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Sofia Gruskin is an activist and professor whose work of the past 25 years has focused on shaping academic research, government and organizational policy which combines public health, law and human rights, particularly in the areas of HIV, sexual and reproductive health, child and adolescent health, gender-based violence, and health systems. A revolutionary pairing which has changed the way in which public health conceptualizes its interventions as moving beyond the medical and into the political and social. Her distinct contribution is to make tangible the added value that human rights bring to public health practice, by defining key concepts, developing and testing conceptual and analytical frameworks, as well as creating policy and programming tools. Gruskin works with numerous International Organizations and on-the-ground with both state and non-state actors in many, many countries -- including particularly intensive work in Brazil, South Africa, and Vietnam -- in developing practical applications of the conceptual breakthroughs of which she has been a part.

Professor of Preventive Medicine at the Keck School of Medicine and Professor of Law and Preventive Medicine at the Gould School of Law, University of Southern California. An Adjunct Professor of Global Health and the head of Harvard School of Public Health's Program on International Health & Human Rights, and a Co-Director of the Interdepartmental Program on Women, Gender and Health, and Chair of the Group on Reproductive Health and Rights based at the Harvard Center for Population and Development Studies. Joint coordinator of the Rights-Oriented Research and Education (RORE) Network in Sexual and Reproductive Health.

Background
Gruskin’s focus on public health, human rights and law emerged during the early years of the AIDS crisis. Gruskin observed that around the world a broad range of rights were being restricted in the name of public health but without proper justification, resulting in widespread violations of rights with devastating health effects.

Gruskin’s work suggests three relationships between health and human rights -- the impact of health policies and programs on human rights, the impact of human rights violations on health, and a fundamental interdependence between the two. Her distinct academic contribution to these efforts is exemplified in ‘Health and Human Rights’, the article widely recognized as setting the basis for development of the field of health and human rights by contributing the idea that the use of human rights language in public health had to be grounded in international law. She did so in order to bring attention to the ultimate responsibility and accountability of the state under international law for issues relating to health and well-being. This fundamental observation informed a research agenda that shaped the field’s development. Gruskin’s efforts, since, have been to define, operationalize and test what is meant by a “rights-based” approach to health; produce scholarly work to define the conceptual differences between human rights and other frameworks concerned with justice, including ecosocial, ethics, and equity; and to make clear the distinct contributions human rights offer the health field.

Career
In 1993, [|Jonathan Mann] brought Gruskin and [|Daniel Tarantola],M.D., together to establish the François-Xavier Bagnoud Center for Health and Human Rights. At that time there were no documented research efforts or programmatic activities, and no evidence of the utility of these links for the work of public health. Now, fifteen years later the field of health and human rights is well-recognized, with sections and special issues devoted to the topic in the world’s premier public health journals including Lancet, AIDS, and the American Journal of Public Health, international organizations such as WHO and UNAIDS having integrated health and human rights approaches into their on-the-ground programming around the world, and transnational actors increasingly incorporating the insights of this field into their work. While Gruskin has not, of course, worked alone on this, she has been a singular figure continuously at the cutting edge of these conceptual and programming advances.

From 2002 through 2006, Gruskin served as Chair of the UNAIDS Global Reference Group on HIV/AIDS and Human Rights, where she led the effort for UNAIDS to determine the validity of rights-based approaches for their HIV/AIDS programming. Along these same lines, she served as the principal architect of the 2003 General Comment on HIV/AIDS promulgated by the UN Committee on the Rights of the Child. These are just a few of the positions she has held outside of Harvard and she is a major presence at virtually every major meeting in the field, and has a sterling reputation in engaging with stakeholders from around the world, as well as serving as a mentor.

Her academic breakthroughs underpin the operational approach that has been adopted by several international organizations, including UNFPA and UNAIDS. A distinct contribution to this operationalization has been to show how use of human rights principles in public health efforts draws attention not only to how many people are gaining access to services, but who is gaining access (and who is not), how they are gaining access, over what period of time, and with what long term implications. In this respect, responding to the approaches being undertaken to scale-up HIV testing, she has worked with UNAIDS and WHO in development of their guidance on provider-initiated HIV testing and counseling, arguing that what is needed for the success of any testing strategy is long-term connection with relevant health services and not simply increases in the numbers of people being tested.

She has also argued that a rights-based approach is useful for creating opportunities to address the intersections between HIV and reproductive health, and developed a framework to ensure that women and men living with HIV have access to sexual and reproductive health services and programs. Explicitly, this means systematic consideration of the rights, needs and aspirations of the individuals who use the services; the health systems within which they are delivered; the national legal and policy framework within which they operate; and key elements of the broader social and economic context. A key effort in Gruskin’s work involves providing an approach to identify and address barriers in law, policy, regulations and standards of care. This approach, which includes both a research instrument and a method, demonstrates how law and human rights can provide a practical framework for improving access to and quality of health services, especially for vulnerable populations. Based on an analysis of governments’ human rights obligations, key findings are the ability to systematically identify and assess those laws, policies, strategies, plans – in sum the government’s efforts and practices – that facilitate and constrain their ability to appropriately address the health area of concern.

Originally tested in the area of maternal and neo-natal health, this approach is already being adapted for use in the areas of adolescent health and sexual and reproductive health more broadly. Within the next several years, Gruskin and her staff will also be adapting, testing and validating this approach in the areas of HIV and women’s health in conflict settings. Testing the application of a rights-based approach for monitoring and evaluation is having its most tangible impact in the area of HIV. Gruskin developed the human rights related questions asked of governments in 2005 and 2008 to monitor their compliance with the 2001 UN General Assembly Special Session on AIDS (UNGASS), and actively helped shape the National Composite Policy Index more generally.

Quotes
“We have to recognize that law impacts health and we need to know when law is harming and when it needs to change,” said Gruskin. “What should be done to be sure you can access what you need, when you need it, no matter where you are or who you are? How do we change health systems so they are supportive of the health and human rights of all populations?”

Education
After completing a degree in sociology that focused on ethnomethodology from the University of California at Santa Cruz, Gruskin earned a juris doctor from Yeshiva University’s Benjamin N. Cardoza School of Law in 1990, and then went on to Columbia University’s School of International and Public Affairs in1993 to obtain a master’s degree in International Affairs with specialization in Public Health and Human Rights.

Books
Health and Human Rights in a Changing World (with M. Grodin, D, Tarantola,  and G. Annas, eds.) (Routledge, Taylor & Francis Group, 2013). Perspectives in Health and Human Rights (with M. Grodin, G. Annas, and S.P. Marks, eds.) (Routledge,Taylor & Francis Group, 2005). Health and Human Rights: A Reader (with J. Mann, M. Grodin, and G. Annas, eds.) (New York:  Routledge, 1999).

Articles
Gruskin is currently an associate editor for The American Journal of Public Health, Global Public Health, and Reproductive Health Matters.


 * "Realigning Government Action with Public Health Evidence: The Legal and Policy Environment Affecting Sex Work and HIV," (with G. Williams, and L. Ferguson) Culture, Health and Sexuality (2013).(forthcoming)
 * "Identifying Structural Barriers to an Effective HIV Response: Using 2010 NCPI Data to Evaluate the Human Rights, Legal and Policy Environment," (with L. Ferguson, T. Alverson, G. Peersman, and D. Rugg)  Journal of the International AIDS Society, vol. 16, 2013).
 * "Human Rights in Health Systems Frameworks: What is There, What is Missing and Why Does it Matter?," (with S. Ahmed, D. Bogecho, J. Hanefeld, L. Ferguson, S. MacCarthy, Z. Raad, R. Steiner) Global Public Health, Vol. 7, no. 4, pp. 337-51 (2011).
 * "The Impacts of AIDS Movements on the Policy Responses to HIV/AIDS in Brazil and South Africa: A Comparative Analysis," (with A. Nunn, S.L. Dickman, and N. Nattras) Global Public Health, vol. 7, no. 20, pp. 1031 – 1044 (2012).
 * "Are Drug Companies Living Up to Their Human Rights Responsibilities? Moving Toward Assessment," PLOS Medicine, vol. 7, no. 9 (2010).
 * "Rights-Based Approaches to Health Policies and Programmers: Articulations, Ambiguities and Assessment," (with D. Bogecho, L. Ferguson) Journal of Public Health Policy, vol. 31, no. 2, pp. 129-145 (2010).
 * "Using Human Rights for Sexual and Reproductive Health: Improving Legal and Regulatory Frameworks," (with J. Cottingham, E. Kismodi, A.M. Hilber, O. Lincetto, and M. Stahlhofer) Bulletin of the World Organization, vol. 88, no. 7, pp. 551-55 (2010).
 * "Human Rights in the Global Response to HIV: Findings from the 2008 UNGASS Reports," (with L. Ferguson, G. Peersman, and D. Rugg) JAIDS, vol. 52, suppl. 2, S104-S110 (2009).
 * "Government Regulation of Sex and Sexuality: In Their Own Words," (with L. Ferguson) Reproductive Health Matters, vol. 17, no. 34, pp. 108-118 (2009).
 * "Using Indicators to Determine the Contribution of Human Rights to Public Health Efforts: Why? What? And How?," (with L. Ferguson) Bulletin of the World Health Organization, vol. 87, no. 9, pp. 714-719 (2009).
 * "Justice and Human Rights: Priority Setting and Fair Deliberative Process," (with N. Daniels) American Journal of Public Health, vol. 98, no. 9, pp. 1573-1577 (2008).
 * "Health, Development and Human Rights," Australian Journal of Human Rights, vol. 13, no. 2, pp. 1-32 (2008).