On 25 February president Emmerson Mnangagwa announced at a public rally that although vaccination will not be mandatory, there will come a time when those who have not been inoculated will not have access to jobs and public transport. His statements were reiterated by his governing party’s ZANU PF youth secretary, Godfrey Mugwadi, who stated that those who refuse to be vaccinated were a threat to national security. Amnesty International is concerned that the potential threats of mandatory vaccination made by the Zimbabwean authorities violate rights guaranteed in the constitution and international law.
Whilst the authorities have obligations to safeguard people’s right to life and promote public health, no one should be forced to receive vaccination without their consent. The right to consensual medical treatment should be respected. The constitution of Zimbabwe guarantees the right to personal security, in particular the right not to be subjected to medical experimentation without one’s consent. The Public Health Act provides, however, that the Minister of Health may, by notice in the gazette, authorise the compulsory immunisation of children and people with disabilities, in the interest of public health.
The deadly impact of the COVID-19 pandemic around the world has led to government measures that pose threats to a range of human rights, as states endeavour to prevent the spread of the virus and distribute much-needed vaccines. States are obliged to ensure that COVID-19 vaccines are available, accessible, affordable and of good quality for everyone without discrimination. In that regard, states must devise national COVID-19 vaccine distribution plans that are accessible, inclusive and non-discriminatory. The Zimbabwean government’s response to Covid-19 and the management of the vaccine rollout should be done without violating any rights and the state must ensure that citizens are protected from the life-threatening pandemic.
States must ensure that any vaccines distributed are deemed safe and effective through rigorous trials by independent and objective regulatory agencies, and making information available in a timely, transparent, and accessible fashion to allow for public scrutiny. COVID-19 vaccines should be scrutinised for quality and acceptability through strict approval processes.
In line with the CESCR’s General Comment 25, acceptable vaccines are those that respect medical ethics and informed consent, and are designed to respect privacy and confidentiality, while being culturally appropriate by being sensitive to age, gender, religion or other characteristics. To be deemed acceptable, the scientific benefits of these products must be explained and disseminated in a manner that is understandable in a range of social and cultural contexts. This is a crucial component to the right to health because individuals and communities can only make informed decisions about their health when they are given accurate, timely and accessible information, available in all local languages and in accessible formats for all people. Within the context of COVID-19, questions surrounding the quality and acceptability of vaccines have led to debates on the human rights implications of clinical trials, mandatory vaccines and “vaccine hesitancy”. The World Health Organisation has named lack of confidence in immunisations as one of the main reasons why people chose to not be vaccinated.
Amnesty International strongly opposes the use of threats, sanctions or of the criminal law and the imprisonment of people who refuse vaccination. The threatened lack of access to jobs and public transport by authorities in government will affect ordinary people who require these essential services. Should these threats be implemented, fundamental rights, such as the right to equal treatment and protection, will be jeopardised. Zimbabweans’ job security and livelihoods should not be threatened nor should people be barred from using public transport because of lack of vaccination. Such threats by the state and ruling party officials violate the non-discrimination provisions of the constitution of Zimbabwe.
COVID-19 immunization plans must be carried out in a way that is consistent with the protection of human rights. The authorities in Zimbabwe should promote and facilitate the take up of COVID-19 vaccines and ensure that they are fully voluntary wherever and whenever possible. In this respect, states must always guarantee individuals the right to prior, free and informed consent. The Universal Declaration on Bioethics and Human Rights further explains that, “consent should, where appropriate, be expressed and may be withdrawn by the person concerned at any time and for any reason without disadvantage or prejudice.”
The Zimbabwean government must not introduce blanket mandatory vaccine policies and should seek to ensure that vaccination is voluntary wherever and whenever possible. While blanket mandates on vaccination infringe human rights, it is plausible that states could justify certain vaccine requirements, as a specific measure to prevent the spread of COVID-19, especially in situations of heightened risk. These requirements could include situations where people are not forced per se to be vaccinated, but their employment, schooling or freedom of movement may be contingent upon an immunization requirement. Several international instruments allow for limitations on rights for the sake of public health, provided these include safeguards. The Universal Declaration on Bioethics and Human Rights stipulates that these principles could be limited by law “for the protection of public health or for the protection of the rights and freedoms of others. Any such law needs to be consistent with international human rights law.
Recommendations to the Zimbabwe authorities:
- Amnesty International strongly opposes the use of threats or any other punitive sanctions against people who refuse vaccination. The Zimbabwe authorities must not impose blanket mandatory vaccine policies and should seek to ensure that vaccination is voluntary. As states carry the burden of justifying a limitation upon a right guaranteed under international human rights law, any potential mandatory vaccination policy must reflect the Siracusa Principles and states must demonstrate that this requirement: a) pursues a legitimate aim to prevent disease or injury and constitutes a necessary, proportionate and reasonable measure to achieve this aim through an evidence-based rationale that explains why the goal cannot be achieved with less restrictive measures; b) includes regulations that are consistent with human rights, in line with the CESCR’s General Comment 25, and undergoes periodic monitoring and review, with channels to challenge and remedy against its possible abusive application by the state.
- The state must embark on wide reaching education campaigns, educating citizens on the benefits of vaccination, without issuing threats of mandatory inoculation.
- The state should focus on building the confidence of citizens in the vaccines to be administered.
- The state must address the concerns of the people and conduct scientific investigations on the side-effects, quality, acceptability, and effectiveness of the cocktail of vaccines being brought into Zimbabwe.
Background
Like many nations around the world Zimbabwe has embarked on a COVID – 19 vaccination program with the Vice President and Minister of Health, Dr. Constantine Chiwenga, taking the first jab at Harare’s Wilkins Hospital on 18 February 2021. The first focus has been frontline personnel. According to reports from the Ministry of Health, over 25 077 people have been vaccinated since 18 February. The president of the Zimbabwe Nurses Association, Enock Dongo, also reported that “the uptake of the vaccine is low among health workers”. To date, president Mnangangwa and cabinet ministers are yet to be vaccinated. Zimbabwe received 200,000 Sinopharm doses, a donation that China has promised to double, with the government buying another 1.8 million doses. Zimbabwe will receive 1, 152 million vaccines through the African Union from the Covax facility to which the EU is the biggest contributor.