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Gambling is a public health issue
by The Lancet Public Health Commission on gambling
 
The global gambling industry is rapidly expanding, with net losses by consumers projected to reach nearly US$700 billion by 2028. Industry growth is fuelled by the rise of online gambling, widespread accessibility of gambling opportunities through mobile phones, increased legalisation, and the introduction of commercial gambling to new areas.
 
Recent expansion is most notable in low-income and middle-income countries, where regulatory infrastructure is often weak. Gambling, in some form at least, is now legally permitted in more than 80% of countries worldwide. Online gambling, given its borderless accessibility, is available everywhere via the internet.
 
Digitalisation has transformed the production and operation of commercial gambling, but the consequences of this shift and its effects on consumers have not yet been fully recognised.
 
The production of online gambling is interconnected with an ecosystem of software, information technology infrastructure, and financial technology services. The commercial gambling industry has also developed strong partnerships in media and social media.
 
Sponsoring and partnering with professional sports organisations provides gambling operators with marketing opportunities with huge new audiences. This far-reaching and interdependent corporate ecosystem collectively wields substantial influence over policy and has multiple points-of-contact through which to leverage the behaviour of consumers.
 
Online gambling products are designed to be rapid and intensive, characteristics that are associated with higher risk of harm for consumers. The introduction of in-game betting during live matches has made online sports betting instantaneous and increased both its frequency and prevalence. Traditional gambling products, such as lotteries and bingo, now have faster cycles and are continuously accessible through smartphone apps. The boundaries between digital gaming and gambling are becoming blurred, with gaming increasingly acting as a conduit into gambling.
 
Leveraging online digital infrastructures and surveillance data, gambling companies now have unparalleled capabilities to target consumers, including through the use of social media and influencers to engage individuals and online user data to tailor marketing to individuals, cross-sell products, and prolong user engagement.
 
To safeguard their interests, stakeholders in the commercial gambling ecosystem deploy a range of strategies, many of which are similar to those used by other industries selling potentially addictive or health harming products.
 
To shape public and policy perceptions, and as they lobby policy makers directly to further their commercial interests, the industry portrays gambling as harmless entertainment and stresses the economic benefits (including tax revenues) and employment opportunities that the industry provides.
 
The gambling industry particularly stresses the social benefits that accrue when some portion of gambling profits are used to fund education, health services, or other worthwhile social causes. According to industry narratives, responsibility for gambling harm is attributed to individuals, particularly those deemed as engaging in problematic gambling, which deflects attention from corporate conduct.
 
The gambling industry also exerts considerable influence over research into gambling and gambling harms, which helps it to retain control of the framing and messaging surrounding these issues.
 
Industry messaging has substantially influenced gambling policy and regulation. Most policy solutions to gambling harms rest on the notion of individual responsibility. Providing support services, treatments, and protections for at-risk individuals is, of course, important. Improving these remedies further and making protective supports broadly available remains a priority.
 
However, framing the problem in this way and narrowly focusing policy attention on a small subset of the people who gamble draws attention away from industry practices and corporate behaviour. We must also seriously examine the structures and systems that govern the design, provision, and promotion of gambling products.
 
Key messages
 
The harms to health and wellbeing that result from gambling are more substantial than previously understood, extending beyond gambling disorder to include a wide range of gambling harms, which affect many people in addition to individuals who gamble.
 
Evolution of the gambling industry is at a crucial juncture; decisive action now can prevent or mitigate widespread harm to population health and wellbeing in the future.
 
Thus far, globally, governments have paid too little attention to gambling harms and have not done enough to prevent or mitigate them.
 
Stronger policy and regulatory controls focused on harm prevention and the protection of public health and wellbeing, and independent of industry or other competing influences, are now needed.
 
Given the increasingly global and boundary-spanning nature of the industry, international coordination on regulatory approaches will be necessary.
 
Gambling harms
 
Gambling can inflict substantial harm on individuals, families, and communities. Beyond the obvious danger of financial losses and financial ruin, these harms can include loss of employment, broken relationships, health effects, and crime-related impacts. Gambling can heighten the risk of suicidality and domestic violence.
 
Research evidence and firsthand accounts from individuals affected by gambling corroborate the association between gambling and these many and various detrimental effects.
 
A substantial proportion of harm is suffered by those individuals who fall below the threshold for gambling disorders outlined in the International Classification of Diseases-11 or the American Psychiatric Association's Diagnostic and Statistics Manual-5. Therefore, examining the effect of gambling across the entire spectrum of consumption is crucial.
 
As with other harmful commodities, adverse effects are often felt not just by the person gambling, but also by significant others, families, and friends, and can result in both tangible and intangible costs to communities and societies. Although some harms might be short-lived, others are long lasting and can affect subsequent generations.
 
This Commission conducted a systematic review and meta-analysis of the global prevalence of gambling participation, including any risk gambling (defined as occasional experience of at least one behavioural symptom or adverse consequence from gambling), gambling disorder, and problematic gambling in adults and adolescents.
 
We estimate that 46·2% of adults and 17·9% of adolescents had engaged in gambling of some form within the preceding year, globally. 10·3% of the adolescents had gambled online, which is noteworthy given the widespread agreement that commercial gambling among adolescents should be prohibited. Approximately 5·5% of women and 11·9% of men experience any risk gambling.
 
Extrapolating these findings globally would suggest that approximately 448·7 million adults worldwide could be similarly affected. Of these, an estimated 80 million adults experience gambling disorder or problematic gambling.
 
Moreover, we estimate that gambling disorder could affect 15·8% of the adults and 26·4% of the adolescents who gamble using online casino or slot products, and 8·9% of the adults and 16·3% of the adolescents who gamble using sports betting products.
 
These findings underscore the potential harmfulness of products (eg, online casino or slot games and sports betting) that are now driving the global expansion of the gambling industry.
 
Our systematic review also uncovered substantial deficiencies in the global monitoring of gambling harms. Monitoring has relied primarily on population surveys, despite recognised methodological issues with these approaches, which are likely to produce conservative estimates. Moreover, in many countries, even general population surveys are unavailable. Consequently, the evidence base remains fragmented and clearly incomplete given the global scale of the issue.
 
This Commission stresses that gambling is a public health issue. A public health approach to regulating the gambling industry and preventing and responding to related harms should underpin policy design, implementation, and review. The Commission assessed the gambling policy process by scrutinising policy framing, adoption, and enforcement, acknowledging the importance of each stage in influencing public health outcomes..
 
http://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(24)00167-1/fulltext


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World entering an era of impunity, climate inaction and unchecked corporate power
by Agnes Callamard
Secretary General, Amnesty International
 
Apr. 2025
 
The State of the World’s Human Rights: Amnesty International’s Annual Report 2024/25
 
World entering an era of impunity, climate inaction and unchecked corporate power, says Amnesty International
 
The first 100 days of Donald Trump’s presidency have “supercharged” a global rollback of human rights, pushing the world towards an authoritarian era defined by impunity and unchecked corporate power, Amnesty International warns today.
 
In its annual report on the state of human rights in 150 countries, the organisation said the immediate ramifications of Trump’s second term had been the undermining of decades of progress and the emboldening of authoritarian leaders.
 
Describing a “freefall” in human rights, the report said growing inaction over the climate crisis, violent crackdowns on dissent and a mounting backlash against the rights of migrants, refugees, women, girls and LGBTQ+ people could be traced to the so-called Trump effect.
 
Amnesty warned the situation would deteriorate further this year as Trump continued to dismantle the rules-based world order that Washington helped to build from the devastation of the second world war.
 
Sacha Deshmukh, Amnesty International UK’s chief executive, described the US president’s swift and deliberate targeting of international institutions designed to make the world safer and fairer as “terrifying”.
 
“You look forward to the end of this decade and wonder whether the basic frameworks and underpinnings of not just human rights but international law will still be standing. You probably haven’t been able to say that since 1935,” he said.
 
Amnesty’s report also documents how mass arbitrary arrests, enforced disappearances and lethal force are becoming increasingly widespread tools of repression.
 
In Bangladesh, “shoot-on-sight” orders during student protests led to hundreds of deaths; Mozambique’s disputed elections similarly sparked a deadly crackdown; and Turkey also imposed draconian bans on demonstrations.
 
The report also identified global inaction as an area of concern, particularly in relation to Sudan’s ruinous civil war. One of the warring sides there, the Rapid Support Forces, has been accused of repeatedly carrying out mass sexual violence against women and girls yet international action remains muted.
 
Trump’s sweeping foreign aid cuts had made conditions worse across the world, Amnesty said, closing crucial programmes in states such as Yemen and Syria, leaving children and survivors of conflict without access to food, shelter or healthcare.
 
Amnesty also raised concerns over failures to uphold international humanitarian law, citing Israel’s military operations in Gaza.
 
In Europe, Amnesty said Russia killed more Ukrainian civilians in 2024 than the previous year and continued to target non-military infrastructure. Trump is proposing that Ukraine cede territory to Russia as part of peace proposals dismissed as appeasement by critics.
 
Agnes Callamard, Amnesty International’s secretary general, said: “Trump has shown only utter contempt for universal human rights – emboldening anti-rights movements worldwide and letting corporate allies run amok.”
 
Looking further ahead, the report warned that governments risked failing future generations on the climate, economic inequality and corporate power.
 
It cited the collapse of the UN’s Cop29 climate conference, under fossil-fuel corporations’ influence, while rich countries “bullied” low-income nations into accepting inadequate climate financing. Trump’s exit from the crucial Paris climate agreement threatened “to drag others with him”, Amnesty warned.
 
Elsewhere, against a backdrop of scapegoating migrants, “billionaires gained wealth as global poverty reduction stalled”, it said.
 
http://www.amnesty.org/en/latest/news/2025/04/global-human-rights-crisis-trump-effect-accelerates-destructive-trends/ http://www.amnesty.org/en/documents/pol10/8515/2025/en/ http://www.dw.com/en/human-rights-amnesty-international-israel-gaza-minorities/a-72379029 http://www.theguardian.com/global-development/2025/apr/29/trump-first-100-days-rollback-human-rights-amnesty-report-repression-climate-corporate-power-women-migrants-lgbtq http://www.amnesty.org/en/latest/research/
 
June 2025
 
UN Human Rights Office Calls for Action on ‘Transnational Repression’. (Human Rights Watch)
 
The United Nations Human Rights Office has issued its first ever guidance paper on “transnational repression,” aimed at increasing awareness and understanding of this expanding global issue.
 
Transnational repression occurs when governments reach across their borders to stifle criticism and dissent. It can take the form of online harassment, surveillance, enforced disappearances, targeting of relatives, and physical attacks, including killings. Last year, Human Rights Watch documented how this phenomenon is often downplayed or ignored.
 
The UN paper notes that victims of transnational repression often face barriers accessing protection and remedies. Authorities in some host countries fail to ensure adequate protective measures, but others have actively facilitated foreign governments’ repression of people seeking refuge.
 
The UN high commissioner for human rights, UN human rights experts, and member states have increasingly been raising the alarm over this practice.
 
In 2024, following a landmark report by the United Nations special rapporteur on freedom of opinion and expression on transnational repression of journalists, dozens of countries from all regions issued a statement condemning transnational repression, committing to supporting those targeted, and holding perpetrators to account.
 
In his global update earlier this year, the UN high commissioner for human rights noted the rising number of “egregious examples” of transnational repression around the world and called for all states to adopt a “zero-tolerance policy” towards the practice.
 
The new UN guidance reminds states of their responsibility to respect and protect rights and refrain from committing, enabling, or condoning acts of transnational repression. It offers concrete recommendations to governments for raising awareness and addressing the protection and accountability gap, including establishing mechanisms for remedies and reparations for victims and issuing a moratorium on exporting surveillance “spyware” tools.
 
Governments should also work together to ensure a coordinated international response to transnational repression that offers robust protection to those at risk.
 
At the current session of the UN Human Rights Council, states will have opportunities to reference transnational repression in a number of relevant resolutions under negotiation: notably on the protection of journalists and of civil society space. This would help acknowledge the concerns expressed by the UN Human Rights Office and independent rights experts, and build awareness and focus attention on coordinated prevention and remedy.
 
It is time for a concerted international effort to better understand and address the serious rights impacts of transnational repression and to ensure protection and justice for those targeted.
 
http://www.hrw.org/news/2025/06/25/un-human-rights-office-calls-for-action-on-transnational-repression http://www.ohchr.org/sites/default/files/documents/publications/transnational-repression-1-en.pdf http://www.icij.org/investigations/china-targets http://docs.un.org/en/A/HRC/56/53 http://www.hrw.org/report/2024/02/22/we-will-find-you/global-look-how-governments-repress-nationals-abroad http://www.hrw.org/news
 
Apr. 2024
 
Reflections on the state of human rights in 2023/24, by Agnes Callamard.
 
I never expected the state of human rights to lead me to reference the 1980s sci-fi film Back to the Future. Yet here we are. A world spiralling through time, hurtling backwards past the 1948 promise of universal human rights, even as it spins ever faster forwards into a future overtaken by Big Tech and unregulated generative artificial intelligence (AI).
 
“Authoritarian” practices on the rise
 
In 2023, V-Dem, the political science research centre, found the number of people living in democracies (broadly defined as countries providing rule of law, constraints on the executive by the legislature and the judiciary, and respect for civil liberties) had regressed to 1985 levels: to levels before the Berlin Wall fell, before Nelson Mandela was released from prison, before the Cold War ended in the hope that a new era for humanity was about to unfold.
 
That new era was all too brief and today is as good as gone. Evidence of its passing grew in 2023. “Authoritarian” practices and ideas permeated many governments and societies. North to south, east to west, authoritarian policies ate away at freedoms of expression and association, hit out at gender equality, and eroded sexual and reproductive rights.
 
The underlying public narratives, based in hatred and rooted in fear, encroached on civic space and demonized marginalized individuals and groups, with refugees, migrants and racialized groups bearing the brunt.
 
The backlash against women’s rights and gender equality intensified in 2023, with many of the past 20 years’ gains under threat.
 
In Afghanistan, being a woman or a girl has been de facto criminalized. In 2023, the Taliban passed dozens of official decrees aimed at erasing women from public life. Similarly in Iran, the authorities continued their brutal suppression of “Woman, Life, Freedom” protests and issued hate-ridden official statements calling the unveiling of women a “virus”, a “social illness” and a “disorder”.
 
In the USA, 15 states implemented total bans on abortion, or bans with extremely limited exceptions, bringing disproportionate impacts on Black and other racialized people. In Poland, at least one woman died because the law denied her the abortion services she needed. Uganda adopted a harsh anti-gay law, while social and political leaders in the US also promoted anti-trans narratives, policies and regulations.
 
Although the world has never been wealthier, 2023 was, as the World Bank called it, “the year of inequality”. In settings as diverse the UK, Hungary and India, defenders of economic and social rights were among the activists most widely targeted.
 
Climate activists were branded “terrorists” for denouncing governments expanding fossil fuel production and investment. Critics of governments’ handlings of the economy in the Middle East, trade unions in Asia-Pacific were silenced and arbitrarily detained, as were those combating corruption in West Africa.
 
However, in 2023, our metaphorical time machine also tossed us much further back than 1985: a descent into a hell whose gates had been bolted closed in 1948. “Never again”, the world had declared in the aftermath of global warfare with its some 55 million civilian deaths, when faced with the abject horror of a Holocaust that saw the extermination of six million Jews and millions of others.
 
Yet in 2023, the “never again” moral and legal lessons were torn into a million pieces. Following the horrific crimes perpetrated by Hamas on 7 October 2023 – when over 1,000 people, mostly Israeli civilians, were killed, thousands wounded, and some 245 people taken hostage or captive – Israel instigated a campaign of retaliation that became a campaign of collective punishment. It is a campaign of deliberate, indiscriminate bombings of civilians and civilian infrastructure, of denial of humanitarian assistance and an engineered famine.
 
By the end of 2023, 21,600 Palestinians, mostly civilians, had been killed in the unrelenting bombardment of Gaza, with thousands more missing, believed buried under the rubble. Much of Gaza’s civilian infrastructure has been obliterated, while nearly 1.9 million Palestinians have been internally displaced and deprived of access to adequate food, water, shelter, sanitation and medical assistance.
 
To be a Palestinian in Gaza today is to be plunged to a far more violent and destructive version of the 1948 “Nakba” or the “catastrophe”, when more than 750,000 Palestinians were forcibly displaced.
 
For millions the world over, Gaza now symbolizes utter moral failure by many of the architects of the post-World War Two system; their failure to uphold the absolute commitment to universality, our common humanity and to our “never again” commitment. The principles enshrined in the UN Charter, the Geneva Conventions, the Genocide Convention, and international human rights law have been dishonoured. That’s clearest in the case of the Israeli authorities.
 
However, Israel is not alone. The USA too has played a leading part, as have some of Europe’s leaders and the EU leadership. So too have those who continue to send arms to Israel, all who failed to denounce Israel’s relentless violations and those who rejected calls for a ceasefire.
 
Their conduct exemplifies the double standards that Amnesty International has denounced over many years. Yet, powerful actors have now gone further, demonstrating a willingness to put at risk the entirety of the 1948 rule-based order, stripping down the founding principles of common humanity and universality and thus stripping away our global capacity to prevent the very worst.
 
It all comes hot on the heels of Russia’s full-scale invasion of Ukraine, a violation of the UN Charter and an undermining of the international rule of law. Russia’s aggression has continued to manifest itself in deliberate attacks against civilians, the killing of thousands, and as widespread destruction of civilian infrastructure, including Ukraine’s grain storage and export facilities.
 
China too, another permanent member of the UN Security Council, has acted against international law, by protecting the Myanmar military and its unlawful air strikes, through its practices of arrest and torture, and by shielding itself from international scrutiny for the crimes against humanity it continues to commit, including against the Uighur minority.
 
The future we don’t want.
 
In 2023, with the much earlier-than-expected launch of ChatGPT-4 and other generative AI tools, we were also thrust faster into the future. If the tech-related abuses witnessed in 2023 are anything to go by, prospects for our future are chilling indeed.
 
Tech is enabling pervasive erosions of rights: perpetuating racist policies, enabling spreading misinformation and curtailing freedoms of expression. Big Tech ignored or minimized those harms, even in armed conflicts contexts such as in Ethiopia, Israel and the Occupied Palestinian Territories, Myanmar and Sudan. With the alarming rise in online incitement and other harmful content against both Palestinian and Jewish communities, Europe and the USA also saw marked increases in anti-Muslim and antisemitic hate crimes.
 
In 2023, States turned increasingly to facial recognition technologies to aid policing of public protests, sporting events and of marginalized communities at large – migrants and refugees in particular. Abusive technologies were relied upon for migration governance and border enforcement, including through border externalization technologies, data analysis software, biometrics and algorithmic decision-making systems.
 
Despite years of evidence of the human rights violations it enables, spyware remained largely unregulated. In 2023, Amnesty International uncovered use of Pegasus spyware against journalists and civil society activists in Armenia, the Dominican Republic, India and Serbia, while EU-based spyware was sold to states the world over. In response, the European Parliament adopted a resolution in November 2023, criticizing the lack of action to curb abuses by the spyware industry.
 
However, with tech-outlaws and their rogue technologies left to freely roam the digital Wild West, such human rights violations are likely to escalate in 2024, a landmark electoral year. It is a foreshadowing of a future that is already upon us.
 
Global solidarity
 
Human rights regressions in 2023 did not go unseen. To the contrary. People around the world have stood up to regression, demonstrating unprecedented global solidarity.
 
The Israel-Hamas conflict sparked hundreds of protests worldwide, with millions protesting civilian deaths, calling for the release of hostages, demanding a cease fire.
 
The UN Secretary-General, heads of UN agencies, and humanitarian organizations took unprecedented steps to denounce war crimes committed in southern Israel and Gaza and to call on Israel to respect international law.
 
The late 2023 UN General Assembly resolutions calling for a ceasefire were adopted with a huge majority while South Africa filed an application before the International Court of Justice, alleging that Israel’s conduct in Gaza violated the 1948 Genocide Convention and insisting on the centrality of the post-World War Two international rule-based system.
 
2023 saw momentum build towards a global regime for fairer taxation, to help prevent tax evasion and avoidance and mobilize resources for lower-income countries. In November, against the wishes of the richer countries, the UN General Assembly adopted a resolution tabled by the African Group establishing an international committee to draft a UN tax convention by June 2025.
 
In 2023, there were many people who resisted and disrupted forces pushing the world backwards to the conditions of 1985 and of pre-1948; people who marched and protested against forces that would propel us all into a future not of our design. They too have shaped 2023, against all odds.
 
I hope that in 2048 – or even 3048 – when diplomats and activists look back at the past year, they will find that there were many, many good people around the world who did all they could. Who stood up and spoke out. For the sake of our common humanity.
 
http://www.amnesty.org/en/latest/research/2024/04/secretary-general-reflections-state-of-human-rights/ http://www.amnesty.org/en/latest/news/2024/04/amnesty-international-sounds-alarm-international-law-flagrant-rule-breaking-governments-corporate-actors/


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