In this paper, grounded theory procedures were use to analyse literature pertaining to dignity and to conduct and analyse 64 semi-structured interviews with persons marginalised by their health or social status, individuals who provide health or social services to these populations, and people working in the field of health and human rights. The results showed that the taxonomy presented identifies two main forms of dignity – human dignity and social dignity – and describes several elements of these forms, including the social processes that violate or promote them, the conditions under which such violations and promotions occur, the objects of violation and promotion and the consequences of dignity violation. Together, these forms and elements point to a human rights-based theory of dignity that can be applied to the health sector.
Values, Policies and Rights
Healthcare providers' conscientious objection to involvement in certain procedures is grounded in the right to freedom of religion, conscience and thought. However, such conscientious objection can have serious implications for the human rights of healthcare users, including their sexual and reproductive health rights. This briefing paper examines the implications of conscientious objection, by healthcare providers, for the protection of sexual and reproductive health rights, and concludes with a set of recommendations for States' policies and laws.
This briefing considers the responsibilities of pharmaceutical companies for enhancing access to medicines in the context of sexual and reproductive health. To provide some substance with which to shape the responsibilities of the pharmaceutical industry, the briefing first examines the issue of access to medicine in the context of both HIV/AIDS and the human papillomavirus (HPV). Various statistics are provided to convey the severity of the situation, and the intersection with the fundamental rights to sexual and reproductive health. Having provided this context, the authors outline the responsibilities of States to ensure that medicines are available, accessible, culturally acceptable, and of good quality. However, they stress that the pharmaceutical sector has an indispensable role to play in relation to the right to health and access to medicines; this is a shared responsibility.
The IFHHRO Africa Regional Training on Monitoring the Right to Health took place in Kampala, Uganda, in December last year. It was organised by AGHA and IFHHRO's Africa Regional Focal Point. The objectives of the training were to bring health professionals and their organisations together to share experiences on monitoring the right to health, to develop an understanding of health related human rights, to make health professionals aware that they have responsibilities regarding the realisation of the right to health, particularly through monitoring, to show the practical meaning and significance of monitoring the right to health in the day-to-day work of health professionals and their organisations, and to develop practical action plans for the future.
In the first ruling of its kind in the world, the Geneva Court of Justice has quashed an 18-month prison sentence given to a 34-year-old HIV-positive African migrant who was convicted of HIV exposure by a lower court in December 2008. This was done after accepting expert testimony from Professor Bernard Hirschel – one of the authors of the Swiss Federal Commission for HIV/AIDS Consensus Statement on the Effect of Treatment on Transmission – that the risk of sexual HIV transmission during unprotected sex on successful treatment is 1 in 100,000. The ruling suggests that, in Switzerland at least, effectively treated HIV-positive individuals should no longer be prosecuted for having unprotected sex. With advocates from around the world taking interest in the case, it is possible that this ruling will have consequences for other countries with HIV exposure laws.
This paper explores the legal and normative potential of the right to health to mitigate the restrictive impact of trade-related intellectual property rules on access to medicines, as evidenced by the global outcomes of the seminal pharmaceutical company litigation in South Africa in 2001. The author argues that the litigation and resulting public furor provoked a paradigm shift in global approaches to AIDS treatment in sub-Saharan Africa. She argues further that this outcome illustrates how human rights in concert with social action were able to effectively challenge dominant claims about the necessity of stringent trade-related intellectual property rights in poor countries, and ergo, to raise the priority of public health needs in related decision-making. The author explores the causal role of rights in achieving these outcomes through the analytical lens provided by international legal compliance theories, and in particular, the model of normative emergence proposed by Martha Finnemore and Kathryn Sikkink. She suggests that the AIDS medicines experience offers strategic guidance for realizing the right to health’s transformative potential with regard to essential medicines more generally.
South African researchers and traditional leaders are reported to have raised concern that scientists could patent the genes of local ethnic groups who have donated blood samples as part of a worldwide genome-mapping project. Several lawyers, researchers and community leaders have denounced an American patent application for unique gene mutations found in DNA samples collected in Tanzania, Kenya and Sudan. The applicants from the University of Pennsylvania, are reported to have collected more than 2,000 samples in East Africa and to have a blood bank of more than 5,000 samples in total, taken from 80 African ethnic groups.
Despite the cholera epidemic in Zimbabwe continuing for more than six months, sanitation remains poor and lack of access to safe drinking water persists against the backdrop of a collapsed health system with degraded infrastructure and very few health workers. Health in Zimbabwe is presently largely unavailable, unacceptable, inaccessible and of poor quality. This report concludes that Zimbabwe will require long term commitment of the humanitarian and donor agencies working in the country with large scale, multi-faceted assistance to address the situation. It urges the government of Zimbabwe to formulate an emergency health response plan to restore the public health system must be produced and implemented. The authors argue that government should also ensure the supply of clean drinking water and adequate sanitation.
Access to medicines forms an indispensable part of the right to the highest attainable standard of health. Numerous court cases, as well as resolutions of the United Nations (UN) Commission on Human Rights, confirm that access to essential medicines is a fundamental element of the right to health. This briefing examines the issue of access to medicines in the context of sexual and reproductive health. Sexual and reproductive health are key elements of the right to the highest attainable standard of health. The briefing considers the responsibilities of pharmaceutical companies for enhancing access to medicines. The briefing also introduces the background and content of the Human Rights Guidelines for Pharmaceutical Companies in Relation to Access to Medicines ('the Guidelines'). Based on the right to health responsibilities of pharmaceutical companies, the Guidelines provide a framework for enhancing access to medicines.
In Part 1 of this three-part study, the authors undertook a multi-method study in three phases – a survey, interviews and case descriptions that drew on site visits – and in each of the second and third phases they focused on a purposive sample of those involved in the previous phase. Seven recommendations emerged for those involved in establishing or leading organisations that support the use of research evidence in developing health policy: collaborate with other organisations; establish strong links with policymakers and involve stakeholders in the work; be independent and manage conflicts of interest among those involved in the work; build capacity among those working in the organisation; use good methods and be transparent in the work; start small, have a clear audience and scope, and address important questions; and be attentive to implementation considerations, even if implementation is not a remit.