HPH NOW, March 3, 2006, Gruskin Applies Tools to Demonstrate Links Between Human Rights and Health

Program on International Health and Human Rights Moving to PIH

When the World Health Organization (WHO) wrote in the preamble to its Constitution that every human being has a fundamental right to the highest attainable standard of health, the agency broke new conceptual ground. Now, the health and human rights field has enough evidence and experience to progress from noble concepts to measurable action, thanks to the efforts of ground-breaking experts such as HSPH Associate Professor Sofia Gruskin.

"This is an exciting period of time," said Gruskin, who directs the Program on International Health and Human Rights at HSPH. "We have talked about the need to move beyond rhetoric to what we mean operationally and programmatically in placing health issues in a human rights framework, and that shift is now happening."

As part of that shift, the Program will be relocating from its current locus in the FXB Center to the Department of Population and International Health, where alliances with faculty in the Department will be strengthened.

"I'm delighted to have Professor Gruskin's program anchored securely within PIH," said David Bloom, department chair. "It is my hope that the development of human rights concepts and tools and their application to health will be accelerated as a consequence of this relocation."

Established 10 years ago, the Program's mission is to promote practical and effective responses to global public health challenges through the innovative application of human rights principles. This is done through a combination of research, capacity building, policy development, and health programming in a variety of areas including HIV/AIDS, reproductive and sexual health, and child and adolescent health.

Gruskin's work quite literally takes her around the world. She recently returned from Vietnam, where she was on a site visit as part of an ongoing research project examining the human rights commonalities between HIV/AIDS and gender-based violence in Vietnam, China, India, and Thailand. Women with HIV are more vulnerable to violence due to discrimination and, subsequently, are less able to respond in the aftermath of attacks than are non-infected women, noted Gruskin. At the same time, it appears that women who are subjected to violence may be more likely to become infected with HIV in the first place.

A second project, in collaboration with colleagues at the Kennedy School of Government, "HIV/AIDS Public Policy Training Program," is an executive training course for national, provincial, and local government officials in China and Vietnam to help them respond to the HIV/AIDS pandemic. Gruskin's role is to ensure that a human rights-based approach forms a cornerstone for the effort.

Soon, Gruskin will travel to Ethiopia for a WHO meeting relating to a project concerned with the reproductive choices of women and men living with HIV/AIDS. At the meeting, she will present an overview paper she has co-written on helping to ensure that policies and programs address the sexual and reproductive health needs, rights, and aspirations of people living with HIV and AIDS.

Gruskin and Program staff Shahira Ahmed and Laura Ferguson are also working on a pilot review for UNAIDS of the approximately 300 indicators used by countries around the world to measure the effectiveness of their HIV/AIDS programs. The team is reviewing each indicator to see if a human rights perspective can be incorporated and if this might provide evidence of the contribution of human rights to overall program effectiveness.

But perhaps more than anything else, Gruskin is looking forward to the adoption of a tool she developed in collaboration with WHO that is currently being piloted in Mozambique, Brazil, and Indonesia. The tool's purpose is to help countries use a human rights framework to identify and address barriers to the use of maternal and newborn health care services. This work is demonstrating how law and human rights can provide a practical framework for improving access to and quality of health services, especially for vulnerable populations.

With the International AIDS Conference and the human rights-themed American Public Health Association (APHA) meeting this year, Gruskin and her team will be sharing their work with an especially wide audience. Gruskin is also convening 25 of the world's top scholars in the field of health and human rights at HSPH this November, prior to the APHA meeting, to discuss different approaches to teaching health and human rights.

"In the coming years, we will carry on the work of strengthening the practical implementation of human rights for public health programming in a variety of ways-from general trainings on health and human rights to specific analytical and operational tools that incorporate human rights into the work of public health," said Gruskin. "Development of tools like these is critical to validating the essential links between health and human rights and to improving not only the delivery of services but health outcomes."