WHO has published a draft proposal for a set Framework and set of policies to address its engagement with Non Sate Actors (NSAs). Member States are being invited to discuss these proposals at WHO’s HQ in Geneva on 27th and 28th March. Public Interest NGOs are not invited. IBFAN has been following the process closely and reports finding serious flaws, inconsistencies and contradictions in the proposals. Despite the many statements of WHO’s Director General, Margaret Chan, that WHO’s policies, norms and standards setting processes should be protected from commercial influence, if the new proposals were to be adopted, the corporate influence would increase. IBFAN fears that this would compromise WHO’s integrity, independence and its ability to fulfil its mandate. In particular, the proposals introduce a new risky element, allowing Official Relations status, with all its related privileges, for International Business Associations. Up to now, if businesses wanted to attend governing body meetings in order to lobby Member States delegations, they could wear a public badge, or, if they wanted to speak, inveigle their way onto government delegations. Some, over the years have slipped through WHO’s admission procedures, pretending to be NGOs. The new proposals open the door wide to participation by any business member of these Associations, except tobacco or arms companies. This would, in effect, legitimize businesses lobbying role at WHO’s global policy-setting meetings - the very thing that WHO alleges that it is trying to avoid. In addition to turning WHO governing bodies meetings into multi-stakeholder public-private gatherings, the proposals would also allow businesses greater engagement at programme level, through agreed 3-year plans with WHO. Lida Lhotska, IBFAN NGO Liaison to WHO says: “If these new policy proposals are adopted, IBFAN fears that WHO will be unable to lead and support Member States in taking the bold decisions necessary to tackle global health challenges. For example, irresponsible marketing is a major underlying cause of Non Communicable Diseases (NCDs). In tackling NCDs, acknowledged to be a major threat to public health, will WHO prefer to engage in partnerships with corporations, who would prefer campaigns for promoting ‘slightly better for you products’– or will WHO help Member States bring in legally-binding controls that truly protect right to health of their citizens?”
Values, Policies and Rights
CEDAW, the Committee on the Elimination of Discrimination against Women, at its recently concluded session, issued a statement (attached) on sexual and reproductive health and rights, which is its contribution to the ICPD@20 review process. The Committee reminds us that it "has observed that failure of a State party to provide services and the criminalisation of some services that only women require is a violation of women's reproductive rights and constitutes discrimination against them." It States that: "the provision of, inter alia, safe abortion and post abortion care; maternity care; timely diagnosis and treatment of sexually transmitted diseases (including HIV), breast and reproductive cancers, and infertility; as well as access to accurate and comprehensive information about sexuality and reproduction, are all part of the right to sexual and reproductive health" and that "every State can and should do more to ensure the full respect, protection and fulfilment of sexual and reproductive rights, in line with human rights obligations."
WHO is launching a public consultation on its draft guideline on sugars intake. When finalized, the guideline will provide countries with recommendations on limiting the consumption of sugars to reduce public health problems like obesity and dental caries (commonly referred to as tooth decay). Comments on the draft guideline will be accepted via the WHO web site from 5 through 31 March 2014. Anyone who wishes to comment must submit a declaration of interests. An expert peer-review process will happen over the same period. Once the peer-review and public consultation are completed, all comments will be reviewed, the draft guidelines will be revised if necessary and cleared by WHO’s Guidelines Review Committee before being finalized.
On 11th March 2014, the legality of the Anti Homosexuality Act was challenged in Constitutional Court by an unprecedented coalition of petitioners and an Injunction against enforcement sought. The petition was filed under the auspices of the Civil Society Coalition on Human Rights and Constitutional Law, a coalition of 50 indigenous civil society organisations that advocates for non-discrimination in Uganda. The petition argues that the Anti Homosexuality Act violates Ugandans’ Constitutionally guaranteed right to: privacy, to be free from discrimination, dignity, to be free from cruel, inhuman and degrading treatment, to the freedoms of expression, thought, assembly and association; to the presumption of innocence, and to the right to civic participation.
The complications of unsafe, illegal abortions are a significant cause of maternal mortality in Botswana. The stigma attached to abortion leads some women to seek clandestine procedures, or alternatively, to carry the fetus to term and abandon the infant at birth. The author conducted research into perceptions of abortion in urban Botswana in order to understand the social and cultural obstacles to women’s reproductive autonomy, focusing particularly on attitudes to terminating a pregnancy. She carried out 21 interviews with female and male urban adult Batswana. The findings however, suggest that socio-cultural factors, not punitive laws, present the greatest barriers to women seeking to terminate an unwanted pregnancy. It is argued that these factors must be addressed so that effective local solutions to unsafe abortion can be generated.
This paper reviews the legal and policy context of HIV disclosure in sub-Saharan Africa, as well as what is known about rates, consequences and social context of disclosure, with special attention to gender issues and the role of health services. Persistent rates of nondisclosure by those diagnosed with HIV raise difficult ethical, public health and human rights questions about how to protect the medical confidentiality, health and well-being of people living with HIV on the one hand, and how to protect partners and children from HIV transmission on the other. Both globally and within the sub-Saharan African region, a spate of recent laws, policies and programmes have tried to encourage or – in some cases – mandate HIV disclosure. These policies have generated ethical and policy debates. While there is consensus that the criminalization of transmission and nondisclosure undermines rights while serving little public health benefit, there is less clarity about the ethics of third party notification, especially in resource-constrained settings. Despite initiatives to encourage voluntary HIV disclosure and to increase partner testing in sub-Saharan Africa, health workers continue to grapple with difficult challenges in the face of nondisclosure, and often express a need for more guidance and support in this area. A large body of research indicates that gender issues are key to HIV disclosure in the region, and must be considered within policies and programmes. Taken as a whole, this evidence suggests a need for more attention to the challenges and dilemmas faced by both clients and providers in relation to HIV disclosure in this region and for continued efforts to consider the perspectives and rights of all those affected.
The Aids and Rights Alliance for Southern Africa (ARASA) has strongly condemned Uganda’s Anti-Homosexuality Act, signed into law by Ugandan President Yoweri Kaguta Museveni in February. According to ARASA the new law is contrary to the provisions of Uganda’s own constitution and goes against its purported aim of protecting the country’s people. The alliance claims that provisions in the law place unacceptable limitations on the rights to freedom of expression and association and will undermine proven prevention, treatment and care efforts targeted at vulnerable populations, such as men who have sex with men, placing them at greater risk both of contracting HIV and of persecution, harassment, violence and even death. According to ARASA the law contradicts the recent recommendations of the Global Commission on HIV and the Law, whose members included prominent African leaders such as Festus Gontebanye Mogae, former president of Botswana. The Global Commission report recommended that in order “to ensure an effective, sustainable response to HIV that is consistent with human rights obligations, countries must prohibit police violence against key populations. Countries must also support programmes that reduce stigma and discrimination against key populations and protect their rights”.
The issue of homosexuality arouses different but deeply felt emotions in many parts of the world. In Africa, 38 countries criminalize homosexuality with sentences ranging from a small fine to life imprisonment. The author notes that criminalization goes well beyond the human rights discourse; it is also a public health issue. He notes the many well researched papers that provide evidence on the negative public health impact of criminalization, not just on the homosexual persons, but also on the public health system of a country, leading global health organizations such as World Health Organization and UNAIDS to issue guidelines on the issue of criminalization. The author presents the arguments, given the demonstrable negative impact of stigma and criminalisation on public health and human rights, whether the Kenyan society can broker a middle ground between morality aspirations on the one hand and public health & human rights on the other.
This report provides the summary findings of a team of expert scientists constituted by the Director General Health Services Uganda at the request of the Minister of Health to review research data, deliberate and advise him on key questions about homosexuality. The conclusions of the report as presented by Pambazuka were that there is no definitive gene responsible for homosexuality; that homosexuality is not a disease or an abnormality; that in every society, there is a small number of people with homosexual tendencies; that homosexuality can be influenced by environmental factors (e.g. culture, religion, information, peer pressure); that the practise needs regulation like any other human behaviour, especially to protect the vulnerable and that there is need for studies to address sexualities in the African context.
This paper seeks to determine how the corporate responsibilities of pharmaceutical companies in relation to access to medicines can be clarified and enforced. Two cases, one each from India and South Africa, are examined to determine how the domestic courts in both countries indirectly utilized the right to health to ensure that pharmaceutical companies did not impede access to affordable medicines through exercising their patent rights. There is a need to clarify and enforce the responsibilities pharmaceutical companies have to promote the right to health. The two cases from India and South Africa demonstrate the potentials of domestic courts as forums where these responsibilities can be effectively enforced. In the absence of a global enforcement mechanism for enforcing the right-to-health responsibilities of pharmaceutical companies, domestic courts can effectively fill this gap. In addition, this paper demonstrates that domestic courts can equally serve as forums for health diplomacy.