Highly acclaimed as a key innovation of the United Nations Human Rights Council, the Universal Periodic Review (UPR) was created in 2006 as a cooperative, peer-review mechanism to shift away from the highly politicized Commission on Human Rights. Despite the significance and hope attached to the UPR, it has been conspicuously under-examined in the U.S. legal scholarship. And most relevant literature elsewhere has avoided directly addressing the fundamental question of exactly what the UPR’s added value is to the global human rights regime in terms of its direct contribution to improving human rights situations on the ground. This is mainly due to methodological and analytical challenges to measure the impact of the UPR in isolation from other existing human rights mechanisms. While acknowledging such challenges, this article attempts to provide one such answer to the question from a normative perspective: it argues that the UPR’s added value lies in providing a forum to incrementally and constantly challenge the threshold of states under review for accepting their commitment to addressing controversial human rights issues. Drawing from the experiences of the Lao People’s Democratic Republic and other countries as well as the literature on peer pressure and acculturation, this article articulates the current issues of the UPR mechanism in terms of recommendations given to states under review by their peers and suggests the way forward for the UPR mechanism by reframing it as a forum of fighting for borderline recommendations.
Individual and population health in unincorporated U.S. territories – American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands – lag terribly behind those in the 50 U.S. states and D.C. The populations in the territories – with drastically higher rates of poverty – suffer and die from chronic conditions like cancer, diabetes, and heart disease at far higher rates; must find facilities and doctors thousands of miles away for even moderately complex cases; and perpetually struggle to make access to basic services available. While scholars have long pointed to the disparate treatment of these populations by Congress – especially with respect to Medicaid reimbursement – this Essay argues that the disadvantages and health disparities experienced by territorial populations run far deeper. In fact, the entire structure of healthcare access and financing in unincorporated U.S. territories is fundamentally shaped by how the U.S. federal government occupied those territories, restructured healthcare practice and facilities to sustain the U.S. presence, and as those territories were transferred to the Department of the Interior, imposed financing and programming constraints that made dependency perpetual. This Essay argues for two immediate measures: parity in Congressional commitment to healthcare financing as between U.S. states and U.S. territories, and establishment of investigatory committees to identify and restore indigenous health practices destroyed by U.S. occupation modeled on the Native Hawaiian Healthcare Improvement Act.