On 21 September 2016 the United Nations General Assembly (UNGA) adopted the political declaration on antimicrobial resistance. Its adoption provides recognition of the critical nature of antimicrobial resistance (AMR) at the highest political level. It recognises the World Health Organisation (WHO) Global Action Plan on AMR as the blue print of action. It also acknowledges that the lack of access to health services and antimicrobial medicines continues to affect more people than resistance, as a major challenge for developing countries. The document clearly states that research and development efforts should be guided by need and by the principles of affordability, effectiveness, efficiency and equity as well as be de-linked from the price and volume of sales. There are two calls for action in the text. The first one calls upon the WHO “together with Food and Agriculture Organisation (FAO) of the United Nations and the World Organisation for Animal Health (OIE), to finalise a global development and stewardship framework. ” Preliminary discussions on this framework have taken place in Geneva at the WHO Headquarters in early 2016 but this call for action gives an explicit mandate to continue the negotiations that will define and structure how this framework would look like. The second call for action requests the Secretary-General to establish an ad hoc interagency coordination group co-chaired by the Executive Office of the Secretary-General and the WHO. During the negotiations for the political declaration civil society groups that were following the process in New York told Third World Network that it was necessary that the UN, with all its agencies, participated in creating actions within their mandates to complement and support the WHO leadership in this issue due to the fact that AMR is interconnected with many other aspects beyond human health. According to several civil society organisations that attended the panel, while the declaration is a good step and recognition at the highest level of this critical issue the declaration had few commitments on the mobilisation of funds to support developing countries. It did not make specific commitments in the animal health sector. The declaration calls for a report back in 2018 at the UNGA and hopefully some of the commitments discussed in this meeting can be truly realised.
Values, Policies and Rights
The authors argue that leaving no one behind is the moral issue of our age, and is at the heart the Sustainable Development Goals (SDGs). One specific goal is ‘ending poverty, in all its forms, everywhere’, but the SDGs also aim to tackle marginalisation. The SDG outcome document specifies that the goals should be met for all segments of society, with an endeavour to reach those furthest behind first. Now the focus is on implementation, particularly at the national level. This report makes the case for early action, and quantifies its benefits. The report outlines the actions that governments can take in the first 1,000 days of the SDGs to respond to what poor people want and to deliver for the most marginalised people and groups. The evidence shows that achieving the SDGs and the ambition to leave no one behind will become far more difficult the longer governments delay. The report concludes that early action is critical for the achievement of the SDGs.
This meeting, organized under the auspices of the Network of Africa Parliamentary Committees on Health (NEAPACOH), and organised by PPD Aro, focused on implementation of regional and international commitments including the International Congress on Population and Development, Program of Action, the Maputo Plan of Action, the Millennium Development Goals (MDGs), and the FP2020 commitments, among others. The meeting provided a platform for building capacity and raising awareness of members of parliament on sustainable development. At the meeting parliamentarians from across the continent assessed progress made, challenges and lessons learned on achieving the country commitments made at its previous 2014 NEAPACOH meeting, built a common understanding of the challenges and opportunities for sexual and reproductive health in the post-2015 development agenda, shared experiences and innovative practices on the implementation of the 2030 Agenda for Sustainable Development, to enhance accountability, political leadership and stewardship for implementation over the coming 12 months. By the end of the meeting, a resolution (The Kampala Call for Action) was adopted by participants, on their commitments to address these issues.
This new report by the Center for Health, Human Rights and Development (CEHURD). “Facing Uganda’s Law on Abortion: Experiences from Women and Service Providers” raises that an unclear abortion law in Uganda means that women and adolescents seek unsafe abortions and are vilified by their families and communities, with doctors and health workers who provide legal post-abortion care being arrested. This report highlights experiences and perspectives of individuals who have been affected by or have dealt with abortion. It includes interviews with women and girls who ended pregnancies, as well as doctors, nurses, health worker, lawyers, police and community members. Abortion in Uganda is legal in limited circumstances, yet approximately 85,000 women each year receive treatment for complications from unsafe abortion and an additional 65,000 women experience complications but do not seek medical treatment. The CEHURD report also draws on a research report by the Center for Reproductive Rights in 2012 on Uganda’s laws and policies on termination of pregnancy that found that the laws and policies are more expansive than most believe, and that Uganda has ample opportunity to increase access to safe abortion services.
The right to health has been enshrined in a number of core international and regional human rights treaties, to which WHO African Region Member States are signatories. This therefore imposes an obligation on them to make every possible effort using available resources to respect, protect, fulfil and promote the right to health of their citizens. This study analysed key issues and challenges affecting the realisation of the right to health in African countries. A survey questionnaire was sent by email to the then 46 Member States in the African Region through the WHO Country Representatives, and explored legal, policy and institutional aspects that affect the realisation of the right to health and the main health related human rights issues, and challenges in implementing the right to health. Twenty-five (54%) countries responded. The main findings were that all countries were signatories to at least one human rights treaty that recognises the right to health; all countries had national legislation touching on aspects of the right to health but only 12 countries (48%) had policies or strategies for mainstreaming human rights in healthcare. On issues affecting the realisation of the right to health: 88% identified access to health care services, medical products, and technologies; 52% identified inadequate financing for health; 28% cited marginalisation, stigma and discrimination of some groups and communities; and 24% cited gender-related inequities and violations. Lack of awareness of the right by the general population and health workers was cited by 52% of the respondents. A lot remains to be done towards the realisation of the right to health in the African Region. Member States are encouraged to review their legislation and policies to assess their consistency with human rights standards, and put in place institutional mechanisms and adequate resources that will ensure their implementation, enforcement and monitoring.
Established under Section 25 of the HIV Prevention and Control Act of 2006, the HIV and AIDS Tribunal of Kenya is the only HIV-specific statutory body in the world with the mandate to adjudicate cases relating to violations of HIV-related human rights. Yet, very limited research has been done on this tribunal. Based on findings from a desk research and semi-structured interviews of key informants conducted in Kenya, this article analyses the composition, mandate, procedures, practice, and cases of the tribunal with the aim to appreciate its contribution to the advancement of human rights in the context of HIV. It concludes that, after a sluggish start, the HIV and AIDS Tribunal of Kenya is now keeping its promise to advance the human rights of people living with and affected by HIV in Kenya, notably through addressing barriers to access to justice, swift ruling, and purposeful application of the law. The article, however, highlights various challenges still affecting the tribunal and its effectiveness, and cautions about the replication of this model in other jurisdictions without a full appraisal.
The authors note a proposal for the World Health Organization (WHO) to provide capacity-building for drafting health laws in Member States. They highlight that WHO has the authority and credibility to work with countries to make their national laws easier to access and understand, and to monitor and evaluate their implementation. WHO’s new technical support work related to universal health coverage (UHC) laws is observed as one example of its support for Member States in this important area. Strengthening countries’ legal and regulatory frameworks and engaging in universal health coverage-compliant law reforms has been missing from the universal health coverage agenda. WHO calls on Member States to align their health system policies with universal health coverage goals such as equity, efficiency, health service quality and financial risk protection. Strengthening health systems using health laws and legal frameworks is a pivotal means for attaining these goals and achieving sustainable results in health security and resilience.
A constitutional guarantee of access to essential medicines has been identified as an important indicator of government commitment to the progressive realisation of the right to the highest attainable standard of health. The objective of this study was to evaluate provisions on access to essential medicines in national constitutions, to identify comprehensive examples of constitutional text on medicines that can be used as a model for other countries, and to evaluate the evolution of constitutional medicines-related rights since 2008. Relevant articles were selected from an inventory of constitutional texts from WHO member states. References to states’ legal obligations under international human rights law were evaluated. Twenty-two constitutions worldwide now oblige governments to protect and/or to fulfil accessibility of, availability of, and/or quality of medicines. Since 2008, state responsibilities to fulfil access to essential medicines have expanded in five constitutions, been maintained in four constitutions, and have regressed in one constitution. Government commitments to essential medicines are an important foundation of health system equity and are included increasingly in state constitutions.
World Population Day in July 2016 was held with the theme “Investing in teenage girls”. “The teenage years are for some girls a time of exploration‚ learning and increasing autonomy. But for many others‚ it is a time of increasing vulnerability and exclusion from rights and opportunities‚ or just plain discrimination‚'” said Babatunde Osotimehin‚ UN under-secretary-general and executive director of the UN Population Fund (UNFPA). “When a teenage girl has the power‚ the means and the information to make her own decisions in life‚ she is more likely to overcome obstacles that stand between her and a healthy‚ productive future. This will benefit her‚ her family and her community.” According to the UN‚ 20 000 girls under the age of 18 give birth every day in developing countries. Siyabulela Mamkeli‚ Cape Town mayoral committee member for health‚ said good health and access to services were “crucial to help young women on the road to success”. In conjunction with other organisations‚ the city has been involved in pilot projects to provide girls who have started with their menstrual cycle with reusable sanitary towels. Meanwhile‚ the UNFPA's initiative - to end child marriages‚ curb adolescent pregnancy and encourage girls to make informed decisions about their futures - helped more than 11-million girls between the ages of 10 and 19 gain access to sexual and reproductive health services and information in 2015.
Governments in low- and middle-income countries are legitimising the implementation of universal health coverage (UHC), following a United Nation’s resolution on UHC in 2012 and its reinforcement in the sustainable development goals set in 2015. UHC will differ in each country depending on country contexts and needs, as well as demand and supply in health care. Therefore, fundamental issues such as objectives, users and cost–effectiveness of UHC have been raised by policy-makers and stakeholders. While priority-setting is done on a daily basis by health authorities – implicitly or explicitly – it has not been made clear how priority-setting for UHC should be conducted. The authors provide justification for explicit health priority-setting and guidance to countries on how to set priorities for UHC.