I have written several articles on the coronavirus and on masks and healthcare issues. A series of links have been provided at the bottom of this article for your convenience. This article will, however address a different aspect of the virus or on healthcare issues in general.

I came across this little gem while researching another article. I am not sure where it was hiding, since it was originally posted in 2020. This article while slightly dated still warrants a second look, so I am using it as a starting point for this article.

1. Medical Doctors Declare That The Pandemic Was Planned

This large group of medical experts publishes a medical newspaper on 500,000 copies every week, to inform the public about the massive misinformation in the mainstream media.

They also organize mass protests in Europe, like the one on August 29, 2020 where 12 million people signed up and several millions actually showed up.

Why do these 500+ medical doctors say the pandemic is a global crime? What do they know, that we don’t?

One of the many protests against the “plandemic” that you will not see in the mainstream media

2. Hundreds Of Spanish Medical Doctors Say The Pandemic Is Planned

In Spain a group of 600 medical doctors called ‘Doctors for Truth’, made a similar statement during a press conference.

Doctors for Truth, Spain

‘Covid-19 is a false pandemic created for political purposes. This is a world dictatorship with a sanitary excuse. We urge doctors, the media and political authorities to stop this criminal operation, by spreading the truth.’ 

Germany and Spain are just two examples. Similar large groups of hundreds of medical experts exist in countries across the world.

In the USA a documentary called PLANDEMIC, which exposes COVID-19 as a criminal operation, is supported by over 27,000 medical doctors!

Why are these thousands of medical professionals worldwide saying the pandemic is a crime? What information do they have access to, that we are not getting from the mainstream media?

I invite you to look at the following facts with an open mind and then come to your own conclusions…

3. In 2015 A Testing Method Was Patented For… COVID-19

In 2015 a ‘System and Method for Testing for COVID-19’ was patented by Richard Rothschild, with a Dutch government organization.

Did you catch that? In 2015 – four years before the disease even existed – a testing method for COVID-19 was developed.

Take a deep breath and let that sink in for a while…

4. Millions Of COVID-19 Test Kits Sold In 2017 And 2018

As we know the new COVID-19 disease appeared in China towards the end of 2019. Therefore it was named COVID-19 which is an acronym for Corona Virus Disease 2019.

Data from the World Integrated Trade Solution, however, shows something astonishing:

“in 2017 and 2018 – two years before COVID-19 – hundreds of millions of test kits for COVID-19 were distributed worldwide.”

‘Quick! Hide It!!’

This baffling data was discovered by someone on September 5, 2020, who posted it on social media. The next day it went viral all over the world.

On September 6 the WITS suddenly changed the original designation ‘COVID-19’ into the vague ‘Medical Test Kits’.

This is not allowed in trade, because you always have to be specific. There are many types of test kits for different diseases.

The fact that they removed the specification ‘COVID-19’, after this data became known worldwide, proves that they don’t want anyone to know about it.

They however forgot to delete one detail: the product code for these ‘Medical Test Kits’ is 300215 which means: ‘COVID-19 Test Kits’.

Their cover up came too late: this critical information was uncovered and is being revealed by millions worldwide. You can download a PDF that shows the original data of this website.

Two years before the outbreak of COVID-19 the USA, the EU, China and nations around the world started exporting millions of diagnostic test instruments for… COVID-19, a disease that supposedly didn’t even exist back then.

6. The COVID-19 ‘Project’ Is Planned Until 2025

The World Bank shows that COVID-19 is a project that is planned to continue until… end of March 2025! So the intention is to continue it for another FIVE YEARS.

7. Anthony Fauci Guaranteed A Pandemic Within The Next Two Years

In 2017 Anthony Fauci made a very strange prediction, with an even stranger certainty.

With complete confidence Fauci announced that during the first term of President Trump a surprise outbreak of an infectious disease would surely happen.

Here’s what he said:

“There is NO QUESTION there is going to be a challenge for the coming administration in the arena of infectious diseases.

“There will be a SURPRISE OUTBREAK. There’s NO DOUBT in anyones mind about this.”

How could Fauci guarantee a surprise outbreak to happen during the first term of the Trump administration? What did he know, that we don’t?

8. Bill And Melinda Gates Guaranteed An Imminent Global Pandemic

In 2018 Bill Gates publicly announced that a global pandemic was on it’s way that could wipe out 30 million people. He said this would probably happen during the next decade.

Melinda Gates added that an engineered virus is humanities greatest threat and also assured this would hit humanity in the coming years.

‘A global pandemic is ON IT’S WAY. An ENGINEERED VIRUS is humanities greatest threat. This will happen in the NEXT DECADE.’ – BILL GATES, in 2018

Let their choice of words resound into your mind for a moment…

They claim that the dense population of the world guarantees this imminent global pandemic.

But let’s be honest: most of the earth is uninhabited. Just fly over America in an airplane and look out the window. You see empty space most of the time, with a few cities here and there. Most of the United States is still wide open and empty.

The same goes for the rest of the world.

Australia, Russia, India, China, America, Africa… it’s wilderness for the most part. Our planet isn’t nearly as populated as Bill Gates wants us to believe. This world map shows it clearly…

Most of the earth is totally void of any human presence. So the idea that the world is vastly overpopulated and is therefor bound to give rise to an imminent global pandemic is a lie.

[The powers that shouldn’t be also use this excuse to justify a reduction in the world’s population – i.e. depopulation.]

The Gates also claimed that air travel was sure to create a global pandemic. But countless people have been traveling in airplanes the past century.

Did that give rise to constant outbreaks of global pandemics? Of course not!

Their arguments why they guaranteed a global pandemic in the next few years are lies. So what is their real basis to make such guaranteed predictions?

9. Practicing For A Pandemic

A few months before the outbreak, Bill Gates – the world’s number one vaccine dealer – organized an event in New York City. Guess what the event was all about? It was a ‘coronavirus pandemic exercise’.

Yes, you read that right:

Bill Gates organized a coronavirus pandemic exercise, right before it happened!

On the large display in the auditorium, you see the text printed: ‘We need to prepare for the event that becomes a pandemic.’ This pandemic exercise was called Event201 and took place in October 2019, literally right before the outbreak.

Their conclusion was that all of humanity must be vaccinated…

10. Excitement About Selling Vaccines In The Next Year

Shortly after this ‘exercise for a coronavirus pandemic’ Bill Gates tweeted:

“I’m particularly excited about what the next year could mean for one of the best buys in global health: vaccines.” – Bill Gates, Dec. 19, 2019

Think about this: the world’s number one vaccine dealer guarantees a global pandemic to occur in the next few years, and his wife said we should all fear an engineered virus that is ‘on its way’. Then they organize an exercise for an imminent global pandemic and say vaccines will be the only solution. Next Bill Gates tweets how excited he is about selling vaccines in the next year. Immediately after that, the announced pandemic breaks out.

Indeed, right away Bill Gates proclaims that the only solution for humanity is to buy his vaccines…

11. 2020 Coronavirus Pandemic Predicted In 2013

Back in 2013 a musician wrote a song called PANDEMIC. In his lyrics he described a global pandemic that kills millions, shuts down economies and gives rise to riots.

His song literally described in great detail what we are seeing in our world today, seven years later.

He even mentioned the exact year of the pandemic: 2020, and the specific type of virus: a coronavirus.

This is a line in his lyrics from 2013:

‘2020 combined with Corona Virus, bodies stacking.’

This song also predicted the riots that are now raging throughout America:

‘The State is rioting, using the street outside. It’s coming to your windows.’

How could this musician have known in 2013 that a coronavirus pandemic would break out in 2020, and that during this pandemic riots would erupt? He explains:

‘I did research back in 2012, and read the so called “conspiracy theories”. You know, those investigations the media doesn’t want us to look into. According to those theories pandemics were bound to happen in the decade of 2020 – 2030. So I wrote the song Pandemic about it.’

12. Global Preparedness Monitoring Board In Sept. 2019: ‘Get Ready For A Global Coronavirus Pandemic’

In September 2019 – also right before the outbreak – the Global Preparedness Monitoring Board released a report titled ‘A World At Risk’.

It stressed the need to be prepared for… a coronavirus outbreak!

On the cover of the report is the picture of a coronavirus and people wearing face masks.

In the report we read the following interesting paragraph:

‘The United Nations (including WHO) conducts at least two system-wide training and simulation exercises, including one for covering the deliberate release of a lethal respiratory pathogen.’

Did you catch that?

They have been practicing for a deliberate release of a lethal respiratory pathogen.

13. Outbreak From China Announced

In 2018 The Institute for Disease Modeling made a video in which they show a flu virus originating in China, from the area of Wuhan, and spreading all over the world, killing millions. They called it ‘A Simulation For A Global Flu Pandemic.’ That is exactly what happened, two years later.

Why did they say it would come from China? Why not Africa, where far more diseases are present? Or why not South America? Or India? How could they know there would be a flu virus coming from China and even show Wuhan as the originating area, that would infect the whole world?

Was This Coronavirus Engineered?

Where did the virus come from? One of the world’s leading experts in bioweapons is Dr. Francis Boyle. He is convinced it originated from a bioweapon lab in Wuhan, the Bio Safety Lab Level 4.

This facility is specialized in the development of… coronaviruses!

They take existing viruses and ‘weaponize’ them, meaning they make them far more dangerous, to be used as a biological weapon.

In the following two minute video clip you see a spokesperson for the Trump administration, bioweapon expert Dr. Francis Boyle and president Trump talk about how this virus came from the lab in Wuhan.

Dr. Li-Meng Yan, a Chinese virologist (MD, PhD) fled the country, left her job at a prestigious Hong Kong university and became a whistleblower. She appeared on British television where she claimed SARS-CoV-2, the virus which causes COVID-19, was created by Chinese scientists in a lab – and she offered evidence to support her claims. 

Now comes the most interesting part:

14. In 2015 Anthony Fauci Gave This Very Lab 3,7 Million Dollars.

Figure this: the same man who guaranteed a surprise outbreak of a virus in the next two years, gave almost 4 million dollars to a lab that develops coronaviruses.

In the short clip below you can see a journalist ask president Trump about this grant given by Fauci to the Wuhan lab.

There are however more options in Wuhan where this virus could have originated from. Some believe it came from the Wuhan Virology Institute, where they also work on weaponizing coronaviruses.

15. Chinese Biological Experiments To Infect Humans With Coronavirus Exposed In 2015 By Italian State Media

Five years ago, Italian state owned media Company, RAI – Radiotelevisione Italiana, – exposed dark efforts by China on viruses.

The video, which was broadcast in November, 2015, showed how Chinese scientists were doing biological experiments on a SARS connected virus believed to be Coronavirus, derived from bats and mice, asking whether it was worth the risk in order to be able to modify the virus for compatibility with human organisms.

Below is a transcription of the Italian broadcast translated in English:

Chinese Biological Experiments

Chinese scientists have created a pulmonary super virus from bats and mice only for study reasons but there are many questionable aspects to this. Is it worth the risk? It’s an experiment, of course, but it is worrisome.

It worries many scientists: It is a group of Chinese researchers attaching a protein taken from bats to the SARS virus, Acute Pneumonia, derived from mice.

The output is a super coronavirus that could affect humans. –

16. Movies Predicted The Coronavirus Pandemic

Predictive programming is the process of informing the population about events that are soon to occur.

The past years several movies and television series were produced, about… a global coronavirus pandemic!

The film ‘Dead Plague’ depicts a global pandemic with a coronavirus and even mentions hydroxychloroquine as the cure.

Another film called ’Contagion’ shows how a coronavirus spreads globally with social distancing, face masks, lock-downs, washing of hands etc. as a result.

Literally everything we see now, is predicted in detail in these movies.

17. Pandemic Depicted During Olympics Summer Games In 2012

Talking about predictive programming: during the opening show of the Summer Olympics in 2012, a coronavirus pandemic was played out for the eyes of the whole world.

Dozens of hospital beds, large numbers of nurses becoming puppets of a controlling system, death lurking about, a demonic giant rising up over the world, and the whole theatre was lit up in such a way that seen from the sky it looked like a coronavirus.

Why did the Olympic Games show a coronavirus pandemic, in their opening show?

18. Worldwide Lockdown Predicted In 2008

The author and investigator Robin de Ruiter predicted in 2008 that there would come a global lockdown.

He said the purpose of this would be to create a new world of authoritarian control.

Because much of what he wrote back in 2008 is now happening right in front of our eyes, this book has been republished.

19. Journalists Predicted Planned Pandemic

In 2014 the investigative journalist Harry Vox predicted a planned global pandemic and said why the ‘ruling class’ would do such thing:

‘They will stop at nothing to complete their toolkit of control. One of the things that had been missing from their toolkit is quarantines and curfews. The plan is to get hundreds of thousands of people infected with it and create the next phase of control.’ 

20. ‘Scenario For The Future’

This renown researcher refers to a famous document by the Rockefeller Foundation in which everything we see happening now is literally predicted in great detail: the global pandemic, the lock-downs, the collapse of the economy and the imposing of authoritarian control.

It’s all described with terrifying accuracy… ten years before it happened!

The document is titled ‘Scenario for the Future of Technology and International Development’.

That says it all: a scenario for the future. It has a chapter called ‘LockStep’ in which a global pandemic is reported as if it happened in the past, but which is clearly intended as a rehearsal for the future.

Rockefeller Foundation’s Operation Lockstep: ‘Under The Guise Of A Pandemic, We Will Create A Prison State’

The ‘Scenario for the Future’ continues with comparing two different responses to their predicted pandemic: the USA only ‘strongly discouraged’ people from flying, while China enforced mandatory quarantine for all citizens.

The first response is accused of spreading the virus even more, while the imposing of a suffocating lock-down is praised. Then it goes on to describe the implementation of totalitarian control:

“During the pandemic, national leaders around the world flexed their authority and imposed airtight rules and restrictions, from the mandatory wearing of face masks to body-temperature checks at the entries to communal spaces like train stations and supermarkets.”

Clearly the flexing of authority is the desired response. But it gets worse, according to this ‘Scenario of the Future’:

‘Even after the pandemic faded, this more authoritarian control and oversight of citizens and their activities stuck and even intensified.’

‘In developed countries, this heightened oversight took many forms: biometric IDs for all citizens, for example, and tighter regulation of key industries whose stability was deemed vital to national interests.’

Handbook For Global Control

Now that the announced pandemic is indeed here, the same Rockefeller Foundation came forward with step two: a handbook on how to implement new control systems during this pandemic. Only when all the required control networks are in place, can the world open up again.

When you combine the two Rockefeller documents, you see the plan:

1) First they announce a global pandemic with a coronavirus and say what it should lead to: a whole new level of authoritarian control.
2) Secondly they give practical steps on how to apply this control system.

These are illustrations and quotes from their guide:

‘Digital apps and privacy-protected tracking software should be widely used to enable more complete contact tracking.’

‘In order to fully control the Covid-19 epidemic, we need to test the majority of the population on a weekly basis.’

According to their ‘Scenario of the future’ the entire world population should get a digital ID that indicates who has received all the vaccines. Without sufficient vaccinations, access to schools, concerts, churches, public transport etc. will be denied.

Now in 2020 that is exactly what Bill Gates and many governments are calling for.

21. Bill Gates Negotiated $100 Billion Contact Tracing Deal With Democratic Congressman Sponsor Of Bill Six Months BEFORE Coronavirus Pandemic

The shocking revelations were unveiled on the Thomas Paine Podcast and the Moore Paine Show on Patreon by the two investigators.

nine months after the meetings with the Gates Foundation in Rwanda — Bobby L. Rush, a Democrat from Illinois, introduced the $100 BILLION H.R. 6666, the COVID-19 Testing, Reaching and Contacting Everyone (TRACE) Act.

Everyone’s Contacts Must Be Checked

In a leaked government video (10) we see a conversation between former American president Bill Clinton and Andrew Cuomo, the governor of the state of New York.

They discuss how to set up a large control system to test the entire population and check all their contacts. They discuss how to build an army to carry out this control system.

A Whole New Level Of Global Control

Bill Gates also made it clear that only people who have been vaccinated against Covid-19 should be allowed to travel, go to school, attend meetings and work.

Digital vaccine ID’s are already being developed and Gates has a patent on the technology that makes it possible to trace an individual’s body anywhere. This technology is called WO2020-060606.

Also very interesting to note: An Enzyme Called LUCIFERASE Is What Makes Bill Gates Implantable Vaccine Work

In addition, Gates wants to set up a global monitoring network, which will track everyone who came into contact with Covid-19.

The Plan: Inject Mankind With DNA Altering Vaccine

The famous investigative journalist Anthony Patch did years of research concerning the plans to control the world, by means of created pandemics and mandatory vaccines. During an interview in 2014 this researcher predicted the following:

‘They will release a man-made coronavirus. As a result the people will demand a vaccine to protect them. This vaccine will add a third strain of DNA to a persons body, essentially making them a hybrid.

‘Once a person is injected, almost immediately their DNA undergoes a transformation. This genetic change will cause people to loose the ability to think for themselves, without them even being aware this happened. Thus they can be controlled easier, to become slaves for the elite.’

Of course that sounds insane and it is insane indeed. Yet we have to be aware that this professional investigator is no fool. He has done years of research and this is what he discovered over the years.

We must be careful not to reject sound knowledge, based on years of research, simply because of our own lack of insight in these topics.

20 Years Of Research Say: The Vaccine Will Change Our DNA

Doctor Carrie Madej directed two large clinics in Georgia, before she went to the Dominican Republic to do humanitarian work. She studied DNA and vaccines for the past twenty years and made an urgent video in which she warns that there is a plan to inject humanity with very dangerous vaccines for Covid-19.

The purpose of these new vaccines will be twofold:

1) reprogram our DNA and make us hybrids that are easier to control.

2) connect us to artificial intelligence through a digital vaccine ID, which will also open a whole new realm of control.

This medical expert says she has observed multiple times how diseases were spread over populations by air craft. Because of safety reasons she is not able to share more details about this in public.

Depopulate The Earth By Means Of Organized Epidemics

Dr. John Coleman is a famous Intelligence Officer from the CIA who wrote a book titled ‘The Committee of 300‘.

In it he explains how secret societies manipulate governments, health care, food industries, the media and so on. This book can be found on the website of the CIA.

One of the primary goals of the many secret societies, that control governments and the media, is to depopulate the earth.

Dr. Coleman says the following about their strategy:

‘At least 4 billion useless eaters shall be eliminated by the year 2050 by means of limited wars and organized epidemics of fatal rapid acting diseases…’ – DR. JOHN COLEMAN, CIA INTELLIGENCE OFFICER

Maintain Humanity Under 500,000,000

In 1980 a granite monument was erected in Georgia, called the Guidestones. A set of 10 guidelines is inscribed on the structure in eight modern languages and a shorter message is inscribed at the top of the structure in four ancient language scripts.

The first guideline goes as follows:

1. Maintain humanity under 500,000,000 in perpetual balance with nature.

The CIA officer Dr. Coleman revealed that one of their methods to ‘maintain humanity’ is to cause ‘organized epidemics of fatal rapid acting diseases’.

Using Vaccines To Reduce Humanity

During a TED talk Bill Gates echoed this goal, when he literally said that new vaccines can be used to reduce the world’s population with 10 – 15%! (16)

‘There are now 6.7 billion people on earth and soon there will be 9 billion. However, we can reduce that number by ten to fifteen percent if we do a good job with new vaccines, health care and birth control’. – BILL GATES, VACCINE DEALER

Covid19 Vaccine For Population Control?

Mike Adams is a published food scientist, author of the popular science book Food Forensics and founder of ISO-accredited CWC Labs.

Years ago he said the following:

“An engineered bioweapon will be released in population centers. There will be calls for massive government funding for the vaccine industry to come up with a vaccine. Miraculously, they will have a vaccine developed in record time. Everyone will be required to line up and take this vaccine shot.”

There is indeed a release of an engineered bioweapon, followed by a vaccine mandate, massive government funding for the vaccine industry and a vaccine that is being developed in record time.

The rest of his message is that this vaccine will slowly begin to kill millions – if not billions – of people over the course of a few years. It will be a kill-switch vaccine, designed to reduce the world’s population.

SUMMARY: WAS THE PANDEMIC PLANNED?

Thousands of medical doctors call the pandemic a global crime, and a world dictatorship with a sanitary excuse.

Two years before Covid-19 came to the global scene, the European Union, the USA, China and other nations suddenly started exporting tens of millions of test kits for Covid-19.

In 2013 a musician predicts a global pandemic with a coronavirus and says this will happen in 2020. He knew this because of personal investigation of so called ‘conspiracy theories’.

In 2017 Anthony Fauci guaranteed a surprise outbreak of an infectious disease during the first term of the Trump administration.

Right before the outbreak of a coronavirus pandemic, Bill Gates organized a global coronavirus pandemic exercise: Event201.

Right before the outbreak the Global Preparedness Monitoring Board told the world to be ready for a coronavirus pandemic.

In 2018 the Institute for Disease Modeling announced a global pandemic with a flu virus, originating in China in the area of Wuhan.

In 2018 Bill and Melinda Gates announced that in the coming years there would be a global pandemic of an engineered virus.

The coronavirus SARS-CoV-2 was created in the Bio Safety Lab Level 4 in Wuhan, which received millions of dollars from Anthony Fauci.

Several movies depicted the coronavirus pandemic with great detail, and even mention hydroxychloroquine as the cure.

The Summer Olympics in 2012 played a pandemic of a coronavirus during their opening show.

The investigative journalist Harry Vox predicted in 2014 that a global pandemic would be caused, so the ‘ruling class’ could implement a higher level of authoritarian control.

The investigative journalist Anthony Patch predicted a global pandemic with a man made virus, that would be used to force a DNA altering vaccine on humanity.

Dr. Carrie Madej studied DNA and vaccines for decades and says the plan is to use the Covid-19 vaccine to start the process of transhumanism: reprogramming the human DNA.

The CIA officer Dr. John Coleman studied secret societies and says their goal is to depopulate the earth by means of organized pandemics of fatal rapid acting diseases.

In the state of Georgia a huge monument was erected in 1980 with ten guidelines for humanity, in eight languages. The first of these ‘Ten Commandments’ is that humanity needs to be reduced to half a billion people.

Bill Gates said during a TED talk that new vaccines can be used to reduce the world’s population with 10-15%.javascript:window[“$iceContent”]

The ‘health ranger’ Mike Adams predicted years ago what we see happening now: the release of an engineered bioweapon, followed by a vaccine mandate, massive government funding for the vaccine industry and a vaccine that is being developed in record time. He also predicted that this vaccine will kill innumerable people over the course of a couple of years.

In 2010 the Rockefeller Foundation published the ‘Scenario for the future…’ in which they describe a coming global pandemic, that should result in the implementation of authoritarian control over the people, which will then intensify after the pandemic.

In 2020 they publish a handbook on how to create this world of control, with a step by step guide. They say life cannot return back to normal, until the world has become ‘Locked Down’ with this top down control from authoritarian governments.

We indeed see that Bill Gates and many others worldwide are right away seizing control in unprecedented ways, with enforcing vaccine ID’s, microchips that will be implanted into people, mandating the wearing of face masks, social distancing, forced lock-downs, extreme contact tracing, and so on.

Part of this top down control is extreme censoring of every single voice from doctors, scientists or other experts that criticize what is going on.

All Predictions Were Done Shortly Before It Happened

Note that every single prediction of this pandemic was announced a few years or even months before it happened. That is significant.

Gates and Fauci lie to their audience when they say ‘history tells us this will happen’, but there is no historic basis for guaranteeing a global coronavirus pandemic to occur within a few months or years.

Never in history did anything like this occur, on such a global scale.

The fact that such a historically unique event was predicted in great detail – by movies, shows, investigators, medical doctors, those who finance labs that develop these viruses, those who earn billions from these pandemics, those who want to create a whole new level of control in our world, etc. – shows it was planned.

Are There Signs That The Pandemic Is Being Manipulated?

So far we have looked at indications that the pandemic was planned beforehand. If it is indeed orchestrated, then that should also be obvious during the pandemic. A planned pandemic is also a controlled pandemic.

The Plan To Control The World

You may have heard the word ‘globalists’ before, but for those who aren’t familiar with it: these are people around the world who plan to create one global government, so they can have total global control over health, religion, finances – everything.

Main players in this are the United Nations, the World Economic Forum, the World Health Organization, the European Union, the International Monetary Fund, and many others.

They recently came together in an event called DAVOS, where they expressed how the pandemic will be used to deploy their plans.

Here are some of the statements they made: (18)

‘Now is the historic moment in time, not only to fight the virus, but TO SHAPE THE SYSTEM.
The pandemic represents a window of opportunity to RESET OUR WORLD.

The world must act jointly and swiftly to REVAMP ALL ASPECTS of our societies and economies, from educational to social contacts and working conditions.

EVERY COUNTRY, from the United States to China, must participate, and every industry, from oil and gas to tech, must be TRANSFORMED.’ – Klaus Schwab, Funder of the World Economic Forum

A major leader of gobalism, is the World Economic Forum, founded by Klaus Schwab. He created a ‘spinning wheel’ with all their objectives. On it we can see the following three ‘projects’: Covid19 followed by Global Governance, and Internet Governance.

Nobody Wants These Organizations

Not a single human on the earth has voted for these organizations to even exist, let alone take full control of our lives, families, communities, jobs, health, industries, etc. Yet they present themselves as our ‘world leaders’ who are planning our entire future.

The World Health Organization presents itself as the global boss over our health, without anyone of us having chosen for them.

They apply a tyranny in mainstream media and social media, where no expression of medical or scientific expertise is allowed, unless it is in line with the guidelines of this ‘World’ organization.

Tens of thousands of medical doctors and scientists have been censored all over the world, by Facebook, Youtube and Twitter. Why? Because these social media giants state that ONLY what the World health Organization says, is true.

All of humanity must submit to these people who have positioned themselves over all of us, without ever asking our opinion or even consulting with other medical experts.

In fact, every single medical expert speaking out against their decisions is censored.

This means complete loss of medical freedom, loss of freedom of speech, loss of true science, loss of true journalism and an imposing of dictatorships by organizations that nobody voted for, lead by people nobody wanted and yet they simply seize ownership of our world.

They are the big fat mean bully on the playground, that plays boss over everyone.

World Health Organization Is Run By A Terrorist

The head of the Word Health Organization, Tedros Adhanom Ghebreyesus, is a member of a violent revolutionary communist party in Ethiopia, Tigray People’s Liberation Front. (19)

The Department of Homeland Security clearly states:

“The TPLF qualifies as a Tier III terrorist organization… on the basis of its violent activities…”

Let this get through to you: the man directing the World Health Organization is literally a communist terrorist, who has been involved in murdering thousands of innocent people, trying to impose communism on Ethiopia.

And this man is bullying the entire world, telling all of us what we can and cannot do, censoring every medical professional who has a different opinion, demanding blind obedience from all of humanity, while imposing mandates to be vaccinated by their number one financial sponsor: Bill Gates.

Is this the world you want to live in, from now on?

More And More Pandemics, Until Mankind Submits

These globalists even threaten humanity with more suffering, if we don’t submit to their total control. Prince Charles recently joined DAVOS and publicly stated:

“There will be more and more pandemics, if we don’t do ‘the great reset’ now.” (18)

Bill Gates already calls this ‘pandemic one’ and is talking about ‘pandemic two and three’.

The investigator who back in 2013 predicted a coronavirus pandemic to occur in 2020, followed by riots, said the plan is to create series of pandemics during 2020-2030.

This decade is the selected timeframe to turn the world into one big banana republic, run by mad power hungry men, who depopulate the earth, and enslave the rest of humanity.

They are planning to cause as many pandemics as needed, in order to break the back of humanity, until everybody submits to their global control.

Are you beginning to understand why more than 500 medical doctors from Germany, 600 doctors from Spain, thousands of medical experts from the USA and many more all over the world are calling this pandemic a ‘global’ crime’?

Leaders Of Catholic Church Warn Humanity

An archbishop and several cardinals of the Roman Catholic Church wrote a letter to humanity, to warn us for global tyranny under the guise of Covid-19.

This is an excerpt of this historic message, that has been translated in many languages and was sent to leaders all over the world.

“We have reason to believe, on the basis of official data on the incidence of the epidemic as related to the number of deaths, that there are powers interested in creating panic among the world’s population with the sole aim of permanently imposing unacceptable forms of restriction on freedoms, of controlling people and of tracking their movements. The imposition of these illiberal measures is a disturbing prelude to the realization of a world government beyond all control.”

Is There Hope? What Can We Do?

Is there any hope for our future, or are we surrendered to the merciless hands of these wicked mega-billionaires who want to depopulate the earth and seize total control over humanity?

Yes, there is hope. The future is brighter than we can even imagine!

This is not a doom and gloom scenario, but a wake up call for humanity to stop blindly believing the mafia-media and perverse politicians, and rise up as one for a future of freedom.

A second Nuremberg Tribunal has been prepared since last week and a class action is being set up

A class action, or representative action, is a lawsuit in which a large group of people collectively bring a claim to court, or in which a certain class of defendants is sued

Reiner Fuellmich  is getting that support from the thousands of lawyers worldwide to bring the Covid19 scandal set up in Davos to the tribunal.

Reiner Fuellmich is the lawyer who succeeded in co-convicting the car giant Volkswagen because of its modified catalytic converters.

And it is the same lawyer who succeeded in condemning Deutsche Bank as a criminal enterprise.

Deutsche Bank agreed to pay more than $130 million to resolve/buy off the case because of foreign corruption practices and fraud cases.

Covid-19 becomes fraud case of the century

So now he faces his next job. The job of a lifetime, supported by thousands of lawyers and experts worldwide.

According to Reiner Fuellmich, all the frauds committed by German companies are nothing compared to the damage this Covid-19 scam has caused and continues to cause.

This Covid-19 crisis should be renamed the “Covid-19 scandal” and all those responsible should be prosecuted for civil damages resulting from manipulation and falsified testing protocols.

Therefore, an international network of corporate lawyers will litigate the biggest tort case of all time namely The Covid-19 fraud scandal which has since become the biggest crime against humanity ever.

On the initiative of a group of German lawyers, a Covid-19 commission of inquiry was set up with the aim of bringing collective action on an international level on the basis of Anglo-Saxon law.

Covid-19 scandal never been a health issue

The hearings of, among others, hundreds of scientists, doctors, economists and lawyers of international repute conducted since October 7, 2020 by the Berlin Commission of Inquiry into the Covid-19 affair have now demonstrated with a probability approaching 100% certainty that the Covid-19 scandal was never a health issue – Dr. Fuëlmich on February 15, 2020

“Rather, it was a matter of strengthening power, illegally obtained by criminal methods of the corrupt ‘Davos clique’, by transferring the wealth of the people to the members of Davos on the backs of small, and especially medium-sized businesses, among others.”

The committee’s conclusion is that Covid-19 is being used as a diversionary tactic by business and political “elites” with the goal of shifting market shares and wealth from small and medium-sized businesses to global platforms such as Amazon, Google, Uber, and other big tech and multinational corporations.

Platforms such as Amazon, Google, Uber, and other bigtech have thus appropriated their market shares and their wealth

Appeal to annul the approval of a vaccination filed against the European Commission, lawsuit in New York on the status of PCR testing, German lawsuits, Canadian lawsuits, Australian lawsuits, Austrian lawsuits, lawsuits at the International Court of Justice and at the European Court of Human Rights.

“We have seen what has been confirmed time and time again: the dangerousness of the virus is about the same as that of seasonal flu, regardless of whether it is a new virus or whether we are simply dealing with an influenza renamed Covid-19 pandemic.”

Meanwhile, Drosten’s PCR tests can tell us nothing about contagious infections. The test is simply irrefutably proven NOT to be made for that and incapable of doing so.

To make matters worse, the health and economic damage caused by the anti-covid measures is so devastating that it is necessary to speak of a historically unique level of destruction.

To panic the population, dangerous and harmful containment measures were introduced (even by the WHO) such as the mandatory wearing of a useless and dangerous mouth mask and social distancing. Useless and counterproductive. So the population was “ready” for the injections.

The world’s population served as guinea pigs for these experimental injections of genes, both gradual and extremely rapid.

Meanwhile, more and more people, and not only lawyers, are demanding, in addition to the immediate termination of these lethal measures, a judicial review by a truly independent international tribunal, on the model of the Nuremberg trials.

Moreover, an interview with a whistleblower from a Berlin retirement home reveals that of the 31 people vaccinated there, some by force and actual violence in the presence of Bundeswehr soldiers, while their (useless) “test” was negative prior to vaccination. Eight people have now died and 11 have serious side effects.

What is really at stake?

To fully understand what is at stake with this new Nuremberg tribunal to try the greatest crime of all time, we must start with the lie of Drosten and the Corman-Drosten paper about the PCR test in the name of Davos… One of the grossest lies in history that has done improbable damage and has everything attached to it.

Then Klaus Schwab, the great architect of this gigantic hostage situation, the sponsors of the financial oligarchy, the politicians at the head of the EU armed with the implementation of Drosten’s guidelines and WHO was what led to all Western governments making the devastating decisions about containment, curfews, mandatory mask wearing, social distancing and other draconian measures against a non-existent danger.

On top of that people are motivated to get vaccinated based on a lie. If that doesn’t work then governments will force the populations. Directly or indirectly.

“These are the truths that will take off the masks of those responsible for the crimes committed“, says Dr. Fuellmich,

And to politicians who trusted these corrupt figures, he says:

“These facts may be another salvation for them that can help them put things right and initiate the long-awaited scientific debate of the public, to avoid that they too will be compared and tried with these criminal charlatans.”

The international legal coalition will become operational this month.

Also, the commission is trying to take protective measures such as protecting regional agricultural structures, securing a regional currency to prevent a new currency from being assigned “from above,” and working to rebuild a new media landscape that offers truly independent information.

Covid-19 is a scam – University Dons

A Professor of Genetics and Animal breeding, Otoohhiaus Cyril has described Covid-19 pandemic as a scam orchestrated by the Western world to generate trillion of dollars at the detriment of Africans and other parts of the world.

Professor Cyril who is a lecturer at Novena University Ogume, Delta State stated this in Lokoja on Saturday while delivering lectures on the virus that has become a pandemic across the globe.

Otoohhiaus who spoke at the State Government House, Lokoja on the invitation of the state Governor, Yahaya Bello said the Western World stands great economic gains from the Covid-19.

“Viruses are not living things as wrongly claimed by WHO. Viruses are made by man to achieve specific purposes, that is why virtually all questions concerning coronavirus posed to the health organisation, they cannot provide answers.

“Covid-19 is not a natural virus that is why even the World Health Organization are not specific in the symptoms the virus pandemic exhibits in the human body” the academia stated.

He cautioned African leaders especially Nigerian Government to look inward and ask questions concerning the virus instead of locking down people at home depriving them of their legitimate businesses.

“Covid-19 is a ‘yahoo’ format brought by the western world to deceive people while they were making money in trillions of dollars at the detriment of African countries that are locked down at home depriving them of their legitimate earnings,” he said.

The Don who commended Governor Yahaya Bello of Kogi state for not succumbing to Covid-19 claims averred that very soon the true nature of the alleged coronavirus would come out in large scale for people to see.

Also, Professor Josiah Adjene of the same University who spoke at the same occasion cautioned Nigerians against persistent use of face mask, stating that the continuous use of the mask reduced the quantity of oxygen required by the body; which poses future health challenges to the people.

Adjene, a Professor of Neuroanatomy and Cell Biology pointed out that the acclaimed symptoms of Covid-19 has been living with Africans, saying there is no new thing in the pandemic that can distract the people of Africa.

He advised Kogi State Government to invest vigorously in agriculture to enable the state feed the nation in the next two years as a result of scarcity of food that will arise due to the lockdown inflicted on Nigerians by government to curb the spread of purported coronavirus pandemic.

“I am appealing to the governor to invest in agriculture because as other states of the federation are on lockdown now, there will be a shortage of food in the next two years; so that Kogi State can feed Nigerians and remove them from impending famine” he appealed.

The State Governor, Yahaya Bello in his own remarks lamented that the state and the entire country are under siege over Covid-19, stressing that the situation is really affecting Kogi State even though there is no case of the virus in the state.

According to him “It is no longer news that we are under siege in Nigeria over Covid-19. Kogi State is under siege even though we don’t have a reported case, but we are on lockdown not by our design or by our wish” he stated.

The Governor noted that his decision to invite academia who specializes in the field of virus and diseases was borne out of his desire to enlighten the people of the state on Covid-19 and how best they can handle the issue of the pandemic to avoid spread.

“I am the Executive Governor of Kogi State and it is incumbent on me to create an avenue for my people to be enlightened, to really know what Covid-19 is all about,” Gov Bello said.

Crime Rates in a Pandemic: the Largest Criminological Experiment in History

The COVID-19 pandemic of 2020 has impacted the world in ways not seen in generations. Initial evidence suggests one of the effects is crime rates, which appear to have fallen drastically in many communities around the world. We argue that the principal reason for the change is the government ordered stay-at-home orders, which impacted the routine activities of entire populations. Because these orders impacted countries, states, and communities at different times and in different ways, a naturally occurring, quasi-randomized control experiment has unfolded, allowing the testing of criminological theories as never before. Using new and traditional data sources made available as a result of the pandemic criminologists are equipped to study crime in society as never before. We encourage researchers to study specific types of crime, in a temporal fashion (following the stay-at-home orders), and placed-based. The results will reveal not only why, where, when, and to what extent crime changed, but also how to influence future crime reduction.

The COVID-19 pandemic of 2020 is unquestionably one of the most significant world-wide events in recent history, impacting culture, government operations, crime, economics, politics, and social interactions for the foreseeable future. One unique aspect of this crisis is the governmental response of issuing legal stay-at-home orders to attempt to slow the spread of the virus. While these orders varied, both in degree and timing, between countries and states, they generally began with strong encouragement for persons to isolate themselves voluntarily. As the magnitude of the crisis grew, governments began legally mandating persons to stay-at-home to reduce the transmission rate of the virus. There were, of course, exceptions; workers who were deemed ‘essential,’ such as those in the fields of medicine, finance, public safety, food production, transportation, and in other miscellaneous industries did not have to abide by these orders to the degree to which the general public did.

Nevertheless, practically overnight, the entire country ceased or significantly reduced day-to-day travels, eliminating commutes from home to work, as well as leisure activities, shopping trips, social gatherings, the ability to dine out, and more. One poll in late March found that 90% of Americans, including essential workers, were ‘staying at home as much as possible’. The ‘stay-at-home’ mandates brought about the most wide-reaching, significant, and sudden alteration of the lives of billions of people in human history. Across the United States and around the world, a positive byproduct of these unprecedented events is a dramatic drop in crime rates.

Initial Crime Data

Several researchers have made initial examinations into how crime rates have fluctuated in the advent of COVID-19. The results have been mixed, to say the least, especially when comparing broad categories of crime across different cities and with different methods and periods of study. However, these initial academic studies are intrinsically valuable and deserve to be mentioned here.

One of the earliest studies with perhaps the most striking results was by Shayegh and Malpede, which identified an overall drop in crime in San Francisco of 43% and Oakland of about 50% following city issuance of some of the most restrictive and early stay-at-home orders in the US, beginning March 16th^, 2020 and the two weeks after.

Surprisingly, significant results are also clearly seen when examining specific crimes against retailers in crime in Los Angeles. Pietrawska, Aurand, and Palme found a 64% increase in retail burglary, while city-wide burglary rates were down 10%. Similarly, Pietrawska, Aurand, and Palmer identified a five-week change in crimes occurring at restaurants in Chicago, a 74% reduction, while city-wide crime declined 35%. Continuing their study of crime rates in the pandemic outside of a retail focus, Pietrawska, Aurand, and Palmer compared crimes against persons and crimes against property in four cities for ten weeks, finding sharp variations from week to week and within different crime types.

Another early study by Ashby of eight large US cities during the first few weeks of the crisis (January to March 23rd—before some states and areas implemented stay-at-home orders) found disparate impacts by crime type and location. For example, burglary declined in Austin, Los Angeles, Memphis, and Scan Francisco, but not in Louisville or Boston. Conversely, serious assaults in public declined in Austin, Los Angeles, and Louisville, but not other cities.

Felson, Jiang, and Xu examined burglary in Detroit during three periods, representing data before stay-at-home orders were in place and two periods under orders (March 10th to March 23rd and March 24th to March 31st). Their findings indicated an overall 32% decline in burglary, with the most substantial change in the third period. However, the decline was more significant in block groups of higher residential parcels than in mix-use land areas.

Campedelli analyzed crime in Los Angeles in two time periods (the first ending March 16th and the second ending March 28th) using Bayesian structural time-series models to estimate what crime would have been if the COVID-19 pandemic had not occurred. Comparing the actual crime data against the estimated ‘sans-pandemic’ data, the first model found an overall crime reduction of 5.6% during the pandemic. Likewise, the second model (ending March 28th) showed a 15% reduction. Specifically, researchers found that overall crime rates significantly decreased, particularly when referencing robbery (−24%), shoplifting (−14%), theft (−21%), and battery (−11%). However, burglary, domestic violence, stolen vehicles, and homicide remained statically unchanged.

While not explicitly measuring crime rates, studies of calls for police service can function as an indirect measure of crime in a given area. Early studies of calls for service during the pandemic present mixed results. Lum, Maupin, and Stoltz found that 57% of 1000 agencies surveyed in the United States and Canada reported a reduction in calls for service in March of 2020. Ashby, on the other hand, found no discernible difference in forecasted calls for service in 10 large US cities between the first identified cases of COVID-19 in the US throughout early March. However, Ashby found that once stay-at-home orders were implemented, calls for service did decline, although not evenly across call types or cities. In another study of police calls for service, Mohler examined calls in Los Angeles and Indianapolis between January and mid-April; they concluded there was some impact on police calls for service but not across all crime types or places.

Internationally, Swedish researchers Gerell, Kardell, and Kindgren examined crime during the five weeks after government restrictions on activities began, observing an 8.8% total drop in reported crime despite the country’s somewhat lax response (when compared to other countries’ policies on restricting the public’s movement). Specifically, the researchers found residential burglary fell by 23%, commercial burglary declined 12.7%, and instances of pick-pocketing were reduced by a staggering 61% —however, there was little change in robberies or narcotics crime. In Australia, Payne and Morgan studied crime in March, finding assaults, sexual violations, and domestic violence were not significantly different from what was predicted under ‘normal’ conditions at the lower end of the confidence interval. They cautioned against early conclusions based on this data as the government orders came only a few weeks into the study.

These initial reports indicate that crime rates have indeed changed, but unequally across different categories, types, places, and timeframes. Among crime researchers, the featured question of this pandemic will be, “Why have crime rates fallen so dramatically?” The corollary is, “What can be learned from this experience to leverage crime reduction in the future?” The data and opportunities before every criminologist will provide near-endless research opportunities at levels never before possible, and every effort should be made to capture data and promote the study of crime. This research note aims to identify and encourage these lines of inquiry, to urge researchers to dive deeply into the data made available from the pandemic, and to provide the impetus for not only discerning why crime fell but also for how to pragmatically utilize this knowledge after the world emerges from seclusion.

Crime in Lock-Down: Theoretical Implications

During the few hours before a legal stay-at-home order was implemented, and throughout the first few weeks that followed, it is essential to note what likely did ‘not’ change. As people around the world returned from frantic and stress-filled trips to stock up on food and other essentials and closed the door to their residence behind them, their biological and physiological conditions changed very little, nor did the labels attributed to them by society, friends, or family. Poverty and inequality did not disappear or increase immediately. It is unlikely that self-control dramatically increased either. There were, however, things that did change; society became more disorganized, and social influences and relationships were suddenly cut, diminished, or otherwise altered. Strain, stress, and anomie likely increased significantly as many became fearful for the future (both financially and physically) and estranged from family and friends whom they could not visit physically. Further, punitive responses to crime (i.e., deterrence) were slowed or ceased altogether as courts closed, police were encouraged to reduce contact with the public, and thousands of prisoners were released early.

With crime declining at such a significant pace and many of the often-attributed circumstances impacting crime staying consistent or in some cases increasing or decreasing in a direction opposite of what many believe drives crime, many criminological theories appear to be struggling to explain the abrupt and sweeping change. We believe the scope and nature of crime changes during the COVID-19 crisis will become a proving ground for the many theories that attempt to explain the etiology of criminal behavior. In the end, this naturally occurring experiment will advance our knowledge of crime and human behavior as no other event has ever done during the era in which criminological data were widely available.

As such, we argue that the single most salient aspect of the steep fall in crime rates during the COVID-19 pandemic are the legal stay-at-home orders (i.e., lock-down, shelter-in-place) implemented to slow the spread of the virus by promoting social distancing. Stay-at-home orders were issued by most states and legally required residence to stay within their homes except for authorized activities. Commonly, these activities included seeking health care, purchasing food and other necessary supplies, banking, and similar activities. The orders either outright closed or by de-facto closed broad swaths of the economy and impacted schools, private social gatherings, religious activities, travel, and more. In short, these orders disrupted the daily activities of entire populations and was the only variable that changed abruptly, just days before double-digit drops in crime around the world. As such, we believe, the Environmental Criminology suite of perspectives including; Rational Choice and Routine Activity will emerge as frontrunners in understanding the crime changes during COVID-19 and will provide insight how to influence crime in the future.

A Call to Examine Crime

Therefore, we offer a call for examining crime before, during, and after a government-imposed stay-at-home order, that coincides with the COVID-19 pandemic. Specifically, we advocate for researchers to consider crime in the context of temporal shifts, in a place-based context, to use emerging data sources, and to study crime with specificity.

Crime Specificity

Criminologists tend to overgeneralize about crime while underestimating the enormous specificity in offender decision making. Even within each crime type, the finer particulars of an offense should be studied to understand how crime patterns change and shift. Specificity is even more critical when researching crime in a pandemic as it allows for an understanding of nuanced changes, such as opportunity structure, that would otherwise be missed. For example, the changes in daily activities in the wake of the pandemic tend to decrease the population in non-residential parts of the metropolis, while increasing the population in residential zones.

For example, the broad category of ‘theft’ appears to be down across many cities in the US. However, theft is likely not declining evenly across all categories. Consider theft in a retail context. The retail sector has experienced an 85% decline in foot traffic after the stay-at-home orders were implemented; many stores are closed, and thus the opportunity for shoplifting and employee theft are curtailed. Pietrawska, for example, identified a 24% decline in shoplifting in Los Angeles, compared to a city-wide decline of theft at only 5%. However, theft may persist (and even see an increase) within stores that remain open such as grocers, construction supplies, convenience stores, pharmacies, and other ‘essential’ retailers. These thefts may be the result of a change in offender behavior (i.e., shifting from targeting a specific store—now closed, to another that is open), due to panic buying (i.e., purchasing limits on essential products may result in theft), or impacted by reduced guardianship within the stores (e.g., short-staffed employees are more focused on service than crime prevention).

One of the most exciting illustrations of crime specificity has to do with pocket-picking the covert removal of a wallet from a pocket or purse in a crowded venue. This crime thrives on a crowd, perhaps more than any other form. As noted earlier, Swedish researchers found that pocket-picking decreased by 61% in Stockholm during the COVID-affected period when crowd-reduction was especially emphasized. These findings underscore the importance of linking specific changes in routines to specific types of crime.

Theft may also be moving outside of the physical retail structure and developing in areas where officially reported came data is not readily available. For example, before COVID-19 package theft (e.g., packages delivered outside a residence and stolen before the owner can retrieve them) was a growing concern, and few, if any, police agencies kept data on the problem. However, with entire populations confined to their homes, shopping has shifted virtually, and delivery of products has risen 74%. As a result, the opportunity for theft of packages left unattended at a residence may be increasing. While more person may be home, daily routine activities have also been interrupted, which impact guardianship. As a result, packages left unattended for extended periods or forgotten altogether.

These are just a few examples of why examining specific crime types and situations is vital to criminology. It allows the researcher to identify nuanced changes that are important when developing future prevention techniques and to test theoretical tools. There are, no doubt, many factors that are impacting pandemic crime rates, and only by examining them with specificity can researchers achieve an enhanced understanding of crime.

Temporal Shift

Temporal understanding of crime is essential because the time of day, day of the week, months, seasons, and other time-related factors are commonly known to impact crime; in other words, crime is not evenly distributed across place or time. However, stay-at-home orders that have people living, working, eating, and finding entertainment at home as weekdays merge into weekends may cause time distinctions to blur when speaking of crime. The change in the population’s routine behavior, even at home, is already being seen in online browsing habits and television use; behavior has shifted to higher viewing rates on Mondays than on the traditional Saturday. To address these unusual, pandemic-generated changes in routine activities, criminologists need to examine crime rates in a different temporal perspective and consider the context of COVID-19 stay-at-home orders. However, there must be more specificity than a pre and post examination of crime trends, and measurements at the state and even community level are needed to ensure accuracy.

We propose the following seven important periods for identification and comparison of crime rate changes related to the crisis (Table ​(Table11).

These measures must be tailored to individual communities or states to coincide with routine activity trends and government orders. Period 1 should be of sufficient time to establish some base levels of crime rates. Period 2 is where the beginning of voluntary behavior changes is likely to be observable, somewhere around mid-February, and extending until the government ordered quarantines for the general population. During this time, as concern swept across the nation, many people chose to alter their lifestyles; schools closed, and other modifications in society likely began to impact crime slowly. For example, an early study of police calls for service by Mohler et al. (2020) found routine activities began to change 8 to 10 days before stay-at-home orders were enacted in Los Angeles, California, and Indianapolis, Indiana, as well as other cities and other nations.

Periods 3 and 4 are contingent on the length of the government-ordered closures. For example, if a state was under stay-at-home orders for 4 weeks, we recommend examining an early period (period 3) as well as a late period (period 4) of two weeks. Dividing the length of stay-at-home orders by half (or more if the order is longer than six weeks) will capture the changes in routine activity as the stay-at-home orders continue. Capturing this data in two or more periods is crucial as the longer the order continues, the more likely people will begin to violate the order, and crime rates may begin to change. For example, early reports in Sweden saw a slight decline in vandalism (−4%), followed by a sharp increase after five weeks into the restrictions. There is also likely some relationship between non-compliance and crime as found non-compliance with stay-at-home orders was associated with delinquent behavior. While early reports have not identified the same trends in the US, news reports during the month of May indicated that a large number of persons were emerging from homes before an official end to the stay-at-home orders. A rise in crime may be detected because it is possible that the longer the orders continue, the less effective they become.

Lastly, periods 5 and 6 are difficult to define as the situation is still unfolding at the time of this publication, as a complete rescinded stay-at-home order has not occurred to date. Moreover, it is also critical to consider that many individuals who live in an area where the stay-at-home orders have been partially revoked may still choose not to return to their daily lives. This is why it will be important to capture data starting at the point of a rescinded stay-at-home order and by measuring crime rates every few weeks after that for an extended period. These periods may coincide with the phased re-opening plan followed by many governments or within a timeframe for several weeks each, which may result in the need to add continued periods of crime data.

Criminologists do not have to rely on the assumption that people follow stay-at-home orders. For the first time, Mobility Trend Reports are being offered free (including in CSV format) by both Google (2020) and Apple (2020). These reports offer aggregated movement data based on anonymized cell phone location history at the national, state, and county levels. The data includes daily reports and includes inferred locations (i.e., retail, grocery, parks, transit, residential, workplace). With this data, it is possible to compare societal behavior within these recommended periods and gain a more accurate picture of where people were and importantly when they were there. Combined with the ability to measure compliance with movement restrictions, criminologists have the data to examine the routine activities of whole populations at a level never before possible while overlaying crime rates for both a temporal a place-based evaluation.

Place-Based

Studying crime based at a place is another critical part of understanding not only crime trends but also methods to disrupt crime. Under the current circumstances with people’s daily routine disrupted, this is even more important as people shift to more time within the home, the opportunities and places for offenders and victims to meet become limited. As a result, there is likely far less crime as people; both victims and offenders are not together in a place for the crime to occur.

To illustrate, consider workplace violence and crime. With a significant number of persons at home, rather than work, there is a reduced opportunity for offenders to assault co-workers. Similarly, there is less opportunity for a victim to have a phone stolen from the breakroom. It is important to remember that during the COVID-19 crisis, variables commonly related to many other criminological theories (i.e., poverty, stress, self-control) have not changed to such a degree to explain the sharp reduction in crime. Instead, the opportunity to be connected to a victim in time and place appears to be the most significant variable that has led to a marked reduction in the workplace and other place-based crimes.

However, in some regards, this place-based shift may result in increased crime rates in other areas. For example, while digital, the internet can be classified as a ‘place’ or medium for victimization to occur. Under the COVID-19 stay-at-home orders, people are spending significantly more time online. By late March, for example, cable internet usage, as reported by The Internet and Television Association (2020), surged more than 30% and continued to grow until mid-April, which appears to coincide with many of the stay-at-home orders. The increased time using the internet likely leads to more opportunities for cybercrimes to occur as the victim’s virtual presence has shifted dramatically (e.g., away from place-based crime at work or school and to place-based crime online). Additionally, offenders may have also been impacted by the COVID-19 stay-at-home orders and have increased time to identify victims.

Shifting back to a physical place and crimes, it is also important to evaluate land usage and population density when considering crime trends. There are emerging trends in the new COVID-19 crime data suggesting crime differences in certain places. For example, public places such as stores, restaurants, and entertainment areas are experiencing sharp decreases in some types of crime, while crime in the home may be remaining consistent, and mix-land use may see relatively stable or slightly increasing crime rates. Here again, routine activities and rational choice perspectives may explain much of the crime in these places. For instance, entertainment businesses and districts, along with dine-in restaurants, were generally closed during the orders. Thus, with fewer offenders routinely in these places and fewer victims present, crime will naturally decline. However, a reasoning offender may choose to target areas with fewer people (i.e., guardians) such as closed malls, business parks, and other places that may see an increase in property crimes. Additionally, mixed land usage, especially in population-dense areas, may allow an offender to travel in areas unnoticed easily and, therefore, present opportunities for crime.

Place, whether virtual or physical, is a crucial factor in crime. The COVID-19 crisis has re-shaped the places that persons routinely visit, increasing some—home and online, while decreasing others—work, retail, school, and entertainment. Highlighting the role that place has played in crime rates during the pandemic should influence how criminologists study crime in a post-pandemic world and lead to further crime reduction through place-based prevention techniques.

Data-Driven

We have listed some initial findings on crime in the COVID-19 era and also described the need to study crime specifically, temporally, and place-based. Next, we will discuss data for measuring crime. One problem in criminology, as in other social science fields, is there are too many variables, too little variation, or an inability to control for specific variables. However, in the current pandemic, these problems decrease dramatically, and criminologists should take advantage of the favorable conditions and abundant data.

First, as described in the introduction, few variables changed during the first several weeks of the pandemic. The most substantial change has been the stay-at-home orders, which impacted the routine activities of entire populations. With so few variables changed, it should be easier to identify and measure significant and substantial changes in crime. Second, the variation in crime rates has been drastic. On the order of 10%, 20%, and even sometimes 60% transformation of crime patterns. These significant measurable changes allow researchers to see ‘past’ other variables that have little impact and focus on the significant variables impacting crime. Third, with entire populations affected by the pandemic, there is little need for controlling traditional variables such as age, gender, education, social status, and more. The impacted population is closer to the entire population rather than a ‘sample population,’ which means it is possible to move beyond inferential statistics and measure the actual change in the whole population.

Another challenge for criminologists is crime data. We encourage the use of four broad categories of data, including official police reports, victim and other self-report surveys, private or anecdotal data, and public data. Police data is an essential source during the pandemic. However, with many agencies experiencing workforce-related issues during the pandemic and purposely reducing the person-to-person contact to reduce the risk of virus spread, the official police data may underreport crime more than usual. Further, with more persons staying inside and not venturing out to school and work, other crimes, such as intimate partner violence and abuse of children, may not be captured through traditional reporting means. Therefore, it will be important that victim and self-report surveys continue to be used to help capture data that official reports do not.

Other sources of direct crime data and ancillary sources are often overlooked. Ancillary sources of data can take the form of calls to abuse hotlines, reports on consumer spending, internet traffic, police call for service, hospital mandatory reporting on specific injuries, and the Bureau of Labor Statics (2020) data on injuries resulting from violence at the workplace. Additionally, sources from private companies also provide insight into crime not always reported through official channels. For example, many retail organizations release data on crime within their stores, credit card companies release fraud statistics, and insurance organizations publish claims related to crime victimization. These sources may be particularly important as many areas where crime is occurring during the COVID-19 crisis are within private spaces, and obtaining non-police data is essential to understanding the crime shift. Lastly, other publicly available resources should be included in the analysis as well. Specifically, Mobility Trend Reports by Apple and Google, which provide detailed information on population location daily that the county level. This data set, never before publicly provided, should be used to overlay with other data.

Moving beyond the data to the methods, the circumstances of the COVID-19 crisis has led to a naturally occurring quasi-random control trial. Because each state-issued stay-at-home order at different times, under different circumstances, and rescinded them at different dates, it is possible to compare crime across many population groups. For example, Kentucky issued an order on March 26th and entered phased re-opening on May 11th (47 days) while neighboring state Tennessee waited seven more days, issuing a stay-at-home order on March 31st, and began a phased re-opening on April 27th, fourteen days ahead of its neighbor. These states, which share many demographic similarities, are ideal for comparison.

In addition to the unequal start and stop dates for state-wide lock-downs, the activities limited by the orders varied as well; for instance, some states kept parks open while others closed them. Similarly, some states outlawed gatherings of 10 or more, while other states established different criteria. The response to alcohol also creates a valuable point in data analysis. Examples abound of states that relaxed laws on alcohol sales, such as Kentucky, which allowed for the first-time home delivery of alcohol and service of alcohol with food take-out orders during the crisis (Minton, 2020). On the other end of the spectrum, some states deemed alcohol ‘non-essential’ but changed course after public backlash. For example, Pennsylvania initially closed liquor stores and created a cascade of persons traveling outside the state seeking alcohol. Conditions such as these either between states or even within states are plentiful and provide essential data points that allow for an excellent comparison of crime and related factors.

The Largest Criminological Experiment in History

There is little doubt that the COVID-19 crisis will impact history on a scale not seen since WWII. Provisional insights indicate that a substantial drop in crime is occurring around the world and within the US. However, these reports also indicate the changes are not even across time, place, or crime type. Therefore, we encourage criminologists to study this crisis through the use of new and existing sources of crime data, with a specificity of crime types, in a temporal fashion, and placed based.

Moreover, the leading feature of these crime changes will be that the government ordered stay-at-home mandates, which impacted the routine activities of entire populations. The variation in these orders by state and community regarding when the orders were implemented and rescinded and what restrictions were in place has provided a naturally occurring, quasi-randomized control experiment. For example, researchers can compare states and communities that released prisoners early, increased or reduced alcohol availability, began lock-downs early, crime in public places as opposed to residential and mixed land use, and operationalize many variables that were previously intangible or inarticulable.

The findings emerging from the COVID-19 crisis will impact criminological theories for the next several decades. We encourage researchers to embark on in-depth explorations of the data made available from the pandemic and to search for not only why, where, when, and to what extent crime fell, but also how to use this knowledge for practical applications after the world returns to ‘normal’ and concludes this experiment in crime reduction and extraordinary test of human determination and resiliency.

Big Pharma, China, Vatican convicted of Genocide and Criminal Conspiracy by International Court – COVID vaccines prohibited as arrest of leaders and seizure of assets ordered

Conclusion

I have always said that if you are having problems sorting anything out or are trying to discover the answers to some question, follow the money. My question when is enough money, enough? When is enough power, enough? Apparently to those who are addicted to money and power there is never enough. When billions of dollars and global dominion at stake, the lives of the minions pales in comparison. The lives of the fly-over populations becomes meaningless. We are now the deplorables and the expendables. If you dig deep enough into our history you will find a common thread and pathway to global power and wealth. The problem is that those who are craving this power and wealth are becoming impatient…they are no longer willing to wait decades to achieve their goals. They are manipulating our history, present and future. By this I mean , they are cancelling our past, and are altering our present, by creating fear and distrust in our masses. After the second market crash, I pulled out my money from my 401K. I realized that none of the “haves” lost any money only the “have-nots” did. The market is geared to screw the little guy. This is the same with politics. Politicians promise their constituency the world, and soon as they get into power the vast majority of them forget all their promises. It is all about wealth and power. We will never know if COVID-19 was an accident or the result of purposeful actions. Too much data has been destroyed and the cover-up is too extensive. There are many reasons why we will never find out the truth, one is that fourth estate is in the pocket of the 1%ers. The internet was supposed to be the great equalizer, where everybody was able to get a voice. That is no longer the case. All the major social media sites are being censored and shadow banned. That is why I started this blog in the spring of 2020. I pay for my own domain and I do not make any money off the site. I was tired of being censored. Now My word gets out across the world. I have readers and viewers from over a 130 countries. While the over all number is still small the coverage is extensive. All it takes is one person to tell another one and so on, to make a difference. The blog has forced me to become more involved in current events. I am now reading more and more about what is happening in todays society, instead of what happened in the past. My book shelves are fast becoming full of books about politics, COVID and many other current events. What I am seeing is that the more you research the more disturbing information you come across.

This article came about, because like I mentioned previously was due not only to my reading, but my research for another article. I also get some of my ideas from watching the news and even suggestions from friends and followers. The story of COVID is a very long and tortuous one. It is also like a jigsaw puzzle, with many pieces missing. When I am watching news shows, I keep a notepad by my TV as well as a cell phone, so I can take notes and take screen shots of charts and tables that are often part of the shows. I have even purchased a book scanner for my computer that makes it easier to copy sections of books to be used for reference. While it is true that I do copy whole articles and sections from various journals and websites, I give full credit to the writers and publishers. I also do not make any money from these articles and this blog. I welcome the sharing of my articles with others, as long as I am getting credit.

As I was saying that many pieces are missing in the COVID jigsaw puzzle, but I am filling them with new pieces that I find, sometimes by accident and other times from purposeful explorations. What I have discovered from my investigations is that COVID was created by man, whether it was released by accident or by intent, may never be known. I have written several articles on the subject, many of which I keep on updating as new data comes forward. I do know one thing, billions of dollars have been made, and many politicians and wealthy individuals have gained a lot of power. What is also evident is that too many sentient events have taken place for them to be mere happenstance. How did Dr. Fauci and Bill Gates know about the pandemic of 2020 years in advance? Was it just a lucky guess or was it due to foreknowledge? Why did Bill Gates get so involved in vaccines? Is he just being altruistic or is he trying to make more money?

The actions taken by the 1% has caused irreparable damage to the common man, millions of people have died worldwide, millions of businesses have been permanently closed while mega corporations have realized record profits. Even scientists and medical professionals have become willing conspirators in this crime of the century. One thing I do know is that if the common man doesn’t do something, our world as we know it is lost.

Resources

tapnewswire.com, “Ultimate Proof: Covid-19 Was Planned To Usher In The New World Order“; nightsfreedoms.wordpress.com, “A second Nuremberg Tribunal has been prepared since last week and a class action is being set up: A class action, or representative action, is a lawsuit in which a large group of people collectively bring a claim to court, or in which a certain class of defendants is sued.” By Greatreject; vanguardngr.com, “Covid-19 is a scam – University Dons.” By Boluwaji Obahopo; ncbi.nlm.nih.gov, “Crime Rates in a Pandemic: the Largest Criminological Experiment in History.” By Ben Sickles and Marcus Felson; “COVID-19 and the Global Predators: We ar the Prey.” By Peter R. Breggin and Ginger Ross Breggin; murderbydecree.com, “Big Pharma, China, Vatican convicted of Genocide and Criminal Conspiracy by International Court – COVID vaccines prohibited as arrest of leaders and seizure of assets ordered”; unaids.org, “RIGHTS IN A PANDEMIC: Lockdowns, rights and lessons from HIV in the early response to COVID-19”; sc.com, “The political implications of COVID-19: As economies and healthcare systems struggle to cope with COVID-19, we share insights on how the coronavirus pandemic is shaping political agendas across the world.” By Philippe Dauba-Pantanacce;

Addendum

RIGHTS IN A PANDEMIC Lockdowns, rights and lessons from HIV in the early response
to COVID-19

Foreward

The COVID-19 crisis has upended the world. It has left everyone scared and many
bereaved. It has damaged economies, weakened health systems, and hampered
progress towards all the Sustainable Development Goals. It has hit the most
vulnerable the hardest. Worldwide, decision-makers have found themselves in hugely
challenging situations, under-prepared and under-resourced, and have had the
responsibility to move fast on the basis of uncertain information. Many exemplary
actions have been taken, saving lives and protecting livelihoods as governments have
worked with communities to provide free emergency medical transport, extend water
services, place moratoriums on evictions, provide temporary shelter, emergency food
supplies or cash benefits, implement community delivery or multi-month dispensing
of medicines, institute prisoner release programs to reduce overcrowding and
lessen pandemic risk, and spend millions to mitigate lost wages. Ensuring an effective
response to this unfolding crisis, however, will also require learning from what has not
gone right.

This is crucial for delivering on the mandate of UNAIDS and its Joint Program. In
our work on the ground, supporting governments and communities, we have seen
how the COVID-19 crisis has exacerbated the difficulties faced by people living with
HIV, including in accessing life-saving healthcare. We have seen too how the crisis has
widened the social and economic inequalities which increase the vulnerability to HIV
of marginalized groups—including adolescent girls and young women, LGBTI people,
migrants, sex workers, people who use drugs, and prisoners. It is clear too that the
crisis is not only a problem of a virus. In many instances, knock-on effects from the
response have had an even deeper impact on marginalized groups than the virus.
The defeat of AIDS depends on how the world responds to COVID-19.

Four decades of learning from HIV have demonstrated the essential relationship
between human rights and public health, and so, as a home for that learning, UNAIDS
has been mandated to help apply those lessons. To overcome COVID-19, and to
avoid slipping back on progress in overcoming AIDS, countries will need to build
COVID-19 responses rooted in respecting human rights, and hearing from the most
marginalized. The purpose of this report is to help governments and other national
stakeholders to do so.

This report was produced because we observed in the first phase of the COVID-19
response many cases where punitive and discriminatory approaches hurt the most
vulnerable and in so doing were impeding progress in tackling COVID-19 and HIV. It
is vital to study them to ensure that they are avoided in future. The examples shared
in the report happen to be from sixteen countries with significant HIV prevalence
and where fuller case studies could be brought together. The issues those examples
highlight go well beyond those countries and elements described in them have
been reported across the world. The illustrative examples are included not to narrow
the focus of discussion down to just the countries they are from, but to illustrate
approaches reflective of many countries. The examples are a snapshot from a period between February and May 2020. In several cases governments have made very
welcome steps to address the specific cases, and both the report and the progress
of our work together in countries have benefitted greatly from our constructive
conversations about the examples included. The purpose of sharing them in this
report is not to apportion blame, but to help the world learn lessons from examples,
including from examples where judicial or government action helped to rectify earlier
damaging impact on rights, to support advances in the effectiveness of the response
in every country in the world.

We are learning more about COVID-19 and about the response day by day.
Learning and adapting is central to success. We invite and look forward to ongoing
conversations with governments and other stakeholders to exchange experiences,
strengthen plans, and continue to learn about how we can best support countries in
our joint work.

What this report highlights most of all is that rather than a public health response and
a rights-based response being opposing poles, public health responses are only fully
effective if they are absolutely grounded in human rights and have the unwavering
trust and confidence of communities. When disease transmission is between humans,
human rights must be the fundamental driver of the response. Discrimination,
stigmatization, and criminalization of marginalized communities are bad for the health
of everyone. No one is safe until all of us are safe. When, in contrast, we ensure that
no one is left behind or pushed behind, it helps us all move forward.

The really good news is that we don’t need to give away our human rights in order
to preserve our health. Human rights are not only intrinsic, but they are also the
very means by which governments can successfully beat a pandemic. We will beat
COVID-19, and we will beat AIDS, while—and indeed by—valuing the rights and
dignity of every person. The conversations sparked by this report will help us to do so.

The Joint Program is working shoulder-to-shoulder with governments, civil society
and communities to advance a human rights-based response to the dual pandemics,
HIV and COVID-19, and together we will succeed.
Winnie Byanyima
Executive Director, UNAIDS

Abbreviations and acronyms
ECOSOC United Nations Economic and Social Council
Global Fund The Global Fund to Fight AIDS, Tuberculosis and Malaria
ILO International Labor Organization
IMF International Monetary Fund
LGBTI lesbian, gay, bisexual, transgender and intersex people
OHCHR Office of the United Nations High Commissioner for Human Rights
PrEP pre-exposure prophylaxis
TB tuberculosis
UNDP United Nations Development Program
UNESCO United Nations Educational, Scientific and Cultural Organization
UNFPA United Nations Population Fund
UNODC United Nations Office on Drugs and Crime
WFP World Food Program
WHO World Health Organization

Executive summary
One of the main lessons learned from the HIV response is that human rights-based
approaches and community empowerment must be at the center of any pandemic
response. Discrimination, overreliance on criminal law, curtailing civil society
operating space, and failing to take proactive measures to respect, protect and
fulfil human rights can hamper mobilization of communities to respond to health
issues—a necessary ingredient for an effective response. Overly restrictive responses—
especially those that do not take the lived realities of communities into account—
and violent and coercive enforcement can undermine trust rather than support
compliance. The COVID-19 pandemic is one of the gravest threats facing society
today. Within a short period of time, it has reached every corner of the globe and it
has touched every aspect of our lives. The socioeconomic impacts of this pandemic
will be deep and long-lasting, and swift and coordinated action is needed to reduce
transmission and protect against the broader impacts of the virus.

At the same time, the HIV pandemic is not over. With 1.7 million new infections in
2019 and 38 million people living with HIV worldwide, we are living in a time of two
parallel pandemics. Not only should the lessons from one pandemic inform the other,
but the responses must mutually support each other, taking care not to harm the
progress that has been made thus far.

The protection and promotion of human rights has been central to the approach
and success of the HIV response. UNAIDS has a responsibility to monitor, review and
provide normative guidance on human rights concerns that impact upon the HIV
response in any way. The United Nations Economic and Social Council (ECOSOC),
in its 2019 resolution on the UNAIDS Joint Program, called for “a reinvigorated
approach to protect human rights and promote gender equality and to address
social risk factors, including gender-based violence, as well as social and economic
determinants of health”. In 2016, the United Nations (UN) General Assembly
requested the UNAIDS Joint Program “to support Member States within its
mandate in addressing the social, economic, political and structural drivers of
the AIDS epidemic, including through the promotion of gender equality and the
empowerment of women and human rights, in achieving multiple development
outcomes”. This includes those related to the elimination of poverty and the
provision of social protection, food security and stable housing. As the UN Secretary General put it in his report on human rights and COVID-19, “we are all in this
together,” and it is the responsibility of all agencies to support the efforts of the World
Health Organization (WHO) in their own respective areas of expertise.

In order to fulfil this obligation, UNAIDS is drawing on lessons learned in the HIV
response to review how COVID-19 public health orders that restrict movement
have impacted human rights in the period leading up to mid-May, paying particular
attention to people living with HIV and those most affected by HIV, including key
populations (sex workers, people who use drugs, gay men and other men who have
sex with men, transgender people and prisoners) and women and girls.

It therefore provides insights and recommendations that build upon and utilize the
knowledge gained in the HIV response about the impacts that public health measures
have on the most vulnerable.

Governments are facing enormous challenges in responding to the COVID-19
pandemic: economies are in decline, airports and borders are closed, unemployment
is growing and health-care systems are overstretched. In many cases, they have
responded quickly to the enormous task of protecting their populations from
COVID-19 and the broader socioeconomic fallout, and they have answered the call for
international solidarity and assistance by helping neighboring and sometimes distant
countries. Social protection schemes have been expanded or created, food packages
have been distributed and community groups have been mobilized to ensure the
continuation of health services. The International Monetary Fund (IMF) estimated that
countries had mobilized approximately US$ 9 trillion globally by 20 May.

As can happen when a significant new infectious disease emerges—and as was the
case in the early days of the AIDS epidemic because modes of transmission were
unknown—attempts to contain the spread of COVID-19 have resulted in human rights
concerns and violations, despite calls for a focus on rights. This has, at least in some
cases, had devastating consequences for communities that may be vulnerable to
COVID-19, HIV or the broader socioeconomic consequences of the pandemic.

While some human rights may be limited for a legitimate purpose, such as protecting
public health, a human rights-based approach mandates that restrictions must be
lawful, necessary, proportionate, evidence-based, time-limited and—importantly—
that they do not discriminate either in policy or implementation. In contexts that are
constantly changing, policies must also change, as new evidence arises or human
rights impacts are uncovered. Restrictions can have a disproportionate impact on
marginalized or stigmatized communities, especially if they are enforced in ways that
magnify stigma and discrimination. Cosponsors of the UNAIDS Joint Program
have put forward guidance and recommendations for countries on ensuring a human
rights-based response. This report builds on those—and on the UNAIDS publication,
Rights in the time of COVID-19: lessons from HIV for an effective, community-led
response—to explore how lessons from the HIV response have been taken up in
practice during the early response to COVID-19 and how the various lockdown
policies have affected people living with or vulnerable to HIV.

Given the urgency of the situation, it was not possible to undertake a global review.
Rather, the policies and practices reviewed in the 16 countries in this report should be
seen as examples of a much broader global phenomenon.1 Due to the necessity of
sustaining services for HIV—and in light of UNAIDS’ responsibility to monitor human
rights concerns affecting people who are living with or vulnerable to HIV—the regions
highlighted in this report were chosen because they contain countries with some of
the highest HIV prevalence in the world.

While there are many good practices that give us reason for hope, other findings
are deeply concerning. Many governments at the national and subnational levels
are taking action to affirm human rights protections and empower communities.
For example, some governments are extending access to water, providing social
protection, adapting health service delivery, providing emergency food supplies,
instructing police to hand out masks and supporting community health workers to
reach those likely to be left behind.

However, there have been repeated examples of rights violations, particularly early in
the pandemic. The cause of rights violations can be separated into three categories:

■ Those where the policy or directives themselves caused rights violations, such as
failing to ensure access to transport for medical emergencies.

■ A policy/implementation gap, where the policy is sound, yet implementation
has resulted in rights violations, such as the disproportionate use of force by
law enforcement.

■ Where COVID-19 is used as a cover for other rights abuses, such as price gouging
or targeting marginalized communities.

While many of the violations in the first category are rectified early on in the
pandemic response, it is the second and third categories that have the potential to
persist. As such, there is a need for continuous human rights monitoring and vigilance
throughout the course of a pandemic.

In the period covered by this report, tens of thousands of people were reportedly
arrested for violating lockdown measures and curfews in the 16 countries discussed.
Key populations have been disproportionately affected, experiencing violence,
exclusion and arrest under lockdown orders. Sex workers have been left out of
financial support measures in most of these countries, while hundreds of people
engaging in sex work have faced arrest in country after country. Gay men and other
men who have sex with men and transgender people have been subject to arrest and
harassment, and people who use drugs lack safe options for accessing harm reduction
services. Overly broad lockdown restrictions have disproportionately affected women—
for example, by making it difficult for women in labor to travel to hospitals.

Young key populations are particularly at risk of being negatively impacted. In
a United Nations Development Program (UNDP) regional project, young lesbian,
gay, bisexual, transgender and intersex (LGBTI) people and people who use drugs
indicated that measures taken to address COVID-19 make them more vulnerable
to violence and service disruption, as they cannot rely on consent and support from
family to access services, cannot access support and health services due to lockdown
restrictions, and face increased violence due to prolonged confinement in homes that
may not be safe.

This report is a snapshot in time, focusing on the very early days of the COVID-19
pandemic, from February to mid-May 2020, drawing attention to the experiences
of some of the most marginalized and vulnerable communities. Since then, many
countries mentioned in this report have made changes and adapted, lessons have
been learned across the world, and some problems have been solved. We hope this
report will generate discussion about these solutions and good practices, similar
to those early good practices outlined in this report. However, the reality remains
that, as we have seen in the HIV response, early responses to outbreaks and crises
can significantly affect the rights and well-being of vulnerable communities, and
it is important to take the time to review and analyze both the approach and the
outcomes, even as we continue to respond to the pandemic.

The analysis of the early COVID-19 response in this report is grounded in
internationally recognized human rights standards, recommendations from public
health bodies and lessons from the HIV response. For human rights to be at the
center of national strategies to address COVID-19—as clearly outlined in this report—
those responses must be continue to be reinforced and supported by international
cooperation and assistance. Based on the lessons learned from the HIV response, the
following are 10 immediate areas for action for governments that are looking ahead
to building effective, rights-based COVID-19 responses.

Laws and enforcement
▶ Avoid disproportionate, discriminatory or excessive use of criminal law:
As experiences with the criminalization of key populations and of HIV exposure,
non-disclosure and transmission have shown, excessive or discriminatory use of
criminal law is detrimental to a public health response. Use of criminal law as a
core part of a public health response—for example, by criminalizing exposure,
transmission or spread of the disease—can increase the risk of transmission and
undermine education and empowerment. Tens of thousands of people have been
arrested for violating COVID-19 orders in the countries reviewed, and research shows
many examples of harmful overreliance on criminal laws and penalties to enforce
compliance. Governments should refrain from imposing coercive and punitive
approaches to responding to COVID-19; instead, they should address barriers to
compliance with public health orders, support information campaigns to educate the
public about COVID-19 and avoid wherever possible the use of criminal sanctions.
Experience from the HIV response has demonstrated that when these punitive
and coercive measures are lifted, new cases decrease, better health outcomes are
achieved and human rights are protected.

▶ Stop discriminatory enforcement against key populations: Sex workers, gay men
and other men who have sex with men, transgender people, and other vulnerable
groups who have experienced violence have been denied access to services or
been subject to discriminatory enforcement under COVID-19 lockdown orders. The
history of the HIV epidemic shows that the violence, harassment and discrimination
of key populations has a direct impact on internalized stigma and HIV outcomes.
Governments should take immediate action to address this, including amending laws
and training front-line personnel in non-discrimination.

▶ Explicitly prohibit state-based violence and hold law enforcement and security
forces accountable for disproportionate responses or actions when enforcing
COVID-19 response measures: This report details multiple and widespread reports
of police and/or security forces using violence, including lethal force, to enforce
public health measures such as curfews and the wearing of masks. As with the
HIV pandemic, such approaches can divert time and resources away from a more
enabling approach that ensures access to essential services, such as health care
(particularly HIV services). They establish fears of arrest or violence, creating barriers
to reaching such crucial services. Governments should deploy law enforcement in a
manner that is consistent with international human rights law and—from the highest
level down—they should: guarantee rights related to the use of force, arrest and
detention, fair trial and access to justice and privacy; ensure police and security forces
exercise restraint; and hold security forces accountable for abuses. Law enforcement
agencies should be reminded that the prohibition against arbitrary deprivation of life,
torture and other ill treatment is absolute and non-derogable at all times.

Access to services and support
▶ Include reasonable exceptions to ensure that legal restrictions on movement do not
prevent access to food, water, health care, shelter or other basic needs: Most laws
in the 16 countries reviewed for this report allow all people to move for food,
water and health care, but in practice, overly broad lockdowns in some countries
are undermining access to essential services, including access to HIV services and
adequate nutrition that are essential for people living with HIV. In some cases,
particularly harsh lockdown measures have led to deaths and physical harm because
people could not meet basic needs. Governments should consistently allow for
exceptions that reflect the complexity of basic survival and diversity of needs during
public health emergencies.

▶ Take proactive measures to ensure people, particularly from vulnerable groups,
can access HIV treatment and prevention services and meet other basic needs:
Beyond making exceptions to movement restrictions, this report details specific
measures that governments are putting in place to support the realization of
the rights to health, food and clean water. The breadth and scale of the need,
however, are often outpacing capacity. Many countries are seeing documented
disruptions in HIV treatment or prevention, with more aggressive policy shifts
needed to ensure access, particularly to harm reduction services. Governments
and international financing agencies should implement diversified service delivery
and accelerate emergency funding and policy shifts.

▶ Rapidly reduce overcrowding in detention settings and take all steps necessary to
minimize COVID-19 risk, and ensure access to health and sanitation, for people
deprived of liberty: Prison populations have an overrepresentation of people with
drug dependence, HIV, tuberculosis, and hepatitis B and C, and prisoners and other
incarcerated people may be at increased risk of complications from COVID-19 that
goes beyond vulnerability to infection with COVID-19. Nearly all of the countries
reviewed have released some people from prisons to address overcrowding
and reduce the spread and risk of COVID-19 among people deprived of liberty.
Several countries have reduced overcrowding significantly. In many settings,
however, the releases have been too small to have a significant impact. This report
details examples where ill-treatment of people in prison is likely to drive the spread
of COVID-19. Testing and medical care are significant problems for many people in
prison amid COVID-19. Where lockdowns cut off family and legal support, there are
further rights concerns. Governments should ensure release of people at particular
risk of COVID-19 where safe, people whose crimes are not recognized under
international law, and any other people who can be released without compromising
public safety, such as those sentenced for minor, nonviolent offences, with specific
consideration given to women and children.

▶ Implement measures to prevent and address gender-based violence against
women, children and LGBTI people during lockdowns: Interpersonal violence
against women is associated with higher rates of HIV, while violence against
LGBTI persons has been shown to impact significantly on access to HIV services
and positive HIV outcomes. Nearly all countries reviewed have seen significant
increases in reports of gender-based violence, and yet none of the lockdown
restrictions reviewed explicitly allow people to leave home or change domiciles
to escape gender-based violence. Governments should expand services and allow
movement of people to escape abuse and support people seeking assistance.

▶ Designate and support essential workers, including community health workers
and community-led providers, journalists and lawyers: The HIV pandemic has
shown how critical journalists are to getting unrestricted, trusted information
to people during a pandemic; lawyers, for creating accountability for a rights based response; and community health workers and community-led health-care
providers, for reaching marginalized people and diversifying delivery of services.
Most but not all governments have designated these three groups as essential
workers, although arrests and harassment have been documented in several
settings. In some countries, there remain major barriers to these groups working
effectively under lockdown orders. Governments should ensure these groups
are designated as essential workers and are supported to be able to work safely
during the pandemic.

Participation and rule of law
▶ Ensure limitations on movement are specific, time-bound and evidence-based,
and that governments adjust measures in response to new evidence and as
problems arise: As this report shows, many of the limitations create barriers or
difficulties for people who are living with or vulnerable to HIV. It is important that
those limitations are regularly reviewed and given time limits. Most public health
orders in these 16 countries are time-bound and specific. Governments should
periodically review public health measures to identify possible rights violations
and other problems. They should adjust measures to rectify these problems and
incorporate new evidence about COVID-19.

▶ Create space for independent civil society and judicial accountability, ensuring
continuity despite limitations on movement: Communities and accountability
mechanisms have been critical to the HIV response, removing discrimination and
reaching those most likely to be left behind. Likewise, in the early days of the
COVID-19 pandemic, we saw communities of people living with or vulnerable to
HIV mobilizing to provide HIV and other services and support. Civil society and
courts have helped improve the COVID-19 response in many countries where
they are enabled to operate freely by highlighting problems experienced by
communities and both offering and implementing solutions. Governments should
engage communities from the beginning in all response measures. This includes
consulting rapidly and widely with a range of stakeholders before imposing
restrictions on movement, and creating space for civil society voices to engage
with and monitor the COVID-19 response. Courts should continue to operate, as
much as possible, particularly where liberty interests or the legality of public health
orders are at stake.

As countries consider the coming months or years of the COVID-19 pandemic,
governments will need to calibrate their responses for a pandemic that is likely to see
waves of new infections and epidemics throughout the world for some time to come.
This report addresses the early response to COVID-19 in the context of rapid change
and evolution based on the lessons learned from the HIV response. Countries are
already shifting from some of the responses reported here to new responses as
the outbreak changes, while others are already reintroducing lockdown measures
where there have been new waves of infections. In this context, interventions to
limit the movement of people through lockdowns, stay-at-home orders, physical
distancing requirements and curfews may continue to be deployed as part of the
broader response to COVID-19. In doing so, urgent consideration must be given to
maximizing rights-based approaches that empower and engage communities, ensure
resilience and build cooperation. This report shows this will be particularly important
for people living with HIV and key populations, and for securing trust for the public
health response ahead.

Introduction
Pandemics are a particular type of crisis—an invisible enemy, not of our making,
spanning the world, and requiring bold and decisive actions to protect the health
of populations. As countries around the world respond to the COVID-19 pandemic,
it is critical that the response is firmly grounded in respect for human rights.

The HIV pandemic taught the world that this imperative comes from the intrinsic value
of human life and dignity, and because rights-based responses are more effective in
the long run for engaging, educating and empowering communities to protect their
own health, and for spreading awareness and accurate information. Rights violations
can undermine trust and compliance with public health directives, economic
resilience, and ultimately the success of public health efforts over time.

Although there are clear differences between COVID-19 and HIV, these principles
continue to be relevant as governments seek to secure the public’s consistent
participation with public health advice over many months while the world waits
for an effective vaccine. Interventions such as physical distancing, wearing masks,
contact tracing, quarantine and isolation of people with COVID-19 are critical tools
in the fight. Without careful planning of the practical implementation of these
interventions early in the pandemic and an overreliance on coercion and force to
promote compliance, governments may catalyze a myriad of negative consequences
for people, including obstructing access to safe housing, food, water, sanitation, HIV
prevention and treatment, and other life-saving medical care, all of which can impact
on HIV services and prevention, and on treatment adherence and outcomes. Due to
patterns of social and economic marginalization and discriminatory enforcement,
these negative consequences fall most heavily on vulnerable communities, including
women, LGBTI people, sex workers, homeless people, indigenous populations and
people living with disabilities. For many people living with HIV, these initial COVID-19
response policies may exacerbate the stigma and challenges they already face.

Governments must act quickly, comprehensively and coherently, updating
their responses based on evolving evidence to react to this rapidly spreading,
highly contagious virus. Yet the urgency presents a challenge: the more rapidly
and expansively governments respond, the greater the risk of rights violations
that undermine public health objectives. At the same time, governments are
implementing policies and programs that protect rights—many of which are
detailed in this report—to ensure access to basic services, provide safety from violence
and deploy law enforcement in a protective and enabling manner.

The COVID-19 pandemic is a public health emergency—but it is far
more. It is an economic crisis. A social crisis. And a human crisis that
is fast becoming a human rights crisis . . . By respecting human rights
in this time of crisis, we will build more effective and inclusive solutions
for the emergency of today and the recovery for tomorrow.
— United Nations Secretary-General António Guterres

The UN General Assembly, the UN Secretary-General, and other human rights
leaders and bodies have issued strong calls for a human rights-based response to
COVID-19 and urged caution about ensuring that restrictions on movements do not
create a human rights crisis. UNAIDS and its Cosponsors have issued a range
of normative advice and guidelines to help governments address COVID-19 with a
human rights-based approach. In March 2020, UNAIDS published Rights in the
time of COVID-19: lessons from HIV for an effective, community-led response to bring
forward particular lessons from the HIV response. This report builds on these
normative and guidance documents to explore how they have been implemented,
and how the lessons from the HIV response have been adopted in practice in the
early response to COVID-19.

The focus of this report is on the very early days of the pandemic, from February through
mid-May. Drawing on the lessons learned in the HIV response, the report looks at how
COVID-19 public health orders restricting movement and other related aspects of the
response have impacted human rights. It also looks at steps taken by governments to
protect rights, with a particular focus on people living with HIV and people affected by
or at risk of acquiring HIV (including key populations and women and girls). In a rapidly
changing environment, this report captures only a snapshot in time, and we recognize
that in many cases, countries have continuously changed and adapted their approaches
and strategies in response to concerns, solving problems as they arise.

Some of these good practices are captured in the report. The first stages of a
pandemic and response are critical, and it is important to reflect on and analyze these
first weeks and months, even as we continue to respond to the crisis. It is our hope that
this report can be used to inform action and update policy responses as COVID-19
continues to disrupt social and economic life in communities across the world.

COVID-19 has affected all regions of the world, and so the issues addressed here are
globally relevant. To allow deeper analysis, the focus here is on two of the regions that
contain countries with some of the highest HIV prevalence in the world: sub-Saharan
Africa and Latin America and the Caribbean. It is critical to note, however, that
lockdowns and human rights concerns related to them are present in countries in all
regions, including in Asia and the Pacific and Europe. The geographical focus of this
report, chosen to fit practical and time constraints and to focus on high-burden HIV
regions, should not be interpreted to imply that concerns are more acute in, or issues
are confined to, the countries explored.

Methodology
This review of policy and practice focuses on restrictions on movement and related
issues during the early response to COVID-19: the laws and policies put in place,
their implementation and their effects on human rights, as well as the actions taken
by governments to protect human rights and ameliorate the negative consequences
of lockdowns or other restrictions. In terms of the issues reviewed, the scope of
this report was based on a combination of early reports of human rights concerns
by communities of people who are living with or vulnerable to HIV, and the prior
experience of UNAIDS with the HIV response. Of particular importance was UNAIDS’
understanding of the types of human rights violations that would affect public health
outcomes—in this case for both COVID-19 and HIV—which were examined in the
Rights in the time of COVID-19 publication, released earlier this year.

The methodology was developed to avoid taking time and resources away from the
COVID-19 response, and to allow information-gathering during a pandemic response
in contexts that featured lockdowns and other limitations on movements across the
period of analysis for a report that would be published in a relatively short period of
time. A global review was beyond the scope and time requirements for this project,
so the report is therefore restricted to two regions: Latin America and the Caribbean
and sub-Saharan Africa. These regions were chosen because they contain countries
with the highest HIV prevalence.

Within each region, the following criteria were used for selecting countries:
■ Ensure representation across income classifications.
■ Include at least one country from each of eastern, southern, western and central
Africa, South and central America, and the Caribbean.
■ Ensure the majority of countries contained a UNAIDS office.

Countries were then picked at random until the above criteria were met. Ultimately,
16 countries were selected: Argentina, Botswana, Brazil, Cameroon, the Central
African Republic, Chile, Colombia, El Salvador, Ethiopia, Jamaica, Kenya, Malawi,
Nigeria, Peru, South Africa and Uganda.

UNAIDS partnered with the O’Neill Institute for National and Global Health Law
at Georgetown University to coordinate research and drafting.

The questions were developed by drawing on the observations and recommendations
contained in Rights in the time of COVID-19 about what the HIV response has taught
us about human rights concerns and how the COVID-19 pandemic could impact
negatively on people who are living with or vulnerable to HIV.

Data were gathered beginning in February 2020 through 19 May 2020, with
limited updates after that time. Information for each country was gathered through:
(a) a qualitative questionnaire sent to human rights experts with local knowledge of each country; (b) the review of legal documents, and reports from government,
nongovernmental organizations and the media; (c) consultation with national human
rights experts; and (d) observations from UNAIDS staff. Wherever possible, the relevant
public sources are cited. Information was verified by experts on human rights, law and
development who have experience working in the relevant countries. The draft report
was then the subject of a dialogue with the 16 countries reviewed, and an invitation was
extended to correct any factual errors within the document.

Although this short report cannot possibly capture the full reality of national contexts,
it seeks to understand some of what is happening in relation to rights and COVID-19
in a rapidly evolving context with limited mobility. The report does not purport to
provide a complete picture of each country, as it was not feasible to cover all areas of
human rights concern or all actions taken by countries. It is also subject to limitations
where complete data or information are not in the public domain or readily available.
These include broader socioeconomic policies and support programs rolled out by
governments to address the direct and indirect effects of the pandemic; human rights
concerns raised by increasing use of digital technologies in COVID-19 responses,
including contact tracing, disseminating public health messages, and health care;
and broader access to COVID-19-related health care during the pandemic, including
current technologies such as ventilators and prospective vaccines and treatments.

Based on the review’s findings related to lessons learned from the HIV response and
UN human rights guidance, this report is structured around 10 key areas for action
by governments as they orient in the coming months for a rights-based response to
COVID-19.

Setting the scene: limiting movement of people in response to COVID–19

Countries around the world have implemented a range of measures to reduce transmission of the virus responsible for COVID-19. One of the most common measures—although it is by no means universal—is that of a lockdown that places restrictions on individual movement, such as limiting people to within a certain radius
of their domicile and/or preventing them from leaving their place of residence. Some
countries have instituted partial lockdowns where restrictions are at the subnational
level or are only for certain times of day, such as a curfew. While restrictions on freedom
of movement are permissible to achieve a legitimate aim, such as protecting public
health, states still have a responsibility to ensure that such restrictions are proportionate,
evidence-based and time-limited.

Of the 16 countries reviewed, 12 have issued varying degrees of lockdown or stay at-home orders; only Cameroon, the Central African Republic and Ethiopia have not.
The Government of Malawi issued a lockdown order, but it was stayed by court order
before taking effect.

The lockdowns are largely nationwide, except in Brazil, where they have been issued by
some state and municipal governments. Argentina, Chile, Jamaica, Kenya and Nigeria
have some nationwide restrictions in place, such as curfews, combined with more
extensive lockdown measures in certain areas. See Table 1 for more details.

Unlike policies for the medical quarantine of people with suspected exposure to
COVID-19 or isolation of cases (both of which apply to specific individuals), lockdown
orders apply to the general population. A core set of restrictions is fairly uniform
across countries. Unessential businesses are closed, with their employees asked
to work from home if possible. The size of gatherings and the number of people
in public transit vehicles are limited. People are instructed to stay at home unless
they are essential workers or engaging in permitted activities. The list of permitted
activities varies across countries. All 12 countries allow people to leave home
to get food or medical care. In Colombia, people are explicitly allowed exercise
outdoors. Nigeria and South Africa also added exercise to the permitted
activities list as they eased their lockdown restrictions.

Chile, Jamaica, Kenya, Nigeria, Peru, South Africa and Uganda have implemented
nightly curfews rather than round-the-clock lockdowns. These curfews make exceptions
only for essential workers and, in some cases, for people seeking emergency medical
care. In Chile and Kenya, the curfews are nationwide, but only some areas have
lockdown orders in place during the day. In Nigeria and South Africa,
the curfews were put in place as part of the first phase of easing lockdowns.

Some countries have taken further steps to restrict people’s movements. Uganda
banned the use of transport without official permission. In Botswana,
Chile and El Salvador, people were required to register or request
permission before they left home. In Chile, people were allowed three hours of
shopping for essential goods twice a week, and five hours or 24 hours (depending on how far they must travel) to attend the funeral of an immediate family member.
In Argentina, people were required to register if they wished to travel further than
one kilometer from their home. The Government of the City of Buenos Aires
initially required people over the age of 70 years to register before leaving home
and to call a hotline, whose operators would inform them of the dangers posed
by COVID-19 and attempt to dissuade them from leaving; a judge declared this
measure discriminatory and overturned it, and so the Government downgraded it
to a recommendation. In parts of Colombia, El Salvador, Jamaica and Peru, people have been allowed out only on certain days of the week, with days sometimes assigned based on gender or national identity number. Cameroon, the Central African Republic, Ethiopia and Malawi have not instituted general lockdown orders, but they have implemented some more specific restrictions. All four countries closed schools and limited the size of gatherings (although in Malawi, the limit is 100 people). Cameroon ordered bars and restaurants to close at 6 pm, while the Central African Republic closed bars and restaurants entirely, except for takeaway services.

COVID–19 public health orders and human rights
The COVID-19 pandemic is an exceptional time, and international human rights law
permits governments to temporarily limit the exercise of some human rights for the
compelling and legitimate purpose to protect lives and public health. Lessons from
the HIV response reaffirm the imperative to follow key principles when applying
rights-limiting measures—namely that these measures must be lawful, necessary,
proportionate, non-discriminatory and limited to achieving a legitimate aim.
The requirement of proportionality means the restrictions must be appropriate to
achieve their function (effective), the least intrusive and least restrictive to achieve their
protective function, and proportionate to the interest being protected.

Recognizing that these limitations and restrictions are impacting the HIV response
and people who are living with and vulnerable to HIV, UNAIDS recommended that
countries ensure that any enforced limitations on individual movement are “carefully
assessed, including their effectiveness and whether more proportionate measures
are available”. In reviewing information gathered for this report, particularly on
the impact on people who are living with or vulnerable to HIV, 10 key areas of human
rights concerns emerged that are applicable both to communities of people who are
living with and vulnerable to HIV and to the broader population. UNAIDS has drawn
on its own experience and that of international human rights bodies and experts to
provide key recommendations for each area of concern. It is hoped that the following
lessons from HIV can be taken up more clearly in the months ahead.

Avoid disproportionate, discriminatory or excessive use of criminal law
Efforts to halt HIV transmission by criminalizing behaviors and activities have
proven ineffective, driving people away from critical services and undermining the
trust that communities have in authorities. UNAIDS has argued that the excessive
or discriminatory application of criminal laws “risks undermining public health and
human rights”.

Hundreds of thousands of people around the world have been arrested for violating
COVID-19 orders. Globally, many countries have introduced new criminal
offences or relied on existing criminal laws—such as manslaughter or endangering the
health of others—to enforce compliance. The use of criminal law for public health
ends is, in most cases, a disproportionate and ineffective response that is vulnerable
to arbitrary and discriminatory implementation. Governments should presume
communities’ desire to comply with sound public health advisories if they are well informed and supported to do so. Wherever possible, governments should plan for
and seek to address barriers to compliance rather than impose criminal penalties or
other punitive measures, particularly where detention in unhygienic and overcrowded
conditions may worsen a health emergency.

The Office of the United Nations High Commissioner for Human Rights (OHCHR)
has made clear that “deprivation of liberty must be reasonable, necessary and
proportionate in the circumstances, even in a state of emergency”. When assessing
the appropriateness of detaining a person, governments should “pay specific attention
to the public health implications of overcrowding in places of detention and to the
particular risks to detainees created by the COVID-19 emergency”. Using criminal
law to fight COVID-19 poses significant perils associated with arrests and detention
to arrestees, police officers and staff of the justice system; it also deflects critical
time, human resources and limited budgets from measures that more effectively
respond to the pandemic, including education, testing, tracing, treatment, temporary
isolation, and supporting people to more effectively and safely reduce physical
interaction. A reliance on criminal laws can also distract from government support
for measures that would assist populations at risk to stay home, such as provision of
medicines, HIV prevention and treatment, food, water or alternative shelter. Reliance
on criminal penalties to enforce curfews and physical distancing guidelines can lead
to discriminatory outcomes where people without access to reliable information, clean
water or safe shelter are most likely to face arrest and detention. The pandemic can
also intensify the disproportionate negative impact of administrative penalties, such
as fines. OHCHR has cautioned governments that “in assessing the appropriate sum of
a fine, consideration should be given to the individual circumstances, including gender
specific impacts. This is particularly relevant for people not in paid employment or
those not generating income because of the emergency measures”.

There is a real risk of the discriminatory application and impact of such criminal
laws. In the HIV response, the disproportionate impact of criminal laws and
law enforcement practices on key and vulnerable populations has been widely
documented. As the United Nations Office on Drugs and Crime (UNODC) has
pointed out, this applies equally under COVID-19: “specific populations such as
LGBTI persons or other groups are at risk of use of force violations by police and
security providers”.

In the 16 countries reviewed, tens of thousands of people have been arrested for
violating lockdown orders, which fits with findings across UN agencies of hundreds
of thousands of people arrested in recent months. Eleven of the 12 countries
with lockdowns have reported arrests relating to COVID-19 restrictions, using short term detention and fines as a deterrent and a way to punish people suspected of
failing to comply with COVID-19 risk mitigation behaviors (see Table 1).

We have also seen the discriminatory impact of criminal laws and enforcement
measures on key populations. Chile has reportedly arrested more than 1,200 people
for violating its curfew orders. Although Ethiopia has not implemented a
lockdown on movement, according to the Ethiopian Human Rights Commission, the
five-month state of emergency in response to COVID-19 established new, broadly
worded crimes and criminal penalties of up to three years imprisonment or a fine of
up to 200,000 Ethiopian Birr (US$ 5,750) for violating physical distancing standards,
including shaking hands and being in public without covering one’s nose and mouth. These new criminal provisions led to the arrest and temporary detainment of
more than 2,800 people. According to media reports, Cameroon has arrested
and detained hundreds of people for not wearing masks in public and issued fines.
This has meant that people who could not pay fines remained in jail longer than those
who could pay.

Food distribution sites need to be managed carefully because they tend to draw
crowds, potentially increasing the risk of COVID-19 transmission. Attempts to manage
these sites through punitive laws are disproportionate, can lead to unjustified use of force, and fail to assist in finding other solutions for delivering food and other
basic resources. For example, the Government of Uganda stated that politicians who
sought to distribute food aid to needy people would be charged with attempted
murder, allegedly because physical proximity during distribution could lead to
COVID-19 transmission. Complying with that order, security forces arrested and
severely beat a member of parliament who was handing out food to community
members in his area. He sustained serious injuries and was ultimately released on
police bond from detention to seek emergency medical treatment. All charges
have since been dropped.

Police officers, however, can play a constructive role in the response. In Mombasa,
Kenya, one governor worked with police to hand out masks to people at checkpoints
rather than arrest them for not wearing masks. Likewise, several Brazilian states
have instructed authorities to prioritize educating the public about the importance of
the new restrictions before resorting to sanctions.

Government efforts should work to respond to the lived reality of people’s lives and
focus on disseminating accurate information and educating the public about COVID-19
risks and transmission. While there is urgency to ensure communities abide by
physical distancing and other COVID-19 response measures to stem transmission, an
overreliance on criminal sanctions risks a raft of human rights violations that undermine
efforts to curtail the pandemic and exacerbate pre-existing social challenges of
poverty, prison overcrowding and inadequate access to accurate information. If and
when police officers are on the front lines of the COVID-19 response, they should be
trained in supporting community education and empowerment efforts, given clear
instructions on when and how to use and not use their law enforcement powers, and
supplied with enough personal protective equipment to carry out their duties without
risk to themselves or the communities they serve.

An overreliance on criminal sanctions also impedes governments’ understanding
of why people are breaching COVID-19-related best practices and their ability to
support communities to comply willingly. Many people have needs—such as access
to medicines, including HIV prevention and treatment, and clean water or food—that
make remaining at home extremely difficult. The practical economic and social costs
of poverty in a pandemic should always be factored into government planning and
buttress governmental ability to provide measures to support a range of urgent
needs so that compliance is possible.

Governments should be—and many are, as detailed later in this report—working with
communities to implement policies and programs that support people’s urgent
needs and make it possible for them to comply with COVID-19 prevention measures.

Stop discriminatory enforcement against key populations
From the history of the HIV epidemic, we have seen how stigma and
discrimination negatively affects people’s physical and mental health
and social support . . . Combat all forms of stigma and discrimination,
including those based on race, social contacts, profession (healthcare
workers), and those directed towards marginalized groups that
prevent them from accessing care . . . Use of criminal laws in a public
health emergency is often broad-sweeping and vague and they run
the risk of being deployed in an arbitrary or discriminatory manner.
— Joint United Nations Program on HIV/AIDS

In many countries around the world, gay men and other men who have sex with men,
transgender people, people who use drugs, sex workers, and other socially and
economically marginalized groups vulnerable to HIV—including women and girls,
people in informal settlements, indigenous groups, young people, and migrants
and refugees—are experiencing discriminatory impacts under COVID-19 lockdown
orders. Governments should take immediate action to address stigma
and discrimination, including amending laws and training front-line personnel in
non-discrimination.

As we have seen in the HIV response, the effects of coercive or restrictive public health
measures and the burden of their enforcement falls disproportionately on some
groups and communities, often those who are already vulnerable or marginalized.
This can have negative effects on HIV programs and outcomes, such as increasing
stigma and discrimination, pushing the HIV epidemic underground, removing the
ability of sex workers to negotiate safer sex, and creating barriers to prevention, testing
and treatment. When stigma and discrimination are reduced and an enabling legal
approach is taken, HIV outcomes improve.

Under COVID-19, this is playing out in many countries worldwide—not because the
law is consistently written in a discriminatory manner, but because its effects are
foreseeably unequal or enforced in ways that reinforce social structures of stigma and
discrimination. Discrimination, whether direct or indirect, is unlawful under international
human rights law and can drive people away from seeking needed health care in crises
and ultimately curtail effective responses. The effects on marginalized communities are
systemic rather than coincidental, and they must be addressed as such. UNAIDS,
the United Nations Educational, Scientific and Cultural Organization (UNESCO),
OHCHR and other organizations have called on governments to take immediate
action to address stigma, xenophobia and other forms of discrimination, including by
amending laws and training front-line personnel in non-discrimination.
Sex workers have been particularly vulnerable to arrest and mistreatment under
COVID-19. With their income at risk or entirely eliminated, and often ineligible for
financial support due to the legal status of their work, many sex workers report having
to choose between physical distancing and meeting basic needs, with many sex
workers arrested globally. In this context, UNAIDS and the Global Network of
Sex Work Projects have called for an immediate halt to arrests and prosecutions of sex
workers, “moving away from punitive measures and criminalization towards reaching
and serving those most in need”.

The review found that this global trend is also reflected within the 16 focus countries
of this report, with punitive measures used against sex workers in at least four of them.
In Cameroon, more than 50 sex workers were reportedly arrested in Yaoundé for
entering hotels in violation of isolation orders. In Kenya, more than 50 sex workers
were reportedly arrested for violating lockdown orders, including 24 reportedly
arrested in one raid in Makueni county. In Uganda, civil society organizations
reported that at least 117 sex workers, bartenders and other vulnerable women
have been arrested for violating lockdown, including 71 within a single day of raids
in Kampala, Kasese, Lira, Masaka, Mbale, Nakasongola, Oyamu and Wakiso.
They were subsequently released. Rights groups in El Salvador report sex workers
being among the hundreds of people arrested for violating lockdown orders.

In countries and regions—including Europe and Asia and the Pacific, both of which
were beyond our research scope—there have been similar reports of arrests, but there
also have been examples of governments supporting and working with sex workers
to address the challenges of COVID-19. For instance, some sex workers have
been enlisted to conduct contact tracing, while in some countries where sex work
is not criminalized, they have been able to access financial assistance alongside other
workers, thus eliminating the conflict between basic needs and compliance with public
health directives. In Argentina, the Ministry of Social Development launched
an online registry for informal workers to access social benefits; initially, this included
sex workers, but sex work was then removed as an eligible category. At the time of
writing, the registry was taken down while the Government undertakes consultations
on the matter. There have been some positive developments from civil society as
well, such as in Botswana, where the nongovernmental organization Sisonke has been
distributing food aid to sex workers, addressing the key driver of lost income.

LGBTI people have found themselves disproportionately impacted by enforcement
measures in some countries. In Peru between 3 and 10 April 2020, mobility outside the
home was segregated by gender, which created particular problems for transgender
people. The Government of Peru specifically noted that people should follow the
policy based on their self-identification, yet there were several reports of LGBTI people
being attacked or humiliated by state agents during the gender-specific lockdown,
including abuse of transgender and other gender-diverse people. In response,
the Peruvian Government passed a legislative decree to protect against discrimination
by law enforcement on the basis of gender identity and sexual orientation (among
other bases), and it drew attention to the regulations for the use of force by the police
and armed forces.

Under COVID-19 restrictions, Ugandan officials arrested at least 23 LGBTI youth
who were living in a safehouse on 29 March. Of those arrested, 19 were eventually
charged with violating physical distancing orders and officially accused of committing
a “negligent act likely to spread an infectious disease” under the criminal code,
allegedly because of the total number of people living in the house.
They were denied bail and were unable to see their lawyers while in detention.
They were never tested for COVID-19 during their detention. Significant efforts
from civil society eventually secured their release on 19 May, and all charges were
dropped. A court later ordered compensation for the rights violations of those
arrested and charged. In Jamaica, UNAIDS has heard testimonials from
gay men and other men who have sex with men living on the streets who have been
receiving harassment from security forces to comply with the curfew. The higher
rates of homelessness among LGBTI persons due to stigma and discrimination within
families is a global phenomenon, which means that targeting or harassing homeless
persons has a discriminatory impact on LGBTI persons.

Explicitly prohibit state-based violence, and hold law enforcement
and security forces accountable for disproportionate responses or
actions when enforcing COVID-19 response measures
In most cases, lockdown measures are accompanied by powers of enforcement
that—if excessive, overused or used in a discriminatory manner—could have serious
consequences for the public, in terms of their rights to be free from arbitrary detention,
violence and discrimination, their right to access services, and their right to health.

From very early in the COVID-19 pandemic, there have been reports from across the
world of the excessive and disproportionate use of force in enforcing lockdowns,
curfews and other restrictions or requirements (such as wearing a mask).
The review found these same trends in the countries reviewed for this report, with
many examples of law enforcement and/or security forces using violence, including
lethal force, to enforce COVID-19 transmission reduction measures.

From the highest level down, governments should: guarantee rights related to
the use of force, arrest and detention, fair trial and access to justice and privacy;
ensure law enforcement and security forces exercise restraint; and hold them
accountable for abuses. Under the principles of international law, law
enforcement officials should apply nonviolent means before resorting to the use
of force, use force only in proportion to the seriousness of the offence, and use
lethal force only when strictly unavoidable to protect life. No country should permit
or condone brutality, such as beatings, humiliation or killings, under the guise of
enforcement of physical distancing, curfews or other behavior modification, such
as wearing a mask in public. Arbitrary deprivation of life, torture, and inhumane or
degrading treatment are banned under international human rights law at all times,
in all places. OHCHR has weighed in extensively on this issue in the context of
COVID-19 and states: “Law enforcement officials may use force only when strictly
necessary and to the extent required for the performance of their duty and only
when less harmful measures have proven to be clearly ineffective”. As noted
by a number of UN human rights experts, “breaking a curfew, or any restriction
on freedom of movement, cannot justify resorting to excessive use of force by the
police; under no circumstances should it lead to the use of lethal force”.

We have seen in the HIV response that education, consent, engagement and
community empowerment are the most effective ways to achieve compliance, and
yet state-based violence not only persists but has in many cases increased with the
onset of COVID-19. As noted above, this can have a disproportionate impact on key
and other vulnerable populations by increasing stigma, sending people underground
and driving them away from services. It also can divert time and resources away
from a more enabling approach that ensures access to essential services, such as
health care (particularly HIV services), and it can make people fearful of leaving their
homes because of the potential for arrest or violence, thus creating further barriers to
reaching these crucial services.

Examples of this global phenomenon were found in a number of the countries
reviewed. Police enforcing the curfew in Kenya reportedly killed at least six people. Nigeria’s National Human Rights Commission, an independent body that was
monitoring human rights in law enforcement activities relating to COVID-19, including
setting up special hotlines to receive reports, reported that between 30 March and
13 April, there were eight incidents of extrajudicial killings perpetrated by the police
force, army and the Nigerian Correctional Service, resulting in 18 deaths.

Law enforcement officials have relied on unlawful enforcement tactics, such as beatings,
extortion and humiliating alleged transgressors, in some cases in ways that may
exacerbate the risks of COVID-19 transmission. In South Africa, there have been multiple
reports of excessive use of force by police and other security forces. As of 8 May, the
Independent Police Investigating Directorate is investigating 376 reports of allegations
of abuse of police power. In El Salvador, a video on social media showed
police beating an 80-year-old man for allegedly failing to respect the quarantine,
and there have been other reports of police abuses. In Mombasa, according to
media reports, Kenyan police officers forced crowds of people to lie down together, in
some cases on top of each other, and beat them for allegedly violating curfew.
In Uganda, civil activists decried multiple incidents of brutality in curfew enforcement in
several locations across the country, including Elegu, Kampala and Lira, particularly by
members of the police and local defense units. Sixteen security personnel
were reportedly arrested in Elegu. At the time of writing, six army officers have been
sentenced to six months in prison and the police officers are awaiting a court verdict.

In some instances, government officials have issued formal apologies for brutality and
conducted isolated arrests of abusive security forces. Given the practical constraints
of the ongoing pandemic and the urgent need for basic livelihoods, it is unclear
whether survivors of such abuses will be able to seek justice or compensation. If left
unchecked, countries may end up inadvertently allowing the pandemic to erode
or destroy future trust and confidence in government public health efforts, further
impeding the fight against the pandemic.

UNODC and UNDP released guidelines on ensuring access to justice in the context
of COVID-19, noting “protocols and training are required for police and security
personnel, including border authorities, to ensure the respect for dignity and rights
of people in the context of implementing emergency regulations and quarantine
rules, including adopting a gender-sensitive and child-friendly approach. This will be
particularly relevant in the treatment of marginalized groups that may be constrained
in their ability to follow quarantine rules (such as day laborers, migrant workers,
street vendors, sex workers, or homeless persons)”.

Include reasonable exceptions to ensure legal restrictions on movement do not prevent access to food, health care, shelter or other basic needs
All public health orders reviewed officially allow people to move for food and health
care (except during curfew hours), but not to shelter. Emergency medical care is
supposed to be accessible at all times, but in practice, overly broad lockdowns in
some contexts have undermined access and led directly to deaths and physical harm.
Governments should consistently allow for exceptions that reflect the complexity of
basic survival and the diversity of needs during public health emergencies within
and across borders.

UNAIDS warns that where public health measures restrict people’s movements,
governments must “put in place exceptions where necessary for vulnerable groups and
to ameliorate the consequences of such restrictions”. Specifically, governments
must take appropriate measures, including making targeted exceptions to lockdown
restrictions, to ensure lockdowns do not “deprive people of food, medication or
housing”. This is particularly important for populations at higher risk, such as older
people, who may be subject to stricter stay-at-home rules than the general public.

Continued access to health care is, of course, critical for the HIV response, including
HIV-specific services for prevention, testing and treatment, sexual and reproductive
health and rights services, integrated tuberculosis services and broader health
services for comorbidities. Service interruptions can have significant detrimental
impacts on the mental and physical well-being of individuals, and on the HIV
response as a whole. This was demonstrated in recent modelling on interruptions to
HIV services during the COVID-19 pandemic. Likewise, food is critical, not only
for general nutrition and well-being, but for people living with HIV, whose medication
must be taken with food. There have been reports of people not being able to take
their HIV medication due to a lack of food.

Across most of the countries we reviewed, governments have largely made appropriate
exceptions in public health orders and laws to allow people to access food and
health care, but not shelter. In practice, however, examples exist in many countries of
challenges imposed by public health orders on people’s ability to meet these basic
needs, particularly among vulnerable groups. These examples reflect a global trend of
difficulties experienced by vulnerable groups in accessing essential health care, shelter
and food due to lockdown measures, despite exemptions to restrictions.

Health care
Globally, communities are facing barriers to accessing health care due to lockdown
measures. For example, the United Nations Population Fund (UNFPA) has warned
in a Lancet article that there potentially will be thousands of deaths worldwide
from unsafe abortions and complicated births due to inadequate access to
emergency care; it also suggested that mobility restrictions have prevented people
from accessing sexual and reproductive health clinics. All 12 countries with
lockdowns have explicit exceptions in their regulations to allow people to purchase
food and essential goods. In Chile, Kenya and Uganda, however, lockdown measures
initially did not contain explicit exceptions allowing people to seek emergency
medical care as needed, in some cases requiring them to first register or request
official permission to do so. In Colombia, El Salvador, Kenya and Uganda curfews or
travel restrictions are reportedly created barriers to people seeking medical care,
sometimes with tragic results.

Uganda’s lockdown order, for instance, required people to seek special permission
from a resident district commissioner to travel in private vehicles, even to hospitals
in cases of emergency. Reports indicate that the officials who can provide this
authorization are often absent and unreachable, and the public vehicles that take
people to the hospital are too few and take too long to arrive. According to
reports from nongovernmental organizations, at least 11 pregnant women have died
since the ban came into effect, some while walking to reach a hospital, and the
media have reported that multiple infants and children have died. The President
of Uganda has acknowledged the problem, and he has issued a directive
indicating that resident district commissioners should put in place a response system
so that they do not have to issue the permissions themselves. Uganda also has made
efforts to increase the number of public vehicles to take people to hospitals.
On 20 April, the Government of Uganda declared “visibly pregnant women” should
be allowed to travel without permits—but this exception does not help other people
who need urgent care, including women in the early stages of pregnancy who require
medical care.

Additionally, although Ugandan health workers are legally allowed to travel to work,
the ban on private vehicles is making it difficult for them to do so. Though essential
workers can travel, they require a permit to do so. The Ugandan Medical Association reports that there have been delays in receiving these permits and that, in the interim,
doctors who drive without them have been beaten, arrested and tortured.
As a result, Uganda’s health-care workers “are taking extraordinary measures to get to
work, commuting by foot, bicycle and in at least one case by canoe”.

In El Salvador, the media have reported that shutting down public transport initially
created many obstacles for essential workers, including health-care workers, to reaching
their workplaces, and for people seeking food and medical care. After this decree was
challenged in court, the Government reactivated public transport for health-care workers, and it provided free transport to and from hospital for anyone with a chronic
disease (e.g., cancer, HIV and diabetes), but not for pregnant women.

Kenya required people to seek official permission to leave home during curfew, even
for medical emergencies. A nongovernmental organization survey found that
58.5% of Kenyans in 12 counties were unable to access emergency medical care
during curfew hours due to closures of community health centers, lack of transport
to hospitals, and fear of police harassment for being out after curfew. People
living in informal settlements were especially affected because they were initially
unsure about what to do if they fell sick at night and how they could obtain official
permission or escort to the hospital, calling attention to the need for (at a minimum)
clear public communication. Other reports indicate that violent curfew
enforcement by police officers has interfered with people’s ability to find transport to
hospitals after curfew, particularly in rural areas. According to one report, police
beat a motorbike taxi driver to death after he took a woman in labor to the hospital
during curfew hours. In response, the Kenyan Government has partnered with
civil society and the private sector, including taxi company Bolt, to create the Wheels
for Life program, which provides pregnant women and other people who need
emergency care with free, officially sanctioned transport to hospitals during curfew
hours (140, 141). The reach of this program outside urban areas is not clear,
however, and respondents to one survey have reported that emergency response
teams fear going into some areas at night.

Food and health care for high-risk and vulnerable people
Governments have a particular obligation to ensure that people in higher risk
groups, and people in need of special assistance due to lockdown restrictions, are
able to access food, medical care and other essentials. Certain groups, including
people in prison, older people, and people living with chronic health conditions and
disabilities, are at higher risk from COVID-19 due to their particular circumstances.
Very often, these people rely on caregivers, whether family, friends or health and
social workers, for day-to-day support, and they may not be able to obtain food, take
medication or bathe without assistance. WHO has reminded governments that these
groups warrant specific consideration to preserve their dignity and well-being during
lockdowns.

Governments around the world are strongly advising older people and people
with health vulnerabilities to stay at home. Some countries, including Argentina, Chile, Colombia and Jamaica, have introduced stricter restrictions for these groups than for the general public. Of the 12 countries with lockdowns, only six included specific exemptions explicitly allowing people to provide assistance to family members and neighbors in need: Argentina, Brazil, Chile, Colombia, El Salvador and Peru. Jamaica has no such exemption, but the Government has created a helpline that seniors (who are
mandated to stay home) can call for help accessing food, medicine and other
essential supplies. The city of Buenos Aires, Argentina, has done the same.

Botswana has a lockdown exemption allowing people to assist elderly or sick people
to obtain medical care or social protection packages, but not to purchase food.

Early in the COVID-19 pandemic, the Government of Uganda ordered people not to
use personal or family vehicles, including for transport to hospitals, as this might spread
the virus. According to the Government, this ban was in response to individuals
using their private vehicles as taxis once public transport was halted. Instead, people
were instructed to wait for an official vehicle to transport them. The lack of available
vehicles caused significant and sometimes fatal consequences. In one case, a nurse
reportedly wheeled a patient two kilometers from a local clinic to the hospital after
waiting more than four hours for an ambulance.

Marginalized communities and communities often left behind, including some
indigenous populations, have seen a lack of COVID-19-specific information and
services in some cases. The National Organization of Andean and Amazon Indigenous
Women of Peru reported that in addition to ongoing problems in Peru’s health policies
towards indigenous peoples, understaffed facilities in remote sites and lack of access to
adequate information, especially in local languages, have been critical issues.

Shelter
Lockdown restrictions can leave people displaced, with nowhere to go and
no provisions made for them in law. Across the world, populations living with
or vulnerable to HIV—such as key populations, migrants, women and girls, and
economically disadvantaged groups—all face specific issues of discrimination,
violence or stigma that can leave them at higher risk of homelessness and/or in
need of alternative, safe forms of shelter.

During lockdowns, there have been evictions and demolitions of informal housing,
placing people in precarious situations from a public health and legal perspective,
and prompting the Special Rapporteur on adequate housing as a component of
the right to an adequate standard of living, and on the right to non-discrimination
in this context to issue a statement prohibiting evictions during the pandemic.
As described under Recommendation 2, sex workers and LGBTI youth are facing
the loss of safe housing or even arrest when staying in a shelter. For LGBTI people,
family homes may not be a safe place to live, and other options may not be available.
In Uganda, the 23 people arrested for breaching COVID-19 restrictions were doing so
because they had nowhere else to live.

In the countries reviewed, there are similar examples of evictions and loss of
shelter. UN Special Rapporteurs have received reports from Kenya about mass
evictions, despite the Government’s announcement that it would establish a
moratorium banning them during the COVID-19 crisis. Around 8,000 people were
forcibly removed from Kariobangi and their houses flattened, despite a court order
restraining authorities from conducting the eviction. In South Africa, there have been repeated reports of demolitions by local governments in the Cape Town and Thekwini metropolitan areas, despite the national government issuing regulations stipulating that evictions during COVID-19 are unlawful.

In Peru, hundreds of thousands of people who travelled to Lima for work have lost
their means of support and can no longer afford to remain in the city. When the
Peruvian Government shut down interprovincial transport in March, it gave people
only one day to return home. Regional governments have been allowed
to arrange transportation to bring people home, and the national government
has arranged some temporary shelter and provisions for people who are unable to leave, but in early May, the waiting list for transport still contained more than
170 000 people. Many attempting to return home have no choice but to walk. Reports
describe convoys of hundreds of people trekking for hundreds of hours “up the hair raising Central Highway” into the Andes.

In Chile, public transport is still running, even in the municipalities with lockdowns.
Regulations allow people caught behind cordons sanitary to return home, provided
they agree to be quarantined for 14 days after arrival.

Take proactive measures to ensure people, particularly from vulnerable groups, can access HIV treatment and prevention services and meet other basic needs
Beyond making exceptions to movement restrictions, this report details specific
measures governments are putting in place to support the realization of the
rights to health, food and clean water. Globally, countries are seeing documented
disruptions in HIV treatment or prevention. Countries are expanding
differentiated service delivery options, but more aggressive policy shifts are needed
to ensure access, particularly to harm reduction services. Countries are improving
access to water and food through distribution and placing temporary regulations
and restrictions on the private sector. The breadth and scale of the need, however,
are often outpacing capacity. Governments and international financing agencies
should implement diversified service delivery and speed up emergency funding
and policy shifts.

Including exceptions to movement orders is necessary, but proactive efforts are also
required to create alternative avenues for accessing basic needs while complying with
public health advice. A full review of the range of socioeconomic policies and supports
that governments are putting into place is beyond the scope of this report, but we
note three particularly urgent areas for action amid early responses to COVID-19:
access to HIV services, water and food. International human rights law obligates
governments to protect, respect and fulfil these as rights, including non-discrimination
in the enjoyment of the right to health. WHO has advised governments to develop a
“plan to safely maintain essential health services” during the COVID-19 response.
Likewise, guidance from the International Labor Organization and the UN calls on
governments to provide “targeted social assistance for the most marginalized and
vulnerable” to ensure the availability of food, water and sanitation.

Preserving and extending access to HIV treatment and prevention
services, including harm reduction
UNAIDS and WHO have warned of the real risk that access to vital HIV, tuberculosis
and harm reduction services may be disrupted during the COVID-19 pandemic.

Interruptions in HIV and tuberculosis treatment are particularly
dangerous, since they can lead to treatment failure and HIV and tuberculosis
transmission. “Where public transport may be halted and business operations
shut down, access to medicines and services—including antiretroviral therapy,
pre-exposure prophylaxis, opioid substitution therapy, sterile needles and syringes
and other harm reduction services, mental health care and medication for other
chronic conditions—must continue uninterrupted”. Disruptions to prevention and
treatment services could also have disastrous effects. A UNAIDS and WHO modelling
study of COVID-19-related service interruptions estimated that a six-month disruption
of antiretroviral therapy could lead to more than 500,000 additional deaths from
AIDS-related illnesses.

The multi-sectoral approach that has been key to progress in the HIV response will
again be critical, both in ensuring the continuation of HIV services and for pursuing
the broader COVID-19 response. Governments must work with communities
to find solutions for people who cannot access treatment and harm reduction
services. All HIV services, including harm reduction services, should be defined as
“essential services” that save lives, and they must remain open, with workers classified
as essential health-care personnel.

Reports from across the globe indicate that COVID-19 is creating significant barriers
to accessing HIV services. A study undertaken by UNAIDS, the LGBT+ Foundation,
the Johns Hopkins Bloomberg School of Public Health and others looked at the
experiences of more than 20,000 LGBTI persons in 138 countries and found that
21% had experienced “interrupted or restricted access” to refills of antiretroviral
therapy, and 42% of those had less than a one-month supply on hand. It also found
disruptions to pre-exposure prophylaxis (PrEP) supply and HIV testing, and that racial
and ethnic minorities had lower access to HIV services. A survey by the Global
Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) showed that 85% of
HIV programs reported disruptions to service delivery, with 18% showing high
or very high disruptions. Qualitative data indicate that lockdowns, restrictions on
gatherings of people and transport stoppages are the main reasons that activities
have been cancelled or delayed. WHO reported on 6 July that 36 countries—
home to 45% of people receiving antiretroviral therapy—had reported disruptions in
the provision of treatment since April.

Data gathered by UNAIDS for this report show similar interruptions in HIV prevention
and treatment services in 11 of the 16 countries reviewed: Argentina, Botswana,
Brazil, Cameroon, Chile, El Salvador, Jamaica, Nigeria, Peru, South Africa and Uganda. There have been disruptions to condom distribution in Botswana, Cameroon,
El Salvador, Jamaica, Peru and Uganda; to PrEP in Peru and Uganda; to self-testing in
Uganda; and to prevention of vertical transmission services in Cameroon, El Salvador
and Uganda. In Argentina, Brazil, Chile, El Salvador, Peru, South Africa and
Uganda, facilities where people access HIV treatment have been closed or had
their hours reduced, or facility space and staff members have been reassigned to
the COVID-19 response. In some parts of Brazil, the cancellation of medical
appointments for new patients at the beginning of the COVID-19 pandemic created
an obstacle for people starting PrEP.

On an individual level, lockdown restrictions (including reductions in public transit
services) and people’s fears of entering health-care settings where they might be
exposed to the virus that causes COVID-19, are making it more difficult for people
living with HIV to pick up their medicines. For example, in Gauteng province,
South Africa, the Department of Health reports just under 11 000 people have not
picked up their antiretroviral medicines since the country’s lockdown began, a 20%
reduction in medicine collections.

To address the problems of access during COVID-19 lockdowns and physical
distancing efforts, UNAIDS and WHO recommend that “a people-centered approach
to access to medicines must be maintained throughout the outbreak”.
This approach, which falls under the banner of “differentiated service delivery,”
encompasses a set of strategies designed to minimize the number of trips that
people living with HIV have to make to clinics, and make services more readily
available in the community, with the double advantage of helping people stay at
home and reducing demand on the health system. Two of the main strategies
are providing people living with HIV with a three- or six-month supply of antiretroviral
medicines (multi-month dispensing) and enabling people living with HIV to pick up
their medicines at convenient locations in the community or have their medicines
delivered to them (community antiretroviral therapy distribution).

According to UNAIDS data, as highlighted in Table 2, five countries have community
antiretroviral therapy distribution policies that are being implemented nationwide:
Cameroon, Ethiopia, Kenya (not fully implemented in village settings), Nigeria
and South Africa. The Central African Republic has adopted a community
antiretroviral therapy distribution policy, although this is not yet being implemented.
Brazil, El Salvador and Uganda are piloting community antiretroviral therapy in some
places. Botswana, Brazil, Cameroon, the Central African Republic, El Salvador,
Ethiopia, Kenya, Peru, South Africa and Uganda have multi-month dispensing for
HIV treatment. In March 2020, the Chilean Government announced that it
would move to multi-month dispensing for the first time, although this has not been
implemented systematically.

Many countries report that supply chain problems are a major obstacle to fully
implementing multi-month dispensing, with COVID-19 exacerbating these issues,
such as in South Africa, which was transitioning to a new first-line HIV treatment
regimen when the outbreak happened. Countries that do not offer multi-month
dispensing cite supply chain problems as the major reason for not doing so. In some
cases, this may mean that multi-month dispensing is available in some parts of a
country but not others, or for some treatment regimens but not others.

Having differentiated service delivery policies does not guarantee that people
living with HIV can access those services. In addition to supply chain problems,
communication breakdowns between health officials and pharmacies and the
stresses that the COVID-19 response is placing on the health system create barriers
to access at the local level. In Chile, one woman reportedly heard the
Ministry of Health’s statement that she should be able to receive multiple months
of medication, but when she went to the local hospital, “they told me that it’s a lie
and that because I am from [this area] I have to come every month to look for my
medications”. Chilean activists are mobilizing to address the problem. One man
filed an appeal for protection with the Court of Appeals in Santiago to order the
Ministry of Health to fulfil its promise to provide multi-month dispensing. The
National Network of Indigenous People Living with HIV issued an open letter to the
Minister of Health complaining about stock-outs and the lack of HIV services and
asking for a dialogue to solve the situation. A nongovernmental organization
has set up an observatory to monitor access since the lockdown started to
antiretroviral medicines and HIV-related services for people living with HIV.

An online survey undertaken by UNAIDS of 2300 people in 28 countries in Latin
America and the Caribbean found that seven in 10 respondents do not currently
have enough antiretroviral medicines for a lockdown of more than 60 days. Five in
10 respondents reported difficulties in obtaining antiretroviral therapy during the
pandemic. There is also an indication that fear of HIV-related stigma and discrimination is increasing: the same survey found that 56% of respondents believed they could
experience physical, psychological or verbal violence due to living with HIV in the
midst of the COVID-19 pandemic. Fear of HIV-related discrimination also caused three
in 10 respondents to stop accessing services in the midst of lockdowns.

Communities are uniting to find solutions. In Ethiopia, people living with HIV worked
with the Government to expand multi-month dispensing and introduce community
antiretroviral therapy distribution policies that allow people who are deemed,
according to current evidence, to be at lower risk of acquiring COVID-19 to collect
medications for other people. The Government has agreed to this in the guidance,
although it had not yet been implemented. In Nigeria, treatment access groups
are coordinating and using motorbike riders with travel permits to deliver medicines
to people who live far away from treatment centers. In Lagos, Nigeria, advocates
are working to ensure that people from other states and countries who cannot get
home due to border closures are able to get medicine refills. In Kenya, Peru and
Uganda, communities have set up virtual peer support groups to promote adherence
and help people obtain their medications.

Continuity in access to harm reduction services is critical, and more proactive
responses are needed. Although there are reports of expanded flexibility in opioid
substitution therapy, according to UNAIDS data, none of the 16 countries we
reviewed allows take-home doses of opioids in response to the COVID-19 pandemic,
and only South Africa is permitting secondary distribution or distribution of large
volumes in needle–syringe programs. Enrolment in South Africa’s opioid
substitution therapy programs has increased since the start of the lockdowns, with
one program in Pretoria adding more than 600 people.

Government action to ensure access to HIV services
Since the onset of the COVID-19 pandemic, governments have taken
a wide variety of measures to ensure the continuity of HIV services and
safe access to them. Two are mentioned above: multi-month dispensing
and community distribution. In addition, a number of governments have
informed UNAIDS of various approaches taken in the past few months to
reduce disruptions to services. What follows is a small selection of those
policies, as they were communicated to UNAIDS.

In Botswana, in addition to existing social services, the Government reports
that it undertook a comprehensive assessment of households to determine
food relief requirements, particularly those in the informal sector, leading
to the employment of 952 social workers on a temporary basis. At the time
of writing, 537,466 households have been assessed countrywide; of those,
426,740 have been recommended for food relief, while 429,255 have
already been assisted with food hampers (toiletries inclusive).

Brazil has taken measures to ensure the continuity of HIV services,
including: (a) extending the validity dates of antiretroviral medicine forms;
(b) implementing telemedicine services; (c) beginning to offer HIV tests
for patients with respiratory syndromes; (d) recommending that people living with HIV who have undetectable viral loads reduce the frequency of
their consultations; (e) offering antiretroviral therapy for foreigners unable
to return to their countries of origin due to travel restrictions related to
the COVID-19 pandemic; and (f) beginning to coordinate the national
expansion of self-testing with states and municipalities.

In Chile, pharmacies in public hospitals have been reorganized and moved
to other spaces to ensure the continuity of antiretroviral therapy provision,
and monitoring has been undertaken to ensure all antiretroviral medicines
continue to be dispensed, with 33 of 44 centers dispensing for two to three
months at a time. Chile is also piloting community antiretroviral medicine
distribution through public health centers or home delivery.

In Colombia, the National Government has provided subsidies of more
than US$ 270 million for electricity and natural gas for the poorest
households. It has also suspended the execution of eviction orders and
provided financial relief for more than 300,000 families, which have been
given financial relief for housing.

The Government of El Salvador is providing free antiretroviral medicine
for two months and extending the dates and repeats of prescriptions to
reduce trips to the hospital. It has instituted home delivery of antiretroviral
medicines through a variety of mechanisms, and it is providing food
support for families in need and free antiretroviral medicines for
foreigners who are unable to travel home due to the lockdown.

Jamaica has created new homeless shelters for those in need during this
time, and it has found innovative ways to prevent and respond to child
abuse, including through alternative modes of outreach using social
media, virtual engagements and community motorcades.

In Peru, immediate measures were taken to ensure the continuity of
care for people living with HIV and their access to antiretroviral therapy,
including three-month dispensing and the creation of six new HIV
treatment centers. It has also prioritized the identification of respiratory
infections and the handling of suspected cases of COVID-19 among
users of HIV services.

In Uganda, the National Task Force prioritized providing food to the most
vulnerable communities living in Kampala, including people living with
HIV. The Ugandan AIDS Council also engaged District Task Forces to
include people living with HIV as members, ensuring they are partners—
and not just beneficiaries—of HIV and COVID-19 services.

Access to food
Nutrition and HIV are strongly related to each other. For people living with HIV,
malnutrition and food insecurity reduce HIV treatment adherence: this impacts both
their health and increases their risk of transmitting HIV, because stopping treatment can
increase a person’s viral load, thus increasing their chance of transmitting the virus. Food
insecurity can also increase HIV risk behaviors, potentially putting people at increased
risk of acquiring HIV. Argentina, Botswana, Chile, Colombia, El Salvador, Nigeria, South Africa, Uganda, and some local governments in Brazil have introduced or expanded food distribution
programs. Nigeria provided a two-month supply of food to people residing in
camps for internally displaced people; in Lagos State, the Government has partnered
with civil society to provide food and necessary items to vulnerable groups, including
women, young people and more than 1,250 households of people living with HIV.

Botswana and Uganda have said they are prioritizing food distribution to
vulnerable families or people who have lost work due to the lockdowns. Argentina,
Botswana, El Salvador, Malawi and Nigeria have taken steps to stabilize food prices,
such as by imposing price controls.

Unfortunately, as is the case everywhere, the need for assistance is outstripping the
scale of the problem. Globally, the World Food Program (WFP) has stated that
this is the largest humanitarian response in its history, but it has only received 9% of
its stated required total funding to provide essential food assistance. The Red
Cross has commended food distribution efforts in Kampala, Uganda, but in northern
Uganda, there are reports that more than 1,000 people living with HIV have abandoned
treatment due to lack of food. On 18 May, in response to street protests
over a lack of food, the President of Chile announced the Government would deliver a
“historic” 2.5 million baskets of food and cleaning supplies to vulnerable communities,
including people living with HIV and key populations, within two weeks.
As of 11 June 2020, the Government had reported delivering more than 1,215,000
boxes, including more than 130,000 delivered in one day. Colombia
has seen similar protests, followed by similar pledges from its Government to scale
up assistance to reach the estimated 750,000 people who are going hungry.
But hunger moves faster than aid: across the country, people who need food hang
red cloths from their windows and wait; in some cities, the cloths blanket entire
neighborhoods. Distribution of large-scale relief requires careful monitoring
and oversight. In Uganda, four officials from the Office of the Prime Minister were
arrested for procuring food at inflated prices. In South Africa, more than 100
national groups came together to raise concerns about corruption and call for greater
transparency in the COVID-19 response. On 23 July, the President of South
Africa announced that an operation hub had been created to investigate allegations of
COVID-19-related corruption.

COVID-19 has represented a real threat to indigenous populations in Latin America.
Lockdown measures in El Salvador reportedly prevented indigenous people from
farming for livelihood or selling their agricultural products at local markets.
In addition, in Colombia, Amnesty International reported that even with a governmental
mandate to provide food to indigenous people during a “state of economic, social
and ecological emergency,” several weeks after the quarantine was imposed many
communities stated they had received no support from government authorities, despite
their strict compliance with isolation measures.

According to media reports, the Government of Brazil has not adequately responded
to indigenous people’s requests for pandemic aid to be delivered to their isolated communities in a safe manner, leaving them with no alternative but to travel to cities
to obtain social benefits and then return to the forest, taking the virus with them.
The Government, however, has reported providing food baskets and other supplies
to a number of villages, in addition to other support for indigenous populations.
After indigenous rights organizations and six political parties filed a petition with the Brazilian Supreme Court, a judge ordered the Federal Government to make emergency measures to protect indigenous communities.

Access to water
WHO emphasizes that COVID-19 infection prevention measures such as frequent
handwashing are “dependent on access to safely managed water, sanitation and
hygiene (WASH), particularly for vulnerable communities”. For people living
with HIV, access to clean water and sanitation can be critical, particularly in relation
to opportunistic infections and the effectiveness of treatment. Despite this,
2.2 billion persons globally do not have access to safe water services, 4.2 billion do
not have safely managed sanitation services, and 3 billion lack basic handwashing
facilities. In the regions reviewed for this report, a quarter of the people in Latin
America and the Caribbean and 40% of people in sub-Saharan Africa lack reliable
access to a safe water supply. This problem is particularly acute for people
who live in informal settlements and people with disabilities. This crisis
is being exacerbated by ongoing droughts in southern Africa and parts of South
America.

The governments of Chile, Colombia, El Salvador, Jamaica, Peru and Uganda have declared that water companies may not suspend people’s non-payment of bills. Argentina, Botswana, parts of Brazil, Colombia, EWl Salvador, Malawi, Peru, South Africa and Uganda are working to expand their water supplies, such as by distributing water through tankers or offering financial assistance to help people pay their water bills. Brazilian utility company Companhia de Saneamento de Minas Gerais is easing drought rationing to ensure continuous
water supplies. The South African Government is providing temporary homeless
shelters that meet necessary hygiene standards, and it has also distributed 77,000
water tanks and 1,200 water trucks to villages and townships across the country. Malawi’s COVID-19 response has planned to allocate US$ 5.6 million towards longer term water distribution solutions, including repair of existing water sources and construction of new solar-powered sources.

The human right of access to clean water is particularly imperiled when people
must compete with the agriculture industry for limited water supplies. In Colombia,
COVID-19 has prompted the Government to redirect some of the water usually
allocated for agriculture to increase the human water supply. In the parched
agricultural region of Petorca, Chile, however, families were restricted to
50 liters of water per day—half of the WHO recommended amount.
The Chilean Government has acknowledged the problem, and in early April, it
announced it would increase the daily water supply to 100 liters; this plan was
reportedly later abandoned. In response, civil society activists have petitioned the Inter-American Commission on Human Rights to intervene.

Rapidly reduce overcrowding in detention settings and take all
steps necessary to minimize COVID-19 risk, and ensure access to
health and sanitation, for people deprived of liberty
Nearly all of the countries reviewed for this report have released some people from
prisons to address overcrowding and reduce the spread and risks of COVID-19
among people deprived of liberty. Some countries have reduced overcrowding
significantly, but in many settings, the releases have been too small to have a
significant impact. This report details examples where ill-treatment of people in prison
is likely to drive the spread of COVID-19. Testing and medical care are significant
problems for many people in prison during the pandemic. Where lockdowns cut off
family support, there are further rights concerns. Governments should ensure release
of people at particular risk of COVID-19 where possible, people whose crimes are
not recognized under international law, and any other people who can be released
without compromising public safety, such as those sentenced for minor nonviolent
offences, with specific consideration given to women and children.

In March 2020, the UN Secretary-General stated that because of the serious risks
of COVID-19, imprisonment should be a last resort during the pandemic.
Since then, UN experts have underlined how COVID-19 has “heightened vulnerability
of prisoners and other people deprived of liberty” and encouraged governments to
take all appropriate public health measures to address COVID-19 in prisons.
OHCHR, UNAIDS, UNODC and WHO have urged governments to create release
mechanisms for people at particular risk of COVID-19, such as older people and
people with pre-existing health conditions, and others who could be released without
compromising public safety. It is essential to abide by international human
rights standards on the treatment of prisoners. The obligation to ensure
health, safety and dignity applies “irrespective of any state of emergency”.
In many prisons, physical distancing, handwashing and access to disinfectant
are difficult or impossible, and personal protective equipment for prisoners and
staff is in short supply. As noted by OHCHR, UNAIDS, UNODC and WHO, “prison
populations have an overrepresentation of people with substance use disorders, HIV,
tuberculosis (TB) and hepatitis B and C compared to the general population. The
rate of infection of diseases in such a confined population is also higher than among
the general population. Beyond the normal infectivity of the COVID-19 pandemic,
people with substance use disorders, HIV, hepatitis and TB may be at increased risk of
complications from COVID-19”.

Overcrowding constitutes an insurmountable obstacle for preventing,
preparing for or responding to COVID-19 . . . We urge political leaders to
consider limiting the deprivation of liberty, including pretrial detention,
to a measure of last resort, particularly in the case of overcrowding, and
to enhance efforts to resort to non-custodial measures.
— UNODC, WHO, UNAIDS and OHCHR

Despite the many calls for the release of prisoners, one study estimates that while 109
countries had adopted decongestion policies by June 2020, only 639,000 prisoners
had been released globally, representing only 5.8% of the global prison population. In 15 of the 16 countries reviewed for this report, governments, through
executive or judicial action, have released people from prisons to reduce overcrowding
and stem COVID-19 transmission; El Salvador is the exception. The Ethiopian
Government reported releasing 40,000 people from prisons as of May 2020.
The Supreme Court judicial prosecutor in Chile reported that a third of the country’s
prison population had been released as of June 2020. Efforts in some contexts
have been slow, however, and often not at a scale commensurate with the magnitude
of overcrowding. In Brazil, judges released 30,000 people early in the pandemic, but
this represented only 4% of the overall prison population. In Nigeria, the interior
minister called for a “massive decongestion” of the country’s extremely overcrowded
prisons in March. Civil society organizations have complained about the sluggish
speed of the process of selecting and releasing people from prisons.

Where releases have occurred, civil society groups have noted that women have
been largely absent from the releases. For example, Penal Reform International noted
that in Nigeria, only one of 2,600 people released was a woman.

UNODC has indicated justice system officials should make decisions that contribute
to reducing incarceration rates during the pandemic, including allowing alternatives
to pretrial loss of liberty, the commutation or suspension of sentences, and other legal
mechanisms (263). Many people have been detained, however, for violating curfew
orders or failing to wear masks. Reports indicate that thousands of Salvadorans have
been arrested and detained for an indefinite period of time for violating lockdown
measures, even though the decrees establish 14-day containment as a sanction. This has continued, even though the Supreme Court ruled this to be unconstitutional.

The El Salvador Ombudsperson’s Office reports that people were being held in
overcrowded detention centers. Detainees lack appropriate access to food, water
and medical treatment; many are being forced to sleep on the ground; and there
are no measures in place to separate higher risk people from other detainees.
The Government of El Salvador announced that people held in these centers will not
be a priority for testing, even though this is a criterion for their release from detention. El Salvador also exacerbated the risks of COVID-19 transmission in prisons.
In April 2020, in response to a wave of gang-related homicides, Salvadoran authorities
initiated a crackdown in several of the country’s prisons, forcing people to crowd
together on the ground, photos of which were shared publicly by authorities. OHCHR
has said this “could amount to cruel, inhuman or degrading treatment, and could also
exacerbate the already precarious hygiene conditions”.

The UN Secretary-General and other experts have underscored the importance of
a gender-responsive approach to addressing COVID-19 among people in prisons
and other closed settings. In many countries, people in prison are reliant
on family visits for basic necessities, which may impact women more directly.
Many countries have disproportionately high incarceration rates of prisoners with
disabilities, particularly intellectual and psychosocial disabilities. Countries should
work to ensure that prisoners with disabilities have access to legal avenues for release
due to COVID-19 vulnerability, if applicable, and continuity of access to medical care
and other services.

It is crucial to ensure access to COVID-19 testing in prisons around the world to
efficiently address hotspots when they occur and to ensure adequate access to treatment. In many prison systems around the world, too few clinical or medical
staff are available for the overall number of people in prisons, and decisions
regarding access to medical care are often left to people without appropriate
training. For people in prisons to receive the same standard of health as mandated
by the United Nations Standards on the Treatment of Prisoners (“Mandela Rules”),
timely access to medical care and testing remain critical.

Implement measures to prevent and address gender-based
violence against women, children and lesbian, gay, bisexual,
transgender and intersex people during lockdowns
Nearly all countries have seen significant increases in reports of gender-based
violence, and yet none of the lockdown restrictions we reviewed explicitly allow
people to leave home or change domiciles to escape such violence. Governments
should expand services, allow the movement of people to escape abuse and support
people seeking assistance. UNAIDS, UNESCO, UNFPA and WHO have warned that the
pandemic is intensifying the risk of gender-based violence. Closed schools
and work-from-home orders keep people in constant close proximity to their abusers,
while increased fear, anxiety, stress, economic pressure and social dislocation can put
women and children and other vulnerable people at increased risk of abuse.
Intimate partner violence in areas of high HIV prevalence is associated with women
being 50% more likely to be HIV-positive. Meanwhile, men who are perpetrators
of violence against women tend to be at higher risk of HIV themselves, and to use
condoms less frequently, thus increasing the risk of HIV transmission. Abuse during
pregnancy also makes it less likely that women will seek HIV testing or services to
prevent vertical transmission to newborns. In addition, being HIV-positive is a trigger
for violence, with women living with HIV frequently reporting experiences of violence
or fear of violence, including from intimate partners, and such situations will only be
exacerbated by the COVID-19 pandemic and the related lockdowns.

UNFPA warns: “as systems that protect women and girls, including community
structures, may weaken or break down, specific measures should be implemented
to protect women and girls from the risk of intimate partner violence with the
changing dynamics of risk imposed by COVID-19 . . . Obstacles and barriers must be
addressed, enabling women’s and girls’ access to services, including psychosocial
support services, especially for those subject to violence or who may be at risk of
violence in quarantine . . . Gender-based violence referral pathways must be updated
to reflect changes in available care facilities, while key communities and service
providers must be informed about those updated pathways”.

According to the United Nations Entity for Gender Equality and the Empowerment
of Women (UN Women), emerging data indicate that all types of violence against
women and girls, particularly domestic violence, have intensified since the outbreak
of COVID-19 across the globe, with increases in calls to domestic violence hotlines in
many countries and limited access to support. For the countries in this review,
all 12 countries with lockdowns have recorded increases in gender-based violence,
reflecting the broader global trend.

Given the challenge of timely information collection, the true situation is likely to
be much worse than we know. In most of these countries, reported incidents have
increased by 40–70%, with even greater spikes in certain municipalities, including
Bogotà, Colombia (225%) and Providencia, Santiago, Chile, which has a population
of just over 140,000 people (500%). The Central African Republic, which
does not have a full lockdown, has seen a 24% increase in reports of gender-based violence cases. Additionally, Botswana, Kenya, Peru and Uganda have recorded increased incidents of child sex abuse. There are also concerns that lockdown measures may be making it more difficult to report situations of abuse. Although official records in Jamaica show a decline in reports of child sex abuse, for example, experts working for national child welfare institutions are concerned that while reports continue to come in through WhatsApp and toll-free lines, children could be in situations where the pathways for identifying or reporting abuse are currently less accessible due to the closure of schools, and that abuse is most likely taking place at home or at the hands of relatives.

Government lockdown policies that designate days to leave the home by gender have
also led to additional discrimination, harassment and violence by private and public
actors. In Colombia, there were reports of transgender people unable to access public
services because they were out on the day that corresponds to their gender identity
rather than the gender marker on their identity documents. The Colombia
rights group Red Comunitaria Trans said it had received 18 discrimination complaints
since the measure began, including complaints of violence against transgender
people out on the “wrong” day.

In some countries, there are promising signs that awareness of gender-based
violence as a pervasive problem is during lockdowns. For example, a Colombian
nongovernmental organization describes how “neighbors began reporting cases
of violence like never before . . . This has never happened. I just hope that this never
goes back to being hidden, that violence against women becomes a public issue
because of this surge”. On 30 March, Argentine people took to their balconies,
banging pots and flying purple handkerchiefs for women and children experiencing
gender-based violence.

Governments are aware of the problem and are making efforts to address it. In the
Central African Republic and Jamaica, UNAIDS is working with national governments
and other UN agencies to prioritize gender-based violence in their COVID-19
response programs. Argentina, Colombia, Peru and South Africa have taken steps to prioritize and strengthen the responses of the police and protective authorities and to expedite judicial proceedings against abusers. Argentina, Botswana, Chile, El Salvador, Kenya, Nigeria, Peru and South Africa have strengthened gender-based violence reporting systems by expanding hotlines and offering new WhatsApp, text or email reporting options for women who cannot make a phone call within earshot of their abusers. Argentina and Chile have set up code word-based reporting systems, where a woman can go into a pharmacy and ask for a “red facemask” or a “facemask19” and the pharmacist will call for help. The Bogotà Secretariat for Women partnered with FENALCO, the National Trade Federation of Colombia, to create a “safe spaces” strategy, where women can report gender-based violence in supermarkets.

The impact of COVID-19 on services to aid survivors who report gender-based
violence is less clear. Nor did any of the countries we reviewed have explicit provisions
in their lockdown orders allowing people to leave home or relocate to a different
residence if they felt unsafe. In most cases, it does not appear that governments intend
to prevent people from seeking safety—but that message is not necessarily getting
through. One Colombian nongovernmental organization reports that as soon as the
lockdown started, it began getting texts from women saying “my husband is beating
me up, but I’m not allowed to leave”. Gender-based violence shelters were open
and operating in Chile, Peru and South Africa, but we could not determine whether the same was true for the other countries we reviewed. Peru is guaranteeing the provision of urgent care to people experiencing gender-based violence as a priority. The Buenos Aires Government has said it will pay for transfer, new lodgings and medical costs for survivors of gender-based violence.

Even where emergency centers and shelters are operating, the COVID-19 pandemic
creates a host of new challenges. In South Africa, at the time of writing, in order to
be admitted to a shelter, a survivor must first be tested for the novel coronavirus and
await their results in a quarantine hospital. Once admitted, survivors may not be
released from the facility for the duration of the lockdown, visits were not allowed, and
family reunification and interaction programs have been suspended. These
policies may be necessary to protect shelter residents from COVID-19, but they may
also dissuade survivors from seeking help.

The dangers and hardships of lockdowns are particularly acute for members of the
LGBTI community, especially youth, who may be forced to remain in or return to homes
where they are unsafe and unaccepted. As well as physical dangers, nongovernmental
organization and media reports reveal the extreme psychological and emotional toll
that lockdowns are taking on LGBTI youth. For example, a young Brazilian woman
described her experience in her parents’ home: “Being a lesbian made them so
disappointed in me that no matter what I do, it’s never enough. I feel like I’m watching
my life go by through somebody else’s eyes—because I’m not who they want me to
be, but I also can’t be myself when I’m in their house”. In Nigeria, one LGBTI
organization described how it has been overwhelmed by calls from people needing
support; although most requested food and monetary support, “some people just
requested that they don’t really need anything, they just need someone to talk to”.

Designate and support essential workers, including community health workers and community-led service providers, journalists and lawyers
The HIV and COVID-19 pandemics have shown how journalists are critical to
providing people with unrestricted, trusted information, and the COVID-19 pandemic
has highlighted the impact of lockdown measures on communities, such as key
populations and people living with HIV. It also has illustrated the importance of
lawyers for ensuring accountability for a rights-based response, of community health
workers and community-led service providers for reaching marginalized people
(including key populations and other people vulnerable to HIV), and of diversifying
delivery of services, including those for HIV. Most, but not all, governments have
designated these three groups as essential workers, although arrests and harassment
have been documented in several settings. In some countries, there remain major
barriers to these groups working effectively under lockdown orders. Governments
should ensure they are designated as essential workers and are supported to work
safely during the pandemic. This report has already detailed the importance of each
of these groups to ensuring the protection of key populations and other vulnerable
groups, and the role they play in the continuation of services, from representing
LGBTI youth arrested in Uganda, to providing safe access to HIV prevention and
treatment services, to drawing international attention to violence and discrimination
faced by sex workers and transgender persons.

During lockdowns and other periods of limitations on movement, governments
are making critical decisions about which categories of people are designated as
essential and how they will be supported to carry out important functions in the
disease response. Community health workers and community-led service providers,
lawyers and journalists are not always considered essential, but they provide particularly important support for a rights-based response. OHCHR, UNAIDS, UNODC, WHO and other UN agencies have called on governments to categorize these groups as essential workers. As outlined in Table 3, countries have taken a variety of approaches to designating these workers as essential.

Community health workers and community-led services
Community health workers, health promoters, home health aides and health-service
providers from community-led organizations play a critical role in supporting health and
rights in the HIV response, particularly in reaching those who are the most marginalized
and left behind. It is essential that this approach is carried over into the COVID-19
response, both for people living with and affected by HIV and the broader population.

The World Health Assembly resolution called on Member States to include
exceptions in restrictions on the movement of people for “community health workers
to fulfil their duties”. Health professionals are essential workers under public
health orders in all countries we reviewed; however, community health workers
and community-led service providers often lack official recognition, credentials or
certification guaranteeing them recognition. Some are public employees, but others
are less formally employed in the private or nongovernmental sector—and thus
their status, and the protections and equipment they receive, are far more tenuous
if they are not explicitly exempted from limitations on movement. Community
health workers and community-led service providers are particularly critical in
the realization of the right to health under lockdown for people with less access
to health care because of age, rural geography, lack of transport or immigration
status—not only for COVID-19, but also for the distribution of HIV medicines and
other critical health services, including for sexual and reproductive health. Other
service providers from community-led organizations may not be recognized as
community health workers, and yet “community organizations have an unparalleled
depth of experience in creating and delivering responses to health and human rights
crises within their communities. The many community-led networks and groups that
emerged to respond to HIV possess immense practical experience, organizational
strength and unparalleled community access for facilitating the delivery of lifesaving support, and for influencing people’s real-life practices to better protect their
health” (325). UNAIDS has recommended that governments include “the workforce
of community-led health-care services into the lists of essential service providers and
treat them as equivalent to health-care providers”.

Decrees in Argentina, Brazil, Chile, Colombia and El Salvador broadly cover people working in health, which presumably includes community health workers and similar roles (such as health promoters). In Peru, all people working in health services can request a Special Labor Pass. South Africa explicitly exempts all health workers in the public and private sectors from the
lockdown order and has mobilized 28,000 community health workers to lead
screening, testing and contact tracing efforts, but there have been extensive reports
that health workers lack personal protective equipment, with particular
concern for community health workers. In Nigeria, the President’s COVID-19
Regulations explicitly exempt all organizations involved in health care, while the
local order allows for movement to deliver medical supplies. The Nigerian polio
infrastructure has been mobilized for COVID-19 contact tracing, including hundreds
of disease notification and surveillance officers and more than 50,000 community
informants for community sensitization and case reporting Additionally, the
HIV structure, community volunteers and other relevant agencies were mobilized for
community engagement, risk communication and contact tracing.

Journalists
Access to information and transparency is critical to a rights-based response.
People need accurate information about health, and governments need information
about what is happening in communities in order to calibrate effective policy
responses. They play a key role in ensuring that the experiences of people living with
HIV, key populations, and women and girls are brought to light so that action can be
taken to correct violations. The critical principles of accountability of a government
to its people and participation of communities in decision-making are premised on
transparent information. All of these require journalists to be designated as essential
workers under public health orders and for governments to refrain from restricting
their movement and access to information. Freelance journalists in particular often
lack official credentials, making it hard for them to navigate police checks and
limitations under curfews and lockdowns. The UN Secretary-General has
“urged governments to protect journalists and others who work in media, and to
uphold press freedom,” warning that COVID-19 response measures should not be
abused as an excuse to impede journalists’ ability to do their work.

While there is no global database of which countries have designated journalists
as essential workers, the Special Rapporteur on the promotion and protection of
the right to freedom of opinion and expression called on countries to designate
journalists as essential in April 2020, noting that there have been numerous reports
globally of journalists and media workers experiencing intimidation, detention,
questioning and other forms of repression. Most, but not all, countries have
designated journalists as essential workers. In Uganda, for example, the President
explicitly mentioned that “the media people and journalists are very important to this
country” in his order designating all media as essential— although reports of violence
and harassment continue.

In El Salvador, early executive orders failed to explicitly include journalists, but this
was addressed in more recent ministerial orders. In a Presidential Decree,
Brazil recognizes broadly as essential activities “telecommunications and internet”
and “sound and image broadcasting,” so workers from these sectors would be
allowed to go out if the country were to implement a national lockdown.
At the state level, Maranhão, for example, does not mention journalists but
excludes workers in “telecommunication services,” “postal services and internet”
and “social communication services” from the lockdown. Peru excludes
workers from “telecommunication and call center services” and “sound and image
broadcasting services”.

Journalists have, however, reportedly faced arrest and mistreatment under newly
expanded police powers during the pandemic in a range of countries throughout
the world. Concerns about journalist mistreatment were raised by the
Committee to Protect Journalists in the arrest of South African journalist Paul Nthoba
in the Free State. Nthoba was charged with obstructing law enforcement under
the country’s Disaster Management Act. In Kenya, nongovernmental
organizations have reported a rise in reports of attacks on journalists in recent
months, with at least 22 documented in March and April 2020 by the organization
Article 19, and concerns raised by a range of human rights groups about journalists
arrested for violating curfew laws, even though they are officially exempted.
The Association of Journalists of El Salvador reported several examples of journalists
from the Christian Radio and Television Network and Radio La Voz de Mi Gente being
harassed or prevented from reporting by security forces because of the lockdown
order. It is notable that governments in all of these countries have been
responsive to complaints and have revised rules, laws or procedures.

Lawyers and legal services
As the recent joint UN statement on prisons and COVID-19 noted, the right to
legal representation must continue to be fully respected during public health
emergencies. Doing so requires not only that the judiciary continues to function,
but that lawyers and legal services be allowed to continue to operate effectively, travel
as needed, and perform their functions as essential services. As described in the final
recommendation, courts and lawyers have been critical to ensuring the defense of
human rights during the COVID-19 pandemic, including for key populations and other
vulnerable groups. In Botswana, “legal practitioners” are explicitly included under
the definition of “essential services”. In Jamaica, the public health order allows
“any attorney-at-law attending at police stations or lock-ups, or appearing before a court
. . . or attending to a client of the attorney-at law in the case of an emergency arising due
to the SARS–CoV-2 (coronavirus COVID-19) pandemic”.

In many countries, the position of lawyers were much less clear, which can be a barrier to
effective legal services. For example, in Argentina, “personnel of the justice services on
duty”, and in El Salvador, “legislators and staff of the Legislative Assembly” were
exempt from lockdowns; however, lawyers were not explicitly mentioned.

In Chile, lawyers were not part of the exceptions established by the national
government, but to “attend to a judicial hearing in which a lawyer must be to comply
with the law” is one of the reasons people can argue to access the “temporary permit to
move about during the quarantine”.

In Kenya and Uganda, the governments did not include lawyers in the definition of
“essential workers,” even as hundreds of people in both countries were being arrested
and detained for violations of lockdown measures and courts were continuing to
operate in limited ways. This profoundly hampered or removed access to counsel for
many people in need to legal support. For example, in Uganda, the ban on all public
and private transport meant that lawyers could not use any transport means except
walking or cycling to reach their clients. On some occasions, officials have denied
lawyers access to their clients in prison, citing the lockdown as a rationale. In one
case, the High Court of Uganda found that this practice violated clients’ constitutional
rights and awarded them each 5 million Ugandan shillings (US$ 1,350) in damages.

The Kenya Law Society petitioned the Constitutional Court in April and obtained an
order from the court including lawyers as essential workers. The judge specifically found
that lawyers “can be extra vigilant when the State is exercising emergency powers and
offer legal aid to those in need”. In Uganda, the situation left lawyers vulnerable
to arrest for doing their jobs during the most restrictive time of the lockdown. Ugandan
lawyers sued the state on constitutional grounds, but while the court process was under
way, the Government announced that the Uganda Law Society should designate 30
lawyers countrywide who could receive the permission stickers required to use private
transport and provide services as essential workers. This allows only 1 lawyer per
1.4 million Ugandans, however, creating devastating inequities in access to legal help
(358). In Argentina, the Public Bar Association of the Federal Capital appealed for legal
protection, as lawyers have not been part of the exceptions mentioned in any of the
national decrees regulating lockdowns.

Where lawyers have had the ability to operate, they have been able to: innovate; ensure
timely, fair and effective court processes, despite the challenges of COVID-19; and work
to assist and monitor the important work around decongestion of prisons, which are
hotspots in many countries for the spread of the COVID-19. For example, in South Africa,
public interest law organizations came together to establish a hotline for free legal
advice during COVID-19 restrictions.

Ensure limitations on movement are specific, time-bound and evidence-based, and that governments adjust measures in response to new evidence and as problems arise
Most public health orders in these 16 countries are time-bound and specific.
Governments should periodically review public health measures to ensure they are
proportionate, necessary and legitimate and to identify possible rights violations and
problems in addition to those identified above. They should adjust measures to rectify
these problems and incorporate new evidence about COVID-19. Failure to do so can
lead to the continuation of the negative impacts of lockdowns, including LGBTI youth
staying in unsafe family situations, disruptions or barriers to accessing food, shelter or
health services (including HIV services), and sex workers continuing to face arrest.

At the 73rd World Health Assembly, Member States resolved to “ensure that
restrictions on the movement of persons . . . in the context of COVID-19 are ‘temporary and specific’ and ‘time-bound’”. OHCHR advises that governments can
respect these obligations by ensuring that policies limiting individuals’ movements
have built-in review and expiration dates. This means that governments must
proactively decide to extend the restrictions if necessary; otherwise, the law
automatically reverts to its prior state and people can fully exercise their rights.

Most countries have constructed their lockdown policies in this way, including
Argentina, Botswana, Colombia, El Salvador, Jamaica, Kenya, Nigeria, Peru, South Africa and Uganda. In Brazil, the Federal Government has not instituted lockdowns, but lockdowns have been instituted at the state and subnational levels. Chile stands out since it implemented its
nationwide curfew (which lasts from 10 pm until 5 am) indefinitely, with no review date
specified in law.

Problems can arise, however, when orders are of such short duration that successive
orders result in confusion and lack of time for governments or the judiciary to assess
them. For example, in El Salvador, the Constitutional Chamber of the Supreme Court
has been admitting cases for legal revision of several of the restrictions included
in the executive decrees, but it has been unable to keep up with rapid changes in
policies. Human rights law mandates that governments review restrictions
to assess their effectiveness. If measures that restrict people’s rights are not effective
from a public health standpoint, then they can no longer be justified. It may not be
practicable to conduct a rigorous policy evaluation in the midst of a quickly evolving
pandemic, but one way that governments can act on this obligation and ensure
effective policies is by updating them as new scientific information and evidence from
community and other sources become available.

For example, between early April and early May 2020, Argentina, Botswana,
Cameroon, Chile, Colombia, El Salvador, Ethiopia, Jamaica, Kenya, Nigeria, Peru,
South Africa and Uganda adopted new policies requiring people to wear facemasks
in public. Facemasks are also required in some parts of Brazil and recommended (but not required) in the Central African Republic. The Government of Uganda has said it will provide facemasks free of charge for the entire population, but implementing this commitment has been slow, with distribution beginning on 10 June 2020. Only Malawi has no official facemask policy.

While addressing the public health crisis, lockdown policies limit freedom and
impose heavy economic and social tolls. Governments can honor their human
rights commitments by revising lockdown measures to address unforeseen problems
and ameliorate unintentional consequences, especially for vulnerable groups—but we found relatively few examples of governments doing so. Peru initially allowed
people to leave home only on specific days of the week, depending on their gender:
women on Tuesdays, Thursdays and Saturdays, and men on Mondays, Wednesdays
and Fridays. This measure was abandoned after eight days when policymakers realized it was not effective; the country also added a lockdown exception to allow people with intellectual and psychosocial disabilities and a companion to leave home and spend time outdoors more frequently Argentina and Chile have similar exceptions. In Argentina,
children were initially required to stay with one parent, but restrictions were amended
to allow children to travel between the homes of parents who share custody.
In Uganda, under pressure from civic groups, the Government amended movement
restrictions to allow pregnant women to seek care without official permission.

Create space for independent civil society and judicial accountability, ensuring continuity despite limitations on movement Civil society, particularly community-led organizations, and courts in many of the countries reviewed, have helped improve the COVID-19 response where they are
enabled to operate freely by highlighting problems experienced by communities
and both offering and implementing solutions. Governments should include
community-led organizations in their decision-making bodies, including those focused
on gender, equity and human rights, to ensure COVID-19 policies are designed to
support the range of service providers and activities necessary for an effective and
equitable response. This should be before imposing restrictions on movement and
should create space for civil society voices to engage with and monitor the COVID-19
response. Courts should also continue to operate as much as possible to hear cases
where rights issues, particularly liberty interests, are at stake and cases are related to
the legality or constitutionality of the government’s COVID-19 response.

No country or government can solve the crisis alone; civil society
organizations, particularly community-led organizations, should
be seen as strategic partners in the fight against the pandemic.
I am thus concerned by the information I have received from online
consultations with civil society around the world, suggesting several
worrying trends and limitations, including on civil society’s ability to
support an effective response.
—United Nations Special Rapporteur on the rights to freedom of
peaceful assembly and of association.

One of the key lessons of the HIV response has been that civil society advocacy and public interest legal efforts, especially those led by and for communities most affected, play a key role in responding to the pandemic. They increase the potential for accountability, provide a platform for authentic community voices, and bring critical information to light for governments about what is and is not working to advance public health. Engagement with civil society builds trust, ensures suitability and effectiveness, helps to avoid indirect or unintended harms, and ensures the frequent sharing of information. We have also seen this during the COVID-19 pandemic.

The UN Special Rapporteur on the rights to freedom of peaceful assembly and of
association has underscored this, stating “no country or government can solve the
crisis alone; civil society organizations should be seen as strategic partners in the fight
against the pandemic” (383). A joint statement by UN agencies calls on governments
to “guarantee meaningful participation of all sectors of society and diverse civil society
actors in decision-making processes on COVID-19 response”.

Such independent scrutiny is especially critical now, as governments rush to address
the pandemic, planning outside regular channels, often without past experience to
draw on, complex and multifaceted virus mitigation measures. Consultations with and
participation of civil society on government task forces is an important step—but it is
not sufficient. Civil society should have the space and freedom to use a wide range of
tools, without fear of reprisals, to bring expertise to bear and be a credible partner to
affected communities and governments. From the perspective of HIV, for example, it
would be critical to have representation from communities of people who are living
with or vulnerable to HIV—including key populations, women and girls, and migrants—so
that they can flag the specific or disproportionate impacts that lockdown measures are
having on their communities, and so that they can suggest alternatives and indicate
where existing community structures can be mobilized quickly for the COVID-19
response. However, research by WHO indicates that “civil society is hardly involved
in national government decision-making nor its response efforts, and that female
representation in COVID-19 decision-making entities is particularly paltry”.

In a number of countries, civic campaigns are highlighting the serious threat of rights
violations prompted by disproportionately broad public health orders, and in some
instances, these campaigns have prompted life-saving policy and practice changes.
For example, in Uganda, a campaign by civil society and human rights organizations
was able to document multiple cases of the devastating consequences of the severely
restrictive lockdown on access to medical care for pregnant women and children. The campaign ultimately contributed to shifting World Bank policies and
a change in the Government of Uganda’s policy approach to the issue. Building on
this success, organizations have pressed for more expansive access to health care for
other vulnerable groups, such as people living with HIV or tuberculosis, and people
with other chronic illnesses.

In Santiago, Chile, civil society groups urgently warned of a problem of hunger
as protests broke out over lack of access to food. As mentioned
above, in response, President Piñera announced five measures to support the
most vulnerable people, including the delivery of 2.5 million baskets of food and
essential products.

Activists have been able to provide critical insights on proposed measures, helping
to shape COVID-19 response legislation. For example, in Nigeria, civic groups
came together to provide law-makers with a legal analysis of the pending Infectious
Diseases Bill 2020 submitted to the House of Representatives. The groups raised
specific concerns over the bill granting broad, overreaching powers to public health
officials, including the Minister of Health and the Director General of the National
Center for Disease Control. The groups argued that a provision allowing the
Director General to “stop any meeting” on public health grounds lacked statutory
safeguards and was prone to abuse, and “effectively deprives aggrieved persons the
right to fair hearing”.

Civic activism has paved the way for public interest litigation that has buttressed a
country’s rights-based responses. Kenyan lawyers were able to receive a designation
from the judiciary to be deemed “essential workers”.

Such a designation has allowed lawyers to work in a myriad of areas to support
an effective response, including advocating for victims and survivors of abuse and
discrimination. In Malawi, a coalition of human rights organizations won a court
injunction on 17 April 2020 against government plans to impose a lockdown without
first ensuring that vulnerable people had access to food, water and other basic
needs. The Government withdrew its appeal of the injunction on 23 April 2020 and
announced a new aid program for 1 million people and small businesses affected
by the pandemic. While opposing a lockdown order until protections are in
place, civil society groups have nonetheless called on the Government to move
quickly to establish a rights-based plan to enforce distancing guidelines—particularly
during an election campaign that is drawing large crowds.

Conclusion
We know from our experiences with HIV that public health approaches that are not in
line with human rights can undermine a pandemic response. Efforts should be made
to ensure that lessons learned about human rights and community engagement in
dealing with epidemics such as HIV and Ebola are not forgotten and are included
in the design of the ongoing response to COVID-19, not only to ensure an effective
COVID-19 response, but also to avoid undermining other ongoing public health
efforts, including the HIV response. This 16-country review of policy responses
restricting the movement of people as a strategy to halt COVID-19 finds that current
responses in many countries have resulted in significant breaches of rights, including
of people who are living with or vulnerable to HIV—some of which have already cost
lives. Discriminatory enforcement, violence, overly restrictive lockdown orders, prison
overcrowding and overreliance on criminal law enforcement are harmful in and of
themselves, disproportionately impact key populations and are likely to undermine
public health strategies and community trust in government.

The actions of some states show that rights-based responses to COVID-19 that also
support the HIV response and communities are possible. Many states have made
clear provision in public health orders for people to address their basic needs; taken
proactive measures to address access to HIV treatment, food and water; expanded
gender-based violence programming; designated community health workers and
community-led service providers, journalists and lawyers as essential workers to help
build and support community-based and community-led responses; and made space
for civil society and judicial action to improve accountability and effectiveness of the
COVID-19 response.

As governments and communities in countries around the world consider the coming
months or years of the COVID-19 pandemic, there is an opportunity to calibrate
responses for a pandemic likely to see waves of new infections and epidemics
throughout the world for some time to come. In this context, non-pharmaceutical
interventions, including legal interventions to limit the movement of people, will
continue to be used to varying degrees to fight the disease that, at this point, has
neither a vaccine nor highly effective, widely available treatments. In doing so, urgent
consideration must be given to maximizing rights-based approaches that empower
communities and build cooperation, not simply at the local and national levels,
but internationally. In times of crisis, such as a pandemic, the protection of rights
is everyone’s responsibility, requiring international cooperation and assistance to
support national responses that are grounded in human rights.

In the Rights in the time of COVID-19 report, the final recommendation was “to be
kind”. This was not an idle recommendation but a key element of a successful
response. We are in a time of emergency, panic and fear. It is tempting to respond
with strength and force rather than help and cooperation; easier to blame and
stigmatize rather than empathize and support. To do the former is to risk human rights
violations, as we have seen, and an ineffective response. To do the latter is to succeed.

The political implications of COVID-19

As economies and healthcare systems struggle to cope with COVID-19, we share insights on how the coronavirus pandemic is shaping political agendas across the world.

An infectious disease outbreak turning into a global pandemic has long been on the radar of public health experts and government agencies, who have sounded dire warnings about the likelihood and impact of such an event. The pandemic is now here. It has exposed fraught national public healthcare systems as well as the sharp divides in global politics. It has sparked debates, pitching globalism versus nativism and populist governments versus experts, while the policies of many global leaders have become inward looking. All of this is distracting from the concerted global response required to curb the coronavirus.

Strong global initiatives are required to trace and detect cases; fund not-for-profit scientific research into vaccines and cures; and achieve a balance between travel restrictions and necessary trade. However, such initiatives have been discredited in recent years, by political agendas undermining the concept of globalisation. The growing geopolitical fragmentation since the global financial crisis – with a world increasingly multipolar and with competing ‘value-systems’ – have weakened the role of the global institutions precisely designed to coordinate a response.

US President Trump’s ‘America First’ agenda, and similar populist agendas around the world, are incompatible with the concept of multilateralism. In this context, global agencies such as the UN’s WHO – which were designed to help tackle such crises – have had their purpose and credibility questioned, and their role reduced. Even in the middle of the crisis, Trump announced in April he would halt US funding (the world’s largest) for the World Health Organisation.

The struggle for a global response

The initial global response to the coronavirus outbreak has been criticised as piecemeal and contradictory: some countries in the West saw it as ‘an Asian problem’; the EU’s inconsistent national policies struggled to deliver a coordinated response; Trump called it a ‘hoax’ aimed at discrediting his leadership, while contradicting public health experts on Twitter; and, in Brazil, President Bolsonaro defied health agencies to attend packed public rallies.

Travel restrictions, in many cases, blindsided countries. For example, the US ban on visitors who had been into the Schengen area came without warning, impacting airlines on both sides of the Atlantic.

US – the politics of healthcare

Healthcare challenges – already top-of-mind for voters – will play heavily into the ongoing US election campaign. Healthcare policy is fast becoming the central theme of the race. Republican’s attempts to dismantle the ‘Obamacare’ or Affordable Care Act (which has been weakened but is not dead) are likely to be a key campaign theme for the Democratic nominee.

While the US’ diagnostic capabilities, medical R&D, and ability to treat medically complex cases are among the most sophisticated in the world, the system at large – balkanised and without universal coverage – is ill-equipped to deal with an epidemic. The US has half the number of doctors per patient compared with Germany and lags substantially behind many OECD countries in its ratio of beds to 1,000 patients.

Inadequate insurance coverage in the US also risks undermining treatment and containment of the outbreak. Around 28 million (or 10 per cent) of non-elderly Americans did not have medical insurance in 2018, according to the Kaiser Family Foundation, a non-profit organisation that analyses healthcare issues.

As voters in the US increase their focus on healthcare benefits, Democratic presidential candidate Joe Biden may shift his stance closer to that of former rival Bernie Sanders, who has advocated universal health coverage in the form of ‘Medicare for all’. In that sense, the coronavirus crisis may be a crucial factor in shaping the Democratic platform.

Euro area – fractures and a possible Brexit impact

Europe’s ability to stage a unified response to the crisis has also faced initial setbacks amid disparate (or even contradictory) national responses; coordination issues between France and Germany (on the border closing, for example); and chaos at borders between countries that took unilateral decisions to close them. In addition, Italian bond yields saw their steepest rise since the global financial crisis after ECB President Lagarde said it was not the ECB’s job to close spreads – a comment she subsequently apologised for.

Only on 17 March did European countries agree to the 30-day closure of EU and Schengen external borders. In the UK, meanwhile, the initial public health response diverged sharply from that of most European countries. The government initially saw no need to impose restrictions on movement or activities, instead allowing the virus to spread based on the scientific concept of ‘herd immunity’. This stance was reversed when models showed that the statistical occurrence of cases requiring ICU treatment would quickly overwhelm the National Health Service.

In the UK, the health crisis could have an impact on Brexit negotiations and the government’s narrative. Each passing week without progress makes the UK’s December 2020 deadline more unrealistic.

Should healthcare be a public good?

The pandemic also raises the more fundamental political question of whether healthcare should be primarily a ‘public good’ or a personal choice.

For the most part, infectious diseases that pose a collective threat – such as cholera, smallpox and the plague – have disappeared from our collective memories and are, rather, frightening tales of an ancient past. Today, 71 per cent of global deaths annually (more in developed countries) are from non-communicable diseases such as heart disease and cancer; these diseases – arguably – often demand personal rather than collective healthcare choices.

But all of this is fundamentally put into question when faced with a pandemic like COVID-19 which demands a collective response, and the health of the entire population – whether rich or poor – becomes interdependent. Personal risks and costs become secondary to the systemic response needed to contain the outbreak.

The COVID-19 pandemic has also intensified the focus on healthcare policy outside the US, particularly as governments face increasing fiscal constraints on their ability to provide such benefits. In several countries – including in Europe, where universal healthcare is already part of the social contract but has faced fiscal constraints – budget priorities could be reassessed in the wake of the coronavirus crisis. French President Emmanuel Macron has cited the crisis as evidence that healthcare must remain a public good and be prioritised.

Government responses: local versus national

In the US, the virus reignited the debate on federal versus local government. During the coronavirus outbreak, sub-national governments were the first movers in dealing with the crisis; state and city governments moved faster than the federal government in declaring states of emergency and restrictions on movement. The Trump administration has recently attempted to take the lead on the US national policy response to the coronavirus outbreak, in cooperation with Congress. But local authorities (at the governor, state and city level) have continued to disagree with the White House on which measures to adopt. The crisis could exacerbate the longstanding divide on this issue, with Democrats tending to be more supportive than Republicans of a stronger role for the federal government.

This stands in stark contrast to most other countries – including those with relatively high levels of decentralisation, such as Italy or Germany – where major public crises tend to trigger a strong top-down approach, with a centralised decision-making process and policy direction.

Information, fake news, and politics

While a public health crisis would, by definition, appear apolitical and a strict science/sanitary challenge, public perceptions of the coronavirus have proved very different depending on their political affiliations and the echo chamber they live in. Leadership, trust, science-based language, transparency and resistance to politicising data are all key elements of success but have been lacking in this crisis, in many geographies. Polls in the US have revealed that deep political and cultural divide in the understanding of the crisis. In the current polarised climate, two sides of the country appear to be living in different “realities”. An early March poll (NBC News/WSJ,) showed 80 per cent of Democrats thought the worst of the coronavirus outbreak was yet to come, versus 40 per cent of Republicans (and 57 per cent of independents).

Similarly, 56 per cent of Democrats believed their day-to-day lives would change in a major way in the future because of the crisis, while only 26 per cent of Republicans thought so. This clearly shows the impact of political affiliations on perceptions of the health crisis.
These divergent perceptions have been shaped partly by political signalling from leaders of the two parties, but also by different sources of information. Trump, for instance, repeatedly downplayed the risks, comparing it to the seasonal flu and calling it a hoax. This view was echoed on conservative news networks and websites.

Partisan approach to the crisis or the spread of misinformation is not a US specific situation. Data and info have been widely used for political gains in Brazil, Turkey, Russia but also among various fringe-parties in Europe. Fake news and conspiracy theories have flourished; a widely circulated idea linking the spread of the coronavirus to 5G technology has led to hundreds of incidents – such as wireless towers being set ablaze – in multiple countries. Other incidents involved people dousing themselves or others with chlorine – causing serious injuries – as they read it would kill the virus. This led to the UN creating a specific website dedicated to busting false information.

Will the virus shape the future of healthcare?

Healthcare systems in many counties have very limited ability to absorb massive shocks like the one being caused by the COVID-19 outbreak. Even in rich economies such as the US and the UK, the lack of emergency healthcare facilities has forced an economic shutdown, which could have been less severe if adequate treatment facilities had been available. In the US, the question of universal healthcare will come back as a main policy topic (probably through an Obamacare reform) while in many other countries – such as in Europe – where universal healthcare is already a reality, the question will turn to budget prioritisation when recent years of deficit reduction had often meant cuts in these public healthcare systems.

The cost implications of rescuing economies from collapse are immense. As we emerge from this crisis, policymakers across the world, with varying approaches to public health, will need to consider how to build and fund healthcare systems with enough capacity to deal with the next pandemic, without needing to shut down economies for long periods of time.

covid-19 and Healthcare Postings
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