NYT on the relationship between health and climate change: unraveling the science is “tricky” but the risks are real

Note: This was cross-posted to my own blog.


Last week, the New York Times published a nuanced and thoughtful piece on the complicated scientific relationship between climate change and health outcomes. It lays out several health effects that advocates frequently bring up – vector-borne diseases, natural disasters, and temperature extremes – and examines the strength of the research behind each association.

The article’s tone is cautious, and it acknowledges early on that public health initiatives based on climate risk are politically fraught and, in some cases, the science is not as robust as some would like.

A White House report listed deepening risks. Asthma will worsen, heat-related deaths will rise, and the number and traveling range of insects carrying diseases once confined to the tropics will increase.

But the bullet points convey a certainty that many scientists say does not yet exist. Scientists agree that evidence is growing that warmer weather is having an effect on health, but they say it is only one part of an immensely complex set of forces that are influencing health.

“There’s a lot of evidence showing that extreme weather can hurt people, but what we don’t know is whether those effects are getting worse,” said Patrick L. Kinney, director of the Columbia University Climate and Health Program, adding that scientists don’t have the long-term data needed to pinpoint how climate change is affecting health.

Mary H. Hayden, a scientist at the National Center for Atmospheric Research in Boulder, Colo., who studies climate and health, said of dengue fever, a tropical disease carried by mosquitoes: “I don’t think we can dismiss the role of climate. But can we say there is a direct causal link? No, we can’t. It’s more complex than that.”

The central point of the article is that the science examining climate and its effects on health is (as most scientists will cheerfully admit) quite complicated, and the data that the scientific community has on the subject is incomplete and patchy for many countries and geographic regions. The upside to this, however, is that we now have much more data than we used to, in no small part thanks to increased political will and a greater sense of urgency.

Evidence is accumulating, however. In 2000, the first National Climate Assessment, a government document weaving together the best evidence on climate change, had just 21 pages on health. The most recent assessment included a special section on health that filled more than 400 pages.

Two peer-reviewed British journals — Philosophical Transactions B and The Lancet — have dedicated many pages to the topic this year. Europeans, unburdened by the level of political controversy over climate change in the United States, often give more conclusive interpretations of the science.

“We are in a far more certain place now,” said Nick Watts of the University College London Institute for Global Health and a co-author of the Lancet analysis. “We feel very comfortable talking about direct effects of climate change on health.”

One thing that the article pointed out was that the effects of climate health – particularly with regard to temperature extremes – is that they disproportionately affect the poor because they are more vulnerable to the elements. This is one thing that we focused on in the health chapter of Climate Risk and Resilience in China (which I co-authored) and why I like the idea of working to reduce climate-related risks to the most vulnerable populations, as that may be a less politically controversial option. No one can argue that many lives are at risk from a heat wave when so many have no access to AC.

Rose Schneider, the IH Section’s Climate Change Working Group Chair, agreed on that point of the article. “It makes sense to be ‘skeptical’ and it is true that especially in developing countries most is written about ‘projections’ of the effects on health, but it is true that the toll is much worse, especially on the poor, if from nothing else than major climate events like floods, windstorms, crop damage from drought, and sea rise. I liked the last line of the article; I’m not waiting.”

As Dr. Kinney noted, “if we wait for the health evidence to be ironclad, it may well be too late.”

WHO Video: Touchy-feely response to harsh international criticism?

Note: This was cross-posted to my own blog.


Yesterday, the WHO released a short YouTube video, “If you can beat Ebola, you can beat anything,” featuring the story of a Liberian doctor who contracted Ebola and recovered with the help of his family. After some dramatic music and musing from Dr. Philip Ireland, the video goes on to interview several other clinicians who provide hopeful reflections on how to better prepare African countries to respond to future outbreaks.

The video’s description reads:

When Ebola hit West Africa the healthcare systems of the region were under-financed and poorly equipped. Liberia had only 130 doctors for a country of 4.5 million people. Many of those doctors died of the disease. As Liberia, Guinea and Sierra Leone look to the future and to rebuilding their countries, recruiting and training doctors, nurses and other health professionals will be key to avoiding another devastating crisis. Dr Ireland, a Liberian doctor who has recovered from Ebola, says in the video that if
you can beat Ebola you can beat anything.

Ensuring quality healthcare and protection from disease outbreaks for the people living in Ebola affected and other poor countries is possible and our Number 1 health priority.

It’s safe to assume that the video is part of WHO’s PR response to the damning assessment of its handling of the persistent Ebola outbreak that is still (yes, still) going after over a year. While MSF began calling for outside intervention fairly early on, the WHO intentionally delayed sounding its own alarm and even contradicted MSF’s assessment of the severity of the outbreak due to political pressures:

Among the reasons the United Nations agency cited in internal deliberations: worries that declaring such an emergency — akin to an international SOS — could anger the African countries involved, hurt their economies or interfere with the Muslim pilgrimage to Mecca.

Those arguments struck critics, experts and several former WHO staff as wrong-headed.

In public comments, WHO Director-General Dr. Margaret Chan has repeatedly said the epidemic caught the world by surprise.

“The disease was unexpected and unfamiliar to everyone, from (doctors) and laboratory staff to governments and their citizens,” she said in January. Last week, she told an audience in London that the first sign that West Africa’s Ebola crisis might become a global emergency came in late July, when a consultant fatally ill with the disease flew from Liberia to a Nigerian airport.

But internal documents obtained by AP show that senior directors at the health agency’s headquarters in Geneva were informed of how dire the situation was early on and held off on declaring a global emergency.

More recently, an expert assessment commissioned by the WHO to review the organization’s response released its own findings. While somewhat critical, the report was much more muted and also fairly optimistic (as self-assessments are bound to be). In addition to internal reforms, the report calls for a revision of the International Health Regulations; there was a commentary piece calling for the same thing in the most recent issue of Lancet Global Health (I am not sure if the authors of the article were also on the panel). For its own part, MSF responded in its typical straight-shooting fashion:

“MSF has repeatedly raised the alarm on the WHO and global response to Ebola and was also interviewed by the panel. On paper, there are a lot of strong points in the report that reflect many issues MSF is concerned about, but the question how will this translate into real action on the ground in future outbreaks and epidemics and what will Member States do to make sure this really happens?

We have seen so many reports calling for change, with everyone focused on how to improve future response and meanwhile, with 20-25 new Ebola cases per week in the region, we still don`t have the current epidemic under control. On Ebola, we went from global indifference, to global fear, to global response and now to global fatigue. We must finish the job.”

Guest Blog: Sepsis – A Neglected Global Killer (CUGH)

Guest Blogger: Amanda Hirsch


Sepsis can be caused by any serious infection that leads to multi-organ dysfunction. Diseases that most commonly lead to sepsis infection are pneumonia, TB, HIV/AIDS, dengue, diarrheal diseases, etc. Multi organ dysfunction can lead to death if not recognized and treated early.

Every year, approximately 30 million cases of sepsis are documented. However, it is speculated that the 30 million known cases only comprise a portion of the actual incidence of sepsis each year. Recognition and documentation of sepsis cases is lacking and the exact global burden of sepsis remains unknown.

Many deaths that occur due to sepsis are attributed to the original disease. For example, if a patient succumbs to sepsis after contracting pneumonia, their cause of death will likely be recorded as pneumonia. Secondly, late mortality from sepsis contributes to its underreporting. Many sepsis infections occur after a patient is discharged from the hospital. Yet, very few patients return to seek help for their rapidly advanced infection, resulting in a mortality due to sepsis.

The highest burden of sepsis infections occurs especially in low income countries. The lack of resilient health systems, little public education and awareness, costs of healthcare, long distances to healthcare facilities, and poor transportation all make it difficult for individuals to seek and receive care for sepsis. Also in poor countries, low immunization rates, low coverage for citizens, high levels of disease co-morbidity, unprepared or undertrained healthcare workers, a low emphasis on preventative services, few new drugs for tropical diseases circling through the market, and the export of healthcare staff make sepsis significantly more of a threat.

This underrepresentation of sepsis and lacking preparedness and recognition in the healthcare world has pushed members of organizations such as the Global Sepsis Alliance to call for help- bringing public awareness to the unacceptably high current incidence of morbidity and mortality from sepsis, asserting that something must be done.

To curb the incidence of sepsis, a multi-faceted approach is needed. This approach, according to Dr. Ron Daniels includes the following:

  • Vaccinations
  • Strict hygiene
  • Early recognition
  • Aggressive treatment
  • Rational us of antimicrobials
  • Innovations in care
  • Knowledge translation
  • Capacity building
  • Advocacy

On the topic of advocacy, Dr. Daniels spoke of turning sepsis into a political movement of sorts, putting a face and a name to the infection and what it includes. The public must be educated on the signs and symptoms, the media must spread the word, and governments must allow for more data to be collected, support more funding for sepsis research and treatment, and use their power and platform to make sepsis a priority on both the national and international political arenas.


twitter photoAmanda Hirsch is a summer Global Health intern for APHA. She is starting her final undergraduate year at the GWU Milken Institute School of Public Health. Her passion for global health began in rural Honduras, and she is particularly interested in disparities in healthcare systems that affect the Latino community. She intends to pursue an MPH degree with a dual concentration in Community-Oriented Primary Care and Global Health. You can follow her on Twitter at @amandahirsch12.

Cultural Challenge of Female Genital Circumcision by M.L. Tatum

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A very basic definition of culture is the cumulative deposit of knowledge, experience, beliefs, values, attitudes, meanings, hierarchies, religion, notions of time, roles, spatial relations, concepts of the universe, and material objects and possessions acquired by a group of people in the course of generations through individual and group striving (Hofstede, 1997).

Undoubtedly, most humanitarians, community workers, and public health specialists would be able to supply a sufficient definition for culture. The words may vary somewhat, but the basic concept would be the same. However, how many of them truly grasp the vitality of this definition? Moreover, truly value why various practices or beliefs came to be and have continued for generations even in today’s fast-paced and shrinking world with advances in technology, increased availability of education, increases in family income, et cetera.

One cultural practice common in parts Africa and a part of the Middle East is the practice of female genital circumcision (FGC). FGC is believed to have been initiated in the fifth century B.C and continues today, affecting an estimated 2 million girls annually (Shah, Luay, & Furcroy, 2009).

FGC is a coming-of-age tradition for females which takes a variety of forms. It includes the partial or total removal of the external female genital, near complete sewing-up the vagina with only a small opening for urination and menstruation, introduction of corrosive substances into the vagina, and other injury for non-therapeutic reasons (WHO, 1997). Some of the biomedical consequences include infection or hemorrhaging which can lead to loss of life, bowel and bladder incontinence, painful intercourse, and complications with childbirth.

Many persons would consider this to be an atrocity and defilement of girls; as a result, there has been a great deal of global support to implement programs and various interventions to support the cessation of this act. However, termination of FGC continues to be an uphill battle.

I believe us, as professionals, sometimes, do not grasp how deeply ingrained FGC is believed to be necessary in the preparation of a young girl for womanhood. The roots of this practice are so deeply psychologically and emotionally based that families have risked breaking judicial law to continue preparing their child for womanhood. For example, Kenya’s Children’s Act of 2001 made it illegal to subject girls to any form of FGC; consequently, it is believed that practicing tribes are now performing the act secretly, to decrease the risk of being imprisoned. This theory has been supported by people being caught in the act or dealing with girls who are infected or bleeding after going through the procedure (Library of Congress, 2011). What’s more, families who have migrated to Europe and the United States bring their daughters back to their country of origin when they come of age to have this procedure performed.

The complexity of cultural beliefs and their unseen components are sometimes difficult to conceptualize, thus, making it challenging to influence health behavior change. FGC is not just a physical alteration to the body; it is a celebration among friends, mothers, grandmothers, aunts, cousins, and neighbors. It means the individual has now graduated to the next level. She is now of age and ready to progress to the next stage in life. Yes, female genital mutilation is a procedure with unfortunate consequences and it should be addressed by community workers, public health professionals, and humanitarians. Nevertheless, we have to proceed respectfully and view cultural practice in a holistic manner to be effective in implementing sustainable behavioral changes.

The Severity of Racial Health Inequities

Guest Blogger: Tiffany Gilliam


African American women are more likely to succumb to negative health outcomes than any other race or ethnicity. Health inequities are classified as the differences in health status between one disadvantaged population and a group of advantaged. Numerous social determinants of health are related to health inequities, such as:

  • Socioeconomic status
  • Education
  • Age
  • Sex
  • Race and ethnicity
  • Lack of access to quality healthcare

These factors also increase the risk of cardiovascular disease, high blood pressure, diabetes, strokes and healthcare inequity. Nearly 50,000 African American women die each year from cardiovascular diseases. There is a significant gap in life expectancy for African American women compared to white women.

Research has shown that larger populations, like those found in metropolises, correlate to wider gaps in life expectancy. The county of Philadelphia is one of the most racially diverse counties in the United States. That same county contains one of the most racially segregated cities in terms of access to quality healthcare and positive health outcomes. The Philadelphia population is estimated at 1,560,006 residents: 44.2 per cent of which are African American. A recent study conducted by the University of Pennsylvania examined the patient ratio to primary care physician (PCP) in low socioeconomic neighborhoods. The study revealed a PCP ratio of 3,000:1  in underserved areas of Philadelphia. Given this PCP a question is raised regarding the level of care provided to patients. The patient to primary care physician ratio is high due to several reasons such as shortage of primary care physicians, increased amount of Affordable Care Act-covered patients, and the high density of elderly and chronically ill in underserved areas.

In a recent conversation with Sheila, my esthetician, she stated a previous diagnosis of ovarian cancer. The physician immediately advised a treatment of chemotherapy, without any willingness to answer questions or provide additional information.

Before that treatment occurred, however, Sheila received a second opinion from another physician, which revealed that she suffered from endometriosis, not ovarian cancer. After this conversation, numerous questions were raised.  How many other African American women were misdiagnosed and treated for illnesses they did not have? Why was it so difficult for the doctor to make an accurate diagnosis? How often are doctors encouraging participatory medicine when interacting with patients?

How can public health clinicians improve negative health outcomes amongst underserved African American women populations? It is crucial that health polices are created to enforce the overall well-being of African American women of disadvantaged populations. Health policies that promote affordable education, employment opportunities, and adequate accessible health promotion programs are needed in order to improve fair and equal treatment, along with disease prevention and detection.


 Tiffany Gilliam is a first year masters student in Public Health, with a focus in Maternal and Child Health, Social and Behavior Sciences and Health Equity.  Tiffany was elected to serve as the Secretary for La Salle University Public Health Student Organization in April of this year. She received B.S. in Health Studies from La Salle University in 2014.  Tiffany spent much of undergraduate years providing service coordination for adults with developmental disabilities and mental illness for a non-profit in home and community care organization in Philadelphia. Her academic interest includes Global Health, Reproductive and Sexual Health and Public Health Policy.  For the past three years, Tiffany has worked as a Behavioral Health Worker at Northeast Treatment Center, providing coping strategies, social skills, methods to reduce impulsive behavior at school to children with Attention Hyperactivity Deficit Disorder (ADHD), Oppositional Defiant Disorder (ODD)/Conduct Disorder and Mood Disorder.  Her experience as a Breastfeeding Counselor at North Inc. Mangers of the W.I.C program aspired Tiffany to seek graduate studies in public health.  In the near future, Tiffany hopes to become a Certified Health Education Specialist (CHES) as well as teach teens and young adult’s workshops focused on violence prevention, substance abuse and HIV/STI prevention. After completing her masters, Tiffany hopes to pursue a doctorate degree in public health.   Apart from school/work Tiffany enjoys outdoor activities, loves listening to music, traveling, most of all spending time with her three daughters Zaynah (13), Zahraa (12) and Amarachi (3) friends.

Guest Blog: Second Annual Global Social Service Workforce Alliance Symposium at the US Institute of Peace

Guest Blogger: Amanda Hirsch


The SSW symposium provided a forum for practitioners, government representatives, academics, and other experts from around the world to discuss current efforts (3) being undertaken internationally to expand the social service systems for the health and safety of children and families. The presentation was broken into three parts, each part discussing one component of the stride to strengthen the social service workforce.

  1. Planning: Dr. Jini Roby, a professor in the Department of Social Work of Brigham Young University along with Ms. Joyce Nakuta, Deputy Director of the Namibia Ministry of Gender Equality and Child Welfare spoke on the topic of planning the social service workforce. Planning the workforce, they agreed, “takes a system”- a calculated outline of each potential worker and their respective responsibility. To be most effective, social service must work on a network basis from workers on the ground (ie child health workers who raise and mentor orphaned children) to policy makers that have the capacity to encourage funding of child health worker training programs- all positions are necessary for the job to effectively get done.
  2. Robin Sakina Mama, Dean of Monmouth University School of Social Work and Ms. Zenuella Sagantha Thumbadoo, Deputy Director of National Association of Child Care Workers, South Africa discussed developing the social work force. This component of the process deals with educating and training social service workers. Dr. Robin Sakina Mamma spoke about the issue of certification and degrees. Today, many countries in need of social service work are left at a disadvantage because they lack existing institutions that provide proper degrees for social work or do not yet have a place in  the workforce for professional social workers. With that, many do not receive enough of an education in social work to be effective and many do not have a chance to practice and/or use their degrees in their home countries of need.
  3. Natia Partskhaladze of UNICEF and the Georgian Association of Social Works discussed the issue of supporting the workforce. Dr Partskhaladze spoke about worrisome recruitment and retention rates that are particularly high in developing countries, such as her home country of Georgia. The social work profession was non-existent in Georgia as of fifteen years ago. After establishing a study program and professional network for social work in the year 2000, an organization of social workers has since been formed. Centered on retention and development, the organization strives to keep social workers in the workforce while encouraging Georgians to get involved in the field of social work through the development of academic and professional programs and support groups. This organization of social workers now boasts 600 members, making Georgia an example of what committed recruitment and retention efforts can do to create or revive a supply of social workers within a country in need.

In her opening remarks Deputy of the Child Protection Section of UNICEF, Dr. Karin Heissler, noted that social work uses data and lessons learned in order to make decisions about the social service workforce and influence policy- a concept that is very familiar in public health.

Public health is entirely driven by data and “lessons learned”- both are at the base of nearly all interventions and both are necessary when public health professionals must have a voice at the community or policy levels.

The process of “planning the workforce” described is similar to the process of planning an intervention in public health. Both require assessing an issue; anticipating the immediate, medium, and long-term needs to be addressed; and creating a system with which to achieve a goal at all anticipated levels.


twitter photoAmanda Hirsch is a summer Global Health intern for APHA. She is starting her final undergraduate year at the GWU Milken Institute School of Public Health. Her passion for global health began in rural Honduras, and she is particularly interested in disparities in healthcare systems that affect the Latino community. She intends to pursue an MPH degree with a dual concentration in Community-Oriented Primary Care and Global Health. You can follow her on Twitter at @amandahirsch12.

It’s (UN) official: South Korea’s mandatory HIV testing for foreigners is racial discrimination

Note: This was cross-posted to my own blog.


South Korea has come under fire in recent years for its treatment of immigrants, migrant workers, and non-ethnic Koreans (and even their own working-class people). Last fall, Bitter Harvest, Amnesty International’s report on the country’s treatment of agricultural migrant laborers highlighted how Southeast Asian migrants went unpaid, were subjected to harsh treatment and squalid living conditions, and were either deprived of medical care or forced to pay for their own care out of pocket (from their own meager wages). In some cases, the migrants were forced to take (and pay for) an HIV test, with employers requiring a negative test result.

In the case of migrant workers, this is clearly illegal – currently, the only visa category for which the South Korean government requires an HIV test is E-2 (native-speaking English teachers from the US, Canada, the UK, Ireland, South Africa, Australia, and New Zealand). However, even this requirement – first implemented in 2007 in response to a racially-fueled moral panic – has been determined to be discriminatory and racially motivated, according to a ruling from the UN’s Committee to End all forms of Racial Discrimination (CERD) handed down last week. The ruling, issued in response to a case filed by a New Zealand woman who lost her job in 2009 after refusing to take an HIV test to renew her contract – has been long awaited by the expat ESL community in Korea. Whether the Korean government will remove the requirement remains to be seen.

The case was brought to CERD by Benjamin Wagner, an international human rights attorney who co-authored a legal paper on the issue of South Korea’s use of HIV testing as a proxy for racial discrimination with Matt van Volkenburg. The paper (PDF) provides an excellent background on the history, political and cultural climate, and xenophobic advocacy efforts that led to the implementation of the testing requirement, as well as how the requirement is a clear example of South Korea shirking its international human rights obligations:

The HIV and drug test requirements for foreign teachers were first established as emergency measures in 2007 by the Ministry of Justice
(“MOJ”), which claimed they were necessary in order to “ease the anxiety of the citizens.” Part II of this Article examines the background and
context of the implementation of these requirements and argues that they were introduced during a period of media hysteria and moral panic…a civil society group called the “Citizens’ Group for Upright English Education”…succeeded in courting public opinion against foreign English teachers by contributing to highly sensationalized media reportage replete with lurid tales of perversion, sex crimes, drug use and AIDS. This group was also successfully able to influence national policy by petitioning the government for measures against foreign teachers, including mandatory HIV and drug tests.

Part III examines the ROK’s international commitments to eliminate discrimination and stigma based on actual or presumed HIV status and
examines how and why the ROK has failed to honor these commitments.

Korea’s HIV restrictions for foreign teachers are among the most extreme form of HIV restrictions in the world…Of the forty-nine countries in the world that continue to have some form of HIV-related restrictions in place for foreigners only about six have restrictions so extreme as requiring in-country testing for foreign workers that must be repeated on a regular basis, and nowhere are teachers subject to such restrictions. Indeed, the ROK’s extreme position toward its foreign teacher population has attracted the attention of UN Secretary-General Ban Ki-moon who has urged the ROK to eliminate its HIV restrictions on foreign teachers.

Obviously, any foreigner who tests positive for HIV is immediately detained and deported; in 2008, the Korean CDC reported that it had deported 521 out of 647 HIV-positive foreigners. Non-nationals of Korean ethnicity have been able to successfully challenge such deportations, but the Korean judicial system explicitly differentiates between the legal rights of citizens versus foreign nationals.

Interestingly, South Korea has given CERD “the same authority as domestic law” regarding foreign nationals; however, this means next to nothing as Wagner explained in a different piece last week:

Professor Kyong-Whan Ahn…remarked that the constitutional analysis used by Korean courts to determine whether an incidence of discrimination has occurred is relatively underdeveloped. The method relied upon by courts is the “reasonableness test”. But, Ahn complains, decisions are all too often “a foregone conclusion” with little analysis or scrutiny.

[T]he status of the CERD is unique in that “it has the same authority of domestic law and does not necessitate additional legislation,” as the Republic of Korea has made clear to the Committee on several occasions. Nevertheless, the Committee has responded, “although the Convention forms part of the domestic law and is directly applicable in the courts of [South Korea], there are no court decisions which contain references to or confirm the direct applicability of its provisions.” The Committee has pointed out to the government that the situation may be the result of “a lack of awareness of the availability of legal remedies” and has recommended “information campaigns and education programmes on the Convention and its provisions.” Unfortunately, however, the treaty remains relatively unknown in Korea and neither the government nor the courts have done enough to change that.

van Volkenburg, who has been covering this issue (and its origins) since it all began in 2005 at the long-running Korean expat blog Gusts of Popular Feeling, has a great summary of the ruling and its implications (as well as the best collection of links to the news coverage of the ruling):

The summary makes public the justification the UMOE offered for the tests – something that many people taking these tests have known for years, but never admitted by the government:
[D]uring arbitration proceedings, L.G.’s employers, the Ulsan Metropolitan Office of Education (UMOE), said that HIV/AIDS tests were viewed as a means to check the values and morality of foreign English teachers.

One of the Committee’s recommendations isn’t very surprising:

The Committee recommends that the State party grant the petitioner adequate compensation for the moral and material damages caused by the above-mentioned violations of the Convention, including compensation for the lost wages during the one year she was prevented from working.

It continues with much more sweeping recommendations, however:

It also recommends that the State Party takes the appropriate means to review regulations and policies enacted at the State or local level related to employment of foreigners and abolish, both in law and practice, any piece of legislation, regulation, policy or measure which has the effect of creating or perpetuating racial discrimination. The Committee recommends the State party to counter any manifestations of xenophobia, through stereotyping or stigmatizing, of foreigners by public officials, the media and the public at large, including, as appropriate, public campaigns, official statements and codes of conduct for politicians and the media. The State party is also requested to give wide publicity to the Committee’s Opinion, including among prosecutors and judicial bodies, and to translate it into the official language of the State party.

This doesn’t just refer to English teachers, but to regulations for all foreign workers. And as I’ve covered here, the references to the conduct of the media and politicians is very pertinent, considering the ‘Citizens Group for Upright English Education’ (also known as Anti English Spectrum) worked closely with the media and had access to politicians when pushing for the creation of the HIV testing policy (among others) in the first place.

It will be interesting to see how the Korean government will respond to the CERD’s ruling – whether it will in fact change the law in accordance with its treaty obligations. Based on South Korea’s history of human rights protections, it does not look promising. Even when human rights principles are codified into law, employers (and often police officers) who violate workers’ legal rights do so with widespread impunity and are rarely prosecuted or held accountable – as demonstrated by the cases of the migrant workers in Bitter Harvest and the workers enslaved on salt farms on the islands of Jeollanam-do. The admission that HIV tests were seen as a way to “check the values and morality” of visa applicants is a slap in the face – doubly so considering that only foreigners are required to have “upright values” in order to get jobs.

Nonetheless, the CERD ruling is a major victory – a solid foundation on which to pressure the South Korean government, which has demonstrated that it wants to be taken seriously in the international community.