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Thailand: Halt Forced Returns to Myanmar
(Bangkok) – The Thai government’s decision not to forcibly return 19 children to Myanmar should be expanded to include all refugees from Myanmar, Human Rights Watch said today.
On March 12, 2024, officials from Thai immigration and the Ministry of Social Development and Human Security took 19 Myanmar children, ages 5 to 17, from Wat Sawang Arom School in Lopburi province in central Thailand and brought them without their parents to the border in Chiang Rai province prior to repatriating them to Myanmar. Thai members of parliament, human rights groups, and the National Human Rights Commission of Thailand strongly criticized the planned return. On March 26, Social Development and Human Security Minister Varawut Silpa-archa said in a media interview that his agency would not return the 19 children to Myanmar, and that they could remain in Thailand.
“Thai authorities showed sympathy and support by allowing 19 children from Myanmar to remain in Thailand,” said Elaine Pearson, Asia director at Human Rights Watch. “The government’s next step should be to assure all those fleeing Myanmar that they can seek protection in Thailand.”
Prior to Varawut’s announcement, Thai officials had said that the 19 children were “undocumented” and were irregularly living in Thailand. The previous government in July 2023 had used a similar argument to justify sending back 126 “undocumented” Myanmar children from a school in Ang Thong province, despite concerns raised by the National Human Rights Commission of Thailand and human rights groups.
Varawut’s assurances that these 19 children could remain in Thailand should become Thai government policy for all Myanmar refugees, as long as the human rights situation in Myanmar remains dire, Human Rights Watch said. Fighting since early April around the Myanmar border town of Myawaddy, opposite Mae Sot in Thailand’s Tak province, has raised concerns about future influxes of refugees.
Thai Foreign Minister Parnpree Bahiddha-Nukara said on April 9 that the government has prepared to receive up to 100,000 refugees temporarily.
Not everyone fleeing conflict and rights abuses in Myanmar has been able to seek protection in Thailand. In late October, the Thai military forcibly returned thousands of refugees who had been sheltering in border areas next to Myanmar’s Karenni State.
Any forced returns to Myanmar may violate Thailand’s obligations as a party to the Convention Against Torture and the customary international law principle prohibiting refoulement, the forcible return of anyone to a place where they would face a genuine risk of persecution, torture or other ill-treatment, or a threat to their life.
Since the February 2021 coup, Myanmar’s military junta has carried out a nationwide campaign of mass killings, torture, arbitrary arrests, and indiscriminate attacks that amount to crimes against humanity and war crimes. More than two million people have been internally displaced and more than 95,000 refugees have fled to neighboring countries.
The Thai government should promptly fulfill its pledge at the Global Refugee Forum in December 2023 to withdraw its reservation to the United Nations Convention on the Rights of the Child. Article 22 guarantees the rights of refugee children, but Thailand’s reservation calls for refugee children to be treated “subject to the national laws, regulations and prevailing practices in Thailand.” The convention also contains protections for children from being forcibly separated from their parents.
Thailand should also provide protection and support to all refugees, including by permitting the UN refugee agency, UNHCR, to undertake refugee status determinations.
“The deteriorating human rights situation in Myanmar could mean that Thailand receives many more refugees in the near future,” Pearson said. “While the Thai government should be assuring refugees that they will not be returned into harm’s way, concerned governments should be prepared to support Thailand to provide protection.”
Nigeria: 10 Years After Chibok, Schoolchildren Still at Risk
(Abuja) –Ten years after the abduction of over 200 schoolgirls in Chibok, Nigerian authorities have failed to put in place and sustain crucial measures to provide a secure learning environment for every child, Human Rights Watch said today.
Since 2014, according to Save the Children, more than 1,600 children have been abducted or kidnapped across northern Nigeria. In the northeast, the armed conflict between Boko Haram and Nigerian armed forces continues to take its toll and, in the northwest, criminal groups commonly called bandits are terrorizing communities. During February and March 2024 alone, bandits kidnapped over 200 children from their schools in Kaduna and Sokoto states.
“For many children across northern Nigeria, the pursuit of an education means facing the constant threat of abduction or kidnapping,” said Anietie Ewang, Nigeria researcher at Human Rights Watch. “Children should never face the harrowing dilemma of sacrificing their safety for education, but this untenable choice, which echoes the profound insecurity plaguing the country, is thrust upon them daily.”
On April 14, 2014, Boko Haram, an Islamist armed group, abducted 276 girls from their school in Chibok, a town in northeastern Borno state, sparking global outrage. Although some of the girls escaped, or were released or rescued, 96 remain in captivity according to UNICEF, and civil society groups continue to pressure the government to ensure they are rescued. Boko Haram, known for its opposition to education, has carried out other such abductions, including one of 110 girls from a school in Dapchi, a town in Yobe state, in 2018.
In addition to kidnappings by Boko Haram in the northeast, the ongoing banditry crisis in the northwest has in recent years made that area a hub for criminal kidnapping for ransom. The crisis emerged after years of conflict between herders and farmers, giving rise to the criminal groups, which have carried out widespread killings, looting, extortion, and kidnapping for ransom in mostly rural communities.
Between December 2020 and February 2021, a series of high-profile incidents, including the abduction of over 600 schoolchildren across Zamfara, Katsina, and Niger states, thrust the kidnapping issue into the spotlight.
In the aftermath of Chibok, the Nigerian government endorsed the Safe Schools Declaration, an international political commitment to protect education from attack and schools from military use which turns them into targets. The government also adopted a Safe School Initiative for Nigeria with the support of the global community and Nigerian business leaders. The initiative aimed to raise funds with an initial US$10 million pledge to help make schools safer, including by moving them to safer areas and creating a safe school model for schools across Borno, Adamawa, and Yobe, the three states worst hit by the Boko Haram insurgency.
However, the multi-stakeholder initiative faced problems, and there has been a decline in momentum over the years with little or no progress made in fortifying schools, Human Rights Watch said. In 2021, Nigeria’s then-Senate president Ahmad Lawan, following an investigation into the utilization of the funds for the initiative, declared that it was designed to fail without a National Policy and Strategy for the Safe School Initiative and the leadership of the Federal Education Ministry. In the meantime, communities continue to suffer the brunt of bandit attacks and schoolchildren remain vulnerable prey.
A Chibok girl who was in Boko Haram captivity for over two years, and was released with 20 others, told Human Rights Watch that news of school kidnappings brings back memories of her ordeal. “Whenever I hear that more children have been kidnapped, I feel terrible, helpless,” she said. “We are still not safe ... It brings back memories of what happened to me. I can never forget being snatched from my parents, my family for so long. I pray this is not the case for those that are kidnapped.” She is now a 28-year-old university student studying natural and environmental sciences.
Kemi Okenyodo, an expert in security and governance and the executive director of the Rule of Law and Empowerment Initiative in Abuja, told Human Rights Watch that the ongoing school kidnappings, resembling those in Chibok a decade ago, highlight a failure to learn from past experiences, as they are taking place without adequate security infrastructure or intervention from authorities to prevent dozens or hundreds of children being snatched away at once.
Amid the heightened threat of attacks on schools, many have been forced to shut down completely, with more than 20 million children out of school in Nigeria, according to UNESCO, among the highest number in any country in the world. According to UNICEF, 66 percent of out-of-school children in Nigeria are from the northeast and northwest, which are among the poorest regions in the country.
For girls especially, the challenges are double edged. They risk rape and other forms of sexual violence if kidnapped, and if kept out of school, they risk child marriage, which is a common practice in these regions.
In 2021, the government adopted the National Policy on Safety, Security and Violence Free Schools aimed at improving school security, strengthening the capabilities of security agents to respond to threats, and ensuring that education continues for children displaced by conflict and crisis, among other reasons.
The authorities committed to investing 144.8 billion naira (about $314.5 million at the time) over a certain period to finance this initiative. In 2023, they announced that 15 billion naira (about $24 million at the time) had been earmarked to pilot the initiative in 18 high-risk states and 48 schools. However, details of the implementation are sparse, and it remains unclear the extent to which this has been done.
Okenyodo told Human Rights Watch that the government needs to involve communities in designing and implementing initiatives to make schools safer to create a sense of ownership and reduce inefficiency and corruption.
“Now more than ever, the Nigerian authorities should step up efforts to make learning safe for children,” Ewang said. “They should work with communities to adopt rights-respecting measures and put in place adequate financing, systems, and structures to ensure quick, effective, and transparent implementation to ensure that children can learn without being exposed to grave harm.”
France: Groups Seek UN Intervention to Address Racial Profiling
(Paris, April 11, 2024) – Racial profiling by French police violates international human rights law, five French and international groups said in a complaint filed today with the UN Committee on the Elimination of Racial Discrimination (CERD).
Although in France the Council of State recognized in October 2023 that racial profiling by the police is not limited to “isolated cases,” the government has taken no action to address the problem. This inaction led the five groups to lodge a complaint before the UN Committee, which monitors compliance with the International Convention on the Elimination of All Forms of Racial Discrimination. France is a party to the treaty.
The groups are Community House for Solidarity Development (Maison Communautaire pour un Dévelopement Solidaire, MCDS); Pazapas; Equality, Anti-discrimination, Interdisciplinary Justice Network (Réseau Egalité, Antidiscrimination, Justice Interdisciplinaire, Reaji); Amnesty International France; and Human Rights Watch.
The groups have been working to eliminate racial profiling by French law enforcement since a landmark Court of Cassation ruling in 2016 condemning the French state for “gross misconduct that engages the responsibility of the state” in five cases of identity checks.
As evidenced by an extensive body of research, reports from independent institutions, including the French Defender of Rights, and testimony from numerous victims as well as police officers, racial profiling particularly targets Black and Arab young men and boys or those perceived as such, including children as young as 10. These abusive and illegal identity checks, which are widespread throughout the country and deeply rooted in police practices, constitute systemic racial discrimination.
The groups appeal to the United Nations’ expert body on racial discrimination that they recognize the systemic nature of the problem of racial profiling in France, and set out specific steps the French government should take to eliminate racial profiling.
The persistence and scale of the scourge of racial profiling has been recognized by numerous rights bodies, including national ones like the Defender of Rights (Défenseur des Droits, DDD) and the French National Consultative Commission on Human Rights (Commission nationale consultative des droits de l'homme, CNCDH) as well as European bodies like the European Commission against Racism and Intolerance (ECRI).
In the context of the class action before the Council of State, the DDD and the former United Nations special rapporteur on racism drafted voluntary interventions in support of the associations' arguments.
By failing to take the necessary measures to put an end to this practice, the French government is failing to meet its obligations under several international treaties, including the International Convention on the Elimination of All Forms of Racial Discrimination, the organizations said.
The groups outlined the measures that the government should take to put an end to systematic racial profiling by police in France. These measures include:
Redefining and clarifying the legal framework for police identity checks to eliminate discrimination by requiring objective and individualized grounds for all checks, clarifying the prohibition of discrimination, and establishing specific regulations and instructions for stops targeting children; Creating traceability for all such stops and identity checks by the police by creating a system for recording and evaluating the justification for each identity check, while requiring the police to issue those stopped with a record of the action; Strengthening victims’ rights by providing a system for effective recourse to an independent complaints mechanism; Changing the institutional objectives, guidelines, and training for the police, including with respect to interactions with the public.The associations therefore wish to bring these failings to the attention of UN Committee’s independent experts, who have already expressed concerns about France’s failure to address police violence in the context of systemic racism.
MCDS, Pazapas, and Reaji are represented before CERD by the organization (Re)Claim.
Global Failures on Healthcare Funding
(Washington) – New data from the World Health Organization (WHO) shows that many governments around the world did not meet public healthcare spending benchmarks amid the Covid-19 pandemic, Human Rights Watch said today. The new information indicates possible violations of countries’ obligations to the human right to health.
WHO’s Global Health Expenditure Database, released in December 2023, shows that most governments did not spend more than 5 percent of Gross Domestic Product (GDP) or 15 percent of their national budget on health care through public means in 2021. These two benchmarks are common and important tools for assessing whether countries are on track to ensure universal health coverage, an international policy target grounded in the human right to the highest attainable standard of health. Despite a global surge in spending related to the Covid-19 pandemic, about 80 percent of the world’s population lived in countries that met neither spending benchmark.
“When governments neglect to invest in their healthcare systems, people and families end up shouldering the burden,” said Matt McConnell, economic justice and rights researcher at Human Rights Watch. “While more spending is not enough on its own to ensure universal access to high quality healthcare services, it can help shift this burden, which causes the most harm for people with the fewest resources.”
The Human Rights Watch analysis of healthcare spending in more than 190 countries around the world, available in a summary table at the end of this document, also found that:
Despite a mass increase in healthcare spending across the globe in response to the pandemic, 38 governments spent less on health care in 2021, as a share of their GDP, than the year before it began. Despite governments’ commitments to reduce out-of-pocket expenditures, individuals and their households collectively paid the equivalent of about US$1.68 trillion for health care out of their own pockets in 2021, a figure comparable to the annual GDP of Australia or the Republic of Korea. At the height of the pandemic, out-of-pocket payments covered the costs of more than 20 percent of health care in 119 countries. Only high-income countries averaged less than 20 percent in 2021 (17 percent), while upper-middle (29.9 percent), lower-middle (34.6 percent), and low-income (39.1 percent) countries averaged far more. In 47 countries in 2021, individuals and their households collectively paid more out-of-pocket for health care than their governments spent on it. Twenty years after agreeing to the Abuja Declaration and committing to spend at least 15 percent of their national budgets on health care, only 2 of the African Union’s 55 member countries met this target in 2021: Cabo Verde (15.75 percent) and South Africa (15.29 percent). On the whole, countries in the African Union spent an average of 7.35 percent of their national budgets on health care that year. Eighty-three governments paid more per person to service their external public and publicly guaranteed debts in 2021 than on health care.The International Covenant on Economic, Social and Cultural Rights requires countries to dedicate the maximum available resources toward the progressive realization of economic, social, and cultural rights, which includes ensuring universal access to quality healthcare services. They should also avoid, unless fully justified, any backward steps, including through budget cuts.
The next few months will provide multiple opportunities for governments to do more than just renew their rhetorical commitments to the realization of the right to health, including at the 77th World Health Assembly in May, at the United Nations Summit of the Future in September, and at the fourth International Conference on Financing for Development in 2025.
Governments should, among other things, set spending benchmarks such as the equivalent of at least 5 percent of GDP or 15 percent of general government expenditures on health care through domestically generated public funds, or an amount that otherwise ensures the maximum available resources for the realization of rights, including the right to health.
Many governments could increase their revenues to fund health care by levying progressive taxes, stemming tax abuses, and tackling public corruption. Wealthier creditor governments should also deliver on their commitments to international assistance and cooperation by ensuring that public debt repayments do not hinder debtor governments’ ability to adequately fund health care.
The coming months also provide an opportunity to address the impact of debt payments on the ability of governments to fund human rights obligations. At the 2024 spring meetings of the World Bank Group and International Monetary Fund, creditor governments and institutions should commit to conducting assessments of such impacts and to considering debt restructuring or relief where appropriate to ensure that debtor governments can adequately protect rights, including health.
“The pandemic showed the vulnerability of healthcare systems around the world to external shocks,” McConnell said. “But it also exposed just how many of these systems were already failing people. Governments need to put their money where their mouth is and commit to financing more resilient, more sustainable, and more rights-realizing healthcare systems for all.”
Health Budgets Under International Human Rights Law
International human rights law includes obligations to respect, protect, and fulfill economic, social, and cultural rights, which includes the right to health.
Governments have the duty to make constant progress toward realizing these rights, and to do the best within their capacities (an obligation to use “the maximum of their available resources”) to reach the highest possible standards of these rights. Retrogressive measures, which can include a decrease in funding for realization of a right, are presumptively a violation of this obligation unless fully justified, such as in some cases of natural catastrophe or financial crisis.
The ultimate measure of progress is the impact of spending on people’s health. For example, the United States spent about 9.6 percent of its GDP on health care through public means in 2021, about 2.56 percentage points above the average among countries in the Organization for Economic Co-operation and Development (OECD). But the impact of this spending on healthcare outcomes was low when compared with other OECD countries, with the US having the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, among the highest suicide rates, and among the worst maternal mortality within the OECD in 2021.
There are many reasons why the US healthcare system is expensive, complicated, and does not work for the vast majority of people in the US. But as recent Human Rights Watch research has illustrated, its expensive, largely market-based healthcare system and failure to appropriately regulate pharmaceutical companies and private healthcare serviceproviders produces immense disparities of access and quality that disproportionately affect people with lower incomes and people with medical conditions.
Funding is a key indicator of a government’s priorities, though how much a government spends on health care also does not necessarily capture all its efforts, or lack thereof, to realize the right to health. This includes other indicators, such as laws and policies that effectively address structural or other discrimination, or efforts to improve the social determinants of health with better food, water, housing, and education. Additionally, the reliability and accuracy of official records and other government data, upon which the WHO’s estimates largely depend, can differ, particularly among countries that are less transparent and publicly accountable.
Comparing Public Healthcare Spending to International Benchmarks
Two of the most common and useful ways of assessing governments’ healthcare spending are by comparing public healthcare expenditures to either (1) the size of the country’s economic output (that is, Gross Domestic Product or “GDP”); and (2) to the size of a country’s total national budget.
Status of Global Public Healthcare Spending, 2021
Benchmark
Global Median
Global Average
Countries & Est. Pop. Above (#/%)
Countries & Est. Pop. Below (#/%)
5% of GDP
3.54%
4.08%
63 Countries; or about 1.4 billion people (18% of world pop.)
126 Countries; or about 6.3 billion people (82% of world pop.)
15% of National Budget
10.53%
11.22%
47 Countries; or about 1.4 billion people (18% of world pop.)
142 Countries; or about 6.3 billion people (82% of world pop.)
Benchmark 1: Percentage of GDP Needed to Fulfill Universal Coverage
The WHO has estimated that providing universal health coverage, a goal distinct from but grounded in the human right to universally accessible health care, will generally require governments to spend the equivalent of at least 5 to 6 percent of their GDP on health care. It has used a 5-percent-of-GDP figure as an indicator to monitor health spending for several decades.
Numerous other assessments of the cost for achieving universal health coverage and related healthcare goals have similarly coalesced around this range. For example, a 2017 review of health economics literature conducted by academics at the University of Cape Town and Harvard University found that:
Government spending of about 6 percent of GDP reduces the incidence of financial catastrophe and impoverishment from out-of-pocket payments to negligible levels, in-line with WHO guidelines; Government spending on health of more than 5 percent of GDP will achieve the very conservative coverage target of 90 percent, set by the WHO’s Commission on Macroeconomics and Health, for 2 fundamental healthcare access and utilization indicators (that is, deliveries performed by a skilled birth attendant and child immunization).Many of these healthcare goals correspond with several targets and indicators for Sustainable Development Goal (SDG) No. 3, one of the 17 SDGs adopted by all UN Member States in 2015 as part of a global plan to drive economic prosperity and social well-being. When Human Rights Watch compared the WHO healthcare expenditure data with the WHO’s UHC Service Coverage Index, which measures countries’ progress toward SDG 3.8.1 (i.e. “Coverage of essential health services”), there was a moderate-to-strong, positive correlation between public healthcare spending as a percentage of GDP and coverage for essential healthcare services. In general, the more a country spends on health care through public means, the greater share of its population has access to essential healthcare goods and services.
In 2021, however, the last year for which global data is available, the global median public healthcare expenditure was only 3.54 percent of GDP, well below that benchmark. Only 63 of 189 governments spent the equivalent of more than 5 percent of their GDP on health care in 2021. This means that, despite being at the height of the Covid-19 pandemic, 126 countries – governing about 82 percent of the world’s population, or 6.3 billion people – spent less than 5 percent of their GDP on health care through public means in 2021.
Public Healthcare Spending (GGHE-D) as Percent GDP, 2021 2021 Public Health Spending (GGHE-D) as % GDPSource: World Health Organization, Global Health Expenditure Database
Data: Public Healthcare Spending (GGHE-D) as Percent GDP, 2021 2021 Public Health Spending (GGHE-D) as % GDP percent Country 0.72 Afghanistan 2.88 Albania 3.27 Algeria 6.17 Andorra 1.71 Angola 3.93 Antigua and Barbuda 1.74 Egypt 6.14 Argentina 2.19 Armenia 8.02 Australia 9.47 Austria 1.49 Azerbaijan 2.81 Bahrain 0.4 Bangladesh 4.38 Barbados 4.87 Belarus 8.57 Belgium 3.43 Belize 0.32 Benin 2.21 Bhutan 5.88 Bolivia 6.53 Bosnia and Herzegovina 4.82 Botswana 4.5 Brazil 2.06 Brunei 5.38 Bulgaria 2.73 Burkina Faso 2.23 Burundi 2 Cambodia 0.48 Cameroon 8.99 Canada 4.71 Cape Verde 1.26 Central African Republic 0.9 Chad 5.2 Chile 2.91 China and Tibet 6.55 Colombia 0.94 Comoros 1.9 Congo (Brazzaville) 3.66 Cook Islands 5.3 Costa Rica 1.03 Côte d'Ivoire 6.81 Croatia 12.63 Cuba 7.99 Cyprus 8.18 Czech Republic 0.63 Democratic Republic of Congo 9.22 Denmark 0.97 Djibouti 4.17 Dominica 3.29 Dominican Republic 5.28 Ecuador 6.4 El Salvador 0.68 Equatorial Guinea 0.88 Eritrea 5.71 Estonia 3.73 Eswatini 0.98 Ethiopia 1.89 Federated States of Micronesia 3.36 Fiji 8.41 Finland 9.31 France 1.59 Gabon 4.49 Georgia 10.22 Germany 2.24 Ghana 5.43 Greece 2.22 Grenada 2.33 Guatemala 0.69 Guinea 1.14 Guinea-Bissau 3.34 Guyana 0.43 Haiti 3.44 Honduras 5.33 Hungary 8.14 Iceland 1.12 India 2.2 Indonesia 2.59 Iraq 5.2 Ireland 3.19 Iran 5.39 Israel/Palestine 7.08 Italy 5.12 Jamaica 9.17 Japan 2.59 Jordan 2.56 Kazakhstan 2.22 Kenya 11.12 Kiribati 5.19 Kuwait 2.91 Kyrgyzstan 0.72 Laos 6.27 Latvia 2.9 Lebanon 4.2 Lesotho 1.09 Liberia 5.26 Lithuania 4.93 Luxembourg 0.74 Madagascar 1.36 Malawi 2.46 Malaysia 7.18 Maldives 1.31 Mali 7.13 Malta 5.32 Marshall Islands 1.6 Mauritania 3.14 Mauritius 3.05 Mexico 5.06 Moldova 3.31 Monaco 4.53 Mongolia 6.46 Montenegro 2.23 Morocco/Western Sahara 2.57 Mozambique 1.06 Myanmar (Burma) 4.45 Namibia 11.34 Nauru 1.8 Nepal 7.88 Netherlands 7.74 New Zealand 6.14 Nicaragua 2.12 Niger 0.54 Nigeria 7.05 Niue 4.64 North Macedonia 8.49 Norway 3.81 Oman 0.84 Pakistan 7.4 Palau 5.38 Panama 1.16 Papua New Guinea 4.47 Paraguay 3.99 Peru 2.31 Philippines 4.64 Poland 7.03 Portugal 2.46 Qatar 1.35 Venezuela 5.69 South Korea 4.9 Romania 5.26 Russia 2.99 Rwanda 3.54 Saint Kitts and Nevis 2.63 Saint Lucia 3.63 Saint Vincent and the Grenadines 5.12 Samoa 7.03 San Marino 3.35 São Tomé and Príncipe 4.59 Saudi Arabia 1.12 Senegal 6.26 Serbia/Kosovo 4.02 Seychelles 1.94 Sierra Leone 3.51 Singapore 6.18 Slovak Republic 6.94 Slovenia 3.33 Solomon Islands 5 South Africa 0.93 South Sudan 7.69 Spain 1.89 Sri Lanka 0.77 Sudan 3.33 Suriname 9.66 Sweden 4.27 Switzerland 1.94 Tajikistan 0.91 Tanzania 3.63 Thailand 3.98 Bahamas 1.62 Gambia 7.26 Timor-Leste 0.55 Togo 3.62 Tonga 3.32 Trinidad and Tobago 4.13 Tunisia 3.6 Türkiye 0.89 Turkmenistan 10.14 Tuvalu 1.05 Uganda 4.09 Ukraine 3.4 United Arab Emirates 10.35 United Kingdom 9.62 United States 6.93 Uruguay 3.03 Uzbekistan 1.21 Vanuatu 1.96 Vietnam 2.82 Zambia 0.91 ZimbabweAbout half the countries that met this 5-percent-of-GDP indicator were members of the OECD, a group of high-income countries. Together, these countries, which have some of the most developed health systems, spent an average of about 7.04 percent of GDP on health care from public sources in 2021, roughly double the global median at the height of the pandemic.
High-income countries were not the only ones that heavily invested in health care. Some of the countries that spent the most on health care through public means in 2021, as a share of GDP, were smaller island nations. Cuba, for example, reported spending the equivalent of 12.63 percent of GDP on health care in 2021.
While no low-income countries met this benchmark, six lower-middle income countries did: Kiribati (11.12 percent), Timor-Leste (7.26 percent), El Salvador (6.40 percent), Nicaragua (6.14 percent), Bolivia (5.88 percent), and Samoa (5.12 percent).
Benchmark 2: 15 Percent of National Budget
On average, a country’s national budget equates to about one-third of its GDP. If a country’s budget-to-GDP ratio is around this global average, 15 percent of its national budget will also be about 5 percent of GDP, the level of public investment discussed above that generally corresponds to better healthcare access and outcomes.
Only 47 countries spent more than 15 percent of their national budgets on health care in 2021, with the average around 11.22 percent. That means that 142 countries with about 6.3 billion people – or 82 percent of the total world’s population – did not reach that threshold.
However, if a government does not raise sufficient revenues to meet the global average budget-to-GDP ratio, it can spend 15 percent of its national budget on health care and still fall short of 5 percent of GDP. Comparing these two benchmarks can help identify countries that are demonstrating a commitment to funding health care through their national budgets but may have room to improve by increasing their revenues.
Only 10 Countries Spent More than 15 Percent of their National Budget on Health Care in 2021, But Not 5 Percent of GDP
Country
Public Healthcare Spending (%GDP)
Public Healthcare Spending
(% National Budget)
Size of National Budget
(%GDP)
Iran (Islamic Republic of)
3.19%
26.11%
12.21%
Singapore
3.51%
20.81%
No Data
Paraguay
4.47%
18.01%
24.80%
Dominican Republic
3.29%
17.74%
18.54%
Guatemala
2.33%
17.41%
13.53%
Peru
3.99%
16.94%
23.56%
Lebanon
2.90%
16.70%
9.13%
Cabo Verde
4.71%
15.75%
30.61%
Antigua and Barbuda
3.93%
15.54%
24.01%
South Africa
4.99%
15.29%
32.59%
These differences are most stark among countries in the African Union (AU), which made an explicit commitment to meet this 15-percent-of-budget benchmark in the 2001 Abuja Declaration. Twenty years later, only 2 of the AU’s 55 member countries spent more than 15 percent of their national budgets on health care: Cabo Verde (15.75 percent) and South Africa (15.29 percent). However, both fell short of meeting the 5 percent of GDP benchmark, although just barely, in the case of South Africa.
Public Healthcare Spending as Percent of General Government Expenditure in Africa, 2021 Twenty Years after the Abuja Declaration, Only Two Countries Met Spending Commitments. Domestic General Government Health Expenditure (GGHE-D) as % General Government Expenditure (GGE)Source: World Health Organization, Global Health Expenditure Database (Domestic General Government Health Expenditure (GGHE-D) as % General Government Expenditure (GGE))
Data: Public Healthcare Spending as Percent of General Government Expenditure in Africa, 2021 Country percent Algeria 8.8% Angola 8.8% Benin 1.6% Botswana 14.6% Burkina Faso 9.8% Burundi 7.3% Cape Verde 15.7% Cameroon 2.8% Central African Republic 6.4% Chad 4.8% Comoros 4.7% Congo (Brazzaville) 8.2% Côte d'Ivoire 5% Democratic Republic of Congo 4.3% Djibouti 4.2% Egypt 6.7% Equatorial Guinea 5.3% Eritrea 2.3% Eswatini 12.3% Ethiopia 7% Gabon 9.5% Gambia 7.5% Ghana 8.2% Guinea-Bissau 4.6% Kenya 9.3% Lesotho 7.9% Liberia 3.7% Madagascar 5.3% Malawi 5.8% Mali 5% Mauritania 8.3% Mauritius 10.2% Morocco/Western Sahara 7.2% Mozambique 8.2% Namibia 11.2% Niger 8.7% Nigeria 4% Rwanda 9.5% São Tomé and Príncipe 13.1% Senegal 4.4% Seychelles 10.2% Sierra Leone 6.9% South Africa 15.3% South Sudan 2.1% Sudan 7.9% Togo 2.6% Tunisia 12.4% Uganda 4.9% Tanzania 5.1% Zambia 9.3% Zimbabwe 5.2%While some other AU countries were not far off – notably Botswana (14.62 percent), São Tomé and Príncipe (13.14 percent), Tunisia (12.40 percent), and Eswatini (12.30 percent) – most countries in Africa were far from meeting this goal.
On the whole, countries in the AU spent an average of 7.35 percent of their national budgets on health care in 2021. Since 2000, the year before Abuja, the average allocation of public funds for health care in Africa has grown by only about 0.31 percentage points, or about one-third the global average over this period.
Retrogression in Public Healthcare Spending
The 20 years leading up to the Covid-19 pandemic were a period of growth in public healthcare spending. In 2000, the average country spent the equivalent of only 2.9 percent of GDP on health care through public means. By 2019, this had grown to 3.59 percent.
However, this growth in public healthcare spending was not equally distributed. The average for high-income countries crossed over the 5 percent of GDP threshold around 2008 and has stayed above this benchmark ever since. Public healthcare spending in low-income countries, meanwhile, essentially stagnated, only slightly growing at a rate about one-sixth the global average.
A Widening Gap: Low-Income Countries’ Public Healthcare SpendingThese disparities and trends in healthcare spending are even clearer when using per-person data adjusted for purchasing power, that is, the amount of goods and services that this money can actually pay for. When data from different countries is equalized to adjust for differences in purchasing power, that metric is often referred to as purchasing power parity (PPP).
Using this approach, the average high-income country’s public healthcare spending per person has been worth more than double what is spent by the average country globally since 2000. Only upper-middle-income countries gained much ground over this period, with their income-group average rising to about one-half of the global average by 2021. Low-income countries, meanwhile, went from spending about 3.7 percent of the global average in 2000 to just 2.2 percent in 2021, a roughly 40 percent decline from already-low levels.
Between 2019 and 2020, public healthcare spending surged by about 0.51 percent of GDP, reflecting the exceptional circumstances of the pandemic. Much of this spending was allocated toward important but costly reactive needs like vaccines and personal protective equipment. But preliminary data from 2022 suggests that this pandemic-related increase in public healthcare spending was largely temporary.
Despite increased healthcare spending across the globe by 2021, 38 governments actually spent less on health care as a share of their GDP, than in the year before the pandemic began.
Economic decreases can hide real-term declines in public healthcare spending, for example, if spending as a percentage of GDP stays the same while a country’s GDP shrinks, hospitals and clinics can receive less funding while government spending appears to remain unchanged. At least six countries had net positive increases in their public healthcare spending as a share of GDP between 2019 and 2021 but decreased their per capita spending when measured in inflation-adjusted US dollars.
Inflation can also hide declines in real-term spending. For example, without adjusting for inflation, Lebanon had a roughly 23 percent decline in its per person public health spending between 2019 and 2021, falling from about 594,388 Lebanese pounds to 519,687. But when adjusted for inflation to constant 2021 values, this is actually a 78 percent real-term decline.
Overall, without adjusting for inflation, 24 governments spent less on health care per person in 2021 than they did in 2019. But when these expenditures are adjusted for inflation, this rises to 41 governments.
Going back further, without adjusting for inflation, only two governments spent less on health care per person in 2021 than they did in 2000: Benin (- 41 percent) and Vanuatu (-16 percent). But when adjusted for inflation into 2021 values, 16 countries reduced their per-person spending, with Madagascar, Benin, and Lebanon all experiencing roughly 62 percent declines.
Sixteen Countries Spent Less on Health Care Per Person in 2021 Than They Did in 2000
Country
2000 Per Capita Public Healthcare Spending (2021 National Currency)
2021 Per Capita Public Healthcare Spending (2021 National Currency)
Change (% Difference)
Madagascar
37,718
14,211
−62
Benin
6,308
2,399
−62
Lebanon
1,364,243
519,687
−62
Eritrea
181
81
−55
Vanuatu
8,681
4,017
−54
Haiti
1,342
631
−53
Central African Republic
5,964
3,319
−44
Tuvalu
1,221
724
−41
Chad
5,447
3,417
−37
Sudan
3,880
2,484
−36
Jordan
116
76
−35
Solomon Islands
736
596
−19
Papua New Guinea
132
108
−18
Brunei Darussalam
1,038
869
−16
Cameroon
4,866
4,482
−8
Marshall Islands
333
325
−2
World Health Organization, Global Health Expenditure Database (Domestic General Government Health Expenditure (GGHE-D), in current NCU per capita); inflation-adjusted to 2021 values using World Health Organization, Global Health Expenditure Database (Gross domestic product - Price index (2021=100).
While these spending changes before and during the pandemic may reflect differences in the healthcare needs of these countries’ populations, they may also reflect changing policy and practice that furthered or hindered the realization of the right to health.
Under the International Covenant on Economic, Social and Cultural Rights, any deliberately retrogressive policies, which can be reflected in decreasing funding allocated to health care, is presumptively a violation of the right to health unless it is fully justified.
Ultimately, what might fully justify such deliberately retrogressive measures is a matter of debate. But the Committee on Economic, Social and Cultural Rights has made clear that the bar is quite high, as even the existence of an armed conflict alone is not sufficient to justify such measures.
The African Commission on Human and Peoples’ Rights General Comment No. 7, providing authoritative normative guidance for interpreting and implementing African state obligations under the African Charter on Human and Peoples’ Rights in the context of private provision of social services, articulates (para. 29) a clearer standard of what states must demonstrate to carry out deliberately retrogressive measures. Stating that such measures must (i) be temporary, (ii) pursue a legitimate aim, (iii) be necessary, (iv) be proportionate, (v) be nondiscriminatory, (vi) involve the full and effective participation of affected groups, and (vii) protect the core content of economic, social and cultural rights at all times.
The Impact of Insufficient Public Healthcare Spending on Out-Of-Pocket Costs
One way to estimate the impact of healthcare spending on people’s right to health is to look at how much people spend on health care from their personal income or savings: their out-of-pocket expenses. When governments don’t fund health care, individuals and households are left to shoulder the burden.
In 2021, households in 47 countries collectively paid more out-of-pocket for health care than their governments spent on it. In Nigeria, the largest economy in Africa in nominal GDP, households’ out-of-pocket health care costs were more than 4.7 times what the government spent. In India, the world’s fifth-largest economy, out-of-pocket costs were the majority of all health care spending that year.
These out-of-pocket expenses generally increase inequalities and create discriminatory barriers to health care based on income, widening gaps in quality of life and life expectancy. The cost of these user fees can also put other rights at risk, including public participation, housing, water, or education.
For example, the WHO’s 2010 World Health Report found that the incidence of financial catastrophe – that is, the proportion of people who spend more than 40 percent of their incomes after deducting expenses for food each year on out-of-pocket healthcare costs – only falls to “negligible levels” when out-of-pocket expenses constitute no more than 15 to 20 percent of a health systems’ total financing. But in 2021, at the height of the pandemic, out-of-pocket payments financed more than 20 percent of the healthcare system in 119 countries.
Only high-income countries averaged below this percent threshold (17.0 percent), while upper-middle (29.9 percent), lower-middle (34.6 percent), and low-income (39.1 percent) countries averaged far higher.
But there is an easy way to bring down healthcare systems’ reliance on out-of-pocket fees. Globally, there is a moderate, negative correlation between public healthcare spending and the share of healthcare costs paid by individuals and households. But this relationship is strongest among low-income countries, where increasing public spending appears to have a much stronger effect on lowering healthcare systems’ reliance on user fees.
Click to expand ImageFunding for Public Healthcare Expenditures
Many countries may find it difficult to garner the financial resources needed to shift their healthcare systems away from regressive user fees and toward a system grounded in universal access through public healthcare expenditures.
This is often especially true during financial crises. But increasing public spending during economic downturns (that is, “counter-cyclical spending”) has a “clear and well-documented effect on economic growth” and can prevent and manage crises, equalize opportunities, and maximize the realization of human rights, as outlined in guiding principlesadopted by the UN Human Rights Council in 2018, which were drafted by the UN independent expert on the effects of foreign debt.
However, whether a country can adopt such policies and adequately fund programs to mitigate the human rights effects of economic downturns may be influenced by many factors. Whether facing an acute crisis or not, governments can increase needed revenues by addressing external public debt, levying progressive taxes and stemming tax abuses, tackling public corruption, and securing external support from donor countries. Some of these require or will be more effective with international assistance and cooperation.
Public indebtedness appears to be a major impediment to governments’ investment in health care. According to the World Bank’s International Debt Statistics database, in 2021, 83 countries paid more per capita to service their external public and publicly guaranteed debts than on public healthcare expenditures. Benin, for example, paid nearly 26 times as much on foreign debts than on health care in 2021. Belize, which had the largest per capita debt servicing payment in 2021, spent more than 14 times as much on its foreign debt as health care on a per capita basis.
Another important consideration is a country’s revenue raising policies, particularly taxes. A 2016 report from the International Monetary Fund (IMF) suggests that tax revenues above 15 percent of GDP are key to reducing inequality. The World Bank has similarly used this 15 percent tax-to-GDP ratio to measure how much more money governments could raise to spend on social services.
Another reference point may be the average tax-to-GDP ratio among OECD countries, which was about 20 percent in 2021. Some nations with robust social welfare systems may even double these World Bank and IMF benchmarks, such as Denmark, which had a tax-to-GDP ratio of about 35 percent in 2021.
As it may be expected, when Human Rights Watch compared IMF tax-to-GDP data with the WHO’s healthcare spending data, there was a moderate, positive correlation between a country’s tax-to-GDP ratio and its public healthcare spending as a percent of their GDP. In short, states with a larger tax base relative to GDP generally spend more on health care, with low-income states showing the strongest relationship (Pearson Coefficient +0.74).
The IMF has only published 2021 tax-to-GDP ratio data for 107 countries. Of these, 34 countries spent less than the equivalent of 5 percent of their GDP on public healthcare spending and had tax-to-GDP ratios below the World Bank and IMF recommended 15 percent. This suggests that some of these countries may be able to improve funding for healthcare services.
Another way governments could increase their health funding is through addressing abuse of tax systems, both within and outside of their borders. For example, a 2023 report from the Tax Justice Network estimated that countries around the world are losing about US$480 billion each year to tax abuse: both illicit and licit means by which companies and people avoid and evade contributing to public coffers. The Tax Justice Network found that this lost revenue amounts to the equivalent of 9 percent of their collective public health budgets. But for lower-income countries, it amounts to the equivalent of 49 percent of their collective public health budgets. Shoring up tax enforcement can raise considerable public funds that can be allocated, among other priorities, to health care.
Data from 2021 suggests that many countries also relied on assistance from wealthier nations to support their healthcare systems. In 32 countries, donor governments and financial institutions paid for more than 25 percent of all healthcare spending.
Between 2020 and 2021, per capita healthcare spending from donors increased by about 60 percent. This equates to the second-largest increase in the past 20 years after 2003 to 2004.
Research from The Brookings Institution in 2022 found that, while official development assistance rose significantly during the pandemic, donor funds appeared to have been reallocated away from spending essential to health care to increase funds for pandemic preparedness and response.
Public corruption is another tremendous drain on the ability of many governments to fund health care. While estimates vary, it is clear that governments need to address it.
Moving Forward
The new data helps show that many healthcare systems around the world are not meeting international healthcare spending benchmarks that are helpful indicators of whether they are realizing the right to health.
It costs money to create and sustain robust public healthcare systems and to adequately regulate private providers to ensure their public service obligations to society are in line with human rights. But even amid a deadly pandemic, many governments’ policy and budgeting decisions resulted in healthcare financing models that indicate backward movement, inconsistent with their international human rights law obligations.
Funding alone is not enough. Cases like the United States show that an inefficient and expensive healthcare system may not deliver on the right to health despite significant public spending. Spending, however, is a necessary condition for delivering on the right to health.
The next months will provide an opportunity for all governments to renew their commitments to the realization of the right to health. Governments will convene to measure their progress towards the Sustainable Development Goals in April at the UN Economic and Social Council Forum on Financing for Development and in September for an ambitiously titled Summit of the Future. This builds on the UN High-Level Meeting on Universal Coverage that occurred in September 2023, where the representatives of nations all around the world reaffirmed their commitments to “scal[ing] up efforts to ensure nationally-appropriate spending targets for quality investments in public health.”
To realign their domestic financing and healthcare spending with their right to health obligations, states should:
Set a goal to spend through domestically-generated public funds the equivalent of at least 5 percent of GDP or 15 percent of general government expenditures on health care, or an amount that otherwise ensures the dedication of the maximum available resources for the realization of rights, including the right to health. Avoid reductions in funding for health care, unless under exceptional circumstances publicly justified, as outlined by the UN Committee on Economic, Social and Cultural Rights. Creditor governments and institutions should assess the impact of debt payments on the ability of governments to meet their human rights obligations and consider debt restructuring or relief where appropriate to ensure governments can adequately protect rights. Seek to increase public revenues for allocation to public health care through progressive taxes and changes to policy and enforcement to reduce tax abuses. Take steps to prevent and combat public corruption and strengthen international cooperation to realize human rights, in line with the 2021 Political Declaration adopted during the Special Session of the United Nations General Assembly Against Corruption. Data: Full Data - Global Failure to Adequately Fund Health Care During PandemicSources: Income Group 2021: World Bank, World Development Indicators,
Population (Thousands) 2021: World Health Organization, Global Health Expenditure Database, Update 2023, Population (in thousands),
Public Healthcare Spending (% of GDP) 2019: World Health Organization, Global Health Expenditure Database, Update 2023, Domestic General Government Health Expenditure (GGHE-D) as % Gross Domestic Product (GDP),
WHO UHC Index Score (SDG 3.8.1) 2021: World Health Organization, UHC Service Coverage Index (SDG 3.8.1),
Public Healthcare Spending (% of National Budget) 2019: World Health Organization, Global Health Expenditure Database, Update 2023, Domestic General Government Health Expenditure (GGHE-D) as % General Government Expenditure (GGE),
National Budget (% of GDP) 2021: World Health Organization, Global Health Expenditure Database, Update 2023, General Government Expenditure (GGE) as % Gross Domestic Product (GDP),
GDP Growth (% Relative Change) 2019-2021: International Monetary Fund, World Economic Outlook, October 2023, GDP per capita, current prices (U.S. dollars per capita),
% Change in Public Healthcare Spending (PPP per capita) Relative to Income-Group Average 2000 - 2021: World Health Organization, Global Health Expenditure Database, Update 2023, Domestic General Government Health Expenditure (GGHE-D), in current PPP per capita,
Out-of-Pocket Costs (% of GDP) 2019: World Health Organization, Global Health Expenditure Database, Update 2023, Household out-of-pocket payments (OOPS), as % of Gross Domestic Product (GDP),
Out-of-Pocket Costs (% of Total Healthcare Expenditures) 2021: World Health Organization, Global Health Expenditure Database, Update 2023, Household out-of-pocket payments (OOPS), as % of Current Health Expenditure (CHE),
External Public and Publicly Guaranteed Debt Service (2023 US$ Per Capita) 2021: World Bank, International Debt Statistics Database, Debt service on external debt, public and publicly guaranteed (PPG),
Public Healthcare Spending (2023 US$ Per Capita) 2021: World Health Organization, Global Health Expenditure Database, Update 2023, Domestic General Government Health Expenditure (GGHE-D) per Capita in US$,
Tax Base (% of GDP) 2021: World Bank, World Development Indicators, Tax revenue (% of GDP),
Donor Healthcare Spending (% of Total Healthcare Expenditures) 2021: World Health Organization, Global Health Expenditure Database, Update 2023, External Health Expenditure (EXT) as % of Current Health Expenditure (CHE)
Thailand: Court Ruling Could Subvert Democratic Rule
(Bangkok) – Thailand’s Constitutional Court will rule on a petition that could result in dissolving the country’s main opposition party and banning its leaders from politics, Human Rights Watch said today. The Move Forward Party (MFP), which won the largest number of seats in the May 2023 general elections, faces politically motivated allegations of high treason.
The Constitutional Court ruling, expected in the last week of April 2024, could have a serious impact on Thailand’s return to genuine democratic rule.
“From the start, the Thai Election Commission’s petition to the Constitutional Court against the Move Forward Party was a politicized battering ram,” said Elaine Pearson, Asia director at Human Rights Watch. “It is crucial for the court to issue its ruling free from political pressure since it will have long-term implications for democracy in Thailand.”
On April 3, the Constitutional Court accepted a petition from Thailand’s Election Commission alleging that the MFP committed high treason by advocating reform of Penal Code section 112 on lèse-majesté (insulting the monarchy). The Election Commission contended that the Constitutional Court should dissolve the party and impose the maximum 10-year ban from politics on its executives under section 92 of the Act on Political Parties. The Election Commission filed its petition without allowing the party to counter the allegations.
The Constitutional Court should provide the Move Forward Party with the opportunity to present evidence and elaborate its defense in person, Human Rights Watch said. The court has given the party until April 18 to file its defense.
The Election Commission’s case is based on the Constitutional Court’s ruling on January 31 that the Move Forward Party’s campaign to amend the lèse-majesté law amounted to an attempt to abolish Thailand’s constitutional democracy with the king as head of state, contravening the constitution. Article 49 of Thailand’s constitution prohibits people from using their rights and freedoms to overthrow the monarchy.
In its January ruling, the Constitutional Court said that the MFP tried to either change or revoke section 112 on March 25, 2021, when its 44 members of parliament submitted a bill to amend the section. The court also ruled that party members in parliament gave tacit support to monarchy reform movements by taking part in civil society activities and providing bail guarantees to detained activists. The Constitutional Court held that such actions showed an intent to subvert the monarchy, which is “significantly dangerous to the security of the state.”
The Constitutional Court then ordered the MFP to cease its actions – including expressing opinions, speaking, writing, publishing, advertising, and conveying messages by any means – in pursuit of amending section 112. The party said that while it accepted the ruling, Thai society would lose an opportunity to use its parliamentary system to find solutions to conflicts. It reiterated that the party had no intention to overthrow the monarchy.
Disbanding the Move Forward Party would violate the rights of its members to freedom of expression, association, peaceful assembly, and democratic participation guaranteed under the International Covenant on Civil and Political Rights (ICCPR), which Thailand ratified in 1996.
Article 25 of the ICCPR ensures the right of citizens to participate in public affairs, and to vote and run for public office in free elections. The United Nations Human Rights Committee, the body of independent experts who review state compliance with the convention, has stated that this article protects the right to “join organizations and associations concerned with political and public affairs,” and that “political parties and membership in parties play a significant role in the conduct of public affairs.”
Eliminating the Move Forward Party would also seriously undermine Thailand’s efforts to fully restore democratic rule after years of military dictatorship. It would weaken checks-and-balances by the political opposition and unjustly cancel the votes of over 14 million supporters of the party.
Thailand’s allies and relevant UN agencies should publicly make clear that dissolving the party would severely affect Thailand’s standing as a generally rights-respecting country, Human Rights Watch said. Concerned governments should withdraw support for Thailand’s bid for the UN Human Rights Council for the 2025 to 2027 term if the MFP is dissolved.
“If a hugely popular political party that calls for reforms can be dissolved on specious grounds, the democratic rights of all Thais are at risk,” Pearson said. “Thailand’s allies should be clear that disbanding the Move Forward Party will damage the country’s efforts to achieve greater respect for human rights and democratic rule.”
Greek Court Deems Surveillance Powers Unconstitutional
Greece’s highest administrative court, the Council of State, has declared unconstitutional a 2021 amendment that barred the Hellenic Authority for Communication Security and Privacy (ADAE), an independent body which oversees surveillance powers, from informing citizens of state surveillance on “national security” grounds.
Until March 2021, those under government surveillance could request information from ADAE about surveillance on them after the surveillance ended, provided disclosure didn’t jeopardize investigations. A March 2021 government-proposed change adopted by parliament removed the ability of ADAE to notify those surveilled, even after surveillance stopped.
The April 5 ruling found this change violated the Greek Constitution, the European Union Charter of Fundamental Rights, and the European Convention on Human Rights. This marks a major victory in Greece’s ongoing surveillance scandal which included revelations that the government surveilled independent journalists, business people, government officials, and opposition leader Nikos Androulakis.
Androulakis brought the landmark case after he discovered in 2022 the National Intelligence Service wiretapped his phone. In September 2022, his ADAE file request was denied based on the 2021 amendment. On April 8, following the Council of State’s decision, Androulakis again requested information from ADAE about his surveillance. The ruling should enable Androulakis and other targets of state surveillance falling under the March 2021 amendment to access information on their cases.
The Council of State found the blanket prohibition on informing individuals about their surveillance an “excessive restriction” on the right to privacy and a threat to the rule of law.
While the ruling doesn’t extend to a separate December 2022 law restricting ADAE’s powers, it’s a significant step. While the 2022 law is more permissive than its predecessor it still contains flaws. Greece’s government should listen to the court and enact reforms that fully guarantee the right to privacy and access to information for its citizens.
Indian Court, Finding Lack of Evidence, Grants Bail to Activist
India’s Supreme Court on Friday granted bail to the activist Shoma Sen nearly six years after she was arrested in 2018 on politically motivated allegations of supporting a Maoist insurgency.
“We do not find prima facie commission or attempt to commit any terrorist act,” the judge said.
Sen is among 16 activists, lawyers, and academics arrested in relation to violence that broke out in Bhima Koregaon village in Maharashtra state in January 2018. One of them, the 84-year-old tribal rights activist Stan Swamy, died in detention in 2021.
They were held under the Unlawful Activities Prevention Act, the country’s counterterrorism law. Only five others have received bail, but the courts have repeatedly questioned the evidence against them. In the case of activist Anand Teltumbde, the Bombay High Court said in November 2022 that there was not enough evidence to conclude he had committed a terrorist act. The Supreme Court in July 2023 granted bail to activists Arun Ferreira and Vernon Gonsalves, saying the evidence did not support the case against them. While the trial has yet to begin, there are multiple reports that malware was used to plant false evidence on the laptops of Swamy and at least two other co-defendants.
In another particularly egregious case, the Bombay High Court in March acquitted academic GN Saibaba and five others who had been jailed since 2014 under the counterterrorism law for alleged links with banned Maoist organizations. Saibaba, who had polio and uses a wheelchair, alleged he was subjected to “inhumane treatment,” including being denied the use of his wheelchair in prison and refused proper medical care.
Indian authorities have also been accused of bias in investigations involving arrests of activists in cases related to the February 2020 violence in Delhi following peaceful protests against discriminatory citizenship policies. Police arrested 20 student leaders and activists, most of them Muslim, under the counterterrorism law. Six have been granted bail by various courts, which noted that the police failed to produce any evidence. In some cases, judges called the police investigations “shoddy” or “callous.”
Indian authorities should immediately drop the charges against these activists, stop the harassment and wrongful arrests of rights defenders, and amend the abusive counterterrorism law to bring it in line with international legal standards.
Thailand: Court Ruling Could Subvert Democratic Rule
(Bangkok) – Thailand’s Constitutional Court will rule on a petition that could result in dissolving the country’s main opposition party and banning its leaders from politics, Human Rights Watch said today. The Move Forward Party (MFP), which won the largest number of seats in the May 2023 general elections, faces politically motivated allegations of high treason.
The Constitutional Court ruling, expected in the last week of April 2024, could have a serious impact on Thailand’s return to genuine democratic rule.
“From the start, the Thai Election Commission’s petition to the Constitutional Court against the Move Forward Party was a politicized battering ram,” said Elaine Pearson, Asia director at Human Rights Watch. “It is crucial for the court to issue its ruling free from political pressure since it will have long-term implications for democracy in Thailand.”
On April 3, the Constitutional Court accepted a petition from Thailand’s Election Commission alleging that the MFP committed high treason by advocating reform of Penal Code section 112 on lèse-majesté (insulting the monarchy). The Election Commission contended that the Constitutional Court should dissolve the party and impose the maximum 10-year ban from politics on its executives under section 92 of the Act on Political Parties. The Election Commission filed its petition without allowing the party to counter the allegations.
The Constitutional Court should provide the Move Forward Party with the opportunity to present evidence and elaborate its defense in person, Human Rights Watch said. The court has given the party until April 18 to file its defense.
The Election Commission’s case is based on the Constitutional Court’s ruling on January 31 that the Move Forward Party’s campaign to amend the lèse-majesté law amounted to an attempt to abolish Thailand’s constitutional democracy with the king as head of state, contravening the constitution. Article 49 of Thailand’s constitution prohibits people from using their rights and freedoms to overthrow the monarchy.
In its January ruling, the Constitutional Court said that the MFP tried to either change or revoke section 112 on March 25, 2021, when its 44 members of parliament submitted a bill to amend the section. The court also ruled that party members in parliament gave tacit support to monarchy reform movements by taking part in civil society activities and providing bail guarantees to detained activists. The Constitutional Court held that such actions showed an intent to subvert the monarchy, which is “significantly dangerous to the security of the state.”
The Constitutional Court then ordered the MFP to cease its actions – including expressing opinions, speaking, writing, publishing, advertising, and conveying messages by any means – in pursuit of amending section 112. The party said that while it accepted the ruling, Thai society would lose an opportunity to use its parliamentary system to find solutions to conflicts. It reiterated that the party had no intention to overthrow the monarchy.
Disbanding the Move Forward Party would violate the rights of its members to freedom of expression, association, peaceful assembly, and democratic participation guaranteed under the International Covenant on Civil and Political Rights (ICCPR), which Thailand ratified in 1996.
Article 25 of the ICCPR ensures the right of citizens to participate in public affairs, and to vote and run for public office in free elections. The United Nations Human Rights Committee, the body of independent experts who review state compliance with the convention, has stated that this article protects the right to “join organizations and associations concerned with political and public affairs,” and that “political parties and membership in parties play a significant role in the conduct of public affairs.”
Eliminating the Move Forward Party would also seriously undermine Thailand’s efforts to fully restore democratic rule after years of military dictatorship. It would weaken checks-and-balances by the political opposition and unjustly cancel the votes of over 14 million supporters of the party.
Thailand’s allies and relevant UN agencies should publicly make clear that dissolving the party would severely affect Thailand’s standing as a generally rights-respecting country, Human Rights Watch said. Concerned governments should withdraw support for Thailand’s bid for the UN Human Rights Council for the 2025 to 2027 term if the MFP is dissolved.
“If a hugely popular political party that calls for reforms can be dissolved on specious grounds, the democratic rights of all Thais are at risk,” Pearson said. “Thailand’s allies should be clear that disbanding the Move Forward Party will damage the country’s efforts to achieve greater respect for human rights and democratic rule.”
Myanmar: Military Forcibly Recruiting Rohingya
(Bangkok) – The Myanmar military has abducted and forcibly recruited more than 1,000 Rohingya Muslim men and boys from across Rakhine State since February 2024, Human Rights Watch said today. The junta is using a conscription law that only applies to Myanmar citizens, although the Rohingya have long been denied citizenship under the 1982 Citizenship Law.
Rohingya described being picked up in nighttime raids, coerced with false promises of citizenship, and threatened with arrest, abduction, and beatings. The military has been sending Rohingya to abusive training for two weeks, then deploying them. Many have been sent to the front lines in the surging fighting between the junta and the Arakan Army armed group, which broke out in Rakhine State in November 2023, and a number have been killed and injured.
“It’s appalling to see Myanmar’s military, which has committed atrocities against the Rohingya for decades while denying them citizenship, now forcing them to fight on its behalf,” said Shayna Bauchner, Asia researcher at Human Rights Watch. “The junta should immediately end this forced recruitment and permit Rohingya unlawfully conscripted to return home.”
Human Rights Watch documented 11 cases of forced recruitment, drawing on interviews with 25 Rohingya from Sittwe, Maungdaw, Buthidaung, Pauktaw, and Kyauktaw townships in Rakhine State and in Bangladesh.
On February 10, the military activated the 2010 People’s Military Service Law, enabling the conscription of men ages 18 to 35 and women ages 18 to 27 for up to five years during the current state of emergency. The announcement followed months of increased fighting with ethnic armed groups and resistance forces.
The junta announced that conscription would start in April, with a monthly quota of 5,000, but the authorities in Rakhine State began forcibly recruiting Rohingya in early February.
In late February, the military abducted over 150 Rohingya in raids on villages in Buthidaung township, according to people interviewed, Rohingya activists, and media reports. A 22-year-old Rohingya man said that light infantry battalion soldiers abducted him and 30 other young men and boys at gunpoint at about 11 p.m. on February 25 in Buthidaung town.
“The youngest boy taken away with us was 15 years old,” he said. “There were three recruits under 18 among us. After we were apprehended and taken to the military battalion, we saw the list of Rohingya who were going to be recruited. All the Rohingya youths in the region were included.”
Further raids took place in Maungdaw township in March. A 24-year-old Rohingya man who was abducted with about two dozen others from Ka Nyin Tan village said the officers told them, “Protecting Maungdaw is upon you.”
An estimated 630,000 Rohingya remain in Rakhine State under a system of apartheid and persecution, including about 150,000 held in open-air detention camps. Since the February 2021 military coup, the junta has imposed severe movement restrictions and aid blockages on the Rohingya, increasing their vulnerability to forced recruitment.
Rohingya camp management committee members said that junta authorities have been tallying “eligible” Rohingya or compelling the committees to make lists. Two members said when they tried to refuse, junta authorities further restricted movement in the camps and threatened mass arrests and ration cuts. “We had no other option,” one committee member said.
At meetings in camps in Sittwe and Kyaukpyu, junta officials promised to issue all forced recruits pink citizenship cards, reserved for “full” citizens. “In the meetings, officers picked up their citizenship cards and told people, ‘We will give you this type of ID card if you join the military service,’” a camp management committee member in Thet Kae Pyin camp said. “People believed them.” Authorities also promised 4,800 kyat (US$2.30) a day and two sacks of rice.
About 300 Rohingya from the Sittwe camps were sent to two weeks of military training in late February. Upon completion, the military gave the forced recruits 50,000 kyats ($24) but no citizenship cards. “When the junta broke their promise to issue citizenship cards to the first 300 Rohingya recruits, people stopped believing them and started avoiding the recruitment campaigns,” a camp management committee member said. Rohingya in the Sittwe camps said that for the second round of forced recruitment, the few hundred Rohingya were taken at gunpoint in raids.
Officials have also threatened to beat Rohingya to death if they refuse to join or to punish their families if they fled.
Many young Rohingya men have tried to escape Rakhine State or gone into hiding in the jungle to escape forced recruitment. The authorities rounded up and beat about 40 Rohingya from Kyauk Ta Lone camp when their family members ran away, according to Radio Free Asia.
The 22-year-old man described the military training as a brutal two-week period under constant harassment, with trainees forced to dig bunkers and split wood, with limited food and water. “We became weak within a few days,” he said. “Some recruits fell unconscious. Three of us were bleeding from our mouths and noses. The military officers used abusive language, called us ‘kalar’ [a slur for Muslims], and degraded our mothers and sisters. Those 12 days felt like 12 years of our lives.”
He witnessed numerous groups of forcibly recruited Rohingya arriving at the cantonment. He was ultimately able to escape, the only one from his ward to do so: “Of us 31, no one else has been released to this day.”
The forcible recruitment campaign has already resulted in casualties. After their training, 100 Rohingya from the Sittwe camps were sent to fight on the front lines in Rathedaung. Five were killed in fighting and 10 were seriously injured, one of whom later died, according to family members and camp leaders. The military authorities promised the families compensation of a million kyat ($476) and two sacks of rice. The five bodies have not been returned.
While 43 forced recruits later returned to the camps, there has been no news from the remainder. “We still don’t know their whereabouts,” a camp leader said. “We don’t know if they’re still alive.”
“They tricked my son into the military,” said the mother of a man who was killed. She said:
They took him to do electrical work, then forced him into the training. Now he’s dead because he was sent to war. They didn’t let us see the bodies. I couldn’t touch my son one last time. When he was taken away, his wife and I followed. He was held at a nearby cantonment for a few hours and we were able to talk to him from outside the fence. Then they were brought to a car. That was the last talk. He was crying.
Conscription without previous legal authorization is a form of arbitrary detention in violation of international human rights law, and the treatment of those forcibly recruited may amount to cruel, inhuman, or degrading treatment. The Optional Protocol to the Convention on the Rights of the Child on the involvement of children in armed conflict, which Myanmar ratified in September 2019, prohibits the forced recruitment, conscription, or use of anyone under 18 in armed conflict.
On March 18, United Nations Secretary-General António Guterres expressed his concern about “reports of forcible detention and recruitment of youths, including Rohingya, and the potential impact of forced conscription on human rights and on the social fabric of communities in Myanmar.”
“The Myanmar military’s forced recruitment of Rohingya men and boys is its latest exploitation of a community made vulnerable to abuse by design, over decades of oppression,” Bauchner said. “Concerned governments should be strengthening avenues to justice to hold junta leaders accountable for their abuses, past and present.”
Texas Constructing Massive Anti-Migrant Military Base
The Texas Military Department is constructing a massive new “Forward Operating Base” outside of the border community of Eagle Pass to house up to 1,800 national guard members. The base is part of the state’s multibillion-dollar anti-migrant program, Operation Lone Star.
Satellite imagery from February 25 to April 3, 2024, shows the clearing of land and stabilization of soil on the site in Eagle Pass, Texas. Image © 2024 Planet Labs PBC
Satellite imagery of the site examined by Human Rights Watch shows the massive clearing of land. A video I shot earlier this month shows numerous construction vehicles at the site.
The base could cost Texas taxpayers up to $400 million by September 2026, according to the Austin American-Statesman, and will include an armory and capacity that can be “surged” to accommodate 2,300 troop members.
It is the latest component of the dragnet of laws and initiatives under Operation Lone Star, a ballooning program that Texas Governor Greg Abbott touts as an effort to curtail cartel activities and to reduce unauthorized migration and drug smuggling at the Texas-Mexico border.
While there is no evidence Operation Lone Star has slowed migration, the program has led to injuries and deaths, including in high-speed vehicle chases that Human Rights Watch has investigated. Operation Lone Star has consistently led to violations of the rights of migrants and US citizens, including attacks on freedoms of association and expression of groups providing support to migrants in Texas.
Eagle Pass residents have increasingly grown weary of the program.
In January, three migrants, two of them children, drowned in the Rio Grande near Shelby Park in Eagle Pass. Days earlier, Texas officials had seized the park, against the city’s wishes, and prohibited federal agents from accessing the park. This impeded rescue operations. The drownings and park seizure followed a statement by Texas Governor Greg Abbott during a radio interview where he said the “only thing we're not doing is shooting people” because “the Biden Administration would charge us with murder.”
Amerika Garcia Grewal, a leader of the Eagle Pass Border Coalition, a community organization working for a positive vision of the border, told Human Rights Watch that the construction of the military base didn’t account for the needs of local community members. “It’s disheartening to see this significant sum of Texas tax dollars funneled into the construction of a military base when it could be invested in the future of our children and the health of our community,” Garcia Grewal said.
Instead of wasting hundreds of millions more on border militarization, Texas should work to create a humane system that respects and welcomes migrants and builds strong, resilient border communities.
Texas Constructing Massive Anti-Migrant Military Base
The Texas Military Department is constructing a massive new “Forward Operating Base” outside of the border community of Eagle Pass to house up to 1,800 national guard members. The base is part of the state’s multibillion-dollar anti-migrant program, Operation Lone Star.
Satellite imagery of the site examined by Human Rights Watch shows the massive clearing of land. A video I shot earlier this month shows numerous construction vehicles at the site.
The base could cost Texas taxpayers up to $400 million by September 2026, according to the Austin American-Statesman, and will include an armory and capacity that can be “surged” to accommodate 2,300 troop members.
It is the latest component of the dragnet of laws and initiatives under Operation Lone Star, a ballooning program that Texas Governor Greg Abbott touts as an effort to curtail cartel activities and to reduce unauthorized migration and drug smuggling at the Texas-Mexico border.
While there is no evidence Operation Lone Star has slowed migration, the program has led to injuries and deaths, including in high-speed vehicle chases that Human Rights Watch has investigated. Operation Lone Star has consistently led to violations of the rights of migrants and US citizens, including attacks on freedoms of association and expression of groups providing support to migrants in Texas.
Eagle Pass residents have increasingly grown weary of the program.
In January, three migrants, two of them children, drowned in the Rio Grande near Shelby Park in Eagle Pass. Days earlier, Texas officials had seized the park, against the city’s wishes, and prohibited federal agents from accessing the park. This impeded rescue operations. The drownings and park seizure followed a statement by Texas Governor Greg Abbott during a radio interview where he said the “only thing we're not doing is shooting people” because “the Biden Administration would charge us with murder.”
Amerika Garcia Grewal, a leader of the Eagle Pass Border Coalition, a community organization working for a positive vision of the border, told Human Rights Watch that the construction of the military base didn’t account for the needs of local community members. “It’s disheartening to see this significant sum of Texas tax dollars funneled into the construction of a military base when it could be invested in the future of our children and the health of our community,” Garcia Grewal said.
Instead of wasting hundreds of millions more on border militarization, Texas should work to create a humane system that respects and welcomes migrants and builds strong, resilient border communities.
Gaza: Israel’s Imposed Starvation Deadly for Children
(Beirut, April 9, 2024) – Children in Gaza have been dying from starvation-related complications since the Israeli government began using starvation as a weapon of war, a war crime, Human Rights Watch said today. Doctors and families in Gaza described children, as well as pregnant and breastfeeding mothers, suffering from severe malnutrition and dehydration, and hospitals ill-equipped to treat them.
Concerned governments should impose targeted sanctions and suspend arms transfers to press the Israeli government to ensure access to humanitarian aid and basic services in Gaza, in accordance with Israel’s obligations under international law and the recent International Court of Justice order in South Africa’s genocide case.
“The Israeli government’s use of starvation as a weapon of war has proven deadly for children in Gaza,” said Omar Shakir, Israel and Palestine director at Human Rights Watch. “Israel needs to end this war crime, stop this suffering, and allow humanitarian aid to reach all of Gaza unhindered.”
A United Nations-coordinated partnership of 15 international organizations and UN agencies investigating the hunger crisis in Gaza reported on March 18, 2024, that “all evidence points towards a major acceleration of death and malnutrition.” The partnership said that in northern Gaza, where 70 percent of the population is estimated to be experiencing catastrophic hunger, famine could occur anytime between mid-March and May.
Gaza’s Health Ministry reported as of April 1, that 32 people, including 28 children, had died of malnutrition and dehydration at hospitals in northern Gaza. Save the Children confirmed on April 2 the deaths from starvation and disease of 27 children. Earlier in March, World Health Organisation (WHO) officials found “children dying of starvation” in northern Gaza’s Kamal Adwan and al-Awda hospitals. In southern Gaza, where aid is more accessible but still grossly inadequate, UN agencies in mid-February said that 5 percent of children under age 2 were found to be acutely malnourished.
Human Rights Watch in March interviewed a doctor in northern Gaza, a volunteer doctor who has since left Gaza, the parents of two infants who doctors said died of starvation-related complications in both mother and child, and the parents of four other children suffering from malnutrition and dehydration.
Human Rights Watch reviewed the death certificate for one of the children, and photos of two of the children in critical condition that showed signs of emaciation. All had been treated at Kamal Adwan hospital in Beit Lahia, northern Gaza.
Human Rights Watch health advisers also reviewed verified pictures and videos online of three other evidently emaciated children who died and four others in critical condition who also showed signs of emaciation.
Dr. Hussam Abu Safiya, who heads Kamal Adwan hospital’s pediatrics unit, told Human Rights Watch on April 4 that 26 children had died after experiencing starvation-related complications in his hospital alone. He said that at least 16 of the children who died were under 5 months old, at least 10 were between 1 and 8 years old, and that a 73-year-old man suffering from malnutrition had also died.
Dr. Safiya said one of the infants died at just two days old after being born severely dehydrated, apparently exacerbated by his mother’s poor health: “[She] had no milk to give him.”
Click to expand Image N. age 11, is being treated for malnutrition and severe dehydration at Kamal Adwan Hospital in Beit Lahia, Gaza, March 25, 2024. © 2024 Mousa Salem/Anadolu via Getty ImagesNour al-Huda, an 11-year-old girl with cystic fibrosis, was admitted to Kamal Adwan hospital on March 15. Doctors there told her mother that Nour was suffering from malnutrition, dehydration, and an infection in her lungs, and administered her oxygen and a saline solution. “Nour al-Huda now weighs 18 kilograms [about 40 pounds],” her mother told Human Rights Watch. “I can see her chest bones sticking out.”
International humanitarian law prohibits the starvation of civilians as a method of warfare. The Rome Statute of the International Criminal Court provides that intentionally starving civilians by “depriving them of objects indispensable to their survival, including willfully impeding relief supplies,” is a war crime.
Since the Hamas-led October 7, 2023, attacks in Israel, the Israeli government has deliberately blocked the delivery of aid, food, and fuel into Gaza, while impeding humanitarian assistance and depriving civilians of the means to survive. Israeli officials ordering or carrying out these actions are committing collective punishment against the civilian population and the starvation of civilians as a method of warfare, both of which are war crimes.
Israeli government actions that undermine the ability of the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) to carry out its recognized role in distributing aid in Gaza have exacerbated the effects of the restrictions.
A doctor who volunteered at the European hospital in Khan Younis in southern Gaza for two weeks in late January said that medical staff were forced to treat patients with limited medical supplies. He described the difficulty of treating malnutrition and dehydration, lacking essential items such as glucose, electrolytes, and feeding tubes. He said that one patient’s mother, desperate for solutions, resorted to crushing potatoes to create a makeshift liquid for tube feeding. Despite its nutritional inadequacy, the doctor said, “I ended up telling my other patients to find potatoes and do the same.”
On January 26, the International Court of Justice, in a case brought by South Africa, ordered provisional measures, including requiring Israel to “take immediate and effective measures to enable the provision of urgently needed basic services and humanitarian aid” and other actions to comply with the 1948 Genocide Convention. On March 28, the court indicated that Israel had not complied with this order and imposed a more detailed provisional measure requiring the government to ensure the unimpeded provision of basic services and aid in full cooperation with the UN, while noting that “famine is setting in.”
Governments should impose targeted sanctions, including travel bans and asset freezes, against officials and individuals responsible for the continued commission of the war crimes of collective punishment, deliberate obstruction of humanitarian aid and using starvation of civilians as a weapon of war.
Several countries have responded to the Israeli government’s unlawful restrictions on assistance by airdropping aid. The United States also pledged to build a temporary seaport in Gaza. However, aid groups and UN officials have said such efforts are inadequate to prevent a famine. Another attempt to deliver aid by sea was halted after an Israeli attack on aid workers on April 1.
On April 4, the Israeli cabinet agreed to several measures to increase the amount of aid entering Gaza, apparently following pressure from the US government.
“Governments outraged by the Israeli government starving civilians in Gaza should not be looking for band-aid solutions to this humanitarian crisis,” Shakir said. “Israel’s announcement that it will increase aid shows that outside pressure works. Israel’s allies like the US, UK, France, and Germany need to press for full-throttle aid delivery by immediately suspending their arms transfers.”
Starvation in GazaPrior to the current hostilities, 1.2 million of Gaza’s then-2.2 million people were estimated to be facing acute food insecurity, and over 80 percent were reliant on humanitarian aid. Israel maintains overarching control over Gaza, including over the movement of people and goods, territorial waters, airspace, the infrastructure upon which Gaza relies, and the population registry. This leaves Gaza’s population, whom Israel has subjected to an unlawful closure for more than 16 years, almost entirely dependent on Israel for access to fuel, electricity, medicine, food, and other essential commodities.
Nonetheless, before October 7, large amounts of humanitarian assistance reached the population. “Before this crisis, there was enough food in Gaza to feed the population,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “Malnutrition was a rare occurrence. Now, people are dying, and many more are sick.”
The WHO reported that the number of children under age 5 who are acutely malnourished has jumped from 0.8 percent before the hostilities in Gaza to between 12.4 and 16.5 percent in northern Gaza. Oxfam said on April 3 that since January, people in northern Gaza have been forced to survive on an average of 245 calories a day, “less than a can of fava beans.”
According to a nutrition vulnerability analysis conducted in March by the Global Nutrition Cluster, a network of humanitarian organizations chaired by UNICEF, 90 percent of children ages 6-23 months and pregnant and breastfeeding women across Gaza faced “severe food poverty,” eating two or fewer food groups each day.
Children with preexisting health conditions are particularly vulnerable to the devastating effects of malnutrition, which significantly weakens immunity. And starvation, even for survivors, leads to lasting harm, especially in children, causing stunted growth, cognitive issues, and developmental delays.
Gaza’s Health Ministry announced on March 8 that about 60,000 pregnant women in Gaza suffered from malnutrition, dehydration and inadequate health care. Poor nutrition during pregnancy harms both the baby and the mother, increasing the risk of miscarriages, fetal deaths, compromised immune system development, growth impacts, and maternal mortality.
Older people are also at particular risk of malnutrition, which increases mortality among those with acute or chronic illnesses. HelpAge International reported that even before October, 45 percent of older people in Gaza were going to bed hungry at least once a week, with 6 percent hungry every night.
The impact on Gaza’s population of the Israeli government’s use of starvation as a weapon of war is compounded by the near-total collapse of the healthcare system. Out of Gaza’s 36 hospitals, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA), only 10 are operational, none of them fully, both as a result of the Israeli military’s repeated, apparently unlawful attacks on medical facilities, personnel, and transport, as well as the severe restrictions on the entry of fuel and other supplies.
Accounts from GazaOn March 19, Andrea De Domenico, head of OCHA in the occupied Palestinian territory, visited Kamal Adwan hospital, where he said about 15 malnourished children arrive daily due to shortages in food, water, and proper sanitation. He described dire conditions at the hospital, noting damage to certain areas and its reliance on a single generator.
Click to expand Image F., age 9, experiencing malnutrition, receives treatment after being evacuated from the northern Gaza Strip to the IMC field hospital in Rafah, Gaza, March 24, 2024. © 2024 Ali Jadallah/Anadolu via Getty ImagesAmong the cases that Human Rights Watch investigated:
A man from Beit Lahia said his infant son, Abdelaziz, died just hours after his severely malnourished mother gave birth to him in Kamal Adwan hospital on February 24. He shared Abdelaziz’s death certificate with Human Rights Watch, which said that Abdelaziz was born premature. His father said that the hospital staff hooked Abdelaziz up to a ventilator because he was having trouble breathing, but that the ventilator stopped working after the hospital ran out of the necessary fuel a few hours later. “Abdelaziz died immediately,” he said. He expressed concern for his wife, who had been surviving on legumes and canned food, emphasizing their ongoing struggle to access adequate nourishment. The father of newborn twin girls said that one of his babies, Joud, died at Kamal Adwan hospital on March 2 after suffering from malnutrition, eight days after she was born. He said that he struggled to feed his family prior to the girls’ birth, but that they only had bread to eat, without meat or protein. He said that after the twins’ birth, his wife could not produce milk to breastfeed the girls and that store-bought milk was scarce. He described Joud’s deteriorating condition, saying that her “limbs became very cold, and she was breathing very slowly.” His mother-in-law accompanied Joud to the hospital, where she later passed away. The father expressed concern for the health of the surviving twin. Fadi, a 6-year-old boy from al-Nasser neighborhood in Gaza City, has cystic fibrosis, a genetic disorder that causes damage to the lungs. Fadi’s mother said that because of the Israeli blockade, she struggled to obtain the necessary medication and provide adequate nourishment. By mid-January, Fadi’s health had deteriorated to the point where he could no longer walk, prompting his hospitalization. “Fadi weighed 30 kilograms [about 66 pounds] before the war, now he is 12 [about 26 pounds],” she said. Fadi was evacuated from Kamal Adwan hospital on March 23 and was receiving treatment at a hospital in Cairo, a relative said on March 28. Wissam Hammad, the uncle of 5-year-old Muhammad, who has cerebral palsy and is lactose and gluten-intolerant and can only eat blended food, had great difficulties in securing food for him:Most of his food should be fruit and vegetables, which is what I try to buy. But all I can find and afford are oranges. The problem is that he cannot chew, so we need to break down the food for him. Everything is very expensive.
Dr. Ahmed Shahin, a pediatrician, said that before he could leave Gaza on November 16, Osman, his 14-year-old son with cerebral palsy, who uses a gastrostomy feeding tube, had lost seven kilograms (about 15 pounds) since the beginning of the hostilities because they lacked access to both the specific food he needed—such as vegetables—and electricity to blend his food. Obstacles to Aid DeliveryOngoing Israeli bombardment and ground operations, lack of security assurances from Israel, widespread infrastructure damage, and communications disruptions make it difficult to distribute the little aid that does get into Gaza. Humanitarian organizations have reported that Israeli forces have attacked their aid convoys and workers. Israeli forces have also shot at and shelled people congregating to collect aid, killing and injuring hundreds.
An Israeli government spokesperson stated on March 18 that aid entering Gaza faced no limits apart from security concerns. Other officials have blamed the UN for distribution delays and accused Hamas of aid diversion or the Gaza police of failing to secure convoys. On March 29, the Israeli Defense Ministry’s body governing civilian affairs in the Palestinian territories, COGAT, disputed the March 18 UN-supported humanitarian report warning of an imminent famine, and said that it “does not reflect the full situation.” COGAT denied that the Israeli government was purposely starving Gaza’s civilian population. Human Rights Watch wrote to COGAT on April 2 seeking comment on our findings, but did not receive a response as of the time of publication.
However, OCHA reported on April 8 that only one of four food aid missions that require coordination in Gaza were facilitated by Israeli authorities in March. Only nine World Food Programme aid shipments have made it to the north since January 1, the most recent of which was 18 truckloads on March 17. The World Food Programme said at least 300 trucks are needed every day for the north alone.
The United States has resorted to airdropping food into Gaza and plans to build a floating pier at sea to deliver aid, a proposal criticized by 26 nongovernmental organizations, including Human Rights Watch, as “risky, expensive, and ineffective.” UN Humanitarian Coordinator Jamie McGoldrick has stressed that road transport is the only viable solution for increasing aid flow.
The restrictions on aid delivery make accessing food for people requiring a specific diet particularly difficult. Several representatives of humanitarian organizations said that they have been unable to provide food for children on special diets or to reach them. A Palestine Children’s Relief Fund staff member said they could only provide baby formula and could not respond to the needs of children with specific diet requirements. Medical Aid for Palestine said the special food items they had in storage ran out quickly, and since then, they have been unable to find and provide those in need with specialized food items:
Assistance is barely coming in: a quarter of the population is at risk of famine. Under these circumstances, people with disabilities and [people in vulnerable situations] suffer the most. When you speak about food, it’s hard to support people who need a specific diet and medical assistance.
Following an Israeli airstrike in central Gaza on April 1, 2024, which hit three marked vehicles from the international food organization World Central Kitchen and killed seven aid workers from several countries, Cyprus announced that ships carrying around 240 tons of aid for Gaza would turn back. World Central Kitchen, Project Hope, and ANERA, all providers of food aid, suspended their Gaza operations in light of the attack, and the United Arab Emirates paused its involvement in a maritime aid corridor.
India: Technology Use Shouldn’t Undermine Free, Fair Elections
(New York) – Voters in India will cast their ballots in a six-week general election beginning April 19, 2024, amid concerns that Indian authorities exert considerable control over the digital ecosystem that can make for an uneven playing field, Human Rights Watch said in a question-and-answer document released today. The party or coalition of parties that wins a majority of 543 seats in the lower house of Parliament will nominate a candidate for prime minister and form a government.
April 8, 2024 India’s General Elections, Technology, and Human Rights Questions and AnswersHuman Rights Watch examined potential threats to India’s online environment ahead of the elections. The authorities have increased their control over digital platforms and amassed extensive amounts of personal data, which may affect the campaign environment. Human Rights Watch details the additional steps technology companies should take to meet their human rights responsibilities in this election.
“The risk of misuse of technology in India’s election is significant and could result in further tilting the playing field in favor of the ruling party,” said Deborah Brown, acting associate technology and human rights director at Human Rights Watch. “The Election Commission of India should ensure that all political parties comply with the model code of conduct and that their use of technology in campaigning respects human rights.”
Human Rights Watch reviewed popular companies’ policies and found that all companies could do more to address any aspects of their products, services, and business practices that may cause, contribute, or be linked with undermining free and fair elections.
Indian political parties campaign extensively through digital platforms. Ahead of the upcoming elections, political advertising on Google surged in the first three months of 2024. The governing Bharatiya Janata Party (BJP) has been the largest advertiser among political parties on both Google and Meta over the past three months, and has built a massive messaging operation through WhatsApp.
In recent years, Indian authorities have applied significant formal and informal pressure on tech companies, both to suppress critical speech and to keep online speech by government-aligned actors that would otherwise violate platforms’ policies. India shuts down the internet more than any other country, with the authorities frequently using internet shutdowns to stem political protests and criticism of the government, violating domestic and international legal standards.
Misuse of personal data, which can contain sensitive and revealing insights about people’s identity, age, religion, caste, location, behavior, associations, activities, and political beliefs, is a major concern in India’s elections. India has developed an extensive digital public infrastructure through which Indians access social-protection programs. The Indian government has collected massive amounts of personal data in the absence of adequate data protection laws to prevent misuse of this data during campaigning and to properly protect privacy rights.
There have already been reports of misuse of personal data in the campaign period, which started on March 16. On March 21, the Election Commission told the government to stop sending messages promoting government policies to voters, as it was a violation of the campaign guidelines. The message and accompanying letter from Prime Minister Narendra Modi to which it referred, had sparked concerns over data privacy as well as abuse of government communications for political purposes.
Social media platforms have come under scrutiny in recent years for failing to adequately invest in and address the use of their platforms to undermine participation in democratic elections. In India, Meta has faced criticism for failing to curb the spread of hate speech and incitement to violence, and for contributing to give the BJP an unfair advantage in political campaigning online during past elections.
The widespread availability of low-cost generative Artificial Intelligence (AI) tools that require little technical expertise raises new concerns. Generative AI can be used to create deceptive videos, audio recordings, and images impersonating a candidate, official, or media outlets. These are disseminated quickly across social media platforms, potentially undermining the integrity of the election or inciting violence, hatred, or discrimination against religious minorities. In the lead-up to the 2024 elections, several parties are using AI in their campaigns.
Companies should resist threats from the authorities when responding to government requests for data or content removals, Human Rights Watch said. They should treat all parties and candidates equitably, especially when it comes to addressing speech that incites violence or hatred.
Under the United Nations Guiding Principles on Business and Human Rights, companies have a responsibility to respect human rights and remedy abuses, including by addressing any aspects of their practices that contribute to undermining the right to participate in democratic elections.
“Ahead of India’s elections, tech companies need to demonstrate that their commitment to human rights is more than words,” Brown said. “This means adequately investing in content moderation, carrying out rigorous human rights impact assessments, and meaningfully engaging with civil society.”
Zambian Police Summon Priest After Critical Sermon
On Saturday, Zambian police summoned a Catholic priest, Fr. Andrew Chewe Mukosa, for “interviews” at the Copperbelt Police Headquarters on April 9. The summons, which was posted online, indicated that the priest was being sought for “the purpose of investigations,” but provided no information regarding the subject of the investigation.
Click to expand Image Fr. Andrew Chewe Mukosa. Source: Radio Icengelo/FacebookSeveral media reports suggest the authorities were summoning the priest because of the content of his Good Friday sermon, delivered in his local language, in which he bemoaned the high cost of living, youth unemployment, and persistent power outages affecting Zambia.
The Zambian Observer reported that Fr. Mukosa had confirmed to a local radio station that he was aware of the police summons, but did not indicate whether he intended to honor it.
Despite initial hopes that the election of President Hakainde Hichilema in 2021 might improve human rights in the country, Zambian authorities have continued to crack down heavily on all forms of dissent. Fr. Mukosa joins a long list including journalists, youth activists, and political opposition leaders who have faced harassment for their perceived criticism of the authorities. And the Zambian authorities have increasingly used provisions of the Public Order Act of 1955 to disrupt opposition activities, including by refusing to grant authorization for opposition meetings and rallies.
In 2023, the United Nations Human Rights Committee expressed concern about allegations of “restrictions on peaceful assemblies, such as cancelling assemblies at the last minute, arbitrary arrests, bodily injuries, deaths and property damage, especially during peaceful anti-government protests and political gatherings organized by the opposition.” Leading civil society and human rights groups expressed similar concerns, urging the government to enact laws to safeguard these rights.
Sunday Chanda, an opposition member of parliament, issued a statement condemning the summons for Fr. Mukosa, adding that “Zambia ought to be a thriving democracy, otherwise how many priests or members of the clergy is the Police going summon, and how does that add to our democratic credentials?”
Instead of to undermining and limiting rights to freedom of expression, peaceful assembly and association, the Zambian authorities should ensure full enjoyment of these rights, which are cornerstones of a functioning democracy.
UN Rights Council Boosts Scrutiny of North Korea
The North Korean human rights movement won a significant victory on April 4 when the United Nations Human Rights Council (UNHRC) adopted a resolution ensuring continued scrutiny of North Korea’s atrocious rights record.
The resolution renews the mandate of the UN special rapporteur on the Democratic People’s Republic of Korea (North Korea) and asks the Office of the UN High Commissioner for Human Rights to prepare its first comprehensive report on the North Korean human rights situation since the Commission of Inquiry (COI) published its landmark report in 2014. The new resolution also increases resources for the high commissioner’s office to focus on criminal accountability for North Korea’s rights violations and stresses the link between North Korea’s weapons program, international peace and security, and human rights.
It is the UNHRC’s most ambitious resolution on North Korea since 2016 and carries immense importance for victims of serious abuses in a country that is among the most isolated and repressive in the world. In sharp contrast to Russia’s veto at the UN Security Council on March 28 that disbanded the Panel of Experts on North Korea, this resolution demonstrates the commitment of concerned countries to ensure accountability.
The 2014 COI report was a watershed moment, shedding light on egregious rights abuses in North Korea. The new report mandated by the UNHRC, to be published in September 2025, will build on the COI’s recommendations, provide a platform for North Korean victims, particularly those who have suffered since Kim Jong Un took power in December 2011, and amplify their stories on the international stage. By highlighting the connection between North Korea’s weapons development and human rights, the upcoming report will remind governments that security cannot be tackled in isolation from underlying rights abuses.
The UNHRC resolution is a crucial step, but North Korea’s victims are entitled to greater support from international institutions. The UN General Assembly and Security Council should also increase their scrutiny of North Korea, including by exploring connections between rights abuses and weapons proliferation and the need to hold rights violators accountable.
New Hope for Love for Japanese Children Needing Families
“They don’t love us,” 17-year-old Kenji M. told me in 2012. He was speaking of staff at the childcare institution where he lived in Tokyo. “Many of the staff seem like they take care of us only because it’s their job.”
Kenji had lived in institutions since age 3. He was identifying a problem underpinning Japan’s system for providing care to children whose parents were unable or unwilling to do so: it had become a business opportunity. Government subsidies to privately run childcare institutions entrenched their opposition to reform and created an incentive to prefer more resident children rather than having children being placed with families who would love and nurture them.
But last week, new reforms came into effect in Japan that might begin to change that financial calculation.
The new system, established by a 2022 law, offers private childcare institutions financing to transform their business model into “Foster Care Support Centers” that recruit, train, select, and support foster parents, and assist the independence of children living in foster families.
If a childcare institution becomes a Foster Care Support Center, the government will fund full-time staff members based on the number of foster households they cater to.
This change was brought about through the hard work of a small group of activists and lawmakers, who for more than 10 years have strived to push back on institutions’ strong lobbying efforts.
When I met Kenji, almost 40,000 children were in Japan’s alternative care system, less than 12 percent were living in a foster family, and the vast majority were living in institutions. In 2017, the Japanese government set a target to have 75 percent of infants and toddlers in foster families, and 50 percent of school-aged children in foster families. But as of 2022, only 24 percent of children were being cared for in foster families.
The latest reform is an important step, but further changes are needed, such as the speedy closure of all infant care institutions.
Every child in Japan has a right to family life. If that cannot be with their biological parents, alternative solutions should not include institutions, but close relatives, or adoptive or foster families, where they are genuinely loved.
Senegal: Human Rights Agenda for President Faye
(Nairobi) – Senegal’s newly elected president, Bassirou Diomaye Faye, should make protecting and promoting human rights a priority during his presidency, both within Senegal and regionally, Human Rights Watch said in a letter to the president made public today.
Human Rights Watch outlined five key recommendations to improve human rights in Senegal, urging Faye, during his term in office, to fight impunity for security forces’ abuse; promote and protect the rights to freedom of expression, assembly, and association; improve prison conditions; prioritize rights and saving lives when addressing irregular migration; and develop a foreign policy based on human rights. He should support rights-respecting democracies in West Africa and moves to strengthen the system of international justice.
“Faye has an important opportunity to create a rights-respecting administration that abides by the rule of law,” said Ilaria Allegrozzi, senior Sahel researcher at Human Rights Watch. “He should commit to reforms that will safeguard and advance human rights in the years to come.”
Faye, 44, the youngest president in Senegal’s history, was sworn into office on April 2, 2024, following delayed elections, and less than two weeks after he was released from prison, where he was serving a sentence over a Facebook post. On the day he was sworn in, Faye appointed his key backer, Ousmane Sonko, as prime minister.
On February 3, former President Macky Sall announced that presidential elections, slated for February 25, would be delayed, citing an institutional crisis that he said could damage the election’s credibility. In January, Senegal’s constitutional council had decided to exclude several candidates, including Sonko, from the electoral race. Senegal’s parliament set up a commission of inquiry to investigate the council's handling of the vetting process amid accusations of corruption against at least two of the council’s judges.
On February 6, Senegal’s parliament voted to delay the elections to December 15 after a chaotic National Assembly session during which security forces removed opposition lawmakers. This sparked violent protests in the capital, Dakar, and across the country on February 9 and 10, leading to the deaths of four people and the arrest of over 270 others.
On March 13, during a Council of Ministers meeting, following national and international pressure and a decision by Senegal’s constitutional court, Sall shortened the delay and announced that elections would be held on March 24.
The elections followed three years of political unrest, which included Sonko’s arrest in July 2023 and concerns that Sall would seek a third term despite constitutional term limits. The violence shook Senegal’s reputation as an example of a stable democracy in a region ravaged by military coups. Dozens were killed in the protests, and over 1,000 were arrested, including Faye.
Faye is the secretary general of the African Patriots of Senegal for Work, Ethics, and Fraternity (Patriotes africains du Sénégal pour le travail, l'éthique et la fraternité, PASTEF) party, the main opposition group dissolved by the authorities in July 2023. He was arrested on April 14, 2023, following a Facebook message in which he criticized magistrates and was charged with “undermining state security” and fomenting insurrection, among others. Faye was released on March 14 after the National Assembly adopted an amnesty law on March 6.
“By taking bold steps to strengthen human rights protections, President Faye would turn the page on the last years of violence, abuse, and impunity,” Allegrozzi said. “The Senegalese people and the world will be watching his actions closely.”
Philippines: New ‘Drug War’ Declared in Davao City
(Manila) – The mayor of Davao City in the Philippines, Sebastian Duterte, recently declared a new “war on drugs,” suggestive of the abusive campaign of his father, former President Rodrigo Duterte, Human Rights Watch said today. Local authorities killed five people in the 24 hours after he made the declaration and at least seven within a matter of days.
The failure of Philippine President Ferdinand Marcos Jr. to end the violent anti-drug raids that underpin the “drug war” has emboldened local leaders such as Duterte to adopt measures in violation of international human rights law.
“Davao City Mayor Sebastian Duterte may have sparked another round of police summary executions by reenergizing his father’s abusive ‘drug war,’” said Bryony Lau, deputy Asia director at Human Rights Watch. “But the sad reality is that these killings never ended, and the thousands of victims and their families in Davao City and elsewhere struggle without a remedy or justice.”
On March 22, 2024, Mayor Duterte declared a new “war against drugs” in Davao. He gave a speech at an event for the city police in which he conveyed a message to drug users: “If you don’t stop, if you don’t leave, I will kill you.”
Hours after the speech, Davao City media reported several killings by the police during drug raids, in which the police alleged that the victims had “fought back,” the same claim that Philippine authorities have used for years to justify “drug war” killings.
These recent killings in Davao City are merely a spike in a “drug war” that has never stopped, Human Rights Watch said. The University of the Philippines Third World Studies Center has reported that since Duterte became mayor in June 2022, Davao del Sur, the city’s greater provincial area, has had more drug-related killings than any other area in the country, including Metro Manila.
Out of the 342 killings the center recorded from July 1, 2022, to June 30, 2023, 53 (15 percent) occurred in Davao del Sur. By comparison, there were 44 killings in Cebu and 43 in Metro Manila, or the National Capital Region. An updated figure published by Rappler indicates that from July 1, 2022, to March 15, 2024, a total of 96 people were killed in “drug-related” incidents in Davao. All but one were committed by police and anti-drug agents during police operations.
Human Rights Watch in 2023 interviewed families of victims of recent drug-related killings in Davao. The 20-year-old wife of a shooting victim said that in April 2023, the authorities had accused her husband of theft and small-time drug dealing: “We had just come from a 7-Eleven to buy food that night when about six men came to our house, dragged my husband to the second floor, where they shot him in the chest.”
She said that a police car, not an ambulance, arrived to retrieve her husband’s body even while about 15 armed men and local officials remained nearby, indicating the authorities were involved in the killing.
Local activists said that the killings under the current mayor were no different from in previous years. “The killings here have been regular,” said a member of a Davao human rights group. “The perpetrators often just wear civilian clothes, but they are always in groups. It reminds us of the days of the ‘Davao Death Squad,’ that’s how bad it is.”
Human Rights Watch in 2009 reported on the “Davao Death Squad,” a shadowy group allegedly responsible for hundreds of extrajudicial executions over two decades when Rodrigo Duterte was mayor of Davao City. After he became president in 2016, police conducted sweeping raids and “buy-bust operations” across the country, resulting in thousands of fatalities, most being of poor drug users and small-time drug peddlers. The International Criminal Court is investigating these killings in its ongoing investigation into crimes against humanity in the Philippines.
President Marcos has continued the anti-drug campaign begun by his predecessor. He has said repeatedly that the campaign against drugs will focus on rehabilitation but killings have continued. Although the rate of killings has dropped since Marcos became president in June 2022, the Third World Studies Center found that more than 600 people were killed in “drug-related” incidents in the 19 months he has been in office.
Marcos appointed a new chief of the Philippine National Police, Rommel Francisco Marbil, who at a news conference on April 2 said he would pursue the anti-drug campaign, although he said he did not want to call it a “war on drugs.” He vowed to abide by the rule of law in achieving “100 percent drug-free” communities and to ensure accountability and transparency in the investigations of drug-related killings such as those in Davao City.
Unless President Marcos clarifies publicly that he has ordered a policy shift to end targeted killings of alleged drug dealers and users, and states clearly that those responsible for unlawful killings will be fully prosecuted, local officials like Duterte will continue to try to justify such killings, Human Rights Watch said.
“The new spate of killings in Davao City and elsewhere shows that President Marcos has not done enough to end the ‘drug war,’” Lau said. “The Marcos administration needs to take stronger action to demonstrate that the ‘war on drugs’ is officially over.”
Saudi Arabia: Global Tennis ‘Sportswashes’ Abuses
(Beirut) – The global governing bodies of men’s and women’s professional tennis have effectively enabled the Saudi government’s efforts to “sportswash” its egregious human rights record through the announcement of two separate deals with Saudi Arabia’s Public Investment Fund (PIF) and the Saudi Tennis Federation, Human Rights Watch said today. Neither of the public announcements of the deals mentioned any measures to address human rights.
On April 4, 2024, the Women’s Tennis Association (WTA) announced that its next three finals, from 2024 to 2026, will be hosted in Riyadh following an agreement with the Saudi Tennis Federation. On February 28, the Association of Tennis Professionals (ATP) and the PIF announced a “multi-year strategic partnership.”
“Global tennis organizations should not contribute to serving up repression in Saudi Arabia,” said Minky Worden, director of global initiatives at Human Rights Watch. “The Women’s Tennis Association and the Association of Tennis Professionals should demand improvements to Saudi’s rights record before making deals that launder Saudi government abuses.”
The agreement between the WTA and the Saudi Tennis Federation “will offer record prize money of US$15.25 million at the WTA Finals in 2024 with further increases in 2025 and 2026.” The Saudi PIF became the official naming partner of the ATP Rankings through the strategic partnership.
The tennis federations should press the Saudi government to release jailed rights activists and urge reforms to allow women and girls to exercise their basic human rights, Human Rights Watch said. These sports federations should also adopt a human rights policy that ensures that they do not enable or facilitate Saudi government abuses. They should also reject any nondisparagement or other clauses in their agreements with the Saudi PIF that restrict the associations, their staff, or athletes from publicly criticizing Saudi authorities’ human rights abuses.
Other sports federations, including Formula 1, have added restrictions to athletes speaking out on issues, including about human rights in their agreements with the Saudis. Formula 1’s ban on political statements came after champion racing driver Lewis Hamilton criticized Saudi Arabia’s rights record.
On April 4, Human Rights Watch wrote to the WTA, asking what, if any, human rights due diligence and stakeholder consultations the federation had carried out with Saudi women’s rights defenders and other key stakeholders before the decision to award the finals to Saudi Arabia. The federation has not yet responded.
WTA tour chairman and CEO Steve Simon told a media outlet on April 4 that, “We’ve … shared the concerns around women’s rights and LGBTQ+ rights within the Kingdom of Saudi [Arabia]. Our focus is on how we develop women’s tennis for the benefit of everybody involved in the game … We participate in many countries that have different cultures and values systems across the board.”
Businesses, including sports federations, have a responsibility to respect human rights throughout all their operations. The United Nations Guiding Principles on Business and Human Rights sets out these responsibilities, including the expectation that businesses will adopt specific policies and conduct due diligence to identify any risks of contributing to human rights harm. Harms may include conferring reputational benefits that help cover up human rights abuses. That standard has clearly been breached by these agreements, Human Rights Watch said.
Saudi Arabia has an egregious women’s rights record. Saudi women’s rights activists have faced arbitrary arrest and detention, torture, and travel bans. Loujain al-Hathloul, a prominent Saudi women’s rights activist, remains subject to a travel ban after she was detained for more than 1,000 days for her women’s rights activism.
Since 2018, Saudi women have been allowed to drive, and women and girls have been allowed to play sports and watch sports in stadiums. However, Saudi women and girls still face significant barriers preventing or limiting their participation in sports and physical activity.
A 2023 study by researchers at King Saud University found uneven access for Saudi female participation in sports and physical activities: Saudi women and girls in rural areas encountered higher constraints than residents of urban areas. The study found that a lack of physical education classes and sports facilities, in public and private girls’ schools, also negatively affects the ability of Saudi girls to participate in sports and physical activities.
The country’s first codified law on personal status formally enshrines male guardianship over women, despite Crown Prince Mohammed bin Salman and other Saudi government officials touting the law as “comprehensive” and “progressive.” The law codifies discriminatory practices and includes provisions that facilitate domestic violence and sexual abuse in marriage. The law also uses vague language that gives judges wide discretion when adjudicating cases, increasing the likelihood of inconsistent interpretations.
On March 27, a Saudi court sentenced 12 football fans to prison terms ranging from six months to up to a year for peacefully chanting during a January football match.
The PIF is a Saudi government-controlled sovereign wealth fund with approximately US$750 billion in assets under management. Under the crown prince, the fund has facilitated and benefitted from human rights abuses directly linked to him, including the 2017 “anti-corruption” crackdown that involved arbitrary detentions, abusive treatment, and the extortion of property from former and current government officials, prominent businessmen, and rivals within the royal family, as well as the 2018 murder of Saudi journalist Jamal Khashoggi.
As part of the crackdown, one of bin Salman’s advisers ordered the PIF’s then-supervisor Yasir al-Rumayyan to transfer 20 companies into the fund, according to internal Saudi government documents submitted to a Canadian court as part of an ongoing legal claim filed by a group of Saudi companies.
One of the companies was Sky Prime Aviation, which owned the two planes later used by Saudi agents to travel to Istanbul, murder Khashoggi in the country’s consulate, and return to Saudi Arabia. In February 2021, the United States Office of the Director of National Intelligence released a report assessing that bin Salman had approved the operation.
The Saudi government has spent billions of dollars hosting major entertainment, cultural, and sporting events as a deliberate strategy to deflect from the country’s image as a pervasive human rights violator. The investment in major entertainment, cultural, and sports events is tied to the crown prince’s Vision 2030, a plan to overhaul the country’s economy and attract foreign investors and tourists. Among the programs it has developed to realize its vision is one focused on creating more leisure and recreational options to “enhance the image of the Kingdom internationally.”
“The WTA still has leverage to press the Saudi government to release jailed women’s rights activists and to urge permanent reforms to allow women and girls to have basic human rights,” Worden said. “The question for sponsors and others who may be involved in tennis is whether they want to be associated with the abuses of its most influential backer, or will they speak out.”
World Health Day Marked amid Widespread Failures to Invest in Public Health Care
As the world prepares to celebrate World Health Day on April 7, governments’ failure to invest adequate resources or appropriate budgetary support in public healthcare systems undermines the right to health for many people around the world.
Forthcoming Human Rights Watch analysis of the most recent available data in the World Health Organization’s (WHO) Global Health Expenditure Database shows that most governments spent less than 5 percent of their Gross Domestic Product (GDP) or 15 percent of their national budget on health care in 2021. These two benchmarks are largely accepted spending targets in public health care.
Even amid the massive surge in global healthcare spending in 2020-2021, at the height of the Covid-19 pandemic, 80 percent of the world’s population lived in countries that met neither spending benchmark. Indeed, when adjusted for inflation, 41 countries saw real-term declines in their per capita public healthcare spending between 2019 and 2021, despite the fact that most of them actually experienced an increase in GDP per capita in the same period.
Access to quality public services, including health care, is essential to the realization of human rights. Under international human rights law, governments have an obligation to ensure that healthcare goods and services are available, accessible, acceptable, and of good quality.
Adequate funding is a vital part of a states’ ability to fulfill these obligations, and they have a duty to use the maximum of their available resources towards realizing rights, including the right to health. While funding is far from the sole criteria to determine availability, accessibility, or quality, these data from the WHO make clear that greater government spending on health care generally correlates with more of the population enjoying access to essential healthcare goods and services.
Governments that are falling behind should set concrete steps to reach these spending benchmarks including, where necessary, by implementing ways to raise revenues such as through stemming tax abuses or via progressive taxes. Over the coming months, governments will have several chances to take these steps, including, in particular, at the 77th World Health Assembly in May, at the United Nations Summit of the Future in September, and at the fourth International Conference on Financing for Development in 2025.
The theme of this year’s World Health Day, “my health, my right”, is more than just a catchy slogan. It’s a reminder of governments’ obligation to ensure the highest attainable standard of health for all.