Reports

The 66-page report, “‘If the Soldier Dies, It’s On You’: Attacks on Medical Care in Ethiopia’s Amhara Conflict,” documents how Ethiopian federal forces and a government-affiliated militia have attacked medical workers, healthcare facilities, and transports in at least 13 towns since the outbreak of fighting between Ethiopian federal forces and Amhara militia known as Fano in August 2023. Ethiopia’s international partners should call for accountability and an end to attacks on healthcare and should resume increased scrutiny of the rights situation in the country.

The 38-page report, “‘A Disaster for the Foreseeable Future’: Afghanistan’s Healthcare Crisis,” describes how the collapse of Afghanistan’s economy after the Taliban takeover in August 2021 inflicted severe harm on the country’s healthcare infrastructure. Donors’ decisions to reduce humanitarian aid have further weakened health care access, destabilized the economy, and worsened food insecurity. The Taliban’s abusive policies and practices have greatly exacerbated the crisis. Bans on education for women and girls have blocked most training for future female healthcare workers, ensuring shortages for the foreseeable future.

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 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.

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 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 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 documents discrimination and barriers to education in the country’s public school system for most children with disabilities. A major obstacle is a mandatory government medical test that can exclude them from education altogether, the groups found. Additional barriers include inaccessible school buildings, discriminatory attitudes of school staff, and lack of adequate training for teachers and school administrators in inclusive education methods.

This report documents gaps in the Brazilian authorities’ response that have a harmful impact on women and girls and leave the general population vulnerable to continued outbreaks of serious mosquito-borne illnesses. The outbreak hit as the country faced its worst economic recession in decades, forcing authorities to make difficult decisions about allocating resources. But even in earlier times of economic growth, government investments in water and sanitation infrastructure were inadequate. Years of neglect contributed to the water and wastewater conditions that allowed the proliferation of the Aedes mosquito and the rapid spread of the virus, Human Rights Watch found.

This report documents how women and girls cannot get contraception and have little access to health care if they face complications during pregnancy and childbirth. The parties to the six-year-long conflict, the Sudanese government and the rebel Sudan People’s Liberation Army-North (SPLA/M-North), have both obstructed impartial humanitarian aid.

This report is based on data obtained via a Freedom of Information Act request to federal immigration authorities. The data covers nearly 300,000 federal detentions of immigrants in facilities in California over a four-and-a-half-year span. Over that period, an average of about 65,000 immigrants a year were detained in California in 15 facilities. Many were parents of US citizen children. Although the records for most of the period do not specify whether detainees have US citizen children, the records for one nine-month span (October 2014 to June 2015) generally do, and statistical methods can reliably fill the gaps. Analyzing the records for that nine-month span, Human Rights Watch found that nearly half – 42 percent – of detainees had US citizen children.

This report reveals systemic failures, such as unreasonable delays in care and unqualified medical staff, that are likely to expose a record number of people to dangerous conditions under President Donald Trump’s ramped-up deportation and detention plans.