Human Rights Watch has urged the Uganda Police Force to urgently investigate the murder of David Kato, a prominent gay activist who opposed the Anti-Homosexuality Bill submitted to parliament in 2009. ‘The government should ensure that members of Uganda's LGBT [lesbian, gay, bisexual and transgender] community have adequate protection from violence and take prompt action against all threats or hate speech likely to incite violence, discrimination, or hostility toward them,’ the group said in its statement. Police are investigating the matter and called for gay people who are being harassed to come forward and report these incidents - otherwise the police are not in a position to protect them. However, homosexuality is a criminal offence in Uganda, and reporting harassment to the police is a risk few are willing to take. Only a handful of gay Ugandans are ‘out of the closet’, with most preferring to live anonymously in a society where homosexuality is taboo. The criminalisation of homosexuality is predicted to have a negative effect on the transmission of HIV in the country, as gay men are unlikely to use health facilities for fear of discrimination and possible legal prosecution.
Values, Policies and Rights
Although HIV and tuberculosis (TB) prevalence are high in prisons throughout sub-Saharan Africa, little research has been conducted on factors related to prevention, testing and treatment services. To better understand the relationship between prison conditions, the criminal justice system, and HIV and TB in Zambian prisons, the authors of this study conducted facility assessments and in-depth interviews with 246 prisoners and 30 prison officers at six Zambian prisons, as well as 46 key informant interviews with government and non-governmental organisation officials and representatives of international agencies and external funders. A review of Zambian legislation and policy governing prisons and the criminal justice system was also conducted. The findings indicated serious barriers to HIV and TB prevention and treatment, and extended pre-trial detention that contributed to overcrowded conditions. Disparities both between prisons and among different categories of prisoners within prisons were noted, with juveniles, women, pre-trial detainees and immigration detainees significantly less likely to access health services. The authors call on the government to make immediate improvements to the situation and they recommend that external funders to co-operate with the Zambian government to ensure that funding in such areas as health services respect human rights standards.
Maternity protection for women workers is essential for ensuring women's access to equality of opportunity and treatment in the workplace, the International Labour Organization (ILO) argues in this review. Maternity protection also contributes to the health and well-being of mothers and their babies, and may thereby be linked to the achievement of Millennium Development Goal 3 (promoting gender equality and women's empowerment) and Goals 4 and 5 on the reduction of child mortality and improvement of the health of mothers. This updated review of national legislative provisions for maternity protection in 167 ILO member states assesses how well countries’ provisions conform to the ILO Maternity Protection Convention of 2000 and its accompanying recommendation no. 191. The review shows that, over the last 15 years, there have been noticeable improvements in maternity protection legislation around the world, with a shift towards longer rest periods at the time of childbirth, and movement away from employer liability systems of financing maternity leaves. The report focuses on the key aspects of maternity leave provisions: the duration, the benefit paid and the source of the funding, as well as other kinds of leave provision, safeguards on employment, health and safety, and breastfeeding. There are also annexes containing information on maternity provisions by region and country.
This article reports the findings of research conducted with a randomly selected sample of men aged 18–49 years from the general population of the Eastern Cape and KwaZulu-Natal, who were asked in an anonymously conducted survey about their rape perpetration practices, motivations, and consequences thereof. Overall 27.6% of men had forced a woman to have sex with them against her will, whether an intimate partner, stranger or acquaintance. Some perpetrated alone, others with accomplices. Most men who had raped had done so more than once, started as teenagers, and often had different types of victims. Asked about motivations, men indicated that rape most commonly stemmed from a sense of sexual entitlement, and it was often an act of bored men (alone or in groups) seeking entertainment. Rape was often also a punishment directed against girlfriends and other women, and alcohol was often part of the context. A third of men had experienced no consequences from their acts, not even feelings of guilt. More commonly there was remorse and worry about consequences, and in a third of cases there had been action against them from their family, that of the victims, or respected community members, and about one in five had been arrested for rape. This research confirms that rape is prevalent in South Africa, with only a small proportion of incidents reported to the police. Many of the roots of the problem lie in an accentuated gender hierarchy. This highlights the importance of interventions and policies that start in childhood and seek to change the way in which boys are socialised into men, building ideas of gender equity and respect for women.
In 2008 WHO analysed 186 national constitutions and found that 135 (73%) include provisions on health or the right to health. Of these, 95 (51%) constitutions mention the right to access health facilities, goods and services, which includes medicines. Only four national constitutions (2%) specifically mention universal access to medicines. There are at least three different routes, the study argues, through which the right to health – and essential medicines – can be recognised in national legal frameworks. The strongest government commitment is created by including the right to essential goods and services in the national constitution. The second approach is constitutional recognition that international treaties ratified by the State override or acquire the status of national law. The third option, inclusion of health rights in other national legislation, is easier to create but also easier to change or cancel. The full range of strategies should be used to promote universal access to essential medicines through rational selection, affordable prices, sustainable financing and reliable health systems, the article argues. Constitutional recognition of the right to access essential medicines is an important sign of national values and commitment, but is neither a guarantee nor an essential step – as shown by those countries that have failing health systems despite good constitutional language, and those that have good access without it. Yet constitutional recognition creates an important supportive environment, especially in middle-income countries where health insurance systems are being created and patients are becoming more aware of their rights and are more vocal in demanding them.
In light of the World Health Organization's declaration that non-dependent drinking contributes more to the global burden of alcohol-related disease than does drinking by those who meet diagnostic criteria for dependence, this article argues that clinicians, researchers and decision-makers need to consider microsocial and macrosocial impacts of alcohol use, not just addiction and clinical effects on individuals meeting diagnostic criteria at the extreme high end of the alcohol-use spectrum. It suggests some qualitative dimensions to further define social or low-risk drinking and proposes that all drinking beyond that be described as harmful, because of its impacts on personal, community and population health.
Gay Kenyans will be driven further underground and away from HIV prevention, treatment and care services following a recent call by Prime Minister Raila Odinga for a nationwide crackdown on homosexuals, activists say. Addressing a rally in Nairobi on 28 November, Odinga ordered the police to arrest and bring criminal charges against anyone found engaging in sex with someone of the same gender. He added that the country's constitution made it clear that homosexual activity was not tolerated. David Kuria, chair of the Gay and Lesbian Coalition of Kenya, said the prime minister's remarks will negatively impact the government's efforts to include the country's gay population in HIV prevention programmes. For example, activists warned that few would be willing to participate in a government survey - due to start in December - that aims to draw on responses from the country's gay population to inform HIV programming for men who have sex with men (MSM). Activists said potential respondents would be too fearful of being targeted by the authorities. Homophobia is widespread in Kenya, but this is the first time such a senior political figure has openly called for legal action against homosexuals. In October, a cabinet minister who called for tolerance towards gays was urged to resign for promoting ‘un-African’ culture.
This article proposes six action strategies to guide global health researchers to synergistically target women's health outcomes in the context of improving their right to freedom, equity, and equality of opportunities. Its main purpose is to offer a feasible approach to health researchers who, conceptually, may link women's health to social and cultural conditions but are looking for practical implementation strategies to examine a women's health issue through the lens of their human rights. The proposed strategies include becoming fully informed of women's human rights directives to integrate them into research, mainstreaming gender in the research, using the expertise of grass-roots women's organisations in the setting, showcasing women's equity and equality in the organisational infrastructure, disseminating research findings to policymakers in the study locale to influence health priorities, and publicising the social conditions that are linked to women's diseases. The article explores conceptual and logistical dilemmas in transforming a study using these principles and also provides a case study to illustrate how these strategies can be operationalised.
This paper identifies South Africa as a country with much internal and cross-border migration within a region of high population mobility, and argues that the country urgently needs to develop, implement and monitor an evidence-based, coordinated, multilevel national response to migration and health. This includes acknowledging the developmental benefits of migration, ensuring ‘healthy migration’ and engaging with a ‘place-based’ approach to addressing the diverse health needs and health impacts of the multiple migrant groups present within South Africa. The paper recommends that South Africa develop a co-ordinated regional response to migration and health. It should support the implementation of a regional framework for communicable diseases and population mobility. Four priority areas were identified: monitoring migrant health, developing partnerships and networks, developing migrant-sensitive health systems and putting in place policy and legal frameworks for migrants’ health. Migrants and migrant communities should be involved in health and migration responses, the paper argues.
This article reviews formal and informal mechanisms through which the World Health Organization (WHO) is promoting policies for the advancement of women's health, such as Countdown to 2015 and the Partnership for Maternal, Newborn, and Child Health. Specific attention is given to examples of innovative strategies WHO has adopted in recent years to increase political commitment to women's and children's health and influence the development of policies supportive of country efforts to achieve Millennium Development Goals 4 (MDG4) and MDG 5 (to reduce child mortality and improve maternal health, respectively). It is expected that WHO’s commitment to women’s health and efforts to translate its political agenda of improving the lives of women and girls through influencing policy development at the country level will progressively increase under the leadership of Dr Margaret Chan, the current WHO Director General. The Director-General has indicated that improvements in the health of the people of Africa and the health of women are considered the key indicators of WHO’s performance in the coming year.