Reports

The 62-page report, “In Sheep’s Clothing: United States’ Poorly Regulated Nonprofit Hospitals Undermine Health Care Access,” describes how the US government’s lack of guidance and oversight allows privately operated tax-exempt hospitals to spend far less on making healthcare services accessible for people without the means to pay than the massive public subsidies they receive. In 2020, for example, nonprofit hospitals collectively received about $28 billion in tax benefits but only spent about $16 billion on free or reduced-price “charity care,” according to the Kaiser Family Foundation.

The 55-page report, “A Nightmare for Everyone: The Health Care Crisis in Pakistan’s Prisons,” documents widespread deficiencies in prison health care in Pakistan and the consequences for a total prison population of more than 88,000 people. Pakistan has one of the world’s most overcrowded prison systems, with cells designed for a maximum of 3 people holding up to 15. Severe overcrowding has compounded existing health care deficiencies, leaving inmates vulnerable to communicable diseases and unable to get medicines and treatment for even basic health needs, as well as emergencies.

The 39-page report, “Access Denied: How Florida Judges Obstruct Young People’s Ability to Obtain Abortion Care,” documents how in Florida many judges deny young people’s petitions, forcing them to continue a pregnancy against their wishes, travel outside the state, or seek a way to manage abortion outside the health system. Judges have the power to make highly subjective determinations about a young person’s maturity and interests. Vague criteria in state law enable highly arbitrary decision-making, with judges making decisions based on factors such as the young person’s grades and impressions of their demeanor during a nerve-wracking hearing.

The 92-page report, “‘If I’m Out of Insulin, I’m Going to Die:’ United States’ Lack of Regulation Fuels Crisis of Unaffordable Insulin,” describes the human rights impacts of US government policies that make essential life-saving medication like insulin unaffordable for many people. Human Rights Watch found that exorbitant insulin prices and inadequate health insurance coverage can cause people to pay high out-of-pocket costs for insulin, contributing to dangerous and potentially lethal medicine rationing, forcing people to forgo other basic needs, and disproportionately affecting socially and economically marginalized groups.

The 82-page report, “‘We Need Access’: Ending Preventable Deaths from Cervical Cancer in Rural Georgia” documents how state and federal policies neglect the reproductive healthcare needs of rural Black women. Cervical cancer is highly preventable and treatable. In 2020, 194 countries committed to ending cervical cancer globally, the first such commitment made for a cancer. While cervical cancer mortality rates have declined in Georgia over recent decades, they are still high and racial disparities persist.

The 39-page report, “‘I Would Like Four Kids—If We Stay Alive’: Women’s Access to Health Care in Afghanistan,” documents barriers to Afghan women and girls obtaining health care and the healthcare system’s deterioration due to declining international support. The drop in international donor funding has already had a harmful—and life-threatening—impact on the lives of many women and girls, as it affects access to and quality of health care.

The 73-page report, “‘The Only People It Really Affects Are the People It Hurts’: The Human Rights Impacts of Parental Notice of Abortion in Illinois,” is the product of a collaboration between Human Rights Watch and the ACLU of Illinois. The groups found that young people often seek judicial bypass because they fear physical or emotional abuse, being kicked out of the home, alienation from their families or other deterioration of family relationships, or being forced to continue a pregnancy against their will. The groups also documented the hardships faced by young people forced to involve unsupportive family members in their abortion decision or navigate an unfamiliar court system to obtain a judicial bypass, and the additional stress and delays in seeking care this caused.

On March 11, 2020, the World Health Organization (WHO) declared that an outbreak of the viral disease Covid-19—first identified in late 2019 in Wuhan, China—had reached the level of a global pandemic. Citing concerns with “the alarming levels of spread and severity,” the WHO called on governments to take urgent and aggressive action to stop the spread of the virus.

The 77-page report, “‘Whoever Finds the Vaccine Must Share It’: Strengthening Human Rights and Transparency around Covid-19 Vaccines,” examines three significant barriers to universal and equitable access to any vaccine that is found to be safe and effective – transparency, supply, and pricing. Human Rights Watch spells out governments’ human rights obligation to ensure that the scientific benefits of the research they fund with public money are shared as widely as possible to protect people’s lives, health, and livelihoods. Human Rights Watch also argues that using public money without reporting its terms and conditions undermines the human rights principles of transparency and accountability. Governments should take steps to maximize the availability and affordability of safe and effective vaccines and minimize debt for low- and middle-income countries.

The 120-page report, “‘My Fear is Losing Everything’: The Climate Crisis and First Nations’ Right to Food in Canada,” documents how climate change is reducing First Nations’ traditional food sources, driving up the cost of imported alternatives, and contributing to a growing problem of food insecurity and related negative health impacts. Canada is warming at more than twice the global rate, and northern Canada at about three times the global rate. Despite its relatively small population, Canada is still a top 10 greenhouse gas emitter, with per capita emissions 3 to 4 times the global average.

The 77-page report named “A Case for Legal Abortion: The Human Cost of Barriers to Sexual and Reproductive Rights in Argentina,” describes the consequences of the Senate’s rejection of a 2018 bill that would have fully decriminalized abortion during the first 14 weeks of pregnancy. Human Rights Watch documented cases of women and girls who have, since then, encountered an array of barriers to access legal abortion and post-abortion care. The barriers include arbitrarily imposed gestational limits, lack of access to and availability of abortion methods, fear of criminal prosecution, stigmatization, and mistreatment by health professionals.

This report documents how since 2016 the government of Tanzania has cracked down on LGBT people and the community-based organizations that serve them. The Health Ministry in mainland Tanzania has prohibited community-based organizations from conducting outreach on HIV prevention to men who have sex with men and other key populations vulnerable to HIV. It closed drop-in centers that provided HIV testing and other targeted and inclusive services, and banned the distribution of lubricant, essential for effective condom use for HIV prevention among key populations and much of the wider public.

This report documents how broad restrictions on financial transactions, coupled with aggressive rhetoric from US officials, have drastically constrained the ability of Iranian entities to finance humanitarian imports, including vital medicines and medical equipment. While the US government has built exemptions for humanitarian imports into its sanctions regime, Human Rights Watch found that in practice these exemptions have failed to offset the strong reluctance of US and European companies and banks to risk incurring sanctions and legal action by exporting or financing exempted humanitarian goods. The result has been to deny Iranians access to essential medicines and to impair their right to health. Under international law, the US should monitor the impact of its sanctions on Iranians' rights and address any violations sanctions cause. 

This report provides an overview of the legal framework behind the human right to water and recommendations on how to work with government officials and other towards the realization of this right.

This report found that instead of providing support to older people with dementia, facilities use drugs to control their behavior, a practice known as chemical restraint. Many of the drugs used to control people in aged care facilities are antipsychotics that are not approved in Australia for older people with dementia. In addition to the physical, social, and emotional harm for older people restrained with these drugs, the use of these drugs in older people with dementia is also associated with an increased risk of death.