Essential medicines must be physically accessible (available), economically accessible (affordable) and must be administered without discrimination. To help ensure this, the HIV Clinical Group at Pretoria University, in conjunction with PIJIP and WCL clinic students, is working to gather widespread NGO support for a submission before the African Commission during its meeting in Abuja, Nigeria from the 10th to the 24th of November. This submission will call upon the African Commission to adopt an interpretation of the right to health under the African Charter, which mirrors the one provided by General Comment 14 to the ICESCR, specifically recognising that access to medicines is a crucial component to the right to health. Furthermore, upon recognising that the right to health includes the components of accessibility, availability, acceptability, and good quality of medicines, the submission will call upon the African Commission, in the future, to use these standards as a means to uniformly monitor the state’s compliance with the right to health.
Values, Policies and Rights
Adopted in 2005, the Paris Declaration on Aid Effectiveness is the most recent framework on management of development aid assistance agreed by the donor community in the OECD, in partnership with some Southern governments. It aims to contribute to achieving the Millennium Development Goals by 2015. There have been some improvements in recognising the importance of gender equality and women’s rights, such as the Accra Agenda for Action (AAA), which emphasises their central place of poverty reduction and human rights in development policy. The AAA also recognises the need to improve access to sex-disaggregated data but fails to explicitly recognise the need for coherence with international agreements on human rights, gender equality, environmental sustainability and decent work as frameworks for aid relationships. Ultimately, there has been no significant change in direction since 2005.
This paper questions the right of corporations in developed countries to own biological samples of traditional medical knowledge in developing nations. This phenomenon has been referred to as biopiracy or as bioprospecting. Biopiracy is tackled in two international treaties - the Trade-related Aspects of Intellectual Property Rights (TRIPS) agreement and the Convention on Biological Diversity (CBD). But these treaties have different goals: the CBD focuses on protecting biological diversity, while TRIPS promotes private ownership. This paper addresses friction about how to interpret international contracts with embedded biopiracy. It recommends collecting traditional knowledge on publicly accessible databases so that patent offices can determine the real source of knowledge. Patent applicants could also be required to disclose the source of biological material to prevent misappropriation of genetic material. Countries should also strike deals with corporations to obtain fair compensation for use of resources.
In the clinical situation it is difficult to know whether gender differences in management reflect physicians' gender bias or male and female patients' different needs or different ways of expressing their needs. To shed some light on these possibilities this study investigated to what extent it was possible to identify patients' sex when reading their blinded illness narratives, i.e., do male and female patients express themselves differently enough to be recognised as men and women without being categorised beforehand? Eighty-one authentic letters about being diseased by cancer were blinded regarding sex and read by 130 students of medicine and psychology. For each letter the participants were asked to give the author's sex and to explain their choice. The students' explanations for their choice of sex agreed with common gender stereotypes implying that such stereotypes correspond, at least on a group level, to differences in male and female patients' illness descriptions. However, it was also obvious that preconceptions about gender obstructed and biased the interpretations, a finding with implications for the understanding of gender bias in clinical practice.
In September 2008 world leaders convened in Accra, Ghana for Third High-Level Forum on Aid Effectiveness to sign what is now popularly called the Triple A (the Accra Agenda for Action). It is actually a prepackaged condensation of evaluations of implementation of the Paris Declaration and consultations about them conducted between 2006 and 2008 in all the regions of the world. It charts the broad actions that will occupy many development actors between now and December 2011 when the Fourth High Level Forum on Aid Effectiveness takes place. This paper attempts to show how and why the text of the Triple A had to be different from the Paris Declaration and notes that gender is absent from the agenda. The custodians of the Paris declaration say the Triple A does not overtake, override nor overwrite the Paris Declaration. The former only reasserts the latter, which does not help gender issues.
The overriding message of this guide is that human rights are not merely add-ons or luxuries that only a few countries may be able to afford – they must be integral to developing health workforce strategies in all countries. Plans should be accountable to human rights obligations and other health goals and commitments. Broad participation in developing the plan will help ensure that it is accountable to those it serves. Planners may need to provide incentives for health workers to stay and should make sure their response to the health workforce crisis is comprehensive, covering aspects of the workforce such as numbers, distribution, quality of training, productivity, management, and information systems. Finally, health workforce strategies must be sustainable, so that countries provide their populations with ever-improving levels of health services, and maintain and enhance commitments to equality. This requires setting priorities that will ensure that essential health services, including those in underserved areas, can continue even if there are funding shortfalls beyond the country’s control.
Although the ethical principles of justice, beneficence and respect for autonomy/persons should be upheld in research, their application in emergency situations may differ from non-emergency situations. Just like in non-emergency situations, research in emergency situations should be conducted in the best interest of the victims or future victims. The research should not unnecessarily expose human subjects and the researcher to careless harm, and should be of adequate scientific rigour. Victims of emergency situations are vulnerable populations that need special protection from exploitation. Researchers should conduct a fair risk-benefit assessment in order to come up with a risk management plan, and be culturally sensitive to the needs of the victims of the humanitarian crisis. In emergency situations, the roles of Institutional Review Boards (IRBs) may have to be modified without compromising the ethical standards that health researchers have globally attempted to achieve.
In this article, the author takes a rights-based view of the current crisis of restricted access to the results of scientific and medical research. Such research is conducted in the interests of the public, and yet the results are largely kept out of the public domain by traditional corporate publishers who own them, subject them to extremely tight copyright restrictions and sell them in a market worth about US$5 billion annually. The results of biomedical research have unfortunately been privatised, monopolised, and concentrated in the hands of a tiny number of multinational corporations.
This paper provides arguments for discussions about the role of property rights for food security and child nutrition in rural Africa. The results are drawn from a case study in the Kafue Flats of Zambia. They show that unclear jurisdictional boundaries and weak authorities facilitated re-negotiations of property rights related to natural resources in the context of the Southern African food crisis of 2002–2003. Access to natural resources was skewed towards the more powerful. On average, food intake was temporarily 50% lower than the annual mean, compared to a less than 10% decrease in the lean season of 2003–2004. Large inequalities existed between different clusters of villages, according to the history of immigration and ethnicity. Yet variability was greatest within villages. Households which reported increasing difficulties with access to natural resources had less diversified income-generating activities, lower food intake and more children showing impaired growth. Discussions addressing the growing disparities in rural areas should focus on a realistic implementation and enforcement of property rights in the context of local power-relations and the harmonisation of different tenure systems related to natural resources.
This booklet addresses the benefit of treating sanitation in human rights terms,the legal basis of the right to sanitation, state obligations and standards for differing environments, and priority actions for governments and other stakeholders. While there has been some progress on the recognition and implementation of the right to water, the same is not true of sanitation services. The current International Year of Sanitation presents an opportunity to address the lack of attention paid to sanitation and hygiene in human rights terms. This publication is a call to recognise sanitation as a crucial aspect of the right to an adequate standard of living, setting out the most important strategies and measures that stakeholders and decision-makers can prioritise in order to ensure that sanitation is accessible and affordable to all. It is an advocacy tool to encourage more funding for sanitation, more debate and more research into the barriers to accessing affordable sanitation and how to remove them.