Values, Policies and Rights

United Nations Report on the Implementation of Economic, Social and Cultural Rights
UN High Commissioner for Human Rights: 8 June 2009

This report considers implementing and monitoring human rights with specific reference to economic, social and cultural rights. It addresses the specific challenges posed by the complex array of obligations that stem from economic, social and cultural rights, including progressive realisation and non-discrimination, outlines various ways of monitoring legislation and other normative measures, such as regulations, policies, plans and programs, and elaborates on monitoring the realisation of rights, paying particular attention to human rights impact assessments. Monitoring the realisation of economic, social and cultural rights can be achieved through assessing progress, stagnation or retrogression in the full enjoyment of those rights over time. The report also provides useful indicators and benchmarks for budget analysis and addresses the issue of monitoring violations of economic, social and cultural rights. Monitoring violations of these rights can be achieved through recording complaints filed before judicial and quasi-judicial mechanisms.

United Nations to establish single new agency to deal with rights of women
United Nations: 15 September 2009

Four United Nations agencies and offices will be amalgamated to create a new single entity within the organisation to promote the rights and well-being of women worldwide and to work towards gender equality. The UN Development Fund for Women (UNIFEM), the Division for the Advancement of Women, the Office of the Special Adviser on Gender Issues and the UN International Research and Training Institute for the Advancement of Women (UN-INSTRAW) will be merged. Secretary-General, Ban Ki-moon, said he was ‘particularly gratified’ that the Assembly had accepted his proposal for ‘a more robust promotion’ of women’s rights under the new entity. Mr Ban said that he had appointed more women to senior posts than at any other time in the history of the UN, including nine women to the rank of under-secretary-general. The number of women in senior posts has increased by 40% under his tenure.

United States aid policy and induced abortion in sub-Saharan Africa
Bendavid E, Avila P and Miller G: Bulletin of the World Health Organisation 89(12): 873-880C, December 2011

In this study, researchers aimed to determine whether the Mexico City Policy, a United States government policy that prohibits funding to non-governmental organisations performing or promoting abortion, was associated with the induced abortion rate in sub-Saharan Africa. Women in 20 African countries who had induced abortions between 1994 and 2008 were identified in Demographic and Health Surveys. A country’s exposure to the Mexico City Policy was considered high (or low) if its per capita assistance from the United States for family planning and reproductive health was above (or below) the median among study countries before the policy’s reinstatement in 2001. The study included 261,116 women aged 15 to 44 years. A comparison of 1994–2000 with 2001–2008 revealed an adjusted odds ratio for induced abortion of 2.55 for high-exposure countries versus low-exposure countries under the policy. There was a relative decline in the use of modern contraceptives in the high-exposure countries over the same time period. In conclusion, the induced abortion rate in sub-Saharan Africa rose in high-exposure countries relative to low-exposure countries when the Mexico City Policy was reintroduced. Reduced financial support for family planning may have led women to substitute abortion for contraception, the authors argue. Regardless of one’s views about abortion, the findings may have important implications for public policies governing abortion.

United States aid policy and induced abortion in sub-Saharan Africa
Brendavid E; Avila P; Miller G: Bulletin of the World Health Organisation 89(12) 853-928, 2011

This study explored the relationship between the reinstatement in 2001 of a US policy requiring all nongovernmental organizations operating abroad to refrain from performing, advising on or endorsing abortion as a method of family planning if they wish to receive federal funding and the probability that a sub-Saharan African woman will have an induced abortion. The authors used longitudinal, individual data on terminated pregnancies collected by Demographic and Health Surveys (DHS) to estimate induced abortion rates. The study found robust empirical patterns suggesting that the policy was associated with increases in abortion rates in sub-Saharan African countries. Several observations were identified to strengthen this conclusion. First, the association was strong: and second, there was broad agreement among the aggregate graphical analysis and both unadjusted and adjusted statistical analyses, robust across a variety of sensitivity analyses. Third, the timing of divergence between high and low exposure countries was coincident with the policy’s reinstatement: in high exposure countries, abortion rates began to rise noticeably only after the policy was reinstated in 2001 and the increase became more pronounced from 2002 onward.

United Towards Achieving Health For All in Kenya
Kariuku S; Chatterjee S: Reliefweb, 2018

Of all the Sustainable Development Goals, few would rival good health as the definition of a country that has a sustainable, inclusive, peaceful and prosperous future. The authors observe that the launch in December 2018 of the pilot phase of Kenya’s journey towards Universal Health Coverage (UHC) heralds a major step towards that future. In Kenya, health-related expenses are driving about one million into poverty every year, and health care is second only in demand on family spending to food in family budgets. Kenya announced that UHC will involve scaling up immunization, prevention of water borne, vector borne, TB, HIV and sexually transmitted diseases, improving maternal and child health as well as nutrition of pregnant women. Kenya will also focus on prevention of non-communicable diseases like diabetes and hypertension. With Kenya’s Vision 2030 ambition of providing a high quality of life to all its citizens, the most urgent need is argued to be that of ensuring that everyone stays healthy to participate in economic development.

Universal Access to Sexual and Reproductive Health: Realising Health and Human Rights
United Nations Research Institute for Social Development: UNRISD, Geneva, 2017

At an official side event of the 34th Session of the Human Rights Council, panelists discussed how people’s sexual and reproductive health rights (SRHRs) around the world could be better protected and promoted. This report presents perspectives raised on challenges and good practices in ensuring full access to SRHRs, environmental dimensions of family planning, the linkages between a human rights-based social protection framework and access to these rights, and current global trends, and what these mean for implementation of the SDGs and their achievement by 2030. Men, women and gender non-conforming persons are all entitled to SRHRs and require these services. And while everyone is affected by limited access to these rights, individuals from already marginalized groups such as children and adolescents, lesbian, gay and trans persons, men who have sex with men, sex workers, drug users, indigenous peoples, and people living in poverty were reported to be the most affected, sometimes fatally.

Universal coverage promoted at World Health Assembly
World Health Organisation: 21 May 2012

Member states at the World Health Assembly (WHA) was held from 21-26 May 2012 in Switzerland supported the concept of universal health coverage as an indispensable precondition for sustainable human development and a fair society. Some of them presented their experiences in implementing universal access to healthcare. Among the tools suggested were mainstreaming health in all national policies, sharing costs between public and private sectors, and offering subsidies and health insurance. Member States expressed their support for a stronger WHO as the organisation has a critical role to play in prevention, equitable access and efficiency in public health.

Universal Health Coverage Data Portal: Supporting the Universal Health Coverage Coalition
World Health Organisation: Geneva, December 2016

To mark Universal Health Coverage Day, WHO launched a new data portal to track progress towards universal health coverage (UHC) around the world. The portal shows where countries need to improve access to services, and where they need to improve information. The portal features the latest data on access to health services globally and in each of WHO’s 194 Member States, along with information about equity of access. In 2017, WHO will add data on the impact that paying for health services has on household finances. The portal shows that less than half of children with suspected pneumonia in low income countries are taken to an appropriate health provider. Of the estimated 10.4 million new cases of tuberculosis in 2015, 6.1 million were detected and officially notified in 2015, leaving a gap of 4.3 million. High blood pressure affects 1.13 billion people. About 44% of WHO’s member states report having less than 1 physician per 1000 population. The African Region suffers almost 25% of the global burden of disease but has only 3% of the world’s health workers.

Universal health coverage law approved in Egypt
Devi S: The Lancet 391(10117), doi: https://doi.org/10.1016/S0140-6736(18)30091-6, 2018

A new universal health coverage law received parliamentary approval in mid-December in Europe after years of discussion and planning. Health care will be provided for everyone including the estimated 30% of Egyptians who cannot afford to pay at present. Enrolment in the scheme will be obligatory, with fees set according to income with additional sources of funding to include taxes on tobacco and polluting industries including cement. Egypt's population is forecast by the UN Population Fund to reach 119 million in 2030. UNICEF says about three in every ten children suffer from multidimensional poverty, which includes factors such as poor health and lack of education. Tedros Adhanom, director-general of WHO, praised the law for including people with major catastrophic conditions such as cancer. The scheme will be mandatory, with those on low incomes to be covered by the state; with split roles for health-care providers and those bodies to oversee quality and accreditation; and patients would be allowed to choose their own doctor and hospital. However, he raised worries about the level of co-payments that patients might have to make and the long period of implementation that might lead to worsening health disparities.

Universal health coverage should be anchored in the right to health
Ooms G, Brolan C, Eggermont N, Eide A, Flores W, Forman L et al: Bulletin of the World Health Organisation 91(1): 2-2A, January 2013

In this article, the authors propose that the right to health and its imperative of narrowing health inequities should be central to the post-2015 international health agenda. However, they argue that universal health coverage - as defined by the World health Organisation and typically conceived - is not enough to ensure the right to health. Policy-makers will need to address the social determinants of health such as safe drinking water and good sanitation, adequate nutrition and housing, safe and healthy occupational and environmental conditions and gender equality. The post-2015 health agenda should also explicitly describe the accountability mechanisms that will make it possible for people to claim – not beg for – additional national public resources and international assistance, if needed. Furthermore, it must specify how citizens will participate in the decision-making processes surrounding their health services and their physical and social environment. Participation must be genuine and built on a continuing relationship among researchers, governments and those communities, otherwise goals may end up being formulated by policy elites after token and superficial consultations, undermining the rights of the very communities they serve.

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