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
Investment treaties should be reviewed to ensure that States have the right to make changes in their laws and policies to further human rights regardless of the impact of such changes on investors’ rights. This recommendation came from the Special Rapporteur on Right to Health, Mr. Anand Grover in his last report to the UN General Assembly (UNGA). The report notes that nearly 40 countries have already began renegotiation of international investment treaties. The Grover report calls for an international treaty to hold transnational corporations (TNCs) accountable for their violations on human rights. The report presents the current state of play with regard to the accountability of TNCs with regard to human rights violations. Two other sub-sections discuss the shortcomings of international investment treaties and the investor -state dispute settlement mechanism.
Governments meeting at the UN General Assembly (GA) in September have heeded civil society demands for human rights to be at the core of the global commitments succeeding the Millennium Development Goals (MDGs) in 2015. The outcome document of the GA Special Event on the MDGs, held on 25 September, calls for a universal framework of goals applicable to all countries which promotes “human rights for all”. Once a lightning rod at UN development forums, human rights appear to have garnered consensus as a central foundation of development - at least on paper.
At the High-level Meeting on AIDS, held 8–10 June 2011 in New York, 3,000 participants gathered to chart a path for the future of the AIDS response, including 30 heads of State and government, along with senior officials, representatives of international organisations, civil society and people living with HIV. The declaration adopted by Member States of the General Assembly contains clear, measurable targets, including targets to halve sexual transmission of HIV by 2015, to reduce HIV transmission among people who inject drugs by 50% by 2015, to ensure that by 2015 no child will be born with HIV, to increase universal access to antiretroviral therapy, to get 15 million people onto life-saving treatment by 2015, and to halve tuberculosis deaths in people living with HIV by 50% by 2015. Member States also pledged to close the global resource gap for AIDS and work towards increasing funding to between $22 and $24 billion per year by 2015. Paul De Lay, Deputy Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS) noted that the declaration clearly outlines the urgent need to increase access to HIV services for people most at risk of infection, including men who have sex with men, people who inject drugs and sex workers. The pledge to eliminate gender inequality, gender-based abuse and violence and to empower women and girls must be fulfilled without delay, he added.
At the 23rd session of the Council held in Geneva on 27 May to 14 June 2013, the United Nations Human Rights Council adopted a resolution on access to medicines despite opposition from the United States and the European Union (included in this newsletter). According to this article, the resolution is a step forward in addressing the issue of access to medicines within the right to health framework. The new Resolution recognises access to medicines as one of the fundamental elements in the realisation of the right to health. Unlike some earlier resolutions, the scope of the new resolution is not limited to essential medicines and covers all medicines. It clearly calls for the regulation of prices of medicines to make them affordable for people, especially those in developing countries. It also clearly establishes the link between local production and the right to health framework and addresses the research and development (R&D) question within the right to health framework, especially referring to a new R&D model based on de-linking of cost of R&D from the price of health products. It also clearly states that the engagement with stakeholders is based on the principle of safeguarding public health from undue influence by any form of real, perceived or potential conflict of interest.
This Guidance Note has been developed to provide a coordinated human-rights-based approach to promoting universal access to HIV prevention, treatment, care and support in the context of adult sex work. It provides clarification and direction regarding approaches to reduce HIV risk and vulnerability in the context of sex work. Its policy and programmatic emphasis rests on three interdependent pillars: access to HIV prevention, treatment, care and support for all sex workers and their clients; supportive environments and partnerships that facilitate universal access to needed services, including life choices and occupational alternatives to sex work for those who want to leave it; and action to address structural issues related to HIV and sex work. Comprehensive rights-based programmes on HIV and sex work are argued to be critical to the success of the HIV response, and policies and programmes to address the links between HIV and sex work must recognise the social and geographic diversity of sex work, as well as the rapid changes that may occur in patterns of sex work.
Since the beginning of the HIV epidemic, governments and the private sector have implemented travel restrictions with regard to HIV positive people wishing to enter or remain in a country for a short stay (e.g. business, personal visits, tourism) or for longer periods (e.g. asylum, employment, immigration, refugee resettlement, or study). UNAIDS has set up an international task team to heighten attention to the issue of HIV-related travel restrictions (both short-term and long-term) on international and national agendas and move towards their elimination.
South Africa, as an emerging middle-income country, is becoming increasingly influential in global health diplomacy. However, little empirical research has been conducted to inform arguments for the integration of domestic health into foreign policy by state and non-state actors. This study aimed to address this knowledge gap, as an empirical case study analysing how South Africa integrates domestic health into its foreign policy, using the lens of access to antiretroviral (ARV) medicines. It explored state and non-state actors’ perceptions regarding how domestic health policy is integrated into foreign policy to achieve better insights into health and foreign policy processes at the national level. Employing qualitative approaches, the authors examined changes in the South African and global AIDS policy environment. Purposive sampling was used to select key informants, a sample of state and non-state actors who participated in in-depth interviews. Secondary data were collected through a systematic literature review of documents retrieved from five electronic databases, including review of key policy documents. Qualitative data were analysed for content. The findings showed the interplay among social, political, economic and institutional conditions in determining the success of this integration process. A series of national and external developments, stakeholders, and advocacy efforts and collaboration created these integrative processes. South Africa’s domestic HIV/AIDS constituencies, in partnership with the global advocacy movement, catalysed the mobilisation of support for universal access to ARV treatment nationally and globally, and the promotion of access to healthcare as a human right. The report concludes that transnational networks may influence government’s decision making by providing information and moving issues up the agenda.
The Zimbabwean study on safe and inclusive cities seeks to research on manifestations of urban violence, poverty exclusion and inequalities informed by the following underlying research questions: Can the State in terms of both its direct and indirect actions, be implicated in promoting urban violence when its role in addressing issues of urban poverty, inequality and exclusion is examined? Has the state embraced laws and policies founded on continuities of inequalities, rather than a focus on structural change in framing state urban policy in townships, in a manner which does not address those factors that link poverty, inequality and exclusion to urban violence? At municipal level, have laws and policies consolidated rather than shifted gender inequalities in urban townships, thereby continuing to contribute to women’s vulnerability to urban poverty, inequality, exclusion and urban violence? Have communities participated in addressing these problems? The research into context and lived realities took place in Kadoma, Zimbabwe, drawing on the services of 38 masters in women’s law research students who worked in six groups in four broad thematic areas: poverty families and employment, urban environmental health issues, security challenges in Kadoma especially for women girls and access to courts and access to justice. The Women’s law approach assessed the gap between what laws such as Legal Aid Act; Maintenance Act, Administration of Estates Act and Domestic Violence Act against women’s lived experiences and impact of such laws on issues of equality, exclusion and poverty related issues. The human rights approach sought to understand the role of the state in practice against human rights standards as provided in selected human rights instruments on matters such as social and economic rights particularly relating to matters such as the right to housing, the right to work; the right to health; the right to food and equality before the law and fair representation.
A HIV-positive South African man has won a case of discrimination and unfair dismissal against his former employers in the Labour Court, and he says he hopes the ruling will encourage other HIV-positive people who are being discriminated against by their employers to come forward. The court ruling stated that he was unfairly dismissed by his employer because of his HIV status. The man was dismissed two years ago immediately after his former employer discovered that he was HIV-positive. Human rights organisation Section 27 has hailed the ruling, saying it sends a clear message that HIV-positive people cannot be discriminated against. According to Section 27, people with HIV should come forward and seek the protection of the law because if they go to court and their case is clear, they will win in court and the employer will be forced to pay compensation or legal costs. Advocates identified two major barriers to seeking legal redress in cases of discrimination against HIV-positive people – most people are not aware of their rights, and lawyers are inaccessible because the cost of their services is beyond the means of ordinary South Africans. Without proper legal services, they warn, it’s unlikely that claims will succeed.