Human Rights Watch News https://www.hrw.org/ en Armenia Strengthens Domestic Violence Law https://www.hrw.org/news/2024/04/18/armenia-strengthens-domestic-violence-law Click to expand Image Taguhi shows scars on her neck and shoulder. In 2016, her former husband attacked her and her mother with an axe, killing her mother.  © 2016 Nazik Armenakyan (Daphne.am) <p>Armenia’s parliament adopted amendments strengthening the country’s domestic violence law. The legislation was adopted last week as postwar Armenia both struggles to secure its border with neighboring Azerbaijan and deepen its relations with the European Union.</p> <p>Armenia’s 2017 domestic violence law was an important first step, but its accountability provisions were inadequate and protective measures were deeply flawed. The law’s title, which included “restoring family harmony,” set the tone.</p> <p>The amendments remove the reference to “family harmony” and add additional acts of physical, sexual, psychological, and economic violence that can be considered domestic violence. These include, among others, forced medical and psychiatric interventions, hindering access to medical care, virginity testing, prohibiting or hindering contacts with relatives and friends, and various forms of exercising control over a partner. The amendments also criminalize stalking as a standalone crime.</p> <p>Armenia’s criminal code doesn’t list domestic violence as a standalone offence, but it does specify that if the perpetrators of certain crimes are close relatives, this can be an aggravating factor. The amendments provide that partners and former partners (who are not deemed relatives) are now also included as perpetrators who can be charged with this aggravating factor. The amendments also specify that causing a child to witness domestic violence is tantamount to an act of violence.</p> <p>The amendments set a minimum time period for urgent intervention measures – which are a step short of court-issued protective orders – and extend the time period for protective orders. Both measures allow police to force an abuser from the home or restrict them from communicating with a victim.</p> <p>Finally, the amendments specify that survivors have priority access to free healthcare services to address conditions caused by domestic violence and that shelters must be accessible to people with disabilities.</p> <p>Authorities noted a doubling in the number of criminal investigations into domestic violence: 1,848 investigations in 2023 compared with 960 in 2022. They partially attributed this to a new methodology of compiling statistics and an increased reporting rate, rather than an increase in violence.</p> <p>Much needs to be done in Armenia to protect women and girls from domestic violence. For example, in some cases, courts invalidate police urgent intervention orders. And Armenia has yet to ratify the Council of Europe’s convention on preventing domestic violence, known as the Istanbul Convention. Meanwhile, the Armenian government should continue promoting zero tolerance on domestic violence and ensure accountability of perpetrators.</p> Thu, 18 Apr 2024 12:32:04 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/18/armenia-strengthens-domestic-violence-law UN Plastics Treaty Should Mandate Protection of Human Rights and Health https://www.hrw.org/news/2024/04/18/un-plastics-treaty-should-mandate-protection-human-rights-and-health Click to expand Image A boy sits on a bicycle in front of a plastic recycling facility in Adana, Turkey. © 2021 Human Rights Watch <p>Next week in Ottawa, countries will reconvene to continue negotiations on an international legally binding instrument on plastic pollution. A revised draft of the treaty published by the United Nations Environment Programme on December 28, 2023, contains certain positive measures to reduce plastic production. However, it lacks the necessary provisions to protect human rights and health from the impacts of plastic pollution, especially for frontline communities and those who are most vulnerable.</p> <p>The draft proposes options to address the full life cycle of plastics, from reducing production to eliminating the use of the most hazardous chemicals to improve plastic safety. However, it promotes higher recycling rates to increase producer responsibility without accounting for the human rights and health harm associated with recycling. It also overlooks a significant element of plastic production: fossil fuels. Ninety-nine percent of plastics are made from fossil fuels, which are also the primary driver of the climate crisis.</p> January 25, 2024 US: Louisiana’s ‘Cancer Alley’ <p class="media-block__subtitle text-gray-700 text-sm">Dire Health Crisis From Government Failure to Rein in Fossil Fuels </p> <p>In January, a Human Rights Watch report found that communities living alongside fossil fuel and petrochemical operations, including those producing the feedstocks for plastics, in Louisiana, United States, suffer elevated risks and rates of severe health harm, including cancer, respiratory ailments, and maternal, reproductive, and newborn health harm. This area has come to be known as “Cancer Alley” due to parts of it bearing the highest risks of cancer from industrial air pollution in the country. In Cancer Alley, health harm from fossil fuel operations disproportionally impacts Black residents.</p> September 21, 2022 Turkey: Plastic Recycling Harms Health, Environment <p class="media-block__subtitle text-gray-700 text-sm">Lax Monitoring, Enforcement Creates Serious Rights Risks</p> <p>Previously, Human Rights Watch documented the harmful impacts of plastic recycling in Turkey, where people living near recycling facilities suffer respiratory and skin ailments from pollutants and toxins emitted from plastic recycling. The treaty should not promote higher recycling rates without outlining measures to mitigate human rights and health impacts linked to recycling.</p> <p>Governments are obligated under international human rights law to respect, protect, and fulfill all human rights, including the rights to health and to a clean, healthy, and sustainable environment. The plastics treaty should uphold existing obligations and commitments, including by phasing out fossil fuels, to address the climate crisis.</p> Thu, 18 Apr 2024 10:40:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/18/un-plastics-treaty-should-mandate-protection-human-rights-and-health German Chancellor’s Trip to China a Wasted Opportunity https://www.hrw.org/news/2024/04/18/german-chancellors-trip-china-wasted-opportunity Click to expand Image German Chancellor Olaf Scholz sits opposite of Chinese President Xi Jinping during talks at the State Guest House in Beijing, China, April 16, 2024. © 2024 Michael Kappeler/picture-alliance/dpa/AP Photo <p>Germany's economy is very dependent on China, so expectations were low that Chancellor Olaf Scholz would place human rights concerns prominently on the agenda of his April 13-16 trip to China. But his apparent unwillingness to publicly say the words “human rights” was deeply disappointing.</p> <p>The Chinese government’s long-egregious human rights record has become dramatically more repressive since Xi Jinping took power in 2013. Thousands of critics of the government are behind bars. The government oppresses and surveils the Tibetan and Uyghur populations and for years has actively suppressed their language, culture, and religion. In recent years, Beijing has deprived the people of Hong Kong’s fundamental freedoms.</p> <p>Scholz’s three days in China were longer than any of his previous trips since taking office. He came with a huge entourage, consisting of the heads of the largest and most renowned German companies, as well as federal ministers, state secretaries, and the media. He spoke for hours with Xi, campaigned for freer trade for German industries, and sought Chinese support on key foreign policy issues, including over Russia’s invasion of Ukraine. He assured journalists that he had addressed "all the difficult issues," but did not once mention “human rights.”</p> <p>Sino-German relations are complicated. But even evaluated against its own metrics, the new German China Strategy, the German chancellor did not achieve its aims. The strategy recognizes China as a security threat and geopolitical competitor from which Germany should “de-risk,” and that the two countries’ relations should be rules-based and values-driven. This broadened Sino-German relations from their traditional focus on improving market access for German industries to a more multifaceted one.</p> <p>But sadly, the German China Strategy proved to be nothing but hollow words. Germany’s experience with Vladimir Putin’s Russia should have made it clear that abusive governments make unreliable trade partners. Instead of steering Sino-German relations on a new course consistent with its own strategy by publicly promoting respect for human rights, Scholz defaulted to the well-worn path that will not further Germany’s long-term interests nor the basic human rights of the people in China.</p> Thu, 18 Apr 2024 09:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/18/german-chancellors-trip-china-wasted-opportunity Explosive Weapons’ Dire Impact on Cultural Heritage https://www.hrw.org/news/2024/04/18/explosive-weapons-dire-impact-cultural-heritage Click to expand Image A statue of 18th-century Ukrainian philosopher and poet Hryhorii Skovoroda stands amidst the ruins of a museum and memorial dedicated to him in Skovorodynivka in the Kharkivska region of Ukraine. The building was destroyed when a munition fired by Russian forces hit the roof on May 6, 2022, sparking a major fire. © 2022 Sergey Kozlov/EPA-EFE/Shutterstock <p>(Oslo, April 18, 2024) – The bombing and shelling of cities and towns during armed conflict has devastating consequences for cultural heritage and civilians, Human Rights Watch and Harvard Law School’s International Human Rights Clinic said in a report released today. Minimizing this harm should be addressed at the first meeting of countries endorsing the 2022 Political Declaration on the Protection of Civilians from the Use of Explosive Weapons, which will be held in Oslo, Norway from April 22-24, 2024.</p> <p>The 80-page report, “Destroying Cultural Heritage: Explosive Weapons’ Effects in Armed Conflict and Measures to Improve Protection,” details both the immediate and long-term harm from the use of explosive weapons in populated areas on cultural heritage, such as historic buildings and houses of worship, museums and archives, public squares, and performance centers. It shows that the Declaration on explosive weapons could serve as a valuable tool for addressing the problem.</p> April 18, 2024 Destroying Cultural Heritage <p class="media-related__subtitle text-gray-700 text-lg font-serif font-normal leading-snug py-2">Explosive Weapons’ Effects in Armed Conflict and Measures to Strengthen Protection</p> <p class="media-related__item-title font-semibold text-sm pl-4">Download the full report in English</p> <p>“Governments should recognize that using explosive weapons in populated areas endangers cultural heritage as well as the people who cherish it,” said Bonnie Docherty, senior arms adviser at Human Rights Watch and a lecturer on law at the Harvard Clinic. “To preserve this heritage for future generations, parties to armed conflicts should abide by the 2022 Political Declaration and refrain from bombing and shelling populated urban areas.”</p> <p>When used in populated areas, explosive weapons, such as aerial bombs, artillery projectiles, rockets, and missiles, kill and injure civilians and destroy civilian objects at the time of attack. These weapons also have long-term indirect, or “reverberating,” effects that aggravate civilian suffering. By harming cultural heritage, the weapons erase history, undermine community identity and unity, and have financial costs.</p> Play Video <p>Human Rights Watch and the Harvard Clinic interviewed 17 experts and affected civilians, reviewed primary and secondary sources, and conducted legal analysis. </p> <p>They examined Russia’s ongoing war in Ukraine to illustrate the vulnerability of cultural heritage to explosive weapons in populated areas. They surveyed five examples – including local museums and archives, cultural sites in urban centers, and places of worship – that highlight the frequency, diversity, and gravity of the effects of explosive weapons on cultural heritage, and why these effects matter to the civilian population. </p> <p>The researchers also drew on examples from other armed conflicts, notably Gaza and Yemen, to differentiate and elaborate on the direct and indirect harm to places and people that this method of war causes.</p> <p>“The use of explosive weapons causes heartbreaking loss to sites and objects that may be treasured locally or globally,” Docherty said. “The damage also strikes at the heart of a nation’s people, who expect to pass their cultural heritage from one generation to the next.” </p> <p>Since November 18, 2022, 86 countries have endorsed the Declaration, which sets standards for preventing and remediating the effects of the use of explosive weapons in populated areas. </p> <p>Countries should interpret the Declaration and put it into practice to maximize the protection of cultural heritage, Human Rights Watch and the Harvard Clinic said. In addition to avoiding the use of explosive weapons in populated areas, countries should, for example, train soldiers to recognize and understand the significance of local cultural heritage, collect and share data related to cultural heritage damage, and allow preservation experts immediate access to affected sites. </p> <p>By taking such steps, parties to armed conflicts can bolster safeguards for cultural heritage laid out in existing international law. In practice, these steps can better protect both cultural heritage and civilians. </p> <p>“Countries should join the Declaration on explosive weapons and use it to maximize its humanitarian impact,” Docherty said. “By implementing its protections for cultural heritage, countries will also benefit civilians and hopefully reduce the long-term horrors of war.” </p> Thu, 18 Apr 2024 02:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/18/explosive-weapons-dire-impact-cultural-heritage West Bank: Israel Responsible for Rising Settler Violence https://www.hrw.org/news/2024/04/17/west-bank-israel-responsible-rising-settler-violence Click to expand Image A family packs up their belongings in Khirbet Zanuta, in the southern West Bank, on October 30, 2023. Attacks by settlers, in some cases accompanied by soldiers, forced all the residents to leave. © 2023 Marcus Yam/Los Angeles Times via Getty Images <p>(Jerusalem) – The Israeli military either took part in or did not protect Palestinians from violent settler attacks in the West Bank that have displaced people from 20 communities and have entirely uprooted at least 7 communities since October 7, 2023, Human Rights Watch said today.</p> <p>Israeli settlers have assaulted, tortured, and committed sexual violence against Palestinians, stolen their belongings and livestock, threatened to kill them if they did not leave permanently, and destroyed their homes and schools under the cover of the ongoing hostilities in Gaza. Many Palestinians, including entire communities, have fled their homes and lands. The military has not assured displaced residents that it will protect their security or allow them to return, forcing them to live in precarious conditions elsewhere.</p> <p>“Settlers and soldiers have displaced entire Palestinian communities, destroying every home, with the apparent backing of higher Israeli authorities,” said Bill Van Esveld, associate children’s rights director at Human Rights Watch. “While the attention of the world is focused on Gaza, abuses in the West Bank, fueled by decades of impunity and complacency among Israel’s allies, are soaring.”</p> <p>Human Rights Watch investigated attacks that forcibly displaced all residents of Khirbet Zanuta and Khirbet al-Ratheem south of Hebron, al-Qanub east of Hebron, and Ein al-Rashash and Wadi al-Seeq, east of Ramallah, in October and November 2023. The evidence shows that armed settlers, with the active participation of army units, repeatedly cut off road access and raided Palestinian communities, detained, assaulted, and tortured residents, chased them out of their homes and off their lands at gunpoint or coerced them to leave with death threats, and blocked them from taking their belongings.</p> <p>Human Rights Watch spoke to 27 witnesses of the attacks, and viewed videos that residents filmed, showing harassment by men in Israeli military uniforms carrying M16 assault rifles. As of April 16, the Israel Defense Forces did not reply to questions Human Rights Watch sent by email on April 7.</p> <p>Settler attacks on Palestinians increased in 2023 to their highest level since the UN began recording this data in 2006. This was the case even before the Hamas-led attacks on October 7 that killed about 1,100 people inside Israel.</p> <p>Following October 7, the Israeli military called up 5,500 settlers who are Israeli army reservists, including some with criminal records of violence against Palestinians, and assigned them to West Bank “regional defense” battalions. The authorities distributed 7,000 guns to battalion members and others, including “civilian security squads” established in settlements, according to Haaretz, and Israeli rights groups. Media reported that settlers left leaflets and sent threats on social media to Palestinians after October 7, such as warnings to “flee to Jordan” or be “exterminate[d],” and that “the day of revenge is coming.”</p> <p>The UN has recorded more than 700 settler attacks between October 7 and April 3, with soldiers in uniform present in nearly half of the attacks. Attacks since October 7 have displaced over 1,200 people, including 600 children, from rural herding communities. At least 17 Palestinians were killed and 400 wounded, while Palestinians have killed 7 settlers in the West Bank since October 7, the UN reported.</p> <p>On April 12, the body of a 14-year-old Israeli boy was found after he had disappeared from the settlement outpost of Malachei Hashalom. Since then, settlers have attacked at least 17 Palestinian villages and communities in the West Bank, according to OCHA. Yesh Din, an Israeli human rights group, reported that four Palestinians, including a 16-year-old boy, have been killed in these incidents, and that houses and vehicles were set on fire, and livestock killed.</p> <p>None of those evicted from the five communities investigated have been able to return, Human Rights Watch found. The Israeli military either rejected or did not answer requests to allow residents to return, leaving Palestinians without protection from the same armed settlers and soldiers who threatened to kill them if they returned. One family with seven children, forced to flee on foot from al-Qanub, now lives in a small cinderblock storeroom with no money to pay the rent.</p> <p>Haqel: In Defense of Human Rights, an Israeli human rights organization, petitioned the Israeli High Court to instruct the army to protect  five Palestinian communities from threats of displacement due to settler violence, and to allow Khirbet Zanuta families to return to their lands. The Israeli state attorney’s February 20 response claimed that no forced displacement occurred in Khirbet Zanuta, and that Palestinians had left voluntarily due to herding and agricultural problems, according to Haqel. The next hearing in the case is scheduled for May 1.</p> <p>The displaced residents raised sheep. Some said that Israeli attackers stole vehicles, cash, and household appliances, as well as sheep and fodder that families had bought on credit and now cannot repay. Other families escaped with their flocks but had to build new shelters and have nowhere to graze them.</p> <p>Settlers have subsequently been grazing their own sheep on the communities’ lands, according to rights groups. The Israeli rights group B’Tselem reported that as of mid-March, settlers had taken over 4,000 dunams (about 988 acres) of Palestinian grazing lands since October 7.</p> <p>Repeated settler attacks, often at night, have caused fear and mental health harm. Children and their parents said children have had nightmares and difficulty concentrating. The attacks destroyed schools in two of the five communities. Most children were unable to go to school for a month or longer after being displaced.</p> <p>The Israeli police have law-enforcement jurisdiction over settlers, while the army has jurisdiction over Palestinians in the occupied West Bank. After October 7, Israel’s National Security Minister Itamar Ben-Gvir instructed police not to enforce the law against violent settlers, an Israeli investigative journalist reported. Police denied the report, though Ben-Gvir did not. The vast majority of Palestinian complaints against settlers and the Israeli military do not result in indictments, based on official data compiled by Yesh Din.</p> <p>After October 7, the National Security Ministry distributed thousands of guns, including to settlers. In December, the Attorney General’s Office stated in the Knesset that they had found the Ministry had unlawfully approved 14,000 firearms permits.</p> <p>Countries including the United States, Germany, Italy, and the United Kingdom have licensed exports of weapons, including assault rifles and ammunition, to Israel. The US has approved more than 100 weapons transfers to Israel since October 7, and exported 8,000 military rifles and 43,000 handguns in 2023, before pausing a shipment of 24,000 assault rifles in December over concerns about settler attacks. It is “almost a certainty” that settlers are using US-made guns, a former US State Department official said.</p> <p>Since December, the United Kingdom, the United States, and France announced visa policies that barred some violent settlers from entry. The US and UK imposed financial sanctions on a total of eight settlers and two settlement outposts. EU sanctions are still being discussed, due to staunch reluctance by the Czech Republic and Hungary.</p> <p>Forcible transfer or deportation and the extensive destruction and appropriation of property in occupied territory are war crimes. Israeli authorities’ systematic oppression of and inhumane acts against Palestinians, including war crimes, committed with the intent to maintain the domination of Jewish Israelis over Palestinians, amount to the crimes against humanity of apartheid and persecution.</p> <p>Governments should suspend military support to Israel, given the risk of complicity in abuses. They should also review and possibly suspend bilateral agreements, such as the EU-Israel Association Agreement, and ban trade with settlements in the occupied territories. The UK should immediately withdraw the Economic Activity of Public Bodies (Overseas Matters) Bill, which restricts public bodies in the UK from deciding not to do business with companies’ operating in illegal Israeli settlements in the West Bank.</p> <p>The US, the EU, UK, and other countries should take action to ensure accountability for those responsible for war crimes and crimes against humanity, including criminal investigations and prosecutions under universal jurisdiction and at the International Criminal Court. This should include those responsible under command responsibility for failures to prevent or punish crimes by those in their chain of command.</p> <p>In addition, they should consider sanctions on those responsible for ongoing Israeli attacks on Palestinian communities or for the prevention of displaced Palestinians from returning to their lands, until those subject to sanctions end the attacks and ensure the displaced Palestinians can return, Human Rights Watch said.</p> <p>“Palestinian children have seen their families brutalized, and their homes and schools destroyed, and the Israeli authorities are ultimately to blame,” Van Esveld said. “Senior state officials are fueling or failing to prevent these attacks, and Israel’s allies are not doing enough to stop that.”</p> Israeli Attacks Investigated <p>*** Names have been changed for people’s protection.</p> Al-Qanub <p>Settler attacks forced the residents of al-Qanub, 10 kilometers east of the town of Sa’ir, near Hebron in the southern West Bank, to flee on the evening of October 9. The community of about 40 people have been unable to return.</p> <p>From October 7 to 9, ten to twelve settlers in civilian clothes, armed with handguns and assault rifles, piled up stones each day to block the only road to al-Qanub, which links it to the town of Sa’ir, said Salma, a 29-year-old resident who fled with her husband, Salim, and their seven children.</p> <p>At 4:30 p.m. on October 9, dozens of armed settlers arrived. “Some went to [get] the sheep, and nine of them came to us,” Salim said. “They had guns and knives.” Settlers ordered them to leave within an hour or they would be killed, and one man said he would “cut our throats, and pointed at us, including our kids.”</p> Click to expand Image One of the homes destroyed in al- Qanub, a Palestinian community in the southern West Bank, after all residents fled from armed settlers on October 9, 2023. © 2023 Private <p>Dozens of men, with dogs, stole and led the 200 sheep that Salim and his father owned toward a settlement outpost, Salim said. He and several neighbors ran toward them, but “that seemed to trigger [the settlers].” His father feared they would open fire and warned the residents to leave. The men, and women and children fled in different groups: “I told my wife to take the kids and run.”</p> <p>Salma carried her 8-month-old boy and walked with her other children through rocky terrain for more than five hours in the dark, until 10 p.m., to reach her parents’ home, she said.</p> <p>Salim, 35, his father, 75, and his children were all born in al-Qanub. “All our life was there,” he said. He is 18,000 shekels (about US$4,800) in debt for sheep fodder that settlers stole, he said. The family is living in a windowless, cinderblock storeroom in a nearby town, with no income to pay the rent.</p> <p>Settlers from an outpost 400 meters away west of al-Qanub, began harassing residents five years ago, Salim said. It appears the settlers came from the outpost of Pnei Kedem North. Settlers prevented residents from grazing their sheep, and “cut the electricity, and three months ago they cut the water. They even took the pipes.” In December 2021, settlers set dogs on two brothers in al-Qanub and hit one brother with an all-terrain vehicle, and in February 2022, settlers attacked the brothers’ father, 76, fracturing two of his fingers and his skull, the rights group B’Tselem reported.</p> Wadi al-Seeq <p>Attacks involving armed settlers in civilian clothes and an Israel Defense Forces unit displaced all 30 families – about 180 people, including 90 children – from Wadi al-Seeq, northeast of Ramallah, on October 12, based on residents’ and human rights groups’ accounts, as well as Israeli news reports.</p> <p>Beginning on October 7, settlers gathered daily at the entrance of the road that leads to the community. At 8 p.m. on October 11, a group of 8 to 10 men in military uniforms, armed with M16s and some wearing masks, arrived in two trucks, said 46-year-old Abu Hasan.</p> <p>The uniformed men first entered the tents belonging to Abu Nayef and his sons, destroyed and stole the family’s belongings, then searched other people’s tents until around 3 a.m., Abu Hasan said.</p> <p>Later that morning, a prominent local settler, armed and wearing civilian clothes, led a group of armed men wearing military uniforms without name tags who had arrived in civilian cars in blocking an access road, while a military vehicle and two police patrol vehicles were stationed nearby, four residents said.</p> <p>Four vehicles with soldiers, some of whom residents recognized as settlers from prior attacks, then entered Wadi al-Seeq, residents said. The soldiers took residents’ phones, car keys, and IDs, hit people, and entered tents where women and children were taking cover, and threw belongings on the ground, said 30-year-old Marwan M.</p> <p>The attackers said they would shoot residents if they did not leave within an hour. Abu Bashar said: “They said, you can’t take anything with you, and even the cars were forbidden.” About 30 people were wounded in the attack, according to news reports.</p> <p>Soldiers entered Reem R.’s tent, shoved her and her children, and took their phones, she said. “One man in uniform kicked me in the back of my neck. They said, ‘Go to the valley, and if you come back, we will kill you.’” As she was fleeing, Reem saw her 20-year-old son, who has a congenital bone condition and a physical disability, lying on the ground, with a settler “stomping on his back,” she said. The women and children, including two with physical disabilities, fled to a cave, where they sheltered for eight hours without food or water, or their phones, until around 8 p.m., then walked toward the town of Taybeh, Reem said.</p> Click to expand Image Bruising on one of the men attacked by settlers and active-duty soldiers, in Wadi al-Seeq on October 12, 2023. The man was hospitalized for his injuries. © 2023 Private <p>Meanwhile, soldiers forced Marwan M., Abu Hasan, and a third man, Nadim N., onto the ground, bound them, and hit, kicked, and beat them with their gun butts, they said. Another group of soldiers arrived and left, and a civilian vehicle arrived with men in military uniforms. Soldiers dragged the three men to a sheep pen, blindfolded and stripped them to their underwear, replaced the zip-tie on Abu Hasan’s wrists with painful metal wire, and for more than two hours, beat and kicked the men in the head and face. Nadim N. was burned with cigarettes. Marwan M. lost consciousness, he said. The attackers posted images of the men online.</p> <p>“They took turns beating us, over and over, with threats like, ‘When you die your wife won’t be able to feed your children’,” Abu Hasan said. One man urinated on him, and another kicked him in the chest, stomach, and genitals. “I was screaming in pain. After that he brought a broom handle, jumped on my back, hit me with it and tried to shove it in my anus.”</p> <p>Abu Hasan said the attackers stole three phones and 2,700 shekels (about US$700) in cash from the three men, and other belongings. In the evening, an Israeli military medic arrived with other soldiers. Marwan M. said, “they gave me glucose, and apologized. We told them how they stole our cars, phones, money, everything, and insisted that they get our things back, but they didn’t respond [to our requests].” He and Abu Hasan were hospitalized.</p> <p>About five days later, Israeli authorities in two police cars escorted some residents back for two hours to retrieve their belongings, Reem R. said. Her household’s mattresses, blankets, clothes, electrical equipment, refrigerator, car trailer, 250 chickens, and 35,000 shekels (about US$9,400) worth of sheep fodder that was bought on credit, were missing, she said. Other residents’ documents, including birth and marriage certificates, were burned or missing, and two cars, water tanks, donkeys, chickens, and 13 sheep had been stolen, Abu Bashar said. Their homes had been destroyed.</p> <p>Residents said they filed a complaint at the police station in the Binyamin settlement but have heard nothing since. The military asked two men to submit complaints.</p> <p>The soldiers involved in the attack were part of the military’s Desert Frontier unit, which recruits residents of settlement outposts, including some settlers with criminal records, Haaretz reported. The military dismissed the commander in October in response to reports about the attack, and in December, dismissed five combat soldiers and froze the unit’s operations following additional violent incidents, Haaretz reported. Human Rights Watch is not aware of anyone having been prosecuted in relation to the events.</p> <p>In December, the Israeli military filed an order barring the settler leader from most of the West Bank, for three months. He appealed the order. The US sanctioned him in March.</p> <p>Reem R. and her family are sheltering in a tent on the outskirts of Taybeh. Her children were out of school for more than two months. The school in Wadi al-Seeq, which opened in 2017 and had over 100 students in grades 1 through 8, including children from neighboring communities, was destroyed after the attack.</p> <p>The families were originally displaced during the 1948 war from what is now Israel. Between 2010 and 2023, the Israeli military issued demolition orders for 110 structures in the community, including the school, for lacking building permits, which are almost impossible for Palestinians to obtain.</p> <p>Settlers began herding sheep on the community’s lands and harassing residents in February 2023. On August 3, settlers beat children and youth with sticks and tried to steal their sheep, residents said. The army arrested three men who prevented the theft and detained 35-year-old Karim K. on charges of assault and resisting arrest, which his uncle said were bogus. He was released in February on bail and a third-party guarantee.</p> Khirbet al-Ratheem <p>Between October 14 and 23, the entire community of about 50 people in Khirbet al-Ratheem, in the southern West Bank, was displaced due to attacks by armed men in military uniforms whom community residents recognized as settlers from previous attacks, accompanied by other soldiers whom residents did not recognize.</p> <p>Settlers began to harass Khirbet al-Ratheem in 2021, destroying crops and raiding homes at night, former residents said.</p> <p>On October 7, 2023, soldiers arrived and warned the community not to leave their homes or graze their sheep and blocked all the roads. On October 8, settlers attacked the home of 50-year-old Ghassan G., his 44-year-old wife Farah, and their three children under the age of 18; destroyed two water cisterns; and smashed their solar panels with stones.</p> <p>At 10 p.m. on October 12, five masked, armed men in military uniforms forced three nearby households into Ghassan’s tent, dragging Ghassan’s elderly father, who had difficulty walking, and pointing an M16 at his head, Farah said. One man told them, “You have 24 hours to leave, [or] we will kill you and take your sheep,” Ghassan said. The attackers punctured their water tanks and cut their gas and water pipes. Ghassan called a humanitarian agency and the nearby municipality of al-Samu’a to help them evacuate but was told it was not possible to coordinate with the Israeli military, he said.</p> <p>On the night of October 13, masked and armed soldiers, whom a family member identified by their voices as “settlers we’re used to,” entered the family home again, threatened them and demanded their phones. The family member, who hid her phone and video camera, showed Human Rights Watch videos of prior settler attacks.</p> <p>As Ghassan’s extended family were leaving on October 14, settlers returned and forced them face-down on the ground, beating, kicking, and threatening to kill them, family members said. The family escaped to the town of al-Samu’a, 15 kilometers away, with 220 sheep, a few solar panels, appliances, and mattresses. A neighbor later filmed a settler bulldozing their home.</p> <p>Ghassan had to build a sheep shelter on the outskirts of al-Samu’a, at a cost of 50,000 shekels (about US $13,400), and buy fodder. Previously, the sheep had grazed on 30 dunams (about 7 acres) of land.</p> <p>The extended family of 76-year-old Abu A. and his wife, Lana, who have five children under the age of 18 along with adult children and their families, lived nearby. On October 8 or 9, men Abu A. recognized as settlers from an outpost of the Asa’el settlement entered their home and warned them to leave or “we’ll cut your throats.” His family found the slain body of one of their sheep next to their door, on October 11. At 11 p.m. on October 12 or 13, settlers smashed their solar panels, Abu A. said.</p> <p>At 9 p.m. on October 16, five masked men, one wearing a military uniform and carrying an M16 assault rifle, arrived at Abu A.’s home, “shoved me on the ground, and the one in uniform kicked me in my stomach and hit me in the forehead with the butt of his gun.” The men punctured a water tank and warned them to leave by October 21 “or we will burn you.” Lana was hiding inside with her daughter in law and her daughters, including Anan, 8. Anan said she was very scared and “hid inside the closet and looked through the keyhole.”</p> <p>Abu A.’s son, Iyad, said that on October 20, a group of uniformed Israeli forces detained him and three of his brothers. Some soldiers beat and stomped on them, and warned them to leave, as other soldiers “sat on the side,” Iyad said.</p> <p>At noon on October 21, as the family was leaving with their belongings, three soldiers armed with M16s, blindfolded and zip-tied Iyad. Iyad said he was hit on the head with gun butts, taken to an outpost and then to two settlements, and finally to an army base in the Otniel settlement. He was released at 10 p.m. after Israeli police came to the settlement. A photograph taken on October 22 shows Iyad’s swollen hands and raw marks on his wrists, consistent with zip tie restraints.</p> <p>Abu A., who has 11 siblings, said his family had owned 600 dunams (about 148 acres) of land in the area, where he was born in 1947. His family are now in al-Samu’a, but he could not graze his herd, forcing him to sell 100 of his sheep. He had previously sold his six cows after the Israeli military prevented him from accessing their grazing lands. “We are in debt, [and] we don’t have any income,” he said.</p> <p>Three brothers from another branch of the family were forced to leave by soldiers whom residents recognized as settlers. One of the brothers, 43-year-old Ayman A., said that after October 7, settlers wearing military-uniform pants, driving a bulldozer and two cars, repeatedly threatened him, his wife and their seven children to leave “or we will burn you.”</p> <p>On October 23, uniformed soldiers whom Ayman described as settlers, fired their M16s in the air and “threw us onto the ground.” He and his brothers, Mohammed and Amer, said settlers hit them and stomped on their backs. At around 9 p.m., the brothers and their families fled to al-Samu’a but had to leave behind their furniture and appliances.</p> <p>Their wives and children are staying in a relative’s home in al-Samu’a, while the brothers and their older sons are staying close to a shelter they built for their 150 sheep. “It cost 8,000 shekels [US $2,100] for a bulldozer to clear the ground,” and thousands more in building materials, Ayman said. The sheep, cut off from grazing lands, need 125 kilograms of fodder each day.</p> <p>Schools in the area switched to online education after October 7 due to the movement restrictions Israel imposed. Only 5 out of 23 schoolchildren in the extended family had devices or phones and were able to attend online classes, a family member said. Some schools reopened in mid-December.</p> Khirbet Zanuta <p>Human Rights Watch interviewed members of the extended S. and N. families who fled Khirbet Zanuta, in the southern West Bank, on November 1 due to settler attacks. The entire community of more than 140 people was displaced.</p> <p>Saleh S., 38, and his wife and four children, ages 5 to 11, said their families had lived in Khirbet Zanuta “since our grandparents’ days.” Settlers established a nearby outpost three years ago and repeatedly harassed the community. After October 7, “they entered the house, cursing at us, harassing the children, swearing at them. It was every other day, if not in the morning, then at night,” Saleh said.</p> <p>On October 7, settlers bulldozed and blocked the entrance to the road into Khirbet Zanuta from al-Dhahiriya, eight kilometers away, said Saleh’s sister, Abier, 45. In the following weeks, settlers regularly threw stones at their homes at night, hitting the metal roof. “For 10 days we weren’t able to sleep,” said Saleh’s brother Sami, 53, who lived nearby with his wife and three children, two of them under 18. Settlers smashed Saleh’s solar panels and windows and destroyed several residents’ cars.</p> <p>On October 31, six armed settlers drove all-terrain vehicles to the home of Saleh’s brother Mahmoud, 42, his wife and three children, ages 2 to 9. They detained and beat him, Mahmoud said. Mahmoud said: “They were choking me, I thought they were going to kill me. They hit me with their M16s, all over, [on] my back, my arms. They cursed me and threatened my family, in Arabic and Hebrew. They threw me on the ground. There were cactus spines stuck in me.”</p> Click to expand Image A room under construction by families displaced after attacks by settlers and soldiers from Khirbet Zanuta, in the southern West Bank, November 23, 2023. © 2023 Bill Van Esveld/Human Rights Watch <p>Saleh and Mahmoud said that they recognized the leader of the settlers who warned residents to leave their homes after October 7. This man had previously carried an M16 or a handgun and led settlers who cut water pipes, punctured water tanks, and used a drone to terrify the family’s sheep, Saleh and Mahmoud said. On November 1, the extended family fled. Sami said settlers armed with M16s “threw rocks at us even while we were leaving.” “We took the solar panels, the sheep, and our [kitchen] cutlery,” but had to leave everything else, said his sister, Abier. The family had to let their 100 pigeons go free. They rented three large trucks to help move their 300 sheep, at a cost of around 3,200 shekels (about US$860).</p> <p>The family paid 60,000 shekels (US$16,000) to build a new sheep shelter, but without access to their lands, including four water cisterns, they cannot afford to keep the flock. The three brothers built rooms to live in, one per family, in a field near al-Dhahiriya. Saleh said, “I haven’t been able to sleep, I haven’t been able to eat. They forced a Nakba [catastrophe] on us.”</p> <p>Munir and Sara N., both 38, and their nine children lived in another part of Khirbet Zanuta. At 7 a.m., a few days after October 7, settlers in two trucks, armed with assault rifles, accompanied by soldiers, beat six of Munir’s neighbors, threatening to shoot them. Settlers smashed the windows of a neighbor’s Mitsubishi truck and the windows of nearby houses.</p> <p>Two days later, at 10 p.m., soldiers and settlers returned. One man threw a stun grenade inside the family home, where the children were sleeping, Sara said. Her daughter, Yara, 13, said, “The soldiers threw a sound bomb [stun grenade] close to us and I got very scared.” “The weapons terrify the younger kids, and we were afraid for their lives,” Munir said.</p> <p>At midnight, several days later, eight or nine settlers arrived, accompanied by a military vehicle from which three soldiers descended. Settlers assaulted four families living nearby, beat Munir with the butts of their guns, and warned, “You have 24 hours to leave, or we’ll set fire to you.” The next day the family rented trucks at a cost of 2,100 shekels (about US$560) to move their livestock, which now shelter in an unfinished building.</p> <p>After October 7, settlers also repeatedly flew drones over the family’s penned-in flock of 250 sheep, causing them to panic and trample one another, killing 10 sheep, Munir said.</p> <p>“We’re all in debt,” Munir said. “If anyone would provide safety and protection for my children from settlers, we would go back [home].” On January 31, rights activists filmed settlers fencing off Khirbet Zanuta’s lands.</p> <p>Sara’s children had gone to school in Khirbet Zanuta before October 7, but afterward, schools shifted to online learning, “and we don’t have internet devices.”</p> <p>The school had 27 students from kindergarten to 6th grade, an education official said. It was burned in an apparent arson attack on November 20, and filmed on November 21 by a member of B’tselem, who posted photos and videos online. The school, built with humanitarian support from the EU, the UK, and other European countries, was later bulldozed.</p> <p>The school’s kindergarten was subsidized and cost parents 150 shekels (about US $40) per year. Nadia, age 4, who had attended the kindergarten, said, “I saw it burned [on social media]. All of it. I got sad, and I started yelling. I used to play with doctor tools, kitchen tools, dolls, and Barbies.” Nadia’s family cannot afford the kindergarten where they are displaced, which costs 200 shekels (about US$53) per month.</p> <p>School officials partnered with civil society groups to offer psycho-social support programs, a weekly health clinic, and purchased hearing aids for one student, the education official said. “The students lost so much with the loss of the school,” he said.</p> Ein al-Rashash <p>All eight families living in Ein al-Rashash fled on October 13 fearing further settler violence, and Bedouin families in the area were also displaced that week due to threats, according to residents and news reports.</p> <p>The Israeli military has since 2010 issued demolition orders against 73 structures in Ein al-Rashash. Settlers began harassing the community in 2014 after establishing a herding outpost, called Angels of Peace, in a former military base, led by a settler whom residents identified by his first name.</p> <p>On October 8, the same men appeared in uniform, carrying M16 assault rifles, and blocked the road to the community, said Wesam W., 25. On October 11 and 12, settlers killed six Palestinians in Qusra, about 10 kilometers north of Ein al-Rashash. Fearing a deadly attack, on October 13, the entire community “decided to leave, for our safety and dignity,” said Wesam’s brother Omar, 33. Omar, his wife, and six children, walked to the nearby town of Maghayir.</p> <p>On October 27, two Israeli rights activists drove Omar back to Ein al-Rashash, hoping to recover some belongings. He found that 18 tents, a car trailer, appliances, solar panels, and sheep fodder that cost 150,000 shekels (about US$40,000) were missing, he said. Seven settlers wearing civilian clothes then arrived on foot and hit and kicked them, said Wesam and one of the activists.</p> <p>Community members said the Israeli police in the Binyamin settlement would not allow them to file a complaint unless they did so in person, but they declined because police had previously detained and interrogated them about false complaints by settlers.</p> <p>Omar's grandparents fled to the West Bank in 1948 as refugees from what is now Israel. The family is now renting a 7-room house in Maghayir, for 35 people. They cannot graze their flock.</p> Wed, 17 Apr 2024 00:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/17/west-bank-israel-responsible-rising-settler-violence Tajikistan: EU States, Türkiye Should Not Return Dissidents https://www.hrw.org/news/2024/04/16/tajikistan-eu-states-turkiye-should-not-return-dissidents Click to expand Image Groups protest against the visit of Tajikistan President Emomali Rahmon and other Central Asian leaders to Berlin, Germany, September 29, 2023. © 2023 snapshot-photography/FBoillot/Shutterstock <p>(Berlin, April 16, 2024) – Several people based in Lithuania, Poland, and Türkiye, linked to a banned Tajik opposition movement, Group 24, have in recent months disappeared or have been arrested and threatened with extradition to Tajikistan, Human Rights Watch and the Norwegian Helsinki Committee said today.   </p> <p>Group 24 is a political movement promoting democratic reforms in Tajikistan, which the Tajik government banned and designated a terrorist organization in October 2014. Tajikistan has for the last decade sought the extradition of exiled activists in other countries, some of whom also have been killed or forcibly disappeared. Host governments should not deport the people concerned to Tajikistan because of the risk of torture and should respect Tajik asylum seekers’ full due process rights, including not arbitrarily detaining them at the behest of unfounded and politically motivated requests by the Tajik government.</p> <p>“Tajikistan should unequivocally end its decade-long hunt of perceived critics abroad, especially those related to Group 24 and other banned groups,” said Syinat Sultanalieva, Central Asia researcher at Human Rights Watch. “The EU and Türkiye should protect opposition activists and refrain from returning them to Tajikistan, a country known for engaging in transnational repression, where they risk being tortured.”</p> <p>Human Rights Watch recently published a report on transnational repression – targeting of critics abroad by repressive governments – that includes several cases of members of Group 24, both former and active, who had fled the country only to be targeted by the Tajik government,  seeking their arrest and extradition to Tajikistan on charges of terrorism or extremism-related activities. Activists in exile have also been subject to enforced disappearances or abusive use of Interpol Red Notices, which is a request to law enforcement worldwide to locate and provisionally arrest a person because a government is seeking their extradition.</p> <p>On April 5, 2024, Lithuanian security services detained Sulaimon Davlatov, a former member of Group 24, in Vilnius on charges of allegedly violating Lithuania’s national security. On April 7, a court in Vilnius ordered his pretrial detention for two months, and on April 9 the Lithuanian Prosecutor General’s office told the media that Davlatov “presents a threat to the national security of Lithuania due to his cooperation with members and allies of terrorist organizations, extremist movements and propaganda of extremism.”</p> <p>Davlatov has been a resident of Lithuania since he was granted asylum in 2015. Lithuanian authorities should rule out any risk that Davlatov could be extradited to Tajikistan, and in line with fair trial rights, grant Davlatov and his lawyer immediate access to any evidence they have to substantiate the allegations.</p> <p>On February 23 and March 10 respectively, two senior figures in Group 24, Nasimjon Sharifov and Sukhrob Zafar, disappeared in Türkiye. Both had previously been detained by the Turkish police in March 2018 at the request of Tajik authorities and threatened with extradition but were eventually released. They had recently told family and colleagues that they were receiving regular threats from Tajik intelligence services. Neither man’s whereabouts is currently known. Friends and colleagues are concerned that they may have been forcibly disappeared by either or both Tajik and Turkish authorities and extrajudicially removed to Tajikistan.</p> <p>On March 19, a court in Poland ordered Komron Khudoydodov, brother of former Group 24 activist Shabnam Khudoydodova, to leave Poland by April 19 voluntarily or be deported to Tajikistan. This followed the rejection of his application for asylum. Khudoydodov moved to Poland in 2018 on a humanitarian visa from the Polish authorities granted because he faced persecution in Tajikistan due to his sister’s peaceful political activity. In 2015, Tajik authorities had Shabnam Khudoydodova placed on the Interpol Red Notices on charges of extremism.</p> <p>Tajik authorities also have an ongoing criminal investigation against Komron Khudoydodov on charges of extremism. Returning Khudoydodov to Tajikistan would place him at risk of torture or ill-treatment, and therefore be a violation of the ban on refoulement. Poland should make clear that it will abide by its international legal obligations and rule out deporting Khudoydodov to Tajikistan.</p> <p>In addition to Lithuania and Poland, other European Union members, such as Austria, Germany, and Slovakia, have in recent years returned or threatened to return Tajik asylum seekers to Tajikistan despite credible evidence of their risk of being tortured. Upon their arrival in Tajikistan, those deported from the EU member states have been jailed.</p> <p>The United Nations Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment, prohibits the expulsion, return (refoulment), or extradition of a person to another state where there are substantial grounds for believing that they would be in danger of being tortured. The European Convention on Human Rights also incorporates this ban as an element of the prohibition on torture and inhuman and degrading treatment. All EU member countries and Türkiye are party to both treaties. This principle is also incorporated into Lithuanian, Polish, and Turkish domestic law.</p> <p>“EU member states and Türkiye should uphold their international human rights obligations, including not to return people at risk of torture and persecution for their political activism to their country of origin,” Sultanalieva said. “They should denounce cases of transnational repression and review any cooperation agreements with states engaged in targeting critics abroad.”</p> Mon, 15 Apr 2024 21:00:01 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/16/tajikistan-eu-states-turkiye-should-not-return-dissidents Saudi Arabia: Free Award-Winning Activist https://www.hrw.org/news/2024/04/15/saudi-arabia-free-award-winning-activist Click to expand Image Waleed Abu al-Khair, prominent lawyer and human rights activist, speaks to Human Rights Watch over Skype from Jeddah, Saudi Arabia on September 19, 2013. © 2013 Human Rights Watch <p>(Beirut) – Saudi authorities should immediately release Waleed Abu al-Khair, an award-winning Saudi human rights defender and lawyer, 17 human rights groups including Human Rights Watch said today, on the 10th anniversary of his arrest. He is serving a 15-year prison sentence due to his peaceful human rights activism.</p> <p>“This grim anniversary of Waleed Abu al-Khair’s arrest undermines Crown Prince Mohammed bin Salman’s hollow narrative of reform,” said Joey Shea, Saudi Arabia researcher at Human Rights Watch. “Waleed Abu al-Khair, along with many other of Saudi Arabia’s best and brightest citizens, remains unjustly locked up for nothing more than demanding a rights-respecting future for their country.”</p> <p>The Specialized Criminal Court (SCC), Saudi Arabia’s terrorism tribunal, convicted Abu al-Khair in July 2014 primarily for his comments to media outlets and tweets criticizing Saudi Arabia’s human rights record, especially the country’s harsh sentences against peaceful critics. The court also issued a 15-year travel ban and imposed a fine of 200,000 Saudi riyals (about US$53,000).</p> <p>Abu al-Khair won the prestigious Human Rights Award from the Law Society of Upper Canada in 2016. He has won numerous other human rights awards as well.</p> <p>“Abu al-Khair has lost 10 years of his life to the Saudi government’s repression,” Shea said.   “The Saudi authorities should release him immediately.”</p> Mon, 15 Apr 2024 06:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/15/saudi-arabia-free-award-winning-activist Justa Libertad: A Movement to Decriminalize Abortion in Ecuador https://www.hrw.org/news/2024/04/15/justa-libertad-movement-decriminalize-abortion-ecuador Click to expand Image Women from different organizations that are part of the Justa Libertad movement raise green scarves outside the Constitutional Court of Ecuador in Quito, March 19, 2024. © 2024 Karen Toro <p>Justa Libertad, an Ecuadorian coalition of eight civil society organizations, recently filed a lawsuit before the Constitutional Court of Ecuador seeking to decriminalize abortion. This crucial initiative seeks to ensure that women, girls, and other pregnant people can access safe abortion care. It follows similar coalitions that achieved progress in other Latin American countries like Colombia, Mexico, and Argentina.</p> <p>Abortion is currently penalized in Ecuador with up to three years in prison, with exceptions for cases in which the pregnancy represents a risk to the life or health of the pregnant woman or, after a 2021 Constitutional Court ruling, when the pregnancy is the result of sexual violence. Even for cases that fit these narrow exceptions, accessing abortion care remains challenging due to stigma among health personnel and other institutions that hold the belief that once pregnant, women and girls are obligated to become mothers.</p> <p>Justa Libertad embodies the struggle for social justice and women’s rights in Ecuador. The denial of abortion services can violate a number of human rights, including the rights to nondiscrimination and equality; life; health; information; freedom from torture and cruel, inhuman and degrading treatment; privacy and bodily autonomy and integrity; and freedom of conscience and religion. Women, girls, and other pregnant people have the right to make decisions about their own body and their future. </p> <p>Regulating abortion via criminal law perpetuates its stigma and disproportionately affects women and girls living in conditions of poverty, including Indigenous and Afro-descendant people.</p> <p>Amid a movement across Latin America to achieve reproductive justice, decriminalizing abortion is an urgent matter. Ecuador should join other countries in taking this step. </p> Mon, 15 Apr 2024 06:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/15/justa-libertad-movement-decriminalize-abortion-ecuador Germany: Scholz Should Stand Firm on Rights in China https://www.hrw.org/news/2024/04/15/germany-scholz-should-stand-firm-rights-china Click to expand Image German Chancellor Olaf Scholz, left, with Chinese President Xi Jinping at the Great Hall of the People in Beijing, November 4, 2022.  © 2022 Kay Nietfeld/AP Photo <p>(Berlin) – German Chancellor Olaf Scholz should stress the importance of human rights in the Sino-German relationship during his visit to China and meeting with Chinese President Xi Jinping, Human Rights Watch said today. Scholz arrived in Beijing on April 13, 2024, and is expected to meet with Xi on April 16.</p> <p>“Chancellor Scholz should not play second fiddle to Germany’s narrow business interests, but should lead by setting the Sino-German relationship on a rights-respecting footing,” said Wenzel Michalski, Germany director at Human Rights Watch. “Promoting human rights is good both for the Chinese people and for Germany’s long-term interests.”</p> <p>Scholz last visited Beijing in November 2022, when he also brought along a large business delegation. Since then, Germany has issued a new China strategy in which it commits to responding to an increasingly assertive and abusive Chinese government by “de-risking," or reducing reliance on China for critical supply chains. The strategy also asserts that “[h]uman rights are at the heart of” German government policies toward China.</p> <p>In an April 12 letter to the German chancellor, Human Rights Watch urged Scholz to make clear to Xi that the Sino-German relationship will suffer if Beijing does not address serious human rights violations in China. These include ending its crimes against humanity targeting Uyghurs and other Turkic communities in Xinjiang and freeing the hundreds of thousands of Uyghurs arbitrarily detained or imprisoned, including Rahile Dawut, a prominent expert on ethnography, and Ilham Tohti, Uyghur scholar and Sakharov Prize laureate.</p> <p>Beijing should also revoke the two draconian national security laws in Hong Kong and release those wrongfully detained in mainland China, including human rights lawyer Yu Wensheng and his wife, Xu Yan.</p> <p>In a 2022 public opinion poll in Germany, 68 percent of those who responded said that is it important for Germany to stand up for human rights when dealing with China.</p> <p>“Scholz needs to put Germany’s China strategy into action by forthrightly putting human rights at the center of the Sino-German relationship,” Michalski said. “The German government should demonstrate its commitment by impressing upon Chinese leaders its principled and public support for the human rights of everyone in China.”</p> Mon, 15 Apr 2024 01:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/15/germany-scholz-should-stand-firm-rights-china Abu Ghraib Torture Case Finally Goes to Trial https://www.hrw.org/news/2024/04/15/abu-ghraib-torture-case-finally-goes-trial Click to expand Image Prisoners stand next to the tents in which they are housed at the Abu Ghraib prison west of Baghdad, Iraq, July 15, 2004. © 2004 Joe Raedle/Getty Images <p>Twenty years have passed since the media broke the story that US forces and the CIA were torturing “war on terror” detainees at Abu Ghraib and other US-run prisons in Iraq. But for the men who were tortured, it feels like only yesterday. The physical and mental scars they carry serve as daily reminders of the abuse they suffered.</p> <p>Still, several of these men told me they hold out hope that the US government will apologize and give them the redress they deserve.</p> <p>On April 15, a federal court in Virginia will hear the case of Al Shimari et al. v. CACI, a lawsuit brought by the US-based Center for Constitutional Rights on behalf of three Iraqi torture victims. The suit asserts that CACI, a private security company which the US government hired in 2003 to interrogate prisoners in Iraq, directed and participated in torture and other abuse at Abu Ghraib. The men are seeking compensatory and punitive damages.</p> <p>CACI has tried to have the case dismissed 20 times since it was first filed in 2008.</p> <p>Al Shimari et al. v. CACI was only able to advance because it targeted a military contractor. US courts have repeatedly dismissed similar cases against the federal government because of a 1946 law that preserves US forces’ immunity for claims that arise during war.</p> <p>What’s more, the US government hasn’t created any official compensation program or other avenues for redress for those who allege they were tortured or abused. Nor are there any pathways available to have their cases heard.</p> <p>This lawsuit is a critical step towards justice for these three men who will finally have their day in court. But they are the lucky few. For the hundreds of other survivors still suffering from past abuses, their chances of justice remain slim. The US Government should do the right thing: take responsibility for their abuses, offer an apology, and open an avenue to redress that has been denied them for too many years.</p> Mon, 15 Apr 2024 00:01:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/15/abu-ghraib-torture-case-finally-goes-trial Brazil: Reject Bill That Entrenches Failed Drug Policy https://www.hrw.org/news/2024/04/15/brazil-reject-bill-entrenches-failed-drug-policy Click to expand Image Protesters supporting marijuana reform at the 15th Marijuana March, in the city of São Paulo, Brazil, on June 17, 2023. © 2023 Paulo Pinto/Agência Brasil <p>(São Paulo) – Brazil’s Congress should reject a proposed constitutional amendment that would entrench the criminalization of drug possession for personal use.</p> <p>The Senate is expected to vote in the coming days on an amendment to article 5 of Brazil’s Constitution, which guarantees the right to privacy, that would restrict that right by criminalizing the possession of illegal drugs regardless of quantity. If approved, the proposed amendment would be put to a second vote at the full Senate and then go to the Chamber of Deputies.</p> <p>“Decades of drug policy failure in Brazil should make clear that criminal law is simply ineffective to address the harmful use of drugs and leads to serious human rights abuses,” said Andrea Carvalho, Brazil researcher at Human Rights Watch. “Instead of cementing a failed policy in the constitution, lawmakers should follow the example of many other countries by decriminalizing the possession of drugs for personal use and developing effective health strategies to prevent and respond to problematic substance use.”</p> <p>Current law already criminalizes drug possession for personal use, but introducing this language in the constitution would make it much harder to pursue much-needed drug policy reforms in Brazil, Human Rights Watch said.</p> <p>The president of the Senate, Rodrigo Pacheco, has made clear that the constitutional amendment is a pre-emptive attempt by lawmakers to counter an upcoming Supreme Court decision that could improve drug policy, Human Rights Watch said. Pacheco introduced the proposal on September 14, 2023, a few weeks after the Supreme Court resumed its review of a case that will decide whether current Brazilian law violates the Constitution. Upon introducing the bill, Pacheco stressed that it is Congress that “defines the laws in the country” and other branches of government should recognize that authority.</p> <p>In March 2024, after the Supreme Court picked up the case again after a pause, Pacheco said that “what motivated” his proposed amendment was a possible ruling by the court to declare the current law unconstitutional. He contended that if the court decriminalized drug use, it would be “invading the jurisdiction” of Congress, as “it is up to the Parliament to decide whether something should be a crime or not.” About a week later, a key congressional committee moved quickly and approved the proposal, which is now being reviewed by the full Senate.</p> <p>Brazil’s Supreme Court has the authority to strike down a law if it violates the constitution. In this case, it is assessing whether the current law violates fundamental rights. So far, five Supreme Court justices have voted in favor of decriminalizing the use of marijuana and three have voted against. Three other justices have yet to vote. If one of them votes in favor, a Supreme Court majority will have supported decriminalizing marijuana for personal use.</p> <p>While the current law considers drug possession for personal use a crime, its sanctions do not include prison sentences but instead warnings, community service, or attending educational programs. Yet, having a criminal record subjects a person to discrimination and stigma that can lead to exclusion from jobs, housing, and other opportunities.</p> <p>Some Supreme Court justices have proposed establishing a threshold quantity of marijuana to differentiate users from dealers. The current law does not determine this threshold, which leaves the assessment of who is a user and who is a dealer at the discretion of the police and the justice system. That opens the door to the discriminatory application of the law.</p> <p>The proposed constitutional amendment could worsen the problem by entrenching in the constitution that users would be differentiated from dealers by “factual circumstances,” a vague provision that would be open to abuse.</p> <p>While Black people make up about 57 percent of Brazil’s population, they are 68 percent of the defendants prosecuted for drug offenses. A 2023 study by a research institution linked to the government that examined the decisions in drug cases against 41,000 defendants in the first half of 2019 concluded that “the judicial processing of drug crimes punishes, as a priority, Black, young, and poorly educated people who possess small amounts of drugs.”</p> <p>The lack of a legal distinction between users and dealers based on clearly-defined parameters has contributed to the explosive rise of Brazil’s prison population in the last two decades. In 2005, the year before Brazil’s drug law came to force, only 9 percent of those in prison were detained on drug charges, compared with the current 28 percent; among women, it is 51 percent.</p> <p>In addition, Brazilian police regularly use drug law enforcement as a justification for raids into low-income neighborhoods that routinely end in killings. Police have killed more than 6,000 people per year since 2018, the vast majority of them Black.</p> <p>In Brazil’s prisons, where criminal groups exploit appalling conditions to recruit new members, people who use drugs who have been wrongfully detained and tried as dealers, and small-scale dealers can be forced to seek the protection of the very criminal organizations the law is intended to fight. More broadly, drug prohibition creates an enormous source of wealth for organized crime, fueling corruption and violence.</p> <p>Rather than criminalizing people who use drugs, authorities should focus on dismantling organized crime groups and the corrupt networks that support them, as well as ensuring accountability for serious violence. Governments should also explore alternatives to prohibition that are less reliant on criminalization and more focused on different forms of regulation and control.</p> <p>Human Rights Watch research around the world has found that criminalizing the possession of drugs for personal use is inconsistent with the rights to autonomy and privacy, as well as the basic principle of proportionality in punishment. These principles are broadly recognized under international law, including the International Covenant on Civil and Political Rights and the American Convention on Human Rights, both ratified by Brazil.</p> <p>Criminalization also undermines the right to health. Fear of criminal penalties deters people who use drugs from using health services and treatment and increases their risk of suffering violence, discrimination, and serious illness. Criminal prohibitions have also impeded the use of drugs for legitimate medical research and have prevented patients from accessing drugs for palliative care and pain treatment.</p> <p>The authorities should rely on non-penal regulatory and public health approaches to address problematic drug use, Human Rights Watch said.</p> <p>Governments should not punish someone simply for using drugs when they aren’t harming others. To protect third parties from associated harm, such as driving under the influence, the authorities may impose, consistent with human rights principles, proportionate criminal penalties on behavior that causes or seriously risks harm to others, in conjunction with drug use.</p> <p>“The personal use of drugs should be treated as an aspect of privacy and personal autonomy,” Carvalho said. “Lawmakers who want to address problematic drug use should heed international evidence that shows that decriminalization of consumption, combined with meaningful access to voluntary evidence-based treatment and other supports for people who are struggling, protects and promotes health much more effectively than the revolving door of criminalization.”</p> Mon, 15 Apr 2024 00:00:01 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/15/brazil-reject-bill-entrenches-failed-drug-policy Sudan: One Year of Atrocities Requires New Global Approach https://www.hrw.org/news/2024/04/12/sudan-one-year-atrocities-requires-new-global-approach Click to expand Image A destroyed medical storage facility in Nyala, the capital of South Darfur province, Sudan, May 2, 2023. © 2023 AFP via Getty Images <p>(Nairobi) – As global and regional leaders meet in Paris to spotlight Sudan and mark the one-year anniversary of the country’s brutal conflict between Sudanese Armed Forces (SAF) and Rapid Support Forces (RSF), they should make clear that those responsible for ongoing atrocities and other violations of international humanitarian law will be held to account, Human Rights Watch said today. This includes widespread intentional killings of civilians, unlawful attacks on civilian infrastructure, as well as the deliberate looting of aid, which constitute war crimes.<br /><br /> On April 15, France alongside Germany and the European Union are cohosting a conference on Sudan to press for an end to the fighting and for a significant uptick in global funding for the grossly under-resourced response as a hunger and broader humanitarian crisis unravels in the country and in refugee hosting countries.<br /><br /> “The warring parties in Sudan have inflicted tremendous suffering on Sudanese from all walks of life. The global response to Sudan’s brutal conflict needs to change,” said Mohamed Osman, Sudan researcher at Human Rights Watch.“Leaders meeting in Paris should act to tackle the shamefully low levels of humanitarian funding, including for local responders, and commit to concrete measures against those deliberately hampering aid delivery to populations in need.”<br /><br /> The conference comes a year after conflict broke out between the SAF and RSF in Khartoum on April 15, 2023, before spreading to other regions including Darfur and central Sudan. Despite the magnitude of suffering and violations by the warring parties, the situation in Sudan has received an underwhelming response from the international community.<br /><br /> Almost 15,000 people are known to have been killed since then, almost certainly an underestimate. The conflict has uprooted 8.5 million people, most internally, making Sudan the world’s largest internal displacement crisis. Around 1.76 million people have fled into neighboring countries.Without significant humanitarian assistance, five million people could risk starvation in the coming months.<br /><br /> Both warring parties have committed serious violations of international human rights and humanitarian law, amounting in some cases to war crimes and other atrocity crimes, Human Rights Watch said. The SAF have unlawfully killed civilians, carried out airstrikes that have deliberately targeted civilian infrastructure, and repeatedly obstructed humanitarian aid among other violations. The RSF has carried out widespread civilian killings, many of which appear to be ethnically targeted notably in West Darfur, while also hampering aid including by widespread looting of humanitarian supplies. They have used heavy explosive weapons in densely populated areas and engaged in widespread sexual violence and pillage. Both forces and their allies have recruited children and arbitrarily detained civilians.<br /><br /> According to the UN, approximately 25 million people, around half of the population, are now dependent on emergency food supplies, which SAF has deliberately restricted and RSF looted, in clear violation of international law, and in acts that could amount to war crimes, Human Rights Watch said.<br /><br /> Human Rights Watch interviews with aid workers described how authorities affiliated with SAF including its military intelligence have imposed a multitude of arbitrary bureaucratic restrictions that have hampered the work of humanitarian organizations and their ability to reach those in need. These include delays, denials, and nonresponse to requests for visas and travel permits, which the authorities require for aid personnel to move between federal states, as well as the imposition of excessive administrative procedures for importing and transporting relief materials. SAF’s unlawful obstruction of aid follows decades of hostility and routine obstruction towards international relief agencies under Sudan’s former President Omar al-Bashir, adding to the suffering of populations in conflict areas.<br /><br /> Rapid Support Forces and allied militias have repeatedly attacked and looted aid supplies and humanitarian infrastructure notably warehouses, such as the stocks in a World Food Programme (WFP) warehouse in Wad Madani in December 2023. “This attack – in areas controlled by the Rapid Support Forces – affected supplies that could have fed 1.5 million acutely food-insecure people for one whole month,” the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) said. Communities in Darfur have also more recently accused the RSF of looting food supplies destined for displaced persons camps. The Darfur Network for Human Rights (DNHR), a rights monitoring group, said in an April 3 statement that RSF and Arab fighters looted aid supplies including food items for malnourished children from residents of an IDP camp in central Darfur.<br /><br /> Both parties, particularly SAF, have sought to restrict aid going to and through the opposing parties’ areas of control, which has put Khartoum under a de facto blockade since late 2023 and also hampered aid access in Darfur.<br /><br /> A local responder from Bahri city in Khartoum, said: “SAF is preventing any supplies entering the city and RSF is restricting movements within. We are forced to smuggle goods in including food, increasing prices of commodities as a result.”<br /><br /> WFP said on April 3 that it had managed to reach the Karrari locality in Omdurman, which is currently under SAF control, for the first time since December.<br /><br /> On March 6, Sudanese authorities informed the UN that they would only allow cross-border movement through specific crossings under the control of forces allied to the military, adding more financial and logistical challenges for humanitarian organizations.<br /><br /> On March 21, the RSF had released a statement on their official X (formerly known as Twitter) account saying they would not allow aid from Port Sudan to reach El Fashir, the capital of North Darfur, saying this plan will be used for rearmament purposes by SAF and their allies.<br /><br /> Warring parties killed, injured, and detained dozens of aid workers and targeted humanitarian convoys. In December, SAF attacked a convoy from the International Committee of the Red Cross (ICRC), which included civilians to be evacuated, killing two people and injuring seven including three ICRC staff. SAF said following the incident that ICRC had diverted from the agreed route and that they were escorted by RSF vehicles. <br /><br /> Given the blocks on the international aid response, Sudanese responders, many of whom volunteer in the country’s emergency rooms, have borne the brunt of seeking to meet civilians’ growing needs in Khartoum, Darfur, Al Gezira, and elsewhere. Both sides in the conflict have harassed, detained, and otherwise abused local responders. The United Nations High Commissioner for Human Rights said in February said that both SAF and RSF were arbitrarily detaining thousands of civilians and had subjected hundreds to enforced disappearances including members of the emergency response rooms. Human Rights Watch has also documented RSF and SAF arbitrary arrests and mistreatment of emergency responders and healthcare workers in Khartoum.<br /><br /> The warring parties’ blatant disregard for international humanitarian and human rights law has caused the current humanitarian nightmare and left civilians in areas hit particularly hard by the fighting, notably Khartoum and its sister cities and large parts of Darfur, reeling and unable to access basic necessities.<br /><br /> Warring parties’ attacks, including of infrastructure such as healthcare facilities and water treatment plants, have made civilian lives precarious and insecure. Since the conflict’s onset, SAF forces have bombed and both parties have shelled health facilities, while the RSF has repeatedly occupied hospitals. The attacks on healthcare, many deliberate, have left 70-80 percent of healthcare facilities non-functional notably in Khartoum and Darfur. Even those deemed functional face massive challenges, due to lack of electricity, staffing and medical supplies including life-saving medication. “We cannot say there is a functioning health sector,” an international healthcare worker told Human Rights Watch in February. Warring parties’ relentless fighting in residential areas of Greater Khartoum, including using weaponry that frequently results in indiscriminate attacks in violation of the laws of war, over the course of the last year has also prevented the safe movement of civilians and local responders.<br /><br /> In May 2023, both parties committed to uphold international humanitarian law and allow aid delivery during talks hosted in Jeddah by Saudi Arabia and the United States and later joined by the African Union and the Inter-Governmental Authority on Development (IGAD). With reports of a resumption of the Jeddah talks, the hosts should press for the establishment of a mechanism that will monitor implementation of the commitments to uphold international humanitarian and human rights law and protect civilians, including calling out attacks on and deliberate obstruction of humanitarian assistance and unlawful destruction of civilian infrastructure.<br /><br /> UN Security Council and African Union Peace and Security Council member states should maintain scrutiny over the food security situation, by holding regular public briefings over the next six months.<br /><br /> The United States, United Kingdom, and European Union and other countries should coordinate action under their respective sanction regimes on Sudan and urgently designate entities and individuals responsible for aid obstruction and other grave violations.<br /><br /> Governments meeting in Paris should also actively and publicly support efforts to investigate ongoing abuses on the ground, Human Rights Watch said. The office of the prosecutor of the International Criminal Court (ICC) announced in July 2023 that it is investigating recent crimes committed in Darfur as part of his office’s ongoing Darfur investigations. The independent international fact-finding mission on Sudan, established by the UN Human Rights Council in October, and mandated to investigate violations across Sudan, including in Khartoum and Darfur, should be given full support and access, and be renewed as needed until investigations are complete.<br /><br /> “The world should be ashamed by the horrific cost of its inaction. Civilians in Sudan deserve to see a robust, concerted global response,” said Osman. “The Paris conference should not be where the focus on Sudan ends, but rather jumpstart a new approach, announcing major increases in humanitarian funding, including for local responders, and spelling out clear benchmarks and concrete measures states will take to end the weaponization of aid by both warring parties.”</p> Fri, 12 Apr 2024 23:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/12/sudan-one-year-atrocities-requires-new-global-approach Belarus Calls LGBT Lives ‘Pornography’ https://www.hrw.org/news/2024/04/12/belarus-calls-lgbt-lives-pornography Click to expand Image Belarusian LGBTQ activists with white-red-white flags participate in the Warsaw Equality Parade, June 25, 2022. © 2022 Sipa USA/AP Photo <p>Belarus has hit a new low in its targeting of lesbian, gay, bisexual, and transgender (LGBT) people. As of today, the definition of pornography under Belarusian law will include depictions of same-sex relationships as well as transgender people.</p> <p>The Culture Ministry recently amended its decree on “erotic materials” to classify “homosexualism, lesbian love” and the “desire to live and be seen by others as a person of an opposite sex”—a reference to transgender people—as “non-traditional sexual relationship or behavior.” This places depictions of LGBT people alongside those of necrophilia, pedophilia, and voyeurism, all of which legally constitute “non-traditional relationships.”</p> <p>Under Belarusian law, they all may also constitute pornography.  </p> <p>Public displays of pornography are punishable in Belarus with up to four years in prison. Child pornography is punishable with up to 13 years behind bars. </p> <p>While it is not yet clear what kinds of depictions of LGBT people could fall under the new definition of pornography, it clearly aims to assault the dignity of sexual and gender minorities, people already demonized and at risk of persecution in Belarus.</p> <p>Belarusian public officials and religious groups periodically advocate for introducing administrative and criminal liability for “non-traditional sexual relationship and gender change propaganda.” Neighboring Russia recently expanded its anti-gay propaganda law and banned the “international LGBT movement” as extremist.</p> <p>In 2020, police arrested numerous peaceful protesters who demonstrated against the rigged presidential elections. Belarusian rights groups documented the systematic and widespread ill-treatment and torture of the protesters, reporting that people perceived as LGBT faced an increased risk of police violence and threats of sexualized violence.</p> <p>Since then, Belarusian authorities have used public humiliation as a shaming tool against critics who are perceived to be or are LGBT. In one such instance, police forced a detainee, arrested for leaving a critical comment online, to “confess” on camera to being gay. At the end of the horrific video, he said: “I understand this is immoral, I promise to correct it.”</p> <p>In their brutal assault against civil society in recent years, Belarusian authorities shut down all human rights organizations, including LGBT rights groups, leaving LGBT people with even less protection.</p> <p>Belarus should annul these despicable amendments and stop cynically targeting LGBT people.</p> Fri, 12 Apr 2024 18:01:37 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/12/belarus-calls-lgbt-lives-pornography Germany: Landmark Vote for Trans Rights Law https://www.hrw.org/news/2024/04/12/germany-landmark-vote-trans-rights-law Click to expand Image Plenary session in the Bundestag in Berlin, January 12, 2022. © 2022 ddp images/Sipa via AP Images <p>(Berlin, April 12, 2024) – Germany’s parliament on April 12, 2024, passed a landmark law that allows transgender and non-binary people to modify their legal documents to reflect their gender identity through an administrative procedure based on self-identification, Human Rights Watch said today. The law will take effect in August 2024.</p> <p>The new law replaces Germany’s outdated 1980 Transsexuals Law (Transsexuellengesetz), which requires trans people to provide a local court with two “expert reports” attesting to “a high degree of probability” that the applicant will not want to revert to their previous legal gender. The German Constitutional Court had previously struck down other draconian aspects of the law, including surgical requirements for gender recognition.</p> <p>“Germany has joined a growing list of countries that are abolishing pathologizing requirements for gender recognition, which have no place in diverse and democratic societies,” said Cristian González Cabrera, senior LGBT rights researcher at Human Rights Watch. “As populist politicians in Europe and beyond try to use trans rights as a political wedge issue, Germany’s new law sends a strong message that trans people exist and deserve recognition and protection, without discrimination.”</p> <p>Under the new law, trans and non-binary people will be able to go to a civil registry office and have their gender marker and their given names changed through a simple declaration. No “expert” opinions or medical certificates will be required. The applicant will be able to choose from several gender markers – male, female, or “diverse” – or opt not to enter a gender at all.</p> <p>According to a 2017 report from the Federal Ministry of Family Affairs, Senior Citizens, Women and Youth, under the Transsexuals Law, applicants said that to secure the necessary “expert” reports, they had to disclose immaterial details from their childhood and their sexual past, and even undergo physical examinations. The ministry found that the legal procedure could take up 20 months and cost an average of €1,868 (about. US$2,000).</p> <p>The gender recognition reform comes as lesbian, gay, bisexual, and transgender (LGBT) activists warn of an uptick in anti-LGBT violence in Germany. The federal interior minister said in June 2023 that in the preceding year the police registered over 1,400 hate crimes against LGBT people. Several attacks occurred at Pride parades in recent years, one of which ended in the death of a trans man in 2022.</p> <p>In May 2023, the federal human rights commissioner expressed worries about setbacks for LGBT rights. In June 2023, state-level interior ministers committed to strengthening their prevention of anti-LGBT hate crimes and violence, including through law enforcement training and the introduction of designated contact people at police stations throughout Germany.</p> <p>Legal gender recognition reform based on self-declaration will not in itself ensure protection for trans people in Germany from abuse and discrimination. But the new law indicates that the government supports trans and non-binary people’s fundamental rights, which contributes to a broader understanding and acceptance of diverse gender identities, Human Rights Watch said.</p> <p>A growing number of countries have removed burdensome requirements for legal gender recognition, including medical or psychological evaluation. Countries including Argentina, Belgium, Denmark, Ireland, Luxembourg, Malta, Norway, Portugal, Spain, and Uruguay provide for simple administrative legal gender recognition processes based on self-declaration.</p> <p>The move toward such straightforward administrative procedures reflects international medical consensus and human rights standards. The World Professional Association for Transgender Health, an interdisciplinary professional association with members worldwide, has found that medical and other barriers to gender recognition for transgender people, including diagnostic requirements, “may harm physical and mental health.” The most recent International Classification of Diseases, the World Health Organization’s global diagnostic manual, formally depathologizes trans identities.</p> <p>The International Covenant on Civil and Political Rights (ICCPR), to which Germany is a party, provides for equal civil and political rights for all, everyone’s right to recognition before the law, and the right to privacy. The United Nations Human Rights Committee, in charge of interpreting the ICCPR, has called on governments to guarantee the rights of transgender people, including the right to legal recognition of their gender, and for countries to repeal abusive and disproportionate requirements for legal recognition of gender identity.</p> <p>The European Court of Human Rights ruled in Goodwin v. United Kingdom that the “conflict between social reality and law” that arises when the government does not recognize a person’s gender identity constitutes a “serious interference with private life.” Since then, the court has ruled that various abusive requirements for gender recognition, like sterilization and other medical interventions, violate trans people’s human rights.</p> <p>The European Union’s LGBTIQ Equality Strategy (2020-2025) also upholds “accessible legal gender recognition based on self-determination and without age restriction” as the human rights standard in the member bloc.</p> <p>Principle three of the Yogyakarta Principles on the Application of International Human Rights Law in relation to Sexual Orientation and Gender Identity affirms that each person’s self-defined gender identity “is integral to their personality and is one of the most basic aspects of self-determination, dignity, and freedom.”</p> <p>As a member of the Equal Rights Coalition, the Global Equality Fund, and the UN LGBTI Core Group, Germany plays a key role in advocating for LGBT and intersex (LGBTI) rights beyond its borders. In March 2021, the federal government pledged to do more through a LGBTI Inclusion Strategy, which, among its many goals, aims to further Germany’s role in promoting LGBTI people’s rights at international and regional human rights institutions.</p> <p>“Germany’s gender recognition reform removes a stain on its national human rights record and bolsters its commitments to LGBT rights at home and abroad,” González said. “Following this critical reform to legal gender recognition, German authorities should continue to push for full equality, to eliminate acts of anti-LGBT violence in Germany and to promote anti-LGBT legislation overseas.”</p> Fri, 12 Apr 2024 13:14:58 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/12/germany-landmark-vote-trans-rights-law Germany’s Antisemitism Battle Needs Focus on Education https://www.hrw.org/news/2024/04/12/germanys-antisemitism-battle-needs-focus-education Click to expand Image Beating of Jewish student intensifies deabte over Gaza conflict at Berlin’s largest public university, the Freie Universität, February 9, 2024.  © 2024 Maja Hitij/Getty Images <p>In early February, a 30-year-old Jewish student was hospitalized following an attack by a fellow student at Berlin’s largest public university, Freie Universität Berlin.</p> <p>Berlin’s authorities treated the attack as politically motivated antisemitic violence and attributed it to the impact in Europe of the escalation in the Israel-Palestine conflict. In response to the attack, Germany’s antisemitism commissioner demanded a clear stance against antisemitism from the university leadership.</p> <p>Berlin has a dedicated general commissioner on antisemitism at the state level as well as within its state police and prosecution office, with the latter two focused on the criminal justice response to antisemitism. They are in regular contact with Jewish communities and groups.</p> <p>In March, Human Rights Watch met with Winfrid Wenzel, antisemitism commissioner for the Berlin Police Department. His role is to liaise with police officers to ensure effective recognition and recording of antisemitic crimes. He also works to build trust among Jewish communities in the police force.</p> <p>Wenzel shared information showing that in 2023, police recorded 72 acts of antisemitic violence in Berlin. The frequency of antisemitic violence suggests policing can’t be the sole answer to hate crimes.</p> <p>International guidelines have demonstrated the critical role education plays in countering the bias and prejudice that underlies antisemitism. The European Commission against Racism and Intolerance highlights the need for educational institutions to be equipped to respond effectively to antisemitic attacks and promote an understanding of antisemitism among students. The German government’s Strategy against Antisemitism and for Jewish Life also highlighted education as a “lifelong goal” to prevent antisemitism.</p> <p>Last month, Berlin’s state government reacted to the violence, threats, and intimidation faced by Jewish students on campuses with assurances that it was in “intense communication” with universities to guarantee the safety of Jewish students. As of April 1, when the new semester began, universities in Berlin have been asked to strengthen their security protocols relating to antisemitic incidents to ensure students are better supported.</p> <p>Freie Universität Berlin decided to ban the alleged perpetrator of the attack from campus for a preliminary three-month period; but there is broader work that must be done by German universities to build trust among Jewish students and assure them of their safety. In addition to appointing a contact person on antisemitism, universities should actively raise awareness about antisemitism and other forms of discrimination on campus and create inclusive and open platforms for dialogue and mutual learning.</p> Fri, 12 Apr 2024 06:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/12/germanys-antisemitism-battle-needs-focus-education Mali: Junta Suspends Political Parties, Associations https://www.hrw.org/news/2024/04/12/mali-junta-suspends-political-parties-associations Click to expand Image Abdoulaye Maïga, Malian minister of territorial administration, speaks at the COP27 UN Climate Summit, November 8, 2022, in Sharm el-Sheikh, Egypt. © 2022 AP Photo/Peter Dejong <p>(Nairobi) – Mali’s transitional military government should immediately reverse its suspension of political parties and associations, Human Rights Watch said today. The suspension violates both Malian law and the rights to freedom of expression, association, and assembly under international human rights law.<br /><br /> On April 10, 2024, the council of ministers adopted a decree suspending the activities of political parties and associations across the country “until further notice.” On April 11, the Malian communications regulatory body (Haute autorité de la communication) directed all media to stop “broadcasting and publishing the activities” of political parties and associations. The action appeared to be in response to the March 31 call by more than 80 political parties and associations for a return to constitutional order by holding presidential elections as soon as possible. The military junta, which seized power in a coup in May 2021, had announced in September that the elections scheduled for March 26 would be delayed indefinitely for technical reasons.<br /><br /> “The Malian authorities apparently suspended all political parties and associations because they didn’t like their call to hold democratic elections,” said Ilaria Allegrozzi, senior Sahel researcher at Human Rights Watch. “Mali’s junta, like all governments, needs to respect human rights, and should immediately lift the suspension.”<br /><br /> Following months of renewed hostilities between separatist armed groups and Malian forces in the northern part of the country, Col. Assimi Goita, Mali’s military president, announced on December 31, 2023, the establishment of an “inter-Malian dialogue for peace and reconciliation,” aimed at eliminating “the roots of community and intercommunity conflicts” by prioritizing “national ownership of the peace process.” In an April 10 news release, Col. Abdoulaye Maïga, the minister of territorial administration, claimed the suspension of political parties and associations was justified to ensure that the inter-Malian dialogue “[would] take place in a climate of serenity and not cacophony.”<br /><br /> “The minister’s declaration has contradictions,” said a member of the political party African Solidarity for Democracy and Independence (Solidarité africaine pour la démocratie et l'indépendance, SADI). “Authorities are inviting people to the national dialogue, and at the same time are stripping them of their political clothes. … Who do they [authorities] want to attend the dialogue? People should be entitled to participate both as citizens and as political leaders or members of political parties.”<br /><br /> In January, the authorities took legal action against the SADI party, threatening to dissolve it, following a message posted on social networks by its leader, Oumar Mariko. Mariko had alleged that the Malian armed forces had committed war crimes against members of the Strategic Permanent Framework (Cadre stratégique permanent), a coalition of armed and political groups from northern Mali.<br /><br /> Since the military coup, Mali’s junta has increasingly cracked down on peaceful dissent, political opposition, civil society, and the media, shrinking the country’s civic space, Human Rights Watch said.<br /><br /> On March 13, the minister of territorial administration dissolved the Association of Pupils and Students of Mali (L’Association des élèves et étudiants du Mali) accusing its members of “violence and clashes in schools and universities.” The association was the fourth organization that the government dissolved in less than four months. On March 6, the authorities had dissolved the Coordination of Movements, Associations, and Sympathizers of Imam Mahmoud Dicko (Coordination des mouvements, associations et sympathisants de l’imam Mahmoud Dicko), which had been calling for presidential elections as part of restoring civilian democratic rule, accusing it of “destabilization and threat to public security.”<br /><br /> On February 28, the authorities had dissolved the political organization Kaoural Renewal (Kaoural Renouveau), citing “defamatory and subversive remarks” against the military junta. And on December 20, the authorities had dissolved the Observatory for Elections and Good Governance (Observatoire pour les élections et la bonne gouvernance), a civil society group that monitored the fairness of elections, accusing its chairman of “statements likely to disturb public order.”<br /><br /> The junta has also targeted dissidents and whistleblowers. On March 4, the authorities forcibly disappeared gendarmerie Col. Alpha Yaya Sangaré, who had recently published a book about abuses by the Malian armed forces. His whereabouts remain unknown.<br /><br /> A Malian human rights activist said that “the authorities want to maintain a monopoly over political power by denying opponents the right to express their views and conduct political activities.”<br /><br /> Mali’s constitution and the International Covenant on Civil and Political Rights, which Mali ratified in 1974, protect the rights to freedom of association, expression, and peaceful assembly. Article 25 of the ICCPR ensures the right of citizens to participate in public affairs. The United Nations Human Rights Committee, the body of independent experts that monitor state compliance with the convention, has upheld everyone’s right to “join organizations and associations concerned with political and public affairs.”<br /><br /> “The junta’s decision to suspend political parties is part of its relentless crackdown on peaceful opposition and dissent,” Allegrozzi said. “The authorities should immediately lift the suspension, allow the political parties and associations to operate freely, and commit to upholding fundamental rights and freedoms.”</p> Fri, 12 Apr 2024 00:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/12/mali-junta-suspends-political-parties-associations Thailand: Halt Forced Returns to Myanmar https://www.hrw.org/news/2024/04/11/thailand-halt-forced-returns-myanmar Click to expand Image Myanmar refugees carry donated lunch boxes along the Thai side of the Moei River in Mae Sot, Thailand, February 5, 2022. © 2022 AP Photo, File <p>(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.</p> <p>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.</p> <p>“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.”</p> <p>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.</p> <p>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.</p> <p>Thai Foreign Minister Parnpree Bahiddha-Nukara said on April 9 that the government has prepared to receive up to 100,000 refugees temporarily.</p> <p>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.</p> <p>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.</p> <p>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 109,000 refugees have fled to neighboring countries.</p> <p>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.</p> <p>Thailand should also provide protection and support to all refugees, including by permitting the UN refugee agency, UNHCR, to undertake refugee status determinations.</p> <p>“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.”</p> Thu, 11 Apr 2024 09:30:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/11/thailand-halt-forced-returns-myanmar Nigeria: 10 Years After Chibok, Schoolchildren Still at Risk https://www.hrw.org/news/2024/04/11/nigeria-10-years-after-chibok-schoolchildren-still-risk Click to expand Image The freed students of the LEA Primary and Secondary School in Kuriga at the state government house in Kaduna, Nigeria, March 25, 2024.  © 2024 Habila Darofai/AP Photo <p>(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.<br /><br /> 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.<br /><br /> “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.”<br /><br /> 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.<br /><br /> 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.<br /><br /> 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.<br /><br /> 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.<br /><br /> 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.<br /><br /> 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.<br /><br /> 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.<br /><br /> 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.<br /><br /> 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.<br /><br /> 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.<br /><br /> 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.<br /><br /> 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.<br /><br /> “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.”</p> Thu, 11 Apr 2024 02:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/11/nigeria-10-years-after-chibok-schoolchildren-still-risk France: Groups Seek UN Intervention to Address Racial Profiling https://www.hrw.org/news/2024/04/11/france-groups-seek-un-intervention-address-racial-profiling Click to expand Image Police officers check IDs of demonstrators near the Palais Vivienne event venue in Paris, France, April 6, 2021. © 2021 Thomas COEX/AFP via Getty Images <p>(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).</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>The groups are asking the United Nations’ expert body on racial discrimination to 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.</p> <p>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).</p> <p>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.</p> <p>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.</p> <p>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:</p> 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. <p>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.</p> <p>MCDS, Pazapas, and Reaji are represented before CERD by the organization (Re)Claim.</p> Thu, 11 Apr 2024 02:00:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/11/france-groups-seek-un-intervention-address-racial-profiling Global Failures on Healthcare Funding https://www.hrw.org/news/2024/04/11/global-failures-healthcare-funding Click to expand Image A health worker checks her smartphone amid the coronavirus pandemic, at the intensive care unit of the Ana Francisca Perez de Leon II public Hospital in Caracas, Venezuela, March 27, 2021. © 2021 AP Photo/Matias Delacroix <p>(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.</p> <p>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.</p> <p>“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.”</p> <p>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:</p> 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. <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>“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.”</p> <p>Health Budgets Under International Human Rights Law</p> <p>International human rights law includes obligations to respect, protect, and fulfill economic, social, and cultural rights, which includes the right to health.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>Comparing Public Healthcare Spending to International Benchmarks</p> <p>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.</p> <p>Status of Global Public Healthcare Spending, 2021</p> <p>Benchmark</p> <p>Global Median</p> <p>Global Average</p> <p>Countries &amp; Est. Pop. Above (#/%)</p> <p>Countries &amp; Est. Pop. Below (#/%)</p> <p>5% of GDP</p> <p>3.54%</p> <p>4.08%</p> <p>63 Countries; or about 1.4 billion people (18% of world pop.)</p> <p>126 Countries; or about 6.3 billion people (82% of world pop.)</p> <p>15% of National Budget</p> <p>10.53%</p> <p>11.22%</p> <p>47 Countries; or about 1.4 billion people (18% of world pop.)</p> <p>142 Countries; or about 6.3 billion people (82% of world pop.)</p> <p>Benchmark 1: Percentage of GDP Needed to Fulfill Universal Coverage</p> <p>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.</p> <p>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:</p> 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). <p>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.</p> <p>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.</p> Public Healthcare Spending (GGHE-D) as Percent GDP, 2021 2021 Public Health Spending (GGHE-D) as % GDP <p class="font-sans text-sm text-gray-500">Source: World Health Organization, Global Health Expenditure Database</p> 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 Zimbabwe <p>About 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.</p> <p>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.</p> <p>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).</p> <p>Benchmark 2: 15 Percent of National Budget</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>Only 10 Countries Spent More than 15 Percent of their National Budget on Health Care in 2021, But Not 5 Percent of GDP</p> <p>Country</p> <p>Public Healthcare Spending (%GDP)</p> <p>Public Healthcare Spending </p> <p>(% National Budget)</p> <p>Size of National Budget </p> <p>(%GDP)</p> <p>Iran (Islamic Republic of)</p> <p>3.19%</p> <p>26.11%</p> <p>12.21%</p> <p>Singapore</p> <p>3.51%</p> <p>20.81%</p> <p>No Data</p> <p>Paraguay</p> <p>4.47%</p> <p>18.01%</p> <p>24.80%</p> <p>Dominican Republic</p> <p>3.29%</p> <p>17.74%</p> <p>18.54%</p> <p>Guatemala</p> <p>2.33%</p> <p>17.41%</p> <p>13.53%</p> <p>Peru</p> <p>3.99%</p> <p>16.94%</p> <p>23.56%</p> <p>Lebanon</p> <p>2.90%</p> <p>16.70%</p> <p>9.13%</p> <p>Cabo Verde</p> <p>4.71%</p> <p>15.75%</p> <p>30.61%</p> <p>Antigua and Barbuda</p> <p>3.93%</p> <p>15.54%</p> <p>24.01%</p> <p>South Africa</p> <p>4.99%</p> <p>15.29%</p> <p>32.59%</p> <p>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.</p> 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) <p class="font-sans text-sm text-gray-500">Source: World Health Organization, Global Health Expenditure Database (Domestic General Government Health Expenditure (GGHE-D) as % General Government Expenditure (GGE))</p> 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% <p>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.</p> <p>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.</p> <p>Retrogression in Public Healthcare Spending</p> <p>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.</p> <p>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.</p> A Widening Gap: Low-Income Countries’ Public Healthcare Spending <p>These 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).</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>Sixteen Countries Spent Less on Health Care Per Person in 2021 Than They Did in 2000</p> <p>Country</p> <p>2000 Per Capita Public Healthcare Spending (2021 National Currency)</p> <p>2021 Per Capita Public Healthcare Spending (2021 National Currency)</p> <p>Change (% Difference)</p> <p>Madagascar</p> <p>37,718</p> <p>14,211</p> <p>−62</p> <p>Benin</p> <p>6,308</p> <p>2,399</p> <p>−62</p> <p>Lebanon</p> <p>1,364,243</p> <p>519,687</p> <p>−62</p> <p>Eritrea</p> <p>181</p> <p>81</p> <p>−55</p> <p>Vanuatu</p> <p>8,681</p> <p>4,017</p> <p>−54</p> <p>Haiti</p> <p>1,342</p> <p>631</p> <p>−53</p> <p>Central African Republic</p> <p>5,964</p> <p>3,319</p> <p>−44</p> <p>Tuvalu</p> <p>1,221</p> <p>724</p> <p>−41</p> <p>Chad</p> <p>5,447</p> <p>3,417</p> <p>−37</p> <p>Sudan</p> <p>3,880</p> <p>2,484</p> <p>−36</p> <p>Jordan</p> <p>116</p> <p>76</p> <p>−35</p> <p>Solomon Islands</p> <p>736</p> <p>596</p> <p>−19</p> <p>Papua New Guinea</p> <p>132</p> <p>108</p> <p>−18</p> <p>Brunei Darussalam</p> <p>1,038</p> <p>869</p> <p>−16</p> <p>Cameroon</p> <p>4,866</p> <p>4,482</p> <p>−8</p> <p>Marshall Islands</p> <p>333</p> <p>325</p> <p>−2</p> <p>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).</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>The Impact of Insufficient Public Healthcare Spending on Out-Of-Pocket Costs</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> Click to expand Image <p>Funding for Public Healthcare Expenditures</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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).</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>Moving Forward</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.”</p> <p>To realign their domestic financing and healthcare spending with their right to health obligations, states should:</p> 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 Pandemic <p>Sources: Income Group 2021: World Bank, World Development Indicators, <br />Population (Thousands) 2021: World Health Organization, Global Health Expenditure Database, Update 2023, Population (in thousands), <br /><br />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), <br /><br />WHO UHC Index Score (SDG 3.8.1) 2021: World Health Organization, UHC Service Coverage Index (SDG 3.8.1), <br /><br />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), <br /><br />National Budget (% of GDP) 2021: World Health Organization, Global Health Expenditure Database, Update 2023, General Government Expenditure (GGE) as % Gross Domestic Product (GDP), <br /><br />GDP Growth (% Relative Change) 2019-2021: International Monetary Fund, World Economic Outlook, October 2023, GDP per capita, current prices (U.S. dollars per capita), <br /><br />% 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, <br /><br />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)) <br /><br />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), <br /><br />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), <br /><br />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), <br /><br />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$, <br /><br />Tax Base (% of GDP) 2021: World Bank, World Development Indicators, Tax revenue (% of GDP), <br /><br />Donor Healthcare Spending (% of Total Healthcare Expenditures) 2021: World Health Organization, Global Health Expenditure Database, Update 2023, External Health Expenditure (EXT) as % of Current Health Expenditure (CHE) </p> Country Income Group Region 2021 Population (Thousands) 2019 Public Healthcare Spending (% of GDP) 2021 Public Healthcare Spending (% of GDP) 2019-2021 % Change, Public Healthcare Spending (% of GDP) 2021 WHO UHC Index Score (SDG 3.8.1) 2019 Public Healthcare Spending (% of National Budget) 2021 Public Healthcare Spending (% of National Budget) 2019-2021 % Change, Public Healthcare Spending (% of National Budget) 2021 National Budget (% of GDP) 2019-2021 % Change, GDP Per Capita 2000-2021 % Change Relative to Income-Group Average, Public Healthcare Spending (PPP per capita) 2000 Inflation-Adjusted Public Healthcare Spending (National Currency Units Per Capita, 2021 Constant NCU) 2021 Inflation-Adjusted Public Healthcare Spending (National Currency Units Per Capita, 2021 Constant NCU) 2000-2021 % Change, Inflation-Adjusted Public Healthcare Spending (National Currency Units Per Capita, 2021 Constant NCU) 2019 Out-of-Pocket Costs (% of GDP) 2021 Out-of-Pocket Costs (% of GDP) 2019-2021 % Change, Out-of-Pocket Costs (% of GDP) 2021 Out-of-Pocket Costs (% of Total Healthcare Expenditures) 2021 External Public and Publicly Guaranteed Debt Service (2021 US$ Per Capita) 2021 Public Healthcare Spending (2021 US$ Per Capita) 2021 Tax-to-GDP Ratio (% of GDP) 2021 Donor Healthcare Spending (% of Total Healthcare Expenditures) Afghanistan Low EMR 40099.46 0.5 0.72 45.04 40.88 1.78 4.05 128.22 -24.36 221.65 11.39 16.85 47.93 77.21 0.96 2.69 19.35 Albania Upper-middle EUR 2854.71 2.93 2.88 -1.52 63.77 10.07 9.14 -9.25 32.12 17.11 18.19 7325.79 19093.58 160.64 3.87 4.34 12.08 59.7 330.34 184.44 18.2 0.54 Algeria Lower-middle AFR 44177.97 3.69 3.27 -11.44 74.11 8.83 8.82 -0.07 37.08 -7.43 -38.62 9990.1 16331.75 63.48 2.08 2.13 2.37 38.53 5.54 120.92 0.63 Andorra High EUR 79.03 5.22 6.17 18.1 78.86 14.59 15.73 7.85 2.75 -1.73 1284.41 2193.74 70.8 0.93 0.98 4.84 11.74 2594.63 Angola Lower-middle AFR 34503.77 1.12 1.71 52.3 36.73 5.51 8.78 59.39 19.48 -16.94 4.37 12122.78 23420.68 93.2 0.82 0.69 -15.3 23.41 515.12 37.09 4.84 Antigua and Barbuda High AMR 93.22 2.56 3.93 53.58 75.8 11.3 15.54 37.49 24.01 -9.56 -39.76 1127.01 1673.34 48.48 1.06 1.12 5.58 19.16 619.76 0.11 Argentina Upper-middle AMR 45276.78 6.08 6.14 0.89 78.53 16.13 16.22 0.55 37.78 5.75 -31.01 39114.78 62728.92 60.37 2.4 2.17 -9.68 22.37 254.54 660.37 11.47 1.26 Armenia Upper-middle EUR 2790.97 1.41 2.19 55.24 68.19 5.67 7.63 34.68 1.8 279.6 6486.85 54829.51 745.24 9.65 9.7 0.57 78.66 279.93 108.84 22 0.89 Australia High WPR 25921.09 7.54 8.02 6.39 86.78 17.11 19.32 12.97 42.13 17.6 8.3 3736.9 7141.83 91.12 1.51 1.46 -3.19 13.82 5364.86 23.03 Austria High EUR 8932.66 7.85 9.47 20.53 84.53 16.13 16.89 4.65 56.05 6.64 -3.86 2661.01 4303.53 61.73 1.88 1.91 1.59 15.78 5089.96 25.84 Azerbaijan Upper-middle EUR 10312.99 1.07 1.49 39.06 65.66 3.29 4.59 39.56 32.28 12.26 119.46 22.66 133.88 490.94 2.98 3.11 4.08 66.03 351.06 78.75 13.42 0.37 Bahamas High AMR 407.91 3.01 3.98 32.04 77.19 15.03 13.75 -8.5 31.9 -13.74 17.23 508.57 1093.89 115.09 1.55 1.75 12.46 24.46 1093.89 13.98 0.46 Bahrain High EMR 1463.27 2.31 2.81 21.95 76.04 7.06 8.69 23.01 31.84 0.25 -43.89 222.17 284.19 27.92 1.19 0.98 -17.13 23.05 755.82 Bangladesh Lower-middle SEAR 169356.25 0.45 0.4 -10.64 51.62 3.3 3.08 -6.6 12.97 15.95 6.92 406.46 832.28 104.76 1.63 1.73 6.12 72.99 32.82 9.78 7.64 7.64 Barbados High AMR 281.2 2.78 4.38 57.39 76.92 10.64 12.42 16.76 33.75 -9.48 -37.34 1082.32 1516.2 40.09 2.9 3.15 8.76 38.92 758.1 0.67 Belarus Upper-middle EUR 9578.17 4.13 4.87 18.14 78.57 11.04 13.15 19.06 6.78 15.83 306 881.01 187.91 1.51 1.44 -4.39 21.93 582.78 347.03 12.83 0.21 Belgium High EUR 11554.77 8.12 8.57 5.52 85.59 15.65 15.46 -1.17 55.41 10.02 3.46 2148.04 3726.61 73.49 2.14 1.97 -7.77 17.86 4407.61 23.1 Belize Upper-middle AMR 400.03 3.29 3.43 4.13 67.6 12.13 13.66 12.6 25.08 -2.1 -13.76 170.82 426.89 149.9 1.11 1.13 2.06 22.76 3065.88 213.44 2.87 Benin Lower-middle AFR 12996.9 0.31 0.32 2.04 37.89 2.13 1.6 -24.96 19.85 16.17 -79.94 6308.25 2398.91 -61.97 1.28 1.26 -1.69 48.63 112.12 4.33 32.07 Bhutan Lower-middle SEAR 777.49 2.65 2.21 -16.7 60.42 10.24 5.61 -45.19 39.35 -2.32 -9.84 3057.64 5113.9 67.25 0.64 0.72 12.76 18.8 298.87 69.16 22.05 Bolivia (Plurinational State of) Lower-middle AMR 12079.47 4.9 5.88 20.13 65.06 13.58 17.1 25.95 34.4 -3.95 109.94 370.41 1359.69 267.08 1.65 1.86 12.27 22.74 132.6 196.77 1.46 Bosnia and Herzegovina Upper-middle EUR 3270.94 6.13 6.53 6.5 66.47 15.37 16.42 6.87 39.87 15.91 87.61 203.67 781.05 283.49 2.62 2.94 12.13 30.71 292.55 472.33 19.12 0.66 Botswana Upper-middle AFR 2588.42 4.37 4.82 10.31 55.18 12.01 14.62 21.73 8.38 -23.14 1991.56 3877.83 94.71 0.28 0.27 -1.37 4.3 115.02 349.76 22.25 5.36 Brazil Upper-middle AMR 214326.22 3.92 4.5 15 80.42 9.24 10.94 18.46 43.49 -12.8 -35.29 1127.31 1870.24 65.9 2.39 2.24 -6.34 22.65 269.75 346.7 14.32 0.13 Brunei Darussalam High WPR 445.37 2.07 2.06 -0.74 78.34 6.39 7.06 10.5 6.42 -70.72 1038.03 868.93 -16.29 0.12 0.15 21.23 6.75 646.62 Bulgaria Upper-middle EUR 6916.55 4.19 5.38 28.18 73.49 11.55 12.92 11.85 38.6 24.06 84.29 301.38 1080.37 258.48 2.76 3 8.61 35.07 166.02 653.42 20.63 0.57 Burkina Faso Low AFR 22100.68 2.22 2.73 22.77 39.6 9.58 9.84 2.73 27.75 15.48 325.2 2766.63 13522.19 388.76 1.85 2.21 19.74 34.65 12.9 24.38 15.98 18.08 Burundi Low AFR 12551.21 2.28 2.23 -2.09 41.46 7.91 7.33 -7.27 30.38 4.85 24.41 8724.98 11736.91 34.52 2.01 2.31 14.81 25.36 2.98 5.94 46.72 Cabo Verde Lower-middle AFR 587.93 2.9 4.71 62.71 71.18 10.17 15.75 54.94 30.61 -9.58 25.04 6195.94 15779.05 154.67 1.24 1.28 3.37 18.52 185.27 169.27 11.42 Cambodia Lower-middle WPR 16589.02 1.67 2 20.25 57.98 6.99 6.99 0 28.64 -3.25 127.02 29273.83 133375.33 355.61 4.41 4.14 -6.18 54.94 47.6 32.54 16.36 14.39 Cameroon Lower-middle AFR 27198.63 0.41 0.48 19.1 43.88 2.18 2.86 31.23 8.75 -51.58 4865.57 4482.23 -7.88 2.64 2.56 -2.92 66.92 58.73 8.08 11.35 16.95 Canada High AMR 38155.01 7.65 8.99 17.53 91.04 18.85 19.61 4.03 45.86 12.78 -8.14 3382.36 5915.7 74.9 1.7 1.73 1.65 14.02 4717.93 13.26 Central African Republic Low AFR 5457.15 0.82 1.26 54.37 32.26 4.84 6.42 32.65 19.69 9.38 -36.76 5964.32 3318.46 -44.36 4.7 4.44 -5.52 48.97 2.47 5.98 8.21 36.27 Chad Low AFR 17179.74 0.7 0.9 28.41 29.4 4.87 4.87 0 18.8 1.12 -54.64 5447.11 3416.73 -37.27 2.92 3.05 4.36 58.79 37.12 6.16 22.06 Chile High AMR 19493.18 4.77 5.2 9.02 82.28 18.01 15.52 -13.81 33.48 10.46 110.59 187431.74 640864.11 241.92 3.07 2.83 -7.92 30.27 844.4 19.6 China Upper-middle WPR 1425893.46 3 2.91 -2.81 81.04 8.77 8.91 1.55 32.69 23.62 430.21 157.07 2337.98 1388.45 1.88 1.85 -1.76 34.39 70.64 362.54 7.97 Colombia Upper-middle AMR 51516.56 5.44 6.55 20.42 79.57 16.53 19.01 14.95 34.34 -4.6 8.65 606754.82 1515384.41 149.75 1.15 1.23 7.52 13.67 518.27 404.72 14.45 Comoros Lower-middle AFR 821.63 0.83 0.94 12.47 48.12 4.13 4.72 14.48 19.82 2.59 -30.7 4916.58 6087.96 23.83 3.2 3.52 9.91 55.57 3.87 14.64 25.64 Congo, Dem. Rep. of the Low AFR 95894.12 0.55 0.63 14.38 41.74 4.37 4.34 -0.76 15.62 5.63 1497.42 1.35 1.48 9.69 39.13 6.48 3.74 37.51 Congo, Republic of Lower-middle AFR 5835.81 1.11 1.9 70.36 41 5.11 8.22 60.89 20.94 -8.84 3.26 8890.15 21871 146.01 1.07 0.93 -12.96 24.08 132.24 39.44 6.8 Cook Islands High WPR 17 2.55 3.66 43.51 45.98 8.24 7.79 -5.53 -38.91 727.53 995.58 36.84 0.09 0.09 5.15 2.38 704.18 2.03 Costa Rica Upper-middle AMR 5153.96 5.24 5.3 1.17 81.08 24.1 25.37 5.27 20.88 -1.72 -4.24 196793.49 412441.63 109.58 1.61 1.57 -2.62 20.74 578.46 664.39 14 0.05 Côte d'Ivoire Lower-middle AFR 27478.25 0.97 1.03 6 42.78 5.73 5.06 -11.76 20.73 13.95 20.91 6566.54 14917.08 127.17 1.2 1.01 -15.42 32.34 93.7 26.9 12.56 15.44 Croatia High EUR 4036.36 5.55 6.81 22.77 80.15 11.98 13.99 16.81 48.67 17.77 11.81 4213.84 7403.66 75.7 0.78 0.76 -2.41 9.4 1164.08 20.13 0.01 Cuba Upper-middle AMR 11256.37 9.87 12.63 27.98 82.81 15.52 21.48 38.45 64.97 1505.4 6116.69 306.32 1.2 1.16 -3.78 8.39 0.01 Cyprus High EUR 896.01 3.83 7.99 108.65 80.69 10.04 18.37 83.03 43.47 7.09 159.01 461.92 2140.67 363.43 2.38 0.94 -60.74 9.92 2532.14 23.23 0.95 Czechia High EUR 10701.78 6.44 8.18 27.02 84.24 15.68 17.58 12.12 46.51 13.46 51.63 17984.92 46675.67 159.53 1.07 1.21 12.7 12.73 2153.12 13.36 Denmark High EUR 5840.05 8.5 9.22 8.52 81.96 17.11 18.15 6.09 49.8 16.4 5.26 24342.95 39546.63 62.46 1.4 1.36 -2.63 12.6 6290.11 34.81 Djibouti Lower-middle EMR 1105.56 1.05 0.97 -7.59 43.91 4.28 4.2 -1.94 24.09 6.48 -49.25 4465.16 5237.54 17.3 0.68 0.58 -13.69 20.3 87.74 29.47 44.91 Dominica Upper-middle AMR 72.41 3.33 4.17 25.15 49.15 7.57 7.24 -4.3 65.98 -11.06 -40.86 614.17 835.02 35.96 1.75 1.55 -11.66 23.77 469.69 309.27 11.45 Dominican Republic Upper-middle AMR 11117.87 2.59 3.29 26.8 76.98 15.62 17.74 13.54 18.54 4.27 63.1 4118.69 15943.16 287.09 1.18 1.16 -2.05 23.59 398.75 278.62 14.38 1.53 Ecuador Upper-middle AMR 17797.74 4.87 5.28 8.36 76.63 13.13 14.76 12.45 37.84 -4.5 199.85 44.13 314.88 613.61 2.4 2.54 5.53 30.62 349.4 314.88 12.86 0.43 Egypt Lower-middle EMR 109262.18 1.3 1.74 33.89 70.23 4.82 6.8 40.98 27.94 -24.7 678.2 1059.15 56.17 2.87 2.53 -11.97 54.9 305.27 67.7 0.63 El Salvador Lower-middle AMR 6314.17 4.71 6.4 35.8 78.04 17.33 20 15.41 31.24 8.97 21.34 128.38 291.41 127 3.32 2.6 -21.7 26.74 351.25 291.41 19.42 0.26 Equatorial Guinea Upper-middle AFR 1634.47 0.65 0.68 4.88 45.75 3.85 5.36 39.18 12.66 1.11 23.77 10764.52 28222.93 162.18 2.42 2.64 8.99 77.47 50.9 5.44 0.43 Eritrea Low AFR 3620.31 0.79 0.88 12.06 44.89 2.35 2.35 0 -61.68 181.02 81.06 -55.22 2.05 2.05 0.03 49.51 11.36 5.38 29.29 Estonia High EUR 1330.07 5.07 5.71 12.53 79.31 12.87 13.76 6.88 41.84 17.52 128.59 423.79 1348.76 218.26 1.64 1.67 1.62 22.25 1595.23 21.42 0.02 Eswatini Lower-middle AFR 1192.27 3.83 3.73 -2.53 55.86 11.23 12.3 9.5 29.4 3.3 8.06 871.44 2195.41 151.93 0.71 0.73 2.79 10.43 106.46 148.5 24.16 Ethiopia Low AFR 120283.03 0.73 0.98 33.97 35.14 4.76 7.1 49.07 13.8 2.67 63.67 201.48 353.42 75.41 1.23 1.19 -3.22 37 33.47 8.08 28.31 Fiji Upper-middle WPR 924.61 2.62 3.36 27.91 58.25 8.73 9.44 8.2 34.35 -21.8 -35.84 233.08 322.96 38.57 0.81 0.96 17.94 17.85 51.95 155.97 15.87 9.73 Finland High EUR 5535.99 7.35 8.41 14.29 85.68 13.79 15.07 9.27 55.76 10.27 8.52 1989.33 3805.07 91.27 1.6 1.65 3.28 16.1 4500.41 20.63 France High EUR 67656.68 8.33 9.31 11.67 84.79 15.06 15.76 4.68 59.11 7.81 -11.26 2286.05 3440.27 50.49 1.05 1.1 4.79 8.92 4068.94 23.96 Gabon Upper-middle AFR 2341.18 1.67 1.59 -4.73 48.97 9.59 9.59 0 16.59 17.18 -53.6 58995.47 76220.92 29.2 0.64 0.59 -7.81 21.77 955.94 137.45 3.99 Gambia Low AFR 2639.92 1.3 1.62 24.23 46.15 5.48 7.54 37.57 6.72 13.64 239.77 642.38 167.91 0.64 0.65 1.9 20.4 25.5 12.48 17.35 Georgia Upper-middle EUR 3757.98 2.72 4.49 65.29 68.23 9.39 14.23 51.59 31.56 6.42 722.4 40.34 717.14 1677.52 3.11 2.63 -15.66 31.2 627.69 222.6 21.73 0.66 Germany High EUR 83155.03 9.04 10.22 13.1 87.96 20.09 19.95 -0.72 50.94 9.94 -3.08 2703.95 4428.54 63.78 1.57 1.57 -0.11 12.16 5237.81 11.18 Ghana Lower-middle AFR 32833.03 2.31 2.24 -2.65 47.79 10.25 8.2 -19.99 27.21 11.91 128.87 55.59 313.83 464.5 1.21 1.13 -6.79 27.25 179.48 54.06 8.89 Greece High EUR 10678.63 4 5.43 35.87 77.19 8.3 9.41 13.36 57.7 5.19 -34.22 753.39 924.05 22.65 2.76 3.06 10.85 33.33 1092.91 25.37 0.13 Grenada Upper-middle AMR 124.61 2.04 2.22 8.7 70.44 9.43 6.99 -25.87 31.24 -8.38 -34.07 361.93 531.39 46.82 2.68 3.06 13.96 53.68 734 196.81 3.34 Guatemala Upper-middle AMR 17608.48 2.37 2.33 -1.79 58.68 17.65 17.41 -1.37 13.53 7.29 -36.33 536.86 890.45 65.86 3.46 4.21 21.72 60.98 100.95 115.13 11.61 2.33 Guinea Low AFR 13531.91 0.92 0.69 -25.29 39.92 6.15 4.49 -26.97 15.63 12.16 234.59 22324.7 80197.8 259.23 2.42 2.01 -17.07 53.47 16.74 8.19 22.65 Guinea-Bissau Low AFR 2060.72 0.46 1.14 147.71 37.25 2.44 4.6 88.48 24.96 11.13 106.84 2183.19 5273.98 141.57 4.98 4.93 -0.88 59.97 42.56 9.51 23.23 Guyana Upper-middle AMR 804.57 2.9 3.34 15.08 75.93 10.32 12.85 24.47 26.01 47.2 135.57 12384.5 66317.81 435.49 1.72 1.42 -17.31 28.72 197.49 318.07 1.18 Haiti Lower-middle AMR 11447.57 0.41 0.43 4.31 54.14 4.02 3.92 -2.56 9.31 38.21 -77.05 1342.43 630.87 -53.01 1.53 1.51 -0.8 43.53 2.6 7.07 35.01 Honduras Lower-middle AMR 10278.35 2.87 3.44 19.64 64.31 11.17 12.09 8.28 28.42 8.89 -10.13 1465.45 2287.94 56.13 3.83 4.74 23.58 51.71 106.26 95.26 4.98 Hungary High EUR 9730.77 4.29 5.33 24.11 79.46 9.31 11.02 18.31 48.34 11.62 19.98 153143.35 302476.32 97.51 1.75 1.82 4.12 24.64 997.81 21.49 Iceland High EUR 370.34 7.1 8.14 14.65 88.92 16.29 16.37 0.47 49.92 0.39 -24.41 490187.03 713607.14 45.58 1.33 1.43 6.9 14.65 5619.45 21.58 India Lower-middle SEAR 1407563.84 1.04 1.12 8.62 63.33 3.85 3.69 -4.18 29.47 9.17 50.47 490.5 1875.49 282.37 1.54 1.64 6.47 49.82 23.03 25.37 2.21 Indonesia Lower-middle SEAR 273753.19 1.4 2.2 57.52 54.78 8.56 12.11 41.55 18.18 4.02 238.36 159102.6 1365573.26 758.3 1.01 1.02 0.9 27.49 276.82 95.44 9.09 2.04 Iran Lower-middle EMR 87923.43 2.79 3.19 14.24 74.31 19.73 26.11 32.31 12.21 17.22 -5.8 9938757.74 24206002.91 143.55 2.44 1.99 -18.37 34.51 2.15 216.83 0.24 Iraq Upper-middle EMR 43533.59 2.1 2.59 23.25 58.51 5.99 6.99 16.54 -15.7 178093.35 2.13 2.62 22.85 49.91 147.14 122.82 0.75 Ireland High EUR 5006.32 4.98 5.2 4.36 82.68 20.54 20.96 2.05 24.36 26.51 35.78 1845.95 4426.45 139.79 0.81 0.72 -11.8 10.69 5235.34 17.16 Israel High EUR 8900.06 4.65 5.39 15.9 85.5 11.88 13.19 11.08 40.15 18.48 -23.13 5198.69 9555.55 83.81 1.53 1.57 2.14 19.8 2958.19 24.62 1.02 Italy High EUR 59236.21 6.38 7.08 10.93 83.84 13.17 12.36 -6.18 57.32 6.21 -24.81 1702.28 2137.12 25.54 2.03 2.05 1.17 21.89 2527.66 24.93 Jamaica Upper-middle AMR 2827.69 3.98 5.12 28.58 74.14 13.32 16.18 21.45 30.1 -7.38 -28.45 24927.09 39984.79 60.41 1 0.94 -6.24 13.08 737.49 265.17 1.38 Japan High WPR 124612.53 9.21 9.17 -0.45 83.49 24.7 21.45 -13.17 42.7 -1.52 -12.99 218990.19 404247.91 84.6 1.42 1.3 -8.02 12.03 3683.21 Jordan Upper-middle EMR 11148.28 3 2.59 -13.68 64.91 10.11 7.91 -21.81 33.13 -0.27 -72.47 116.11 75.55 -34.93 2.52 2.73 8.39 37.45 471.08 106.41 8.34 Kazakhstan Upper-middle EUR 19196.47 1.67 2.56 53.46 80.33 8.25 11.62 40.8 3.65 24.17 36218.19 112129.27 209.59 0.94 0.98 4.07 25.03 143.87 263.27 9.45 0.09 Kenya Lower-middle AFR 53005.61 2.01 2.22 10.33 53.34 8.23 9.29 12.82 24.02 4.79 84.32 1605.89 5058.36 214.99 1.06 1.04 -2.47 22.77 78.54 46.14 13.26 18.43 Kiribati Lower-middle WPR 128.87 11.43 11.12 -2.68 47.71 8.52 9.97 17.01 111.55 25.83 -31.23 200.21 261.5 30.61 0.08 0.1 24.75 0.67 196.43 27.38 22.06 Kuwait High EMR 4250.11 4.72 5.19 9.78 77.81 8.91 9.92 11.34 54.7 1.13 -6.65 197.58 503.54 154.86 0.57 0.54 -6.35 9.31 1669.32 Kyrgyzstan Lower-middle EUR 6527.74 2.31 2.91 25.8 68.54 7.09 8.56 20.73 32.08 -5.18 35 1515.35 3295.18 117.45 2.08 2.21 6.57 40.66 48.15 38.93 16.49 5.86 Lao P.D.R. Lower-middle WPR 7425.06 0.96 0.72 -25.19 51.83 5.12 4.41 -14.01 -4.1 -11.6 109276.48 175088.83 60.23 1.09 0.85 -22.03 30.94 179.04 18.05 38.01 Latvia High EUR 1893.22 3.96 6.27 58.26 74.63 10.35 14.19 37.09 42.84 17.47 236.44 197.79 1112.54 462.48 2.33 2.44 4.7 26.99 1315.85 21.92 0.14 Lebanon Lower-middle EMR 5592.63 4.29 2.9 -32.25 72.62 13.75 16.7 21.49 9.13 -58.97 -80.14 1364242.98 519687.2 -61.91 2.67 3.49 30.82 34.72 89.21 88.63 5.68 10.44 Lesotho Lower-middle AFR 2281.45 5.77 4.2 -27.17 53.25 11.14 7.95 -28.65 50.05 5.15 -6.84 389.06 697.7 79.33 1.54 1.44 -6.7 14.05 260.17 47.21 32.73 44.38 Liberia Low AFR 5193.42 1.36 1.09 -19.95 44.71 4.2 3.66 -12.91 8.58 53.33 201.93 1247.11 517.6 4.58 4.1 -10.54 24.68 7.64 7.34 17.55 Lithuania High EUR 2795.68 4.55 5.26 15.51 75.32 13.1 14.01 6.93 21.06 122.85 293.44 1055.63 259.74 2.26 2.36 4.58 30.16 1248.67 21.27 0.49 Luxembourg High EUR 634.73 4.7 4.93 4.87 83.11 10.89 11.48 5.38 42.88 18.5 -19.03 4812.57 5610.72 16.58 0.53 0.51 -3.79 8.93 6636.03 26.11 1.17 Madagascar Low AFR 28915.65 0.68 0.74 7.97 34.94 4.44 5.27 18.49 13.71 -2.86 -71.17 37717.75 14210.57 -62.32 1.06 1.15 8.01 32.71 8.91 3.71 10.24 40.45 Malawi Low AFR 19889.74 1.67 1.36 -18.6 48.27 8.67 5.76 -33.59 6.86 -3.65 3713.2 6828.33 83.89 0.87 1.05 19.9 14.11 8.21 8.56 11.38 61.74 Malaysia Upper-middle WPR 33573.87 2.01 2.46 22.63 75.99 8.52 10.11 18.58 24.33 2.2 16.74 331.04 1134.28 242.64 1.38 1.41 1.56 32.08 273.76 11.21 Maldives Upper-middle SEAR 521.46 6 7.18 19.69 61.42 17.85 18.17 1.79 39.48 -6.85 50.52 2447.11 11432.86 367.2 1.34 1.44 7.45 14.33 2841.96 743.71 12.88 Mali Low AFR 21904.98 1.12 1.31 17.23 41.28 4.84 4.96 2.62 7.43 23.61 4808.15 6525.61 35.72 1.19 1.53 28.15 34.09 24.64 11.77 29.67 Malta High EUR 516.1 5.72 7.13 24.69 85.24 15.91 16.23 2.01 8.22 39.78 828.11 2074.05 150.46 3.12 2453.34 23.77 Marshall Islands Upper-middle WPR 42.05 6.81 5.32 -21.92 58.94 10.51 7.95 -24.37 70.17 10.66 -59.42 332.95 325.09 -2.36 0.16 0.14 -17.2 1.09 325.09 51.07 Mauritania Lower-middle AFR 4614.97 1.24 1.6 28.46 40.12 7.13 8.34 16.9 17.39 114.51 287.97 1249.03 333.74 1.48 1.36 -7.82 33.1 170.27 34.63 23.8 Mauritius Upper-middle AFR 1298.91 2.84 3.14 10.82 65.65 10.2 10.2 0 -20.4 34.64 3329.28 11586.9 248.03 2.75 2.74 -0.32 42.9 281.9 277.92 18.26 1.38 Mexico Upper-middle AMR 126705.14 2.68 3.05 13.69 74.55 10.32 11.03 6.93 26.77 -1.3 -27.85 3851.56 6201.54 61.01 2.3 2.51 9.17 41.37 821.09 305.91 13.45 0.11 Micronesia, Fed. States of Lower-middle WPR 113.13 3.2 1.89 -40.72 47.66 5.88 2.6 -55.83 63.33 -2.66 -45.26 62.44 67.97 8.85 0.29 0.29 -1.28 2.65 67.97 80.07 Moldova Upper-middle EUR 2587 3.88 5.06 30.42 70.75 12.12 14.62 20.63 34.58 20.94 193.61 793.58 4731.58 496.23 2.32 2.28 -1.7 29.42 267.62 18.39 3.48 Monaco High EUR 36.69 3.34 3.31 -1 85.9 14.5 13.65 -5.89 -3.4 3490.52 6552.91 87.73 0.26 0.25 -1.76 6.88 Mongolia Lower-middle WPR 3347.78 2.12 4.53 113.78 64.95 6.88 12.63 83.56 35.89 4.03 24.39 212816.9 589565.03 177.03 1.94 2.32 19.42 33.53 769.88 206.92 16.91 0.33 Montenegro Upper-middle EUR 627.86 5.07 6.46 27.39 71.94 11.52 14.4 24.97 5.86 509.47 3.21 4.02 25.13 38.08 2213.13 602.64 Morocco Lower-middle EMR 37076.58 2.02 2.23 10.19 69.45 7.39 7.18 -2.9 31.28 7.8 79.08 190.79 772.22 304.75 2.3 2.57 11.59 44.76 243.65 85.91 19.69 3.62 Mozambique Low AFR 32077.07 1.84 2.57 39.65 43.99 6.17 8.15 32.14 30.92 -1.31 259.23 187.9 827.64 340.47 0.76 0.8 6.12 8.88 34.48 12.64 22.75 57.51 Myanmar Lower-middle SEAR 53798.08 0.66 1.06 59.83 52.45 3.28 4.39 34.11 24.14 -6.56 519.66 1351.08 19449.8 1339.57 3.75 3.96 5.62 70.25 29.23 12.29 10.85 Namibia Upper-middle AFR 2530.15 3.99 4.45 11.71 62.64 10.65 11.24 5.48 39.19 -4.32 -50.8 2685.48 3201.39 19.21 0.67 0.72 8.56 7.72 216.62 27.97 8.14 Nauru High WPR 12.51 10.35 11.34 9.63 60.35 9.19 9.14 -0.56 12.05 -45.54 1559.9 1767.8 13.33 0.09 0.09 -4.41 0.68 1327.95 10.46 Nepal Lower-middle SEAR 30034.99 1.1 1.8 63.07 53.66 4.03 6.49 60.79 4.69 242.61 362.14 2561.17 607.24 2.57 2.78 7.86 51.26 18.41 21.68 17.49 12.74 Netherlands High EUR 17475.42 6.69 7.88 17.68 85.21 15.89 16.86 6.13 46.07 11.94 -0.07 2178.71 3855.19 76.95 1.06 1.06 0.2 9.38 4559.69 24.35 0.01 New Zealand High WPR 5129.73 7.13 7.74 8.56 84.83 18.6 18.57 -0.19 42.14 15.38 3.78 2924.7 5343.57 82.7 1.16 1.17 1.31 11.67 3779.58 28.84 Nicaragua Lower-middle AMR 6850.54 5.28 6.14 16.36 70.31 18.96 20.09 5.95 30.3 11.49 77.76 1290.6 4416.8 242.23 2.85 2.98 4.83 30.82 107.72 125.58 18.9 4.32 Niger Low AFR 25252.72 2.02 2.12 4.93 34.98 9.38 8.75 -6.74 24.26 7.16 82.51 2835.52 6950.35 145.12 2.61 2.47 -5.33 42.53 15.26 12.53 14.29 Nigeria Lower-middle AFR 213401.32 0.47 0.54 15.16 38.42 3.75 4.06 8.11 13.34 -6.36 -31.48 2709.24 4463.97 64.77 2.13 3.11 45.6 76.24 24.8 11.13 7.86 Niue High WPR 1.94 5.28 7.05 33.63 43.59 4.85 6.48 33.63 -23.53 1251.02 1385.12 10.72 0.07 0.08 13.27 0.59 979.71 48.16 North Macedonia Upper-middle EUR 2103.33 4.26 4.64 9.09 73.53 13.56 13 -4.07 35.71 10.29 -20.86 10002.35 15907.52 59.04 2.76 3.56 28.81 41.74 911.52 305.29 17.39 Norway High EUR 5391.37 8.95 8.49 -5.15 87.03 17.52 17.57 0.31 47.52 18.66 1.31 42843.72 66296.63 54.74 1.45 1.39 -4.04 14.05 7717.88 25.75 Oman High EMR 4520.47 3.33 3.81 14.34 69.9 8.59 10.54 22.64 36.13 2.15 -43.9 174.14 285.84 64.15 0.23 0.27 18.11 6.13 743.41 Pakistan Lower-middle EMR 231402.12 0.94 0.84 -10.4 45.21 4.95 4.57 -7.57 18.46 4.32 -37.72 1471.34 2037.38 38.47 1.6 1.67 4.45 57.5 84.1 12.51 10.32 Palau Upper-middle WPR 18.02 6.92 7.4 6.93 64.77 16.2 11.1 -31.5 -17.07 -29.57 527.33 923.42 75.11 1.81 2.45 35.46 14.98 923.42 20.02 Panama High AMR 4351.27 4.8 5.38 11.95 78.22 21.94 21.66 -1.25 23.66 -5.96 45.31 344.45 786.26 128.27 3.19 3.61 13.46 37.33 786.26 7.46 1.08 Papua New Guinea Lower-middle WPR 9949.44 1.36 1.16 -14.46 30.39 6.54 5.33 -18.54 21.79 -22.39 -56.68 131.72 107.74 -18.2 0.22 0.24 8.45 10.35 129.56 30.71 39.65 Paraguay Upper-middle AMR 6703.8 3.32 4.47 34.57 72.27 14.45 18.01 24.6 24.8 2.47 15.44 608186.19 1802975.57 196.45 3.01 2.89 -3.94 35.94 273.77 266.15 9.79 0.27 Peru Upper-middle AMR 33715.47 3.26 3.99 22.49 71.11 15.4 16.94 10.01 23.56 -4.73 32.84 309.76 1037.41 234.91 1.46 1.67 14.91 27.22 89.27 267.34 16.11 0.24 Philippines Lower-middle WPR 113880.33 1.69 2.31 36.48 58.21 7.8 8.46 8.48 27.2 1.82 45.38 1272.61 3935.6 209.25 2.03 2.62 28.86 44.61 136.21 79.9 14.13 0.6 Poland High EUR 37840 4.61 4.64 0.67 82.01 11.01 10.53 -4.39 44.09 14.74 56.06 1163.94 3228.2 177.35 1.32 1.31 -1.01 20.31 835.91 19.15 0.06 Portugal High EUR 10298.25 5.78 7.03 21.57 87.91 13.62 14.72 8.08 47.75 5.87 -22.96 1129.83 1465.69 29.73 2.91 3.23 10.87 28.99 1733.53 22.01 0.1 Qatar High EMR 2688.24 2.72 2.46 -9.62 76.42 8.39 8.39 0.06 29.35 3.77 -19.7 2443.54 5985.9 144.97 0.21 0.19 -10.5 6.56 1644.48 Republic of Korea High WPR 51830.14 4.73 5.69 20.3 89.09 13.97 14.83 6.12 25.74 10.16 148.64 407490.12 2275202.3 458.35 2.58 2.72 5.08 29.1 1988.9 16.73 Romania High EUR 19201.66 4.58 4.9 7.03 78.39 12.73 12.32 -3.27 37.2 15.05 207.93 813.95 3030.82 272.36 1.08 1.36 25.79 20.94 728.49 14.96 2.58 Russian Federation Upper-middle EUR 145102.76 3.45 5.26 52.3 79.16 10.2 15.12 48.25 34.79 9.2 125.79 14146.14 49052.05 246.75 2.07 2.01 -2.62 27.22 469.85 665.98 11.65 Rwanda Low AFR 13461.89 2.52 2.99 18.81 48.55 8.93 9.47 6.09 31.6 2.05 921.46 1991.83 24303.7 1120.17 0.77 0.74 -3.38 10.13 68.53 24.58 35.85 Saint Kitts and Nevis High AMR 47.61 2.55 3.54 38.68 78.95 6.7 7.91 18.1 44.92 -24.01 13.85 728.24 1729.62 137.51 2.41 2.39 -0.45 38.85 640.6 Saint Lucia Upper-middle AMR 179.65 2.08 2.63 26.53 76.81 8.28 8.68 4.84 27.04 -12.56 -32.33 411.94 669.25 62.46 1.8 2.31 28.74 37.22 485.87 247.87 14.82 Saint Vincent and the Grenadines Upper-middle AMR 104.33 2.87 3.63 26.57 68.83 9.7 9.6 -1.1 37.85 -4.38 -23.99 403.34 819.68 103.22 1.2 1.4 17.51 26.19 571.24 303.58 3.37 Samoa Lower-middle WPR 218.76 4.31 5.12 18.67 55.13 13.59 14.75 8.56 -8.78 -7.47 277.22 507.67 83.13 0.63 0.76 20.8 11.19 127.22 198.61 25.02 12.9 San Marino High EUR 33.75 7.23 7.03 -2.82 77.11 32.24 17.85 -44.63 13.92 -24.26 2330.23 3078.92 32.13 0.91 0.95 3.42 11.86 3642.07 17.3 São Tomé and Príncipe Lower-middle AFR 223.11 2.16 3.35 55.52 58.79 9.78 13.14 34.41 21.33 -20.63 1081.06 1652.34 52.85 0.9 0.91 1.36 11.66 23.07 79.78 43.69 Saudi Arabia High EMR 35950.4 4.03 4.59 13.89 74.37 11.98 14.4 20.25 31.9 1.16 -31.75 2384.64 4162.89 74.57 0.62 0.61 -2.78 10.16 1110.1 Senegal Lower-middle AFR 16876.72 1.06 1.12 6.36 50.09 4.37 4.37 -0.05 25.8 11.64 -43.55 8523.35 10211.61 19.81 2.19 2.06 -6.06 47.31 171.28 18.41 17.52 18.37 Serbia Upper-middle EUR 6871.55 5.06 6.26 23.81 71.67 12.03 13.45 11.76 23.82 51.09 16119.2 57123.52 254.38 3.21 3.58 11.51 35.76 616.29 574.71 20.61 0.14 Seychelles High AFR 106.47 3.49 4.02 15.16 74.57 10.18 10.18 0 38.38 -20.95 -26.47 6300.54 9301.71 47.63 1.18 1.16 -1.83 21.98 549.73 Sierra Leone Low AFR 8420.64 1.24 1.94 55.77 41 5.84 6.85 17.29 -2.29 114.34 24387.73 101977.05 318.15 4.83 4.4 -8.94 51.41 12.38 9.77 25.67 Singapore High WPR 5941.06 2.27 3.51 54.11 88.51 16.25 20.81 28.09 17.62 156.93 654.51 3359.8 413.33 1.25 1.25 0.09 22.5 2500.82 13.12 Slovakia High EUR 5459.78 5.45 6.18 13.32 81.75 13.46 13.56 0.77 45.57 12.12 37.08 410.66 1135.62 176.53 1.33 1.5 13.44 19.4 1343.14 19.3 Slovenia High EUR 2108.98 6.15 6.94 12.79 84.35 14.17 14.01 -1.12 49.46 12.24 3.05 906.13 1717.46 89.54 0.99 1.22 23.33 12.9 2031.31 18.27 0.22 Solomon Islands Lower-middle WPR 707.85 3.26 3.33 2.03 47.28 9.67 10.54 9.03 31.55 -9.21 -51.24 736.24 596.17 -19.02 0.16 0.17 8.87 3.64 18.36 74.24 20.67 26.55 South Africa Upper-middle AFR 59392.26 4.81 5 3.86 70.95 15.29 15.29 0 32.59 5.45 -8.96 2228.8 5208.69 133.7 0.47 0.46 -3.53 5.51 381.6 352.45 25.85 1.42 South Sudan Low AFR 10748.27 1.01 0.93 -7.89 34.18 2.11 2.11 0 38.49 1588.42 3.83 1.61 -58 27.41 5.18 49.84 Spain High EUR 47398.7 6.45 7.69 19.19 85.26 15.26 15.19 -0.43 49.98 3.24 -0.28 1149.39 1958.08 70.36 2 2.26 12.94 21 2315.9 15.03 Sri Lanka Lower-middle SEAR 21773.44 1.85 1.89 2.36 66.74 9.49 9.49 0 20.01 -2.11 -1.37 8137.93 15342.02 88.52 1.77 1.77 0.01 43.64 380.72 77.19 7.38 4.33 Sudan Low EMR 45657.2 1.04 0.77 -26.12 43.53 5.56 7.86 41.32 9.75 -1.61 -45.76 3880.44 2483.92 -35.99 3.08 1.61 -47.67 56.86 73.89 5.84 10.41 Suriname Upper-middle AMR 612.98 6.14 3.33 -45.75 62.66 15.73 10.02 -36.29 33.8 -26.52 -37.23 2352.76 3195.81 35.83 1.51 1.41 -6.53 24.83 270.01 175.22 2.45 Sweden High EUR 10379.3 9.22 9.66 4.8 85.25 18.77 19.55 4.19 48.16 18.39 7.73 24551.47 50853.36 107.13 1.49 1.47 -0.93 13.08 5929.34 27.21 Switzerland High EUR 8670.3 3.72 4.27 14.75 86.34 11.2 11.72 4.66 34.52 10.92 15.13 1857.39 3606.35 94.16 2.63 2.68 1.88 22.71 3946.35 10.09 Tajikistan Lower-middle EUR 9750.06 1.9 1.94 2.27 67.25 6.58 7.02 6.64 27.64 3.56 202.01 30.55 201.19 558.53 4.95 5.09 2.86 63.54 45.37 17.79 10.35 12.12 Tanzania Lower-middle AFR 63588.33 1.57 0.91 -41.87 42.63 9.44 5.14 -45.59 17.79 8.64 10.93 9390.79 23207.81 147.13 0.85 0.86 1.03 25.56 48.41 10.1 46.31 Thailand Upper-middle SEAR 71601.1 2.72 3.63 33.72 81.98 12.51 13.47 7.66 27.26 -7.49 49.01 2215.21 8198.23 270.09 0.33 0.47 42.08 9.04 43.13 256.38 14.32 0.09 Timor-Leste Lower-middle SEAR 1320.94 3.48 7.26 108.76 52.3 4.19 6.97 66.23 73.18 85.65 0.63 0.67 6.65 5.89 14.53 85.65 15.1 30.67 Togo Low AFR 8644.83 0.86 0.55 -36.08 44.01 5.38 2.56 -52.42 21.79 13.67 93.54 1237.3 2982.7 141.07 3.79 3.83 1.11 69 24.93 5.38 16.18 Tonga Upper-middle WPR 106.02 2.89 3.62 25.09 56.69 7.51 7.34 -2.26 -7.81 -15.88 199.77 365.1 82.76 0.26 0.27 3.72 4.24 90.29 161.2 34.45 Trinidad and Tobago High AMR 1525.66 3.14 3.32 5.79 75 10.24 11.07 8.13 31.93 2.43 29.49 1247.73 3600.44 188.56 3.2 3.23 0.68 45.97 532.72 0.05 Tunisia Lower-middle EMR 12262.95 3.57 4.13 15.7 67.14 12.08 12.4 2.63 33.29 9.23 -1.96 198.03 439.11 121.74 2.14 2.35 9.77 33.74 565.1 157.14 1.99 Türkiye Upper-middle EUR 84775.4 3.39 3.6 6.07 75.59 9.5 11.53 21.41 31.18 5.66 10.91 1173.52 3076.09 162.13 0.74 0.74 -0.19 16.27 520.21 347.57 17.86 Turkmenistan Upper-middle EUR 6341.86 1.01 0.89 -11.55 74.71 8.71 8.68 -0.35 17.33 -47.84 194.04 317.15 63.45 4.38 4.38 0 78.56 513.17 90.62 0.17 Tuvalu Upper-middle WPR 11.2 17.17 10.14 -40.92 52.41 15.22 8.2 -46.13 10.4 -74.61 1221.1 724.35 -40.68 0.07 0.07 4.88 0.35 544.12 46.52 Uganda Low AFR 45853.78 0.57 1.05 83.34 48.57 3.14 4.88 55.52 21.55 5.63 25.61 22726.11 35116.67 54.52 1.45 1.46 0.47 31.25 26.98 9.79 12.46 42.46 Ukraine Lower-middle EUR 43531.42 3.18 4.09 28.57 75.51 7.66 10.15 32.52 40.49 32.13 69.55 1859.21 5123.33 175.56 3.63 3.71 2.29 46.33 232.75 187.76 19.08 United Arab Emirates High EMR 9365.14 2.25 3.4 50.99 81.77 7.92 12.89 62.71 26.39 -1.23 -42.2 3692 5536.91 49.97 0.56 0.55 -0.97 10.44 1507.67 0.54 United Kingdom High EUR 67280 7.97 10.35 29.87 87.8 19.53 22.36 14.52 46.27 8.47 19.7 1611.77 3491.76 116.64 1.65 1.67 1 13.51 4802.54 26.22 0.01 United States High AMR 336997.62 8.63 9.62 11.41 85.73 22.45 21.41 -4.65 43.02 7.81 12.21 3065.92 6655.17 117.07 1.88 1.86 -1.42 10.7 6655.17 11.44 Uruguay High AMR 3426.26 6.25 6.93 10.84 81.53 20.13 22.42 11.38 29.87 -1.72 37.18 18474.87 52269.15 182.92 1.45 1.44 -0.49 15.44 1200.08 Uzbekistan Lower-middle EUR 34081.45 2.26 3.03 34.29 74.84 8.28 9.9 19.57 30.48 11.1 40.48 160258.21 653759.7 307.94 3.13 4.67 49 60.33 63.97 61.62 0.03 Vanuatu Lower-middle WPR 319.14 1.9 1.21 -36.7 46.99 4.78 2.78 -41.95 43.42 -5.32 -76.6 8680.89 4017.09 -53.72 0.27 0.32 19.77 7.33 106.15 36.7 62.42 Venezuela, RB Upper-middle AMR 28199.87 0.81 1.35 66.76 75.13 1.81 5.46 201.96 -20.35 38.27 0.75 1.13 51.9 28.06 53.67 0.47 Vietnam Lower-middle WPR 97468.03 2.02 1.96 -2.89 68.08 10.2 8.97 -12.05 20.14 9.14 75.63 499415.94 1707017.7 241.8 2.24 1.84 -18.1 40.01 92.43 73.71 3.82 Zambia Low AFR 19473.13 2.26 2.82 24.72 55.84 7.57 9.25 22.21 -10.31 120.85 217.36 641.27 195.02 0.49 0.47 -4.27 7.08 41.12 32.03 16.78 49.46 Zimbabwe Lower-middle AFR 15993.52 0.46 0.91 98.06 55.04 3.94 5.21 32.3 32.95 20.54 0.29 0.29 -2.57 10.26 13.73 20.54 45.03 Thu, 11 Apr 2024 00:01:00 -0400 Human Rights Watch https://www.hrw.org/news/2024/04/11/global-failures-healthcare-funding