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Which are the most relevant international and regional human rights standards related to the health of minority communities?
Overview
A wide of variety of human rights standards at the international, regional, and national levels applies to health and human rights in minority communities. These standards can be used for many purposes:
- To document violations of the human rights of the Roma and San people
- To advocate for the cessation of these violations
- To sue governments for violations of national human rights laws
- To report to regional and international human rights bodies about breaches of human rights agreements.
In the tables on the following pages, examples of human rights violations against minority communities, in particular the Roma and San are provided. Relevant human rights standards are then cited, along with examples of legal precedents interpreting each standard.
How to read the tables
As you read through each table, ask yourself the following questions about the violations, standards, and precedents and interpretations that are cited:
EXAMPLES OF HUMAN RIGHTS VIOLATIONS
Do any of these violations occur in your country? Are there other violations of this human right that exist in your country? |
HUMAN RIGHTS STANDARDS
Are these violations prohibited by the "human rights standards"? Can the standards be interpreted to apply to this violation? |
PRECEDENTS AND INTERPRETATIONS
Do any of the "examples of precedents and interpretations" apply to this issue? Can they be interpreted to apply to this issue? |
Remember that human rights law is an evolving field, and that many human rights violations are not directly addressed by existing legal standards and precedents. Through ongoing documentation and advocacy, advocates can build a stronger body of jurisprudence on health and human rights in minority communities.
Abbreviations
In the tables, the ten treaties and their corresponding enforcement mechanisms are referred to with the following abbreviations:
| Treaty |
Enforcement Mechanism |
International Covenant on Civil and Political Rights
(ICCPR) |
Human Rights Committee (HRC) |
| International Covenant on Economic, Social, and Cultural Rights (ICESCR) |
Committee on Economic, Social and Cultural Rights (CESCR) |
| International Convention on the Elimination of all forms of Racial Discrimination (ICERD) |
Committee on the Elimination of Racial Discrimination
(CERD) |
| Convention concerning Indigenous and Tribal Peoples in Independent Countries (ILO Con) |
International Labour Organization (ILO) |
| Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) |
Committee on the Elimination of All Forms of Discrimination Against Women (CEDAW Committee) |
| Convention on the Rights of the Child (CRC) |
Committee on the Rights of the Child (CRC Committee) |
| African Charter on Human and People’s Rights (ACHPR) & Protocols |
African Commission on Human and People’s Rights (ACHPR Commission) |
| [European] Convention for the Protection of Human Rights and Fundamental Freedoms (ECHR) |
European Court of Human Rights (ECtHR) |
| European Social Charter (ESC) |
European Committee of Social Rights (ECSR) |
| Framework Convention for the Protection of National Minorities (FCNM) |
Committee of Ministers of the Council of Europe & Advisory Committee (AC) |
Also cited in this report is the Special Rapporteur on the situation of human rights and fundamental freedoms of indigenous people (SR).
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Table 1: Minority health and the right to non-discrimination and equality
| Examples of Human Rights Violations |
- Housing policies force Roma communities into separate settlements that lack basic infrastructure and render inhabitants more vulnerable to illness and disease.
- Roma members are further more likely to be evicted from their homes and left to fend for themselves on the street.
- San communities have been expelled from their land and forced into settlements with inadequate facilities.
- Hospitals place Roma women in a separate maternity ward.
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| Human Rights Standards |
Precedents and Interpretations |
ICCPR 26 All persons are equal before the law and are entitled without any discrimination to the equal protection of the law. In this respect, the law shall prohibit any discrimination and guarantee to all persons equal and effective protection against discrimination on any ground such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status.
ICERD 2(1) States condemn racial discrimination and undertake to pursue by all appropriate means a policy of eliminating racial discrimination in all its forms.
2(2) State Parties shall… take… special and concrete measures to ensure the adequate development and protection of certain racial groups or individuals belonging to them, for the purpose of guaranteeing them the full and equal enjoyment of human rights and fundamental freedoms.
3 States particularly condemn racial segregation and apartheid and undertake to prevent, prohibit and eradicate all practices of this nature in territories under their jurisdiction.
5 State Parties undertake to prohibit and eliminate racial discrimination in all its forms and to guarantee the right of everyone, without distinction as to race, colour, or national or ethnic origin, to equality before the law, notably in the enjoyment of… (e) …[t]he right to housing; [t]he right to… social services.
ILO Con 2 Governments shall have the responsibility for… [a]ssisting the members of the peoples concerned to eliminate socio-economic gaps that may exist between the indigenous and other members of the national community, in a manner compatible with their aspirations and ways of life.
3(1) Indigenous and tribal peoples shall enjoy the full measure of human rights and fundamental freedoms without hindrance or discrimination.
4(1) Special measures shall be adopted as appropriate for safeguarding the persons, institutions, property, labour, cultures and environment of the peoples concerned.
FCNM 4(1) The parties undertake to guarantee to persons belonging to national minorities the right of equality before the law and of equal protection of the law. In this respect, any discrimination based on belonging to a national minority shall be prohibited.
4(2) The parties undertake to adopt… adequate measures in order to promote, in all areas of economic, social, political and cultural life, full and effective equality between persons belonging to a national minority and those belonging to the majority.
See also:
- ICCPR 2(1)
- CEDAW 2(a),(e)
- ACHPR 2
- Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa, art. 2 (elimination of discrimination against women)
- European Race Directive 2000/43/EC
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HRC: referring to ongoing discrimination faced by the Roma in Hungary in almost all aspects of life covered by the ICCPR. [CCPR/CO/74/HUN (HRC, 2002), para. 7].
CESCR: noting persistent discrimination against the Roma in Greece, Lithuania, and Serbia in the fields of housing, health, employment, and education. [E/C.12/1/ADD.97 (CESCR, 2004), para. 11; E/C.12/1/ADD.96 (CESCR, 2004), para. 9; e/c.12/1/ADD.108 (CESCR, 2005) para. 13].
CESCR: noting that many Roma settlements in Serbia lack access to basic services such as electricity, running water, sewage facilities, medical care, and schools. [E/C.12/1/ADD.108 (CESCR, 2005), para. 30].
CERD: urging the Czech Republic to ensure that domestic legislation clearly prohibits racial discrimination in the enjoyment of the right to housing and protects the Roma from evictions. [CERD/C/CZE/CO/7, March 2007].
CERD: linking the critical health situation of Roma communities in Lithuania to their poor living conditions and calling for addressing issues of drinking water supplies and sewage disposal systems in Roma settlements. [CERD/C/LTU/CO/3 (CERD, 2006), para. 22].
CEDAW Committee: referring to the multiple forms of discrimination faced by Roma women and girls in Romania, who remain marginalized with regard to their education, health, housing, employment, and participation in political and public life. [CEDAW/C/ROM/CO/6 (CEDAW, 2006), para. 26].
CRC Committee: remarking that children in Roma communities in Greece are exposed to substandard living conditions, including inadequate housing, poor sanitation and waste disposal, and no running water. [CRC/C/15/ADD.170 (CRC, 2002), para. 64]. |
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Table 2: Minority health and the right to the highest attainable standard of health
| Examples of Human Rights Violations |
- Doctors and health facilities are not located in or in close proximity to Roma and San neighbourhoods.
- Roma and San patients are refused treatment, given inferior care, or abused in public health facilities.
- Roma and San women lack access to maternal and reproductive health services.
- Social policies disproportionately exclude Roman individuals from access to health insurance.
- Displaced from their lands, the San have been deprived of their traditional livelihood, and their health has suffered.
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| Human Rights Standards |
Precedents and Interpretations |
ICESCR 12(1) The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
12(2) The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for…. (c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases; (d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness.
ICERD 5 State Parties undertake to prohibit and eliminate racial discrimination in all its forms and to guarantee the right of everyone, without distinction as to race, colour, or national or ethnic origin, to equality before the law, notably in the enjoyment of… (e)… [t]he right to public health, medical care, social security and social services.
ILO Con 25(1) Governments shall ensure that adequate health services are made available to the peoples concerned, or shall provide them with resources to allow them to design and deliver such services under their own responsibility and control, so that they may enjoy the highest attainable standard of physical and mental health.
CEDAW 12(1) States Parties shall take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to health services, including those related to family planning.
12(2) State Parties shall ensure to women appropriate services in connection with pregnancy, confinement and post-natal period.
14(2)(b) To have access to adequate health care facilities including information, counselling and services family planning.
CRC 24(1) States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health.
ACHPR 16(1) Every individual shall have the right to enjoy the best attainable state of physical and mental health. 16(2) States Parties to the present Charter shall take the necessary measures to protect the health of their people and to ensure that they receive medical attention when they are sick.
ESC 11 - The right to protection of health
With a view to ensuring the effective exercise of the right to protection of health, the Contracting Parties undertake, either directly or in co-operation with public or private organisations, to take appropriate measures designed...(2) to provide advisory and educational facilities for the promotion of health...
See also:
- Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa, art. 14(1): "State Parties shall ensure the right to health of women, including sexual and reproductive health is respected and promoted."
- African Charter on the Rights and Welfare of the Child 14 (child’s right to the highest attainable standard of health)
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CESCR: “States have a special obligation to provide those who do not have sufficient means with the necessary health insurance and health-care facilities, and to prevent any discrimination on internationally prohibited grounds.” [CESCR GC 14, para. 19].
CESCR: “[I]ndigenous peoples have the right to specific measures to improve their access to health services and care…. [D]evelpment-related activities that lead to the displacement of indigenous peoples against their will from traditional territories and environment, denying them their sources of nutrition and breaking their symbiotic relationship with their lands, has a deleterious effect on their health.” [CESCR GC 14, para. 27].
CESCR: explaining that “the right to health embraces a wide range of socio-economic factors that promote conditions in which people can lead a healthy life, and extends to the underlying determinants of health, such as food and nutrition, housing, access to safe and potable water and adequate sanitation, safe and healthy working conditions, and a healthy environment.” [CESCR GC 14, paras 4, 11, 12].
CESCR: calling for the Roma’s inclusion in Serbia’s health insurance scheme. [E/C.12/1/Add.108, June 2005, para. 60].
CERD: encouraging the implementation of programs to improve Roma health in Lithuania, bearing in mind their disadvantaged situation resulting from extreme poverty and low levels of education. [CERD/C/LTU/CO/3 (CERD, 2006), para. 22].
CEDAW Committee: noting the Roma women’s marginalization and lack of access to health care and calling upon Macedonia to provide information on concrete projects to address these problems. [CEDAW/C/MKD/CO/3, Feb 2006, para. 28].
CRC Committee: noting the limited access to health services for Roma children in Hungary. [CRC/C/HUN/CO/2 (CRC, 2006), para. 41]
SR Indigenous: recommending that South African social services, health, and education departments give high priority attention to San needs and grievances. [E/CN.4/2006/78/Add.2 (SR Indigenous, 2005), para. 92]. |
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Table 3: Minority health and the right to information
| Examples of Human Rights Violations |
- There are fewer health facilities in Roma and San communities, and there is little attempt to provide them with basic health information.
- Due to poor educational facilities in San communities, illiteracy rates are high, and children are unable to access important health information.
- Roma children are channeled into “special schools,” which provide an inferior education and limit their access to health information.
- Roma women lack access to information on sexual and reproductive health.
- Data on Roma and San health is inadequate, hindering the development of policies to address the needs of these communities.
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| Human Rights Standards |
Precedents and Interpretations |
ICCPR 19(2) Everyone shall have the right to freedom of expression; this right shall include freedom to seek, receive and impart information and ideas of all kinds, regardless of frontiers, either orally, in writing or in print, in the form of art, or through any other media of his choice.
ICESCR 13(1) The State Parties… recognize the right of everyone to education…. [E]ducation shall be directed to the full development of the human personality and the sense of its dignity.
ILO Con 26 Measures shall be taken to ensure that members of the peoples concerned have the opportunity to acquire education at all levels on at least an equal footing with the rest of the national community.
CEDAW 10(h) Access to specific educational information to help to ensure the health and well-being of families, including information and advice on family planning.
16(1) (e) The same rights to decide freely and responsibly on the number and spacing of their children and to have access to the information, education and means to enable them to exercise these rights.
CRC 28 States Parties recognize the right of the child to education, and with a view to achieving this right progressively and on the basis of equal opportunity.
ACHPR 9 (1) Every individual shall have the right to receive information.
ECHR 10 (1) Everyone has the right to freedom of expression. This right shall include freedom to hold opinions and to receive and impart information and ideas without interference by public authority and regardless of frontiers. This article shall not prevent States from requiring the licensing of broadcasting, television or cinema enterprises.
10(2) Every individual shall have the right to express and disseminate his opinions within the law.
FCNM 9(1) The Parties undertake to recognize that the right to freedom of expression of every person belonging to a national minority includes freedom to hold opinions and to receive and impart information and ideas in the minority language.
12(3) The Parties undertake to promote equal opportunities for access to education at all levels for persons belonging to national minorities.
See also:
- Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa, art. 14(2)(a) (right to health education and information)
- African Charter on the Rights and Welfare of the Child 11 (right to education);
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HRC: noting the “grossly disproportionate” number of Roma children assigned to special schools and urging Slovakia to take immediate steps to eradicate this segregation. [CCPR/CO/78/SVK (HRC, 2003), para. 18].
CESCR: urging the elimination of discrimination against Roma children in the Czech Republic by removing them from special schools and integrating them into the mainstream educational system. [E/C.12/1/ADD.76 (CESCR, 2002), para. 44]
CERD: calling upon the Czech Republic to promptly eradicate racial segregation and the placement of a disproportionate number of Roma children in special schools. [CERD/C/304/ADD.109 (CERD, 2001), para. 10].
CERD: noting that cultural and linguistic rights of the San are not fully respected in educational curricula in Botswana. [A/57/18(Supp) (CERD, 2001), para. 305].
CEDAW Committee: noting the lack of information on Roma women and their access to health services in Hungary; recommending data collection disaggregated by sex and the implementation of health awareness campaigns. [A/57/38(SUPP), Aug 2002, para. 332].
CEDAW Committee: urging the collection of statistical information on the health of Roma women and girls in Romania in order to develop policies responsive to their needs. [CEDAW/C/ROM/CO/6 (CEDAW 2006) para. 27].
CRC Committee: calling upon Moldova, Poland, and the Ukraine to develop and implement a plan aimed at integrating all Roma children into mainstream education and prohibiting their segregation into special classes. [CRC/C/15/ADD.191 (CRC, 2002), para. 75; CRC/C/15/ADD.194 (CRC, 2002), para. 53; CRC/C/15/ADD.192 (CRC, 2002), para. 50].
CRC Committee: urging South Africa to guarantee the rights of San children, particularly concerning language and access to information. [CRC/C/15/ADD.122 (CRC, 2000), para. 41].
AC: highlighting the need for data to assess Roma (and particularly Roma women’s) access to health services and education in Slovakia; data would have to be provided voluntarily, and Roma communities should be informed about the methods and purpose of data collection. [ACFC/OP/II(2005)004, May 2005, para. 11]. |
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Table 4: Minority health and the right to participate in public life
| Examples of Human Rights Violations |
- Roma members are unable to obtain citizenship papers and a health card, leaving them without access to social and health services.
- Labeled child-like, San members have little say in policy decisions affecting their health and well-being.
- Roma, particularly women, are unable to participate in public life and access needed social services.
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| Human Rights Standards |
Precedents and Interpretations |
ICCPR 25 Every citizen shall have the right and the opportunity, without… distinctions… (a) To take part in the conduct of public affairs, directly or through freely chosen representatives.
ICERD 5(c) States will guarantee political rights, in particular the right to take part in the Government as well as in the conduct of public affairs at any level and to have equal access to public services.
5(d) States guarantee the right to nationality.
ILO Con 6(1) Governments shall… (b) [e]stablish means by which these peoples can freely participate… at all levels of decision-making in elective institutions and administrative and other bodies responsible for policies and programmes which concern them.
7(1) The peoples… shall have the right to decide their own priorities for the process of development… and to exercise control, to the extent possible, over their economic, social and cultural development.
CEDAW 7 State Parties shall take all appropriate measures to eliminate discrimination against women in the political and public life of the country and, in particular, shall ensure to women, on equal terms with men, the right…. (b) [t]o participate in the formulation of government policy and the implementation thereof.
FCNM 15 The Parties shall create the conditions necessary for the effective participation of persons belonging to national minorities in cultural, social and economic life and in public affairs, in particular those affecting them.
African Women’s Protocol 9(1) States Parties shall take specific positive action to promote participative governance and the equal participation of women in the political life of their countries.
See also:
- CEDAW 14(2)(a) (right of rural women to participate in development planning)
- Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa, art. 9(1): "States Parties shall take specific positive action to promote participative governance and the equal participation of women in the political life of their countries."
- European Convention on Citizenship and the Convention Relating to the Status of Stateless Persons
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HRC: calling for the removal of all administrative obstacles and fees to enable the Roma in Bosnia to obtain personal documents necessary for them to access health insurance and other basic rights. [CCPR/C/BIH/CO/1 (HRC, 2006), para. 22].
HRC: urging Slovenia to enhance Roma participation in public life. [CCPR/CO/84/SVN (HRC, 2005), para. 16].
CESCR: stressing the importance of “participation in political decisions relating to the right to health taken at both the community and national levels.” [CESCR GC 14, para. 17].
CERD: expressing concern that a lack of identification documents effectively deprive the Roma in the Ukraine of their right to equal access to health care, housing, social security, education, and the legal system. [CERD/C/UKR/CO, August 2006, para. 11].
CERD: indicating that the Roma Council in Bosnia does not have sufficient funding or resources to fulfill its mandate and is rarely consulted by the Council of Ministers. [CERD/C/BIH/CO/6 (CERD, 2006), para. 14].
CERD: noting the cultural, social, economic, and political exclusion of San peoples in Botswana. [A/57/18(SUPP) (CERD, 2001), para. 301].
CEDAW Committee: calling for the immediate issuance of identity documents to Roma women in Romania.
[CEDAW/C/ROM/CO/6 (CEDAW 2006) para. 27].
CRC Committee: noting that Roma children in Bosnia are often not registered due to the parents’ lack of identification documents. [CRC/C/15/Add.260 (CRC, 2005), para. 32].
SR Indigenous: highlighting that the San are not sufficiently empowered to impact government decisions regarding allocation of limited resources in South Africa. [E/CN.4/2006/78/Add.2 (SR Indigenous, 2005), para. 75].
AC: noting the “weak and ineffective participation by the Roma community” in design and implementation of health strategies in Romania. [ACFC/OP/II(2005)007, Nov 2005, para. 54]. |
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Table 5: Minority health and the right to bodily integrity
| Examples of Human Rights Violations |
- Roma children are disproportionately targeted by police officers and subjected to ill-treatment and abuse.
- Roma women are coercively sterilized without their fully informed consent.
- Roma and San women and children are frequent victims of domestic violence due to extreme living conditions such as land dispossession, community isolation, high unemployment, poverty, and alcohol abuse.
- Due to discriminatory attitudes, police are especially reluctant to interfere when Roma women are victims of domestic violence.
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| Human Rights Standards |
Precedents and Interpretations |
ICERD 5 State Parties undertake to prohibit and eliminate racial discrimination in all its forms and to guarantee the right of everyone, without distinction as to race, colour, or national or ethnic origin, to equality before the law, notably in the enjoyment of…
(b) [t]he right to security of person and protection by the State against violence or bodily harm, whether inflicted by government officials or by any individual group or institution.
ACHPR 4 Human beings are inviolable. Every human being shall be entitled to respect for his life and the integrity of his person. No one may be arbitrarily deprived of this right.
FCNM 6(1) The parties undertake to take appropriate measure to protect persons who may be subject to threats or acts of discrimination, hostility or violence as a result of their ethnic, cultural, linguistic or religious identity.
Note: The right to bodily integrity is not specifically recognized under the ICCPR, ICESCR, or European conventions, but has been interpreted to be part of the right to security of the person (ICCPR 9, ECHR 5), the right to freedom from torture and cruel, inhuman, and degrading treatment (ICCPR 7, ECHR 3), and the right to the highest attainable standard of health (ICESCR 12, ESC 11). The CESCR remarked that a "major goal" under the right to health should be "protecting women from domestic violence." [CESCR GC 14, para. 21]. Although CEDAW does not specifically address bodily integrity, the CEDAW Committee indicated that the "definition of discrimination includes gender-based violence." [CEDAW Committee, General Rec. 19, paras 6-7].
See also:
- CRC 19(1) (protecting the child from all forms of physical or mental violence)
- Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa, art. 4(1): "Every woman shall be entitled to respect for her life and the integrity and security of her person."
- European Convention on Human Rights and Biomedicine, art 5: "An intervention in the health field may only be carried out after the person concerned has given free and informed consent to it."
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CESCR: noting police violence against the Roma in Greece, including sweeping arrests and arbitrary raids of Roma settlements. [E/C.12/1/ADD.97 (CESCR, 2004), para. 11].
CERD: remarking on police brutality against the Roma in the Ukraine, including arbitrary arrests and illegal detention. [A/56/18(SUPP) (CERD, 2001), para. 373].
CERD: noting that Roma members, especially the young, in Albania are subjected to ill-treatment and improper use of force by police officers. [CERD/C/63/CO/1 (CERD, 2003), para. 18].
CERD: recommending that Slovakia take all necessary measures to end forced sterilization, including the adoption of a new health care law, and ensure victims just and effective remedies. [CERD/C/65/CO/7, 10 December 2004].
CEDAW Committee: noting the continuing gender-based discrimination and violence that Roma women face in their own communities in Sweden. [A/56/38(SUPP) (CEDAW, 2000), para. 356].
CEDAW Committee: calling upon the Czech Republic to provide redress to Roma women victimized by coercive sterilization and to prevent further involuntary sterilizations. [CEDAW/C/CZE/CO/3 (CEDAW, 2006), para. 24].
CEDAW Committee: decision calling for compensation to a victim of coerced sterilization in Hungary and a review of legislation to ensure informed consent for sterilization. [12 February 2004].
CRC Committee: observing continued allegations of ill-treatment and torture by the police of Roma children in the Ukraine and urging investigation. [CRC/C/15/ADD.191 (CRC, 2002), para. 36].
AC: pointing to cases of abusive behavior, hostile attitudes, and violence by police against Roma members in Romania. [ACFC/OP/II(2005)007, November 2005]. |
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