VALUES, POLICIES AND RIGHTS
HIGH-LEVEL DIALOGUE ON HEALTH IN THE POST-2015 DEVELOPMENT AGENDA CONCLUDES IN BOTSWANA
UNAIDS: 6 March 2013
The High-level Global Thematic Consultation on Health brought together representatives from governments, non-governmental organisations, academic and research institutions and the private sector to debate how to advance health priorities in the post-2015 development agenda. The consultation took place in Gaborone, Botswana from 5-6 March 2013. UNAIDS Executive Director Michel Sidibé encouraged participants to seize the opportunity to adopt a bold, transformative vision and goals to guide global health in the post-2015 agenda. He argued that the global community needs to completely rethink how global health will engage on issues from intellectual property to the production of essential medicines and the central role of countries and communities. He also called for stronger attention to critical social enablers such as gender equality, human rights and equity. Health goals and indicators can be used to help track progress in these cross-cutting issues, he added.
THE ACHIEVEMENTS OF HUGO CHAVEZ
Muntaner C, Benach J And Victor MP: Counterpunch, 14-16 December 2012
Written during the final illness of Hugo Chavez, who died of cancer on 5 March 2013, this article considers the achievements of this visionary leader of Venezuela. Chavez used Venezuela’s abundant oil revenues to build needed infrastructure and invest in the social services: during the last ten years, the government increased social spending by 60.6%, a total of $772 billion. During Chavez’s term of office impressive health gains were made, such as a drop in infant mortality from 25 per 1000 (1990) to only 13/1000 (2010), while 96% of the population now has access to clean water, one of the goals of the revolution. In 1998, there were 18 doctors per 10,000 inhabitants, currently there are 58, and the public health system has about 95,000 physicians. It took four decades for previous governments to build 5,081 clinics, but in just 13 years the Bolivarian government built 13,721 (a 169.6% increase). Barrio Adentro (a primary health care partnership with 8,300 Cuban doctors) has saved approximately 1,4 million lives in 7,000 clinics and has given 500 million consultations. In 2011 alone, 67,000 Venezuelans received free high cost medicines for 139 pathologies conditions including cancer, hepatitis, osteoporosis, schizophrenia, and others. Venezuela now has the largest intensive care unit in the region. A network of public drugstores sell subsidised medicines in 127 stores with savings of 34-40%. Over the past few years, 51,000 people have been treated in Cuba for specialized eye treatment and the eye care programme ‘Mision Milagro’ has restored sight to 1.5 million Venezuelans.
HEALTH IN THE POST‐2015 DEVELOPMENT AGENDA
People’s Health Movement (PHM): 2013
As the 2015 deadline for the Millennium Development Goals approaches, the People’s Health Movement (PHM) has produced this statement in which they set out an agenda for the political leaders who will formulate the next set of post-2015 ‘development goals’. First, development must not be construed solely as economic growth and industrialisation; it must include cultural and institutional development and include the rich world as well as low- and middle-income countries. Second, addressing the global health crisis requires that we confront the social, economic, political and environmental determination of health, recognising the negative consequences of neoliberalism. Third, reform of the global economic and political architecture must be an inclusive process. Nation states must achieve sustainable development and universal social protection before the interests of multinationals are even considered. Fourth, the post 2015 development agenda must work towards new approaches to national and global decision making, based on popular participation, direct democracy, solidarity, equity and security. Finally, sustainable and equitable development will be achieved only if people’s movements unite across sectors, cultures and national boundaries and articulate a coherent set of goals and strategies for change.
COLONISING AFRICAN VALUES: HOW THE US CHRISTIAN RIGHT IS TRANSFORMING SEXUAL POLITICS IN AFRICA
Kaoma KJ: Political Research Associates, 2012
This report reports on the impact of Christian conservatism from United States on human rights policies in Africa. A number of churches are reported in this paper to be working in Africa to promote US ‘family values’, campaigning against condom use to prevent HIV transmission, claiming that family planning is a Western conspiracy to reduce African development, and supporting campaigns to pursue the death penalty for gays and lesbians. The author argues that government and civil society should confront the myths of human rights advocacy being western neocolonialism, noting indigenous African human rights agendas and support African advocacy to respect human rights for all.
NEW AVENUE FOR LITIGATING THE RIGHT TO HEALTH: OPTIONAL PROTOCOL TO THE ICESCR COMES INTO FORCE
Cabrera OA Friedman E And HonermannB: O’Neill Institute, February 2013
On 5 February, 2013, Uruguay became the tenth country to ratify the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights (ICESCR), which means the Optional Protocol will come into force on 5 May, 2013. Until now, the CESCR has been limited to issuing concluding observations and recommendations to member countries as part of semi-regular country reporting requirements in the ICESCR and to issuing broad general comments on rights under the Convention. The opportunity will now exist at the global level to litigate and begin to develop more concrete standards around the rights in the ICESCR – including the right to of everyone to the enjoyment of the highest attainable standard of physical and mental health (Article 12 of the ICESCR). The authors of this paper highlight emerging opportunities within the framework of the ICESCR and the Optional Protocol to begin serious investigations into the social determinants of health, such as access to sufficient food, water, sanitation, and education. They call for an approach that goes beyond the typical and narrower construction of the right to health based in access to health care services to include the determinants discussed in Article 12.
HOW DO NATIONAL STRATEGIC PLANS FOR HIV AND AIDS IN SOUTHERN AND EASTERN AFRICA ADDRESS GENDER-BASED VIOLENCE? A WOMEN’S RIGHTS PERSPECTIVE
Gibbs A, Mushinga M, Crone ET, Willan S And Mannell J: Health And Human Rights 14(2), 2012
Gender-based violence (GBV) is a significant human rights violation and a key driver of the HIV epidemic in southern and eastern Africa. In this study, the authors frame GBV from a broad human rights approach that includes intimate partner violence and structural violence. They use this broader definition to review how National Strategic Plans for HIV and AIDS (NSPs) in southern and eastern Africa address GBV. NSPs for HIV and AIDS provide the national-level framework that shapes government, business, external funder, and non-governmental responses to HIV within a country. They authors’ review suggests that attention to GBV is poorly integrated, and few recognise GBV and programme around GBV. The programming, policies and interventions that do exist privilege responses that support survivors of violence, rather than seeking to prevent it. Furthermore, the subject who is targeted is narrowly constructed as a heterosexual woman in a monogamous relationship. There is little consideration of GBV targeting women who have non-conforming sexual or gender identities, or of the need to tackle structural violence in the response to HIV and AIDS.
INTEGRATING INTERVENTIONS ON MATERNAL MORTALITY AND MORBIDITY AND HIV: A HUMAN RIGHTS-BASED FRAMEWORK AND APPROACH
Fried S, Harrison B, Starcevich K, Whitaker C And O’Konek T: Health And Human Rights 14(2), 2012
In sub-Saharan Africa, HIV and maternal mortality and morbidity (MMM) are connected in both outcomes and solutions: HIV is the leading cause of maternal death, while prevention of unintended pregnancy and access to contraception are considered two of the most important HIV-related prevention efforts. Both are central to reducing unsafe abortion, another leading cause of maternal death in Africa. A human rights-based framework helps to identify shared structural drivers include gender inequality; gender-based violence (including sexual violence); economic disempowerment; and stigma and discrimination in access to services or opportunities based on gender and HIV. Therefore the authors call for a human rights-based and integrated response to the two health issues. Governments should establish the health-related human rights standards to which all women are entitled and provide remedy for human rights violations related to HIV and maternal mortality and morbidity. No single goal, such as those addressing HIV and MMM, can be achieved without progress on all development goals.
UNIVERSAL HEALTH COVERAGE SHOULD BE ANCHORED IN THE RIGHT TO HEALTH
Ooms G, Brolan C, Eggermont N, Eide A, Flores W, Forman L Et Al: Bulletin Of The World Health Organisation 91(1): 2-2A, January 2013
In this article, the authors propose that the right to health and its imperative of narrowing health inequities should be central to the post-2015 international health agenda. However, they argue that universal health coverage - as defined by the World health Organisation and typically conceived - is not enough to ensure the right to health. Policy-makers will need to address the social determinants of health such as safe drinking water and good sanitation, adequate nutrition and housing, safe and healthy occupational and environmental conditions and gender equality. The post-2015 health agenda should also explicitly describe the accountability mechanisms that will make it possible for people to claim – not beg for – additional national public resources and international assistance, if needed. Furthermore, it must specify how citizens will participate in the decision-making processes surrounding their health services and their physical and social environment. Participation must be genuine and built on a continuing relationship among researchers, governments and those communities, otherwise goals may end up being formulated by policy elites after token and superficial consultations, undermining the rights of the very communities they serve.
MENTAL HEALTH IN GHANA: A RIGHTS VIOLATION IN ACTION
Asokan I: Consultancy Africa Intelligence, 24 January 2013
This report argues that Ghana is reported to be violating the African Charter on Human and Peoples’ Rights when people with mental disorders are subjected to prayer camps that advocate complete isolation, being chained to trees, and forced exorcism for demonic possession, and fails to provide services for mentally illness. The author suggests that mental health problems often stem from poor nutrition, depressed socioeconomic status, and elevated, persistent violence. Despite the widespread presence of these factors mental heath problems like depression or undiagnosed schizophrenia are often ignored in health policy agendas in Africa. The author proposes that mental health be recognised as a human right, coupled with de-stigmatisation of mental health disorders, and resource allocation for treatment.
INTERIM REPORT OF THE SPECIAL RAPPORTEUR ON THE RIGHT OF EVERYONE TO THE ENJOYMENT OF THE HIGHEST ATTAINABLE STANDARD OF PHYSICAL AND MENTAL HEALTH
United Nations Special Rapporteur On The Right Of Everyone To The Enjoyment Of The Highest Attainable Standard Of Physical And Mental Health: 3 August 2011
In this report, the Special Rapporteur considers criminal laws and other legal restrictions relating to sexual and reproductive health and the right to health. These include criminal and other legal restrictions on: abortion; conduct during pregnancy; contraception and family planning; and the provision of sexual and reproductive education and information. These restrictions violate the right to health by restricting peoples’ access to quality goods, services and information, as well as violating their right to make their own decisions about their bodies. Moreover, the application of such laws as a means to achieving certain public health outcomes is often ineffective and disproportionate, according to the report. In cases where a barrier is created by a criminal law or other legal restriction, it is the obligation of the State to remove it. In response to countries that are calling for the progressive realisation of the right to health, the Rapporteur argues that the removal of such laws and legal restrictions is not subject to resource constraints; therefore he calls for the immediate scrapping of laws and policies undermining sexual and reproductive health to ensure everyone can enjoy full realisation of their right to health.