, “User experience analysis of an eHealth system for tuberculosis in
resource-constrained settings: A nine-country comparison,”
International Journal of Medical Informatics 102 (2017), pp.
118–129; D. Rhoads, B. Mathison, H. Bishop, et al., “Review
of telemicrobiology,” Archives of Pathology and Laboratory
Medicine 140/4 (2016), pp. 362–370; J. Ross, F. Stevenson, R.
Lau, and E. Murray, “Factors that influence the implementation of e-health: A systematic review of systematic reviews
(an update),” Implementation Science 11/1 (2016), p. 146.
34. World Health Organization, Recommendations on
digital interventions for health sytems strengthening (2019).
35. Committee on Economic, Social and Cultural Rights,
General Comment No. 14, The Right to the Highest Attainable Standard of Health, UN Doc. E/C.12/2000/4 (2000),
para. 12(c).
36. UNAIDS, Health, rights and drugs: Harm reduction,
decriminalization and zero discrimination for people who
use drugs (Geneva: UNAIDS 2019).
37. See, for example, World Health Organization (2020,
see note 1); United Nations Development Programme,
Future forward: UNDP digital strategy (New York: United
Nations Development Programme, 2020); World Health
Organization, Digital health for the end TB strategy: Agenda for action (Geneva: World Health Organization, 2015).
By contrast, USAID’s digital strategy does address human
rights risks; see USAID, USAID’s digital strategy (Washington, DC: USAID, 2020).
38. UN Secretary-General’s high-level Panel on Digital
Cooperation, The age of digital interdependence (New York:
United Nations, 2019), p. 4.
39. Ibid., p. 30.
40. World Health Organization, Recommendations
on digital interventions for health system strengthening;
classification of digital health interventions v1.0, WHO/
RHR/18.06 (2018); World Health Organization, Digital
technologies: Shaping the future of primary health care,
WHO/HIS/SDS/2018.55 (2018); World Health Organization,
Global diffusion of eHealth: Making universal health coverage achievable (Geneva: World Health Organization, 2016);
World Health Organization, WHO compendium of innovative health technologies for low-resource settings (Geneva:
World Health Organization, 2015); World Health Organization, The MAPS toolkit: mHealth assessment and planning
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for scale (Geneva: World Health Organization, 2015); World
Health Organization, Early detection, assessment and
response to acute public health events: Implementation of
early warning and response with a focus on event-based
surveillance; Interim version (Lyon: World Health Organization, 2014); World Health Organization, National eHealth
strategy toolkit (Geneva: World Health Organization, 2011);
World Health Organization, mHealth: New horizons for
health through mobile technologies (2011). Available at
https://www.who.int/goe/publications/goe_mhealth_web.
pdf.
41. World Health Organization (2020, see note 1), paras.
22–30.
42. World Health Organization, Data and innovation:
Global strategy on digital health, EB146(15) (2020).
43. Office of the United Nations High Commissioner for
Human Rights, Guiding principles on business and human
rights. (New York: United Nations, 2011).
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HHr
Health and Human Rights Journal
perspective
Emerging from COVID-19: A New, Rights-Based
Relationship with the Nonhuman World?
HHR_final_logo_alone.indd 1
10/19/15 10:53 AM
mia macdonald
Abstract
This essay argues that the global response to COVID-19 should lead to new thinking and action, and
specifically, a new relationship with the nonhuman world that is centered on mutuality and respect,
not commodification and exploitation. Such a response would acknowledge and embed concepts like
ecological justice and One Welfare in policy and practice, particularly regarding the consequences of
intensive animal agriculture and production of monocultures of feedstock for the billions of farmed
animals used in food production each year. Drawing on examples from the Global South and Global
North, the essay suggests ways forward that provide opportunities for new thinking, research, and
action, with the COVID-19 crisis contextualized by the urgency of the climate and biodiversity crises.
With deep inequalities and infringement of rights embedded in each of these global challenges,
successfully addressing them likely depends on useful disruptions in, and a bridging of, the divides that
have separated human and nonhuman rights and have limited the intersections between public health,
the environment, and animal welfare and rights.
Mia MacDonald is the executive director and founder of Brighter Green, Brooklyn, USA.
Please address correspondence to the author. Email: [email protected].
Competing interests: None declared.
Copyright © 2021 MacDonald. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial
License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any
medium, provided the original author and source are credited.
DECEMBER 2021
VOLUME 23
NUMBER 2
Health and Human Rights Journal
13
m. macdonald / perspective, ecological justice and the right to health, 13-20
Any way it’s said, it’s going to be an understatement:
the wreckage caused by the COVID
