This article argues for international legal change in human rights as a consequence of a states-as-bystander effect: When states do neither actively drive nor block change processes, and alternative state-empowered authorities exist in a legal field, states’ position at the sidelines opens a path for non-state actors to enact substantive change. In human rights law, this is a process they route through General Comments, a powerful instrument of the human rights treaty bodies to set, expand, and redefine standards for global human rights. This article bears its core argument of a states-as-bystander effect by taking a single norm, the necessity of water for human life, and tracing its change process from non-existent in human rights law, to a non-right, to a condition for other rights, and, finally, to the recognition of water and sanitation as independent rights at the international level. Ultimately, the analysis shows that non-actors can enact change to law, and do so, on the heels of states’ relegation to the periphery of the human rights system. This opened the door for certain actors – transnational coalitions of expert body members, human rights advocates and issue professionals – to use General Comments in a way that not only impacts international legal change but can also withstand state opposition.

In light of 2014–2016 media coverage about the inadequate water and sanitation services for households in places like Flint and Detroit, Michigan and the Central Valley of California, this paper asks whether places with majority non-White residents in the United States disproportionately lack access to these most basic of services. Investigating this issue through the combined lenses of structural racism, environmental justice, and the human right to water and sanitation, we analyze U.S. Census American Community Survey household data at the county level. Our findings indicate strong White versus non-White racial effects at the national and county levels (R2 = 0.0462, P < 0.05). When the non-White population is broken down into racial categories, places with higher percentages of American Indians and Alaska Native households are significantly associated with lack of access to complete plumbing facilities. Lacking access to complete plumbing does correlate with lower educational attainment and higher percentages of unemployment, and less robustly, it also correlates positively with median household income. The implication is the existence of a pattern of structural environmental racism in terms of the practical accessibility of water and sanitation infrastructure. We suspect, however, that the U.S. Census, while considered the most comprehensive national data source on this issue right now, significantly undercounts those lacking access to water and sanitation services. We argue that better data will be essential in order to carry out a more in-depth analysis of water access conditions and to develop strategies that address this issue of growing importance.

New ways of integrating and scaling up control of neglected tropical diseases (including schistosomiasis) are presently underway. In this context consideration of social science perspectives is essential. In this article, we review social science publications of relevance to sustained control of schistosomiasis in Africa including diagnosis and screening, treatment, supply of clean water and improved sanitation, as well as health communication. Studies of community involvement and links between schistosomiasis control programmes and broader health care systems are also explored. Directions for future social science of relevance to sustainable schistosomiasis control are outlined, including ways of ensuring equitable access to health services as well as involvement of endemic communities and local health care systems based on equal partnership.