In this article, the authors examine how major global health organisations, such as WHO, the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, and GAVI approach human rights concerns, including equality, accountability and inclusive participation. The authors use examples of best practice to indicate how such agencies can advance the right to health, covering nine areas: 1) participation and representation in governance processes; 2) leadership and organizational ethos; 3) internal policies; 4) norm-setting and promotion; 5) organisational leadership through advocacy and communication; 6) monitoring and accountability; 7) capacity building; 8) funding policies; and 9) partnerships and engagement. The proposed UN Framework Convention on Global Health (FCGH) would commit state parties to support these standards through their board membership and other interactions with these agencies. The authors also explain how the FCGH could incorporate these organisations into its overall financing framework, initiate a new forum where they collaborate with each other, as well as organisations in other regimes, to advance the right to health, and ensure sufficient funding for right to health capacity building.
Values, Policies and Rights
This report aims to raise awareness about the role that the reform of public health laws can play in advancing the right to health and in creating the conditions for people to live healthy lives. By encouraging a better understanding of how public health law can be used to improve the health of the population, the report aims to encourage and assist governments to reform their public health laws in order to advance the right to health. The report highlights important issues that may arise during the process of public health law reform. It provides guidance about issues and requirements to be addressed during the process of developing public health laws. It also includes case studies and examples of legislation from a variety of countries to illustrate effective law reform practices and some features of effective public health legislation.
Advocates worldwide on International Women's Day on Thursday highlighted issues such as gender equality, discrimination and the need for justice for survivors of sexual violence, Reuters reports. United Nations Secretary-General Ban Ki-moon on Wednesday said that although world leaders reaffirmed the importance of gender equality in "almost all countries, women continue to be under-represented in decision-making positions." He also said that the majority of the more than 100 million children who are not in school are girls and that women's "work continues to be undervalued, underpaid or not paid at all." In addition, violence against women continues "in every continent, country and culture" because it is concealed or condoned, Ban said. UNICEF director added that "No one, including the UN itself, is doing enough to end this terrible situation. We fail to treat it as a crime".
This brief aims to explain the context of the landmark petition the Centre for Health, Human Rights and Development (CEHURD) on the right to health and maternal mortality. CEHURD and other partners have filed the petition in the Ugandan Constitutional Court to secure a declaration that non-provision of essential maternal health commodities in government health facilities, leading to the death of some expectant mothers, is an infringement on the right to health of the victims. CEHURD argues that these maternal deaths were preventable if the state had taken its human rights obligations seriously and the state should be held accountable. Reproductive health is argued to be a human right protected by both international and domestic law. The petition has generated public debate on maternal health and rallied civil society advocates behind the cause of reproductive health. However, litigation of human rights standards has two significant challenges. First, in situations where the judicial system has a huge case backlog it may take a long time before the case is disposed of. Second, litigation per se may not lead to change, unless followed by deliberate advocacy and lobbying. The authors argue that the case will be useful in identifying other areas of human rights warranting litigation, and lever efforts to build the capacity of various actors to take on litigation as an advocacy strategy.
This issue of the Africa Environment Outlook conveys the following key messages to policy makers and other stakeholders: 1. Environmental and health issues deserve priority consideration in national development. 2. Although indoor air pollution is a profound health problem in Africa, it has been inadequately addressed. 3. Biodiversity provides goods and services such as food and medicinal plants that promote human health in Africa. 4. Climate change and variability severely impact human health owing to individuals’ and communities’ limited coping capacities. 5. Coastal and marine resources are integral to the health of coastal populations and need to be conserved and used sustainably. 6. Access to safe water and adequate sanitation is vital to human health and needs to be scaled up by eliminating impediments such as inadequate infrastructure, pollution of water sources, poor hygiene, retrogressive cultural taboos and gender disparities. 7. Sustainable land management is central to human health because land provides the resource base for the provision of ecosystem services such as food, fibre and medicines. 8. The magnitude of domestic and global uncertainties that decision makers have to grapple with imply that espousing the business as usual model when dealing with environmental problems does not only result in failure to meet internationally set goals and targets, it also undermines human health. 9. Although a number of good policies for addressing environmental challenges that affect human health exist, their implementation has been weak. Making policies more effective requires elimination of barriers to implementation.
The African Youth Conference on Post-2015 Development Agenda, held in Nairobi, Kenya, from 12-16 December 2012, has adopted a Youth Declaration on the Post-2015 Agenda. This Agenda identifies 13 actions for accelerating progress on the Millennium Development Goals (MDGs) and makes recommendations for the post-2015 development agenda. On accelerating MDG progress, the Declaration recommends that governments: increase commitments to achieve the MDGs and honour pledges; strengthen institutions to fight corruption and empower youth; and provide sufficient resources to children, women and youth ministries. It also recommends, inter alia: increasing equitable access to sustainable water and sanitation services and promoting hygienic behaviour; planning and implementing poverty eradication programmes to reach youth; strengthening communication, data collection and monitoring; and empowering and mobilising youth to participate in the MDGs and hold governments accountable. The Declaration asks the UN and its development partners to support projects that mitigate climate change and encourage sustainable consumption. It calls for civil society to engage communities to understand the causes of poverty and to address these challenges.
A number of African gender advocates in both government and civil society have put up spirited fight to have the United Nations create a Fund to address millennium development goal issues of reproductive health and gender empowerment. To be known as the Millennium Development Goal (MDG) Fund, resources channelled to this Fund are to be used to lower the high maternal and child mortality rates in sub-Saharan Africa and ensure gender empowerment and environmental goals are implemented with speed. But the United States, especially the Bush Administration and other pro-life advocates, are said not to be warming up to the idea, which they see as coded attempts to fund abortion related issues and increase procurement of condoms.
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”.
This statement from the People’s Health Movement (PHM) asserts a commitment to Comprehensive Primary Health Care and addressing the Social, Environmental and Economic Determinants of Health. To make health care accessible to all, African governments are considering or have implemented policy reforms with a focus on achieving Universal Health Coverage (UHC). Examples include, the Community Based Health and Planning Services (CHPS) and National Health Insurance Scheme in Ghana; National Health Insurance Scheme in Uganda, expansion of the National Hospital Insurance Fund in Kenya, National Health Insurance in South Africa and Health Financing Policy and Strategy in Zimbabwe. These policy reforms in different ways aim to provide health financing to protect populations from impoverishing health care costs. Despite this momentum, many African countries still provide limited access to quality health services and only a small percentage of the population is protected from financial risks associated with health care costs. PHM identify that the dialogue on UHC in Africa is strongly influenced by the World Bank and other multilateral and bilateral donors, which promote UHC as predominantly a health financing mechanism. Issues of health equity, including a focus on access for the ‘uncovered’ poor, community participation and the strengthening of public health systems are largely ignored. Where UHC is framed as a health financing issue, rather than a human right or public good, and supports charging the poor for health coverage and the creation of health markets (privatisation). Instead PHM assert that PHC is the key to achieving health for all. Efforts to achieve UHC should prioritise reviving and strengthening public health systems in African countries within the Primary Health Care framework which permeates all levels of health care including addressing social determinants of health. The statement identifies actions needed towards addressing the social determinants of health, including: that policies for UHC need to clearly prioritise PHC at the primary and community levels. They argue that a whole of government approach must be applied to support UHC, including Health in All Policies, so that all ministries and departments of government are coordinated in promoting healthier working and living conditions and healthy lifestyles, preventing causes of disease and mortality, and supporting equitable access to health services. Further, governments should increase health sector spending to at least 15% of national budgets, as agreed in the 2001 Abuja Declaration. The PHM call for increased fiscal space by expanding and improving current tax collection measures; as well as implementing new taxes that ensure progressiveness and sustainability and strengthening prepayment mechanisms that pool resources.
A resolution calling on the African Commission on Human and Peoples’ Rights to recognise human rights to access needed medicines was passed at a meeting of African human rights organisations in Abuja, Nigeria. The NGO forum was composed of about 100 human rights organisations in Africa with observer status before the African Commission. The resolution calls on the Commission to recognise access to needed medicines as a fundamental component of the right to health and clarify the state obligations in this regard. It specifically calls on the Commission to fulfil its duty to respect, protect and enforce rights to access to medicines. This includes taking full advantage of all flexibilities in the WTO Agreement on Trade-related Aspects of Intellectual Property (TRIPS) that promote access to affordable medicines.