Activities April–June 2000

Executive Summary
     During the period under review, the Center continued to consolidate the restructured set of three programs and reached out to the Harvard community and the wider public to engage new partners in our endeavors.
Within the Harvard community, the Center was honored three times at the annual HSPH spring dinner and award ceremony and was deeply engaged in the revitalized University Committee on Human Rights Studies and in the Enhancing Care Initiative with the Harvard AIDS Institute.
     Two major activities characterized our outreach to the wider community. First, all energies were focused in April on the Symposium on Health and Human Rights in Times of Peace and Conflict, which took place at the Harvard Club in New York, hosted by Dean Bloom and Countess Albina du Boisrouvray. A stellar panel of speakers addressed the full array of issues of concern to the Center before an audience of leaders in public service and philanthropy.
     The second significant event aimed at a wider audience was the intensive summer course in June. Fifty-five professionals with a wide range of backgrounds and nationalities attended this three-day course. Their enthusiasm and commitment to apply what they have learned has convinced us to repeat this course next year. An issue of the Health and Human Rights journal, focusing on reproductive and sexual rights, appeared in time for the Beijing + Five activities and was well received. It was a particularly intense period for the development of collaboration with WHO in Sofia Gruskin’s program, while Jennifer Leaning in the humanitarian crises program and Stephen Marks in the human rights in development program made critical contacts for future projects.
     As usual, this report will first cover the core activities in education, training, linkages, and information before outlining salient events under each of the three programs. Following are the activities that marked the second quarter of 2000.

Core Activities
Education and Training
At Harvard
In this period, Jennifer Leaning completed her course Disaster Management (CD periods) and her seminar on Complex Humanitarian Emergencies (D period).
     HSPH honored faculty, students, and community members at the annual Spring Dinner and Awards Ceremony on May 11, 2000 at the Omni Parker House in Boston. FXBC was very well represented during the evening’s festivities, with three award recipients. Jennifer Leaning received a Faculty Teaching Citation, and Atti-La Dahlgren, Stephen Marks’s teaching assistant for Health, Human Rights, and the International System, received the Teaching Assistant Award. The FXB Essay Award was also presented that evening (see below).

Intensive Course on Health and Human Rights
On June 26–28, many months of hard work by FXBC faculty and staff paid off during an extremely successful three-day Intensive Course on Health and Human Rights. Stephen Marks and Sofia Gruskin co-directed and taught the course along with George Annas and Michael Grodin from the Boston University School of Public Health’s Health Law Department. Jennifer Leaning also participated in the course and taught two sessions on the final day.
     The course, held at the Harvard School of Public Health, was attended by more than 55 professionals, with a strong representation from the fields of law, public health, nursing, education and medicine, and broad international participation. More than 30% of the students came from outside the U.S.; countries represented included Peru, Australia, Haiti, Germany, Botswana, Cambodia, India, South Africa, Senegal, Thailand, Brazil and Colombia. Participants represented a wide range of fields and organizations concerned with health and human rights, including the World Health Organization, the World Bank, and the U.S. Centers for Disease Control, as well as a variety of NGOs. In addition, participants included faculty from over 20 different nursing, law, and medical schools. Feedback from participants was extremely positive.

FXB Essay Award
The 2000 François-Xavier Bagnoud Health and Human Rights Essay Award was presented to Allison Lane Smith, a doctoral student in the department of Population and International Health at HSPH, for her paper "International Response to Drug Abuse among Young People: Assessing the Integration of Human Rights Obligations."

Other Presentations/Guest Lectures
On April 4, Stephen Marks gave a one-hour guest lecture as the opening session of Professor Richard Cash’s course, War and Public Health. Stephen Marks’s lecture was titled "The Use of Force in International Law." On April 27, he spoke on "Impunity and Reconciliation: Why the Khmer Rouge Have Not Been Tried" at the seminar series at the Center for Population and Developing Studies. On May 8, he presented at the Population and International Health Seminar Series. His seminar was titled "The Role of Health and Human Rights Professionals in Implementing Smart Sanctions to Minimize Health Risks."
     On April 20, Sofia Gruskin gave a talk for the department of Population and International Health titled "HIV/AIDS and the Rights of the Child: Linking Concepts and Methods in Health and Human Rights." On April 25, she gave a seminar talk for this year’s Takemi Fellows titled "Health and Human Rights: Concepts and Implementation Locally and Globally."
     On June 15, Jennifer Leaning gave a guest lecture in HSPH Professor Richard Cash’s course "The Ethics of Research on Trapped Populations."

University Committee on Human Rights Studies
Stephen Marks continues to serve on the multidisciplinary University Committee on Human Rights Studies. The members represent a wide range of human rights-related work being done throughout the university.

Beyond Harvard
People’s Decade for Human Rights Education (PDHRE)
Stephen Marks attended a board meeting of PDHRE in London on June 22, at which health-related human rights issues were discussed.

Other Presentations/Guest Lectures
Stephen Marks traveled to Washington, DC to participate in the Annual Meeting of the American Society of International Law on April 5–8. He addressed a panel on international health, which focused on tobacco, and presented a paper on April 8, on prospects for a trial of Khmer Rouge leaders at a panel on genocide.
     On May 4, Sofia Gruskin traveled to Madison, WI to testify for the National Bioethics Advisory Commission. She was one of two human rights experts asked to review the proposed NBAC report and guidelines on international research ethics and comment on the human rights implications of the draft report. The project will culminate in September with a final report and recommendations to the White House.
     On May 17, Sofia Gruskin traveled to Atlanta, GA, sponsored by the Atlanta Alliance for Health and Human Rights, to give the closing talk in the Jonathan Mann Health and Human Rights Speaker Series. She spoke on "Linking Health and Human Rights: Current Concepts and Methods" at Emory University, where she was introduced by Dean Jim Curren. It was very well attended, with audience members from both the university and the Centers for Disease Control.
     On June 8, Karen Plafker spoke on children, HIV/AIDS, and human rights at a Physicians for Human Rights Student Leadership Institute.

FXB Center Linkages and Partnerships

Health and Human Rights in Times of Peace and Times of Conflict
On April 12, 2000, the FXB Center sponsored a symposium on "Health and Human Rights in Times of Peace and Conflict," held in New York City, which brought health and human rights professionals together with business and civic leaders sharing an interest in securing health and human rights. The event was hosted by Barry Bloom, Dean of HSPH, and Countess Albina du Boisrouvray. A wide range of speakers underscored the urgency of health and human rights issues and engaged a dialogue on practical steps to be taken. Speakers included Aryeh Neier, president of the Open Society Institute; Rakesh Rajani, Harvard Center for Population and Development Studies; Daniel Tarantola, Senior Advisor, World Health Organization; Danilo Türk, UN Assistant Secretary-General for Political Affairs; Makhosazana Xaba, founding member of the Women’s Health Project; Rita Hauser, former U.S. representative to the UN Commission on Human Rights and president of the Hauser Foundation; Alvaro de Soto, Special Advisor to the UN Secretary-General on Cyprus; Susanne I. Giendl, legal expert at the Administrative Supreme Court of Austria; David M. Malone, president of the International Peace Academy; Hanna Nolan, Humanitarian Affairs Advisor, Médecins Sans Frontières; and Kenneth Roth, executive director of Human Rights Watch.

With National and International Organizations
United Nations
On May 22, Stephen Marks spoke on "Due Process and the Rights of International Civil Servants" at the United Nations Panel of Counsel, as part of a 5-day training program for UN staff.
     Professor Marks also participated in a Physicians for Human Rights/American Association for the Advancement of Science (AAAS) meeting in Washington, DC on April 7 to discuss and review a Draft General Comment on the Right to Health. This effort was part of the NGO input to the drafting of a commentary on Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) by a member of the Committee on Economic, Social and Cultural Rights. The commentary was adopted by the Committee in May.

With NGOs and Other Institutions
American Public Health Association
During this period, planning continued for the annual APHA meeting, to be held in Boston in November 2000. FXBC’s application for sponsorship of a Continuing Education Institute was approved during this period. On November 12, FXBC faculty will teach a Continuing Education Institute titled "Human Rights for Public Health Professionals," which will offer a one-day intensive overview of health and human rights. The Institute will be held at the Hynes Convention Center during the annual APHA meeting, along with approximately 20 other topic-specific courses.

Consortium for Health and Human Rights
The Consortium continues to meet regularly. In this period, Consortium members discussed plans for the APHA annual meeting in November (see above). On behalf of the Consortium, FXBC is continuing its project of compiling an updated list of health and human rights courses and syllabi around the world, for web and possible print publication.

Global Health Assembly, April 2001
During this period, the FXBC committed to cosponsor a Global Health Assembly planned for April 20–22, 2001, titled "Advancing the Right to Health," along with the University of Iowa’s Center for Human Rights, led by Burns Weston, and a number of other local cosponsors in the health and medical communities.

At HSPH and Harvard

Africa Now!
The Harvard AIDS Institute, in collaboration with the FXB Center and other partners, will convene a summit on U.S.-based responses to AIDS in Africa, bringing together political, academic, and NGO-based leaders from Africa and the U.S. in November 2000. The purpose of this meeting will be to develop effective strategies for international collaboration to care for those affected by the epidemic, as well as the creation of protocols for future action. Specifically, American leaders from various walks of life will come to learn from African leaders how the U.S. could best respond to the African AIDS epidemic. Stephen Marks and Sofia Gruskin are both on the steering committee for the summit and attended its meetings on April 14, May 3, and June 6. They are also helping to conceptualize the format for the meeting.

HSPH Working Group on Women, Gender and Health
The HSPH Working Group on Women, Gender and Health (WGH) continues to meet monthly. The Working Group has continued to follow up on its report on teaching and research on gender and health at HSPH and other public health schools, prepared for the HSPH administration this past fall.

HMS Program in Psychiatry and the Law
On May 10, Sofia Gruskin, Stephen Marks, and Jenna LeMieux hosted Dr. Harold Bursztajn, Richard Sobel, and Tom Goodall from the Program in Psychiatry and the Law at the Harvard Medical School. The purpose of the lunch meeting was for all parties to become better acquainted and to discuss possible areas of collaboration.

Dissemination of Information
Health and Human Rights Journal
In this period, Vol. 4, No. 2: Reproductive and Sexual Rights appeared. This issue was planned to coincide with the culmination of the five-year review of the Beijing Fourth World Conference on Women. Contributors include Nafis Sadik, UN Under-Secretary-General and Executive Director of UNFPA; Rosalind Petchesky; Tomris Türmen, Alice M. Miller; Carmel Shalev; Marlene Fried; Bonnie Shepard; Barbara Klugman; and Judit Sándor. An extensive publicity campaign was undertaken, and we have received many orders for the issue. Feedback on this issue from colleagues and subscribers has been excellent. Fundraising for the journal remained a priority. With $25,000 from the MacArthur Foundation secured for production and distribution of this special theme issue, Center staff also continued to approach other foundations and corporate donors to raise additional funds for future operations.
     Also during this period, work continued on Vol. 5, No. 1, which will cover topics including women’s mental health and human rights, HIV/AIDS and other health issues in South Africa, informed consent issues in a study involving survivors of Srebrenica, and protecting and promoting the right to health in Latin America. Preliminary planning was also done for Vol. 5, No. 2, a special issue on children’s health and human rights to appear in 2001, which will present a wide variety of conceptual work and practical applications.

Health and Human Rights: A Reader
The next issue of the Harvard Public Health Review will feature the reader in its Bookshelf column. Discussions have begun on publication of companion volumes to the reader.

FXB Center Seminar Series
In this period, the Seminar Series presented two speakers:

Mindy Roseman (Central and Eastern Europe Staff Attorney, Center for Reproductive Law and Policy), "New Frontiers in Reproductive Rights: Emerging Issues in East Central Europe and the Former Soviet Union " (May 19, 2000)
Jim Welsh (Coordinator, Medical Program, International Secretariat of Amnesty International), " The Death Penalty: Medically Humanize or Humanely Abolish?" (April 27, 2000)

Both talks were warmly received by students, faculty, and members of the public. These last two talks of the year are a good illustration of the broad range of health and human rights issues to which we seek to expose students at HSPH.

Program Activities
Program on International Health and Human Rights

Linkages and Partnerships: HSPH and Harvard
Enhancing Care Initiative (ECI)

This project is jointly carried out by the Harvard AIDS Institute, the FXB Center, other entities within Harvard, and counterpart institutions in Brazil, Senegal, Thailand, and South Africa. ECI has been developing a conceptual and practical framework on how to assess, plan for, and evaluate care for people living with HIV/AIDS, which includes human rights and gender-sensitive approaches.
     On April 8–9, the Harvard team and four country teams met in Santos, Brazil in conjunction with the III AIDS Conference on HIV Infection in Women and Children. The purpose of the meeting was to compare Phase I findings and to begin to determine monitoring and evaluation criteria, both common to all sites and individual to each site. Additional plans were made to prepare for the XIII International AIDS Conference, to be held in Durban, South Africa on July 9–14, 2000. In addition, a full-day meeting was held with the entire Brazilian team to provide support for their analysis of Phase I findings and to plan for their Phase II work and research projects to be developed.
     Representatives of ECI teams also visited HSPH during this period. Members of the Thai team worked with the program over a three-week period on substantive writeups of their research and the production of journal articles highlighting the team’s efforts. In addition, each ECI team delegated one team member to attend the Intensive Course on Health and Human Rights given at HSPH in June (see above). After the course, the team representatives remained for two days to work through methods of integrating the work of the course into the substantive country work being done.
     The ECI family has been struck with some very difficult news in this period. Dr. Vinodh Gathiram, the co-leader of the South Africa team, has suffered a major stroke, which will necessitate his undergoing long-term rehabilitation and care. Our love and support are with him, his family, and the South Africa team as they begin to try to come to terms with this tragedy.

Linkages and Partnerships: National and International Institutions
United Nations
In this period, attention focused primarily on the Beijing + 5 review. Sofia Gruskin spent the first week of June at the UN monitoring and working closely with partners from other NGOs and from within UNAIDS and WHO to contribute as much as possible to the negotiated document. In addition, she participated in several meetings and panel discussions relevant to the contents of the document.

UNAIDS
Sofia Gruskin continues to work extensively with UNAIDS, including leading the UNAIDS Human Rights Strategy and fully participating in discussions and efforts toward enunciation of the Global AIDS Strategy.
     Also in this period, a preliminary draft of the Reference Handbook on the Convention on the Rights of the Child and HIV/AIDS was completed. This handbook is intended to serve as a basic reference source for the CRC in its discussions with States parties on the rights of the child in the context of HIV/AIDS. It will also contain information on best practices. The draft will be reviewed by UNAIDS and, once changes have been made, presented to the committee at one of their next meetings.

WHO
The program continues its collaboration with various departments of WHO, including Reproductive Health, Women’s Health, Substance Use, HIV/AIDS, Children’s Health, and the newly created health and human rights unit. She has been slated to serve as an External Advisor on Health and Human Rights, which entails offering substantive and technical assistance when requested.
     In early April, WHO hosted its first-ever high-level consultation on content and adoption of its human rights strategy, which included WHO officials and representatives from UNDP, ILO, UNHCHR, UNHCR, the World Bank, and UNICEF. Sofia Gruskin served as rapporteur for the meeting, presenting the conclusions and directions agreed on by the participants in a final report. The consultation is leading into a revision of the strategy document in preparation for submission to the WHO cabinet in September for adoption.
     Finally, in this period it was agreed that a Memorandum of Understanding between WHO and the FXB Center would be drafted. The memorandum will begin by encompassing the following current and projected areas of collaboration:

• Production of an annotated bibliography on health and human rights, with updates to be done each year for two years.
• Identification of health and human rights actors and institutions doing work on a global level.
• Articulation of WHO’s strategy for the Human Rights Treaty Bodies, which will seek to bring more consistency to the organization’s approach to working with the various bodies on reporting, questioning, and establishing indicators.
• Guidance for WHO in Mozambique on the WHO initiative "Making Pregnancy Safer" (formerly the "Safe Motherhood Initiative"). This is the first time that human rights will form an integral part of a WHO in-country project from analysis and design to implementation and monitoring of proposed interventions.
• Joint production of a paper on poverty, equity, and health with a noted economist recruited by WHO for this purpose.

UNESCO
Karen Plafker participated in a UNESCO consultation titled "HIV/AIDS and Youth: Human Rights for Social Development," held on April 10–13 in Paris. Participants from academic, nongovernmental, governmental, and intergovernmental organizations examined a proposed outline for an action manual for youth organizations interested in working on HIV/AIDS. UNAIDS had requested participation from the Program as an official UNAIDS Collaborating Center. FXBC and UNAIDS hope to collaborate with UNESCO on revisions in the future.

Centers for Disease Control
Sofia Gruskin continues to serve as a technical advisor to the three CDC-funded projects on structural interventions to reduce HIV incidence.

Linkages and Partnerships: NGOs
Operationalizing Cairo and Beijing: A Training Initiative in Gender and Reproductive Health
This leadership training initiative, conducted in partnership with the World Health Organization and the Women’s Health Project, University of the Witwatersrand, South Africa, has created a pilot course that has run three times in South Africa, as well as in China, Australia, Argentina, and Kenya, in preparation for production of a global curriculum in 2001.
     In May, the Coordinating Committee met in Bellagio, Italy to hold its final joint meeting, where members engaged in a frenzied week of drafting, comparing, and editing drafts for the different modules of the curriculum. Following the meeting, Sofia Gruskin worked extensively to finalize a reproductive rights module that would be suitable for field testing by trainers unfamiliar with the course. The final version will be field-tested in South Africa in August, with uninitiated trainers using the curriculum to teach the course.

Amnesty International
The FXB Center continues to engage in a number of activities with Amnesty International, both nationally and internationally. Sofia Gruskin continues her involvement as a member of the U.S. Board of Directors and ombudsperson for the organization.

Center for Reproductive Law and Policy
On June 12, Sofia Gruskin attended a small meeting of experts held at CRLP on Safe Motherhood as a Human Right. The meeting sought to identify the minimum core obligations of governments, the role of law and policy in promoting safe motherhood, and ways of measuring government commitment. Participants included representatives from UN organizations and NGOs, as well as academics.

Contributions to Publications
Family Health International
In this period, Sofia Gruskin and Daniel Tarantola completed a chapter for Family Health International titled "HIV/AIDS, Health and Human Rights," for publication in HIV/AIDS Prevention and Care Programs in Resource-Constrained Settings: A Handbook for the Design and Management of Programs, edited by Peter Lamptey of FHI, Helene Gayle of CDC, and Purnima Mane of UNAIDS. This book will be available by the end of the calendar year.

WHO Paper
In this period, Sofia Gruskin, Karen Plafker, and doctoral student Allison Smith began revising their paper "A Human Rights Framework for Preventing Psychoactive Substance Use by Youth, in the Context of Urbanization," which had been presented at a February WHO meeting in Kobe, Japan. This paper is being revised to provide a historical and legal background and offer strategic directions for policy and program managers involved in this area.

Oxford Textbook of Public Health
In this period, Sofia Gruskin and Daniel Tarantola completed the chapter "Health and Human Rights" for the Oxford Textbook of Public Health. This chapter brings together current thinking, concepts, approaches, and methods in the field and is positioned to become the authoritative work on the topic.

Program on Humanitarian Crises and Human Rights

Linkages and Partnerships: HSPH and Harvard
Expert Assessment Team on Sanctions
Jennifer Leaning has been working to develop an expert assessment team to evaluate the humanitarian impact of sanctions. The core team has met several times.

Emergency Medicine Fellowships on Disasters and War
Jennifer Leaning is working with partners at Harvard Medical School and the Brigham and Women’s Hospital to develop a year-long fellowship in the Department of Emergency Medicine at BWH. The first fellow begins in July 2000.

Linkages and Partnerships: National and International Institutions
UNICEF Zanzibar Project
In this period, Jennifer Leaning’s colleague Arachu Castro traveled to Zanzibar to collect data for the project on sanctions, focusing on civilian impacts in the areas of health, education, and women’s lives. An expanded agreement with UNICEF on this project is being renegotiated.

Linkages and Partnerships: NGOs
International Committee of the Red Cross
In this period, arrangements were finalized for Gilbert Holleufer of the ICRC to join the FXBC this fall as an affiliate. He will be working with Jennifer Leaning on preparing an in-depth analysis of the results the ICRC has obtained from its project on People in War.

Advisory Group on Research Priorities in Emergencies
Jennifer Leaning continues to participate in the ethics subgroup of this advisory group, which has been discussing informed consent issues.

Conferences and Meetings
International Health Systems Group
Jennifer Leaning continues to work with the International Health Systems Group (IHSG) at HSPH on a training program in Kosovo to take place in September 2000.

Publications
British Medical Journal
In June, Jennifer Leaning traveled to the UK for editorial board meetings of the British Medical Journal.

Physicians for Human Rights
Jennifer Leaning has contributed to a report by Physicians for Human Rights on medical human rights violations in Kosovo, due out in summer 2000.

Crimes of War Project
Jennifer Leaning has contributed an analysis of human rights issues to the Crimes of War project, which is posted at http://www.crimesofwar.org/kosovo_casestudy.html.

USAID
Jennifer Leaning is currently working on a paper for USAID on human security.

Program on Human Rights in Human Development

Linkages and Partnerships: National and International Institutions
United Nations Development Programme
During this period, discussions continued regarding the grant proposal submitted to the HURIST program of UNDP. The project proposes to establish small-scale projects applying a human rights–based approach to development in Cambodia and Ghana, as the first of several country-specific projects on sustainable human development.

Conferences and Meetings
United Nations Development Programme
Stephen Marks was invited to speak at a conference sponsored by the United Nations Development Programme titled "Human Rights, Responsibilities and Development," held in Bangkok, Thailand on April 17–18. His presentation was titled "Health, Well-Being and Human Rights: Protecting the Vulnerable." He also traveled to Phnom Penh, Cambodia to begin to re-establish ties with local organizations in preparation for a project in Cambodia.

International Project on the Right to Food and Development
On June 19–21, Stephen Marks participated in the International Encounter on the Right to Food and Nutrition, held in Oslo, Norway and sponsored by the Norwegian Institute of Human Rights. Stephen Marks chaired the closing session, at which plans were made for follow-up work. He also used this occasion to discuss future collaboration with the Norwegian Institute.

Contributions to Publications
Human Development Report 2000
On June 29, UNDP launched HDR 2000: Human Rights and Human Development. Stephen Marks’s contribution is acknowledged in the foreword, as he made numerous suggestions on the manuscript as a member of the Advisory Panel.

Princeton Project on Universal Jurisdiction
During this period, Stephen Marks accepted an invitation to write a paper for a conference on Universal Jurisdiction to be held at Princeton University on November 9–11, 2000. He began work on this paper dealing with the case of Hissène Habré, the former president of Chad. The project will include two meetings. The first, to include approximately two dozen scholars, will be held in November 2000; the second, to include a gathering of international jurists, will be held in January 2001. The purpose of the project is to examine the principled terms under which universal jurisdiction should be accepted by the international community.