“Human rights underpin everything we do” stated Katherine Deland, Chief of Staff of the WHO Ebola Response, at the Human Rights in Public Health Emergencies event on 10 December. The objective of any public health emergency response, she said - including the current Ebola response - is that people feel respected.

Marking International Human Rights day, the event was jointly organised by the World Health Organization and the Global Health Programme, and moderated by Antoine Flahault, Director of the University of Geneva’s Institute of Global Health.  There has been much debate during the ongoing Ebola epidemic that measures such as travel bans and compulsory quarantines, among others, have violated human rights and represent an over-interpretation of the International Health Regulations (IHR). This is despite the fact that the IHR makes many provisions for human rights, including those of travellers specifically, noted Fernando Gonzalez-Martin, (Legal) Technical Officer from the WHO Health Security and Environment Department.

Deland told of her own experience flying into the United States, where an automated customs point asked whether she had visited any of the three countries affected by Ebola in the last 21 days, after which an affirmative response called over a public health representative. Following a screening process with questions about probable and known cases, as well as having her temperature taken, Deland was given a thermometer to take her temperature twice daily and told to report to local public health personnel. Her overall impression was that she did not feel her rights were intruded upon, though she reiterated that screening should be done upon exit, and that she was only monitored - not quarantined.

The Ebola epidemic has undoubtedly elicited an international response based largely on fears both warranted and unwarranted. Once it had been declared a Public Health Emergency of International Concern in August 2014, and briefly left the African continent, the international community woke up to its own exposedness. The creation of the United Nations Mission for Emergency Ebola Response (UNMEER) as the first-ever emergency health mission is illustrative of the serious global implications of the disease, and the fear over its spread.

The response has showcased just how weak and unprepared the health systems of these countries were in facing an epidemic of this magnitude. According to Article 13 of the IHR, by 2012 parties were expected to have developed the capacity to respond promptly and effectively to public health risks and public health emergencies of international concern. They were also meant to be collectively supported in this endeavour, though, as said by human rights lawyer, Gorik Ooms, from the Department of Public Health at the Institute of Tropical Medicine in Antwerp - “collective responsibility is not working.” For it to work, the system needs steady multilateral coordination, and a strong World Health Organization not reliant upon voluntary contributions.

The question raised by Ooms was: have rights had been violated by steady acts of omission spanning years whereby, for example, signatories to the International Covenant on Economic, Social and Cultural Rights  do not heed operational principles to “to take steps, individually and through international assistance and co-operation… to the maximum of [their] available resources, with a view to achieving progressively the full realization of the rights recognized in the present Covenant by all appropriate means”? By being a signatory to this Covenant, he says, parties should have had a legal obligation to assist countries such as those currently combatting Ebola in implementing the right to health. By not assuring this right, he stated, “most victims of Ebola are victims of human rights violations.”

At the global governance level, proposals to uphold collective responsibilities include the creation of a public research fund where a percentage of gross domestic product (GDP) would go towards urgent research needs and gaps, or the creation of a World Health Insurance. Similarly, a dedicated International Health Systems Fund, to help “build national capacities not only to respond rapidly to public health emergencies, but also to enable low-income and some middle-income countries to deliver comprehensive health services” could offer a solution. These would require significant financial contributions and political willpower, something which was lacking when this discussion was raised at the time of the IHR negotiations, noted Gonzalez-Martin. At the time ‘global fund fatigue’ had grounded such an idea, but with the awareness raised by Ebola about the state of health systems in less-developed nations, perhaps social and political mobility around the issue will reach a critical mass. Once this epidemic is controlled, the next chapter will be ensuring the right to health by reinforcing health systems to effectively respond to public health emergencies in the future. As Deland reflected, “Even in the best circumstances, we can do better.”