A/HRC/32/44 result, women face continuous challenges in accessing health care and in maintaining autonomous control in decision-making about their own bodies. Understanding and eliminating the instrumentalization of women’s bodies, which is based on harmful cultural norms and stereotypes, and its detrimental impact on women’s health, is critical for change to occur. 19. A wide range of actors, both public and private, play a role that affects women’s health and access to health care and each of the actors bears responsibility for its actions or inactions. In particular, the significant role of the principles enshrined in the deontological codes of different medical professionals and in the rules governing the corporate social responsibility of the pharmaceutical industry are an essential locus for establishing gendersensitive research, medicines and treatments. 20. The State is accountable for fulfilling its international human rights obligation to ensure that women are provided with gender-responsive scientific research, medicines and health interventions and for providing appropriate and adequate gender-based resources and a system of effective monitoring, budgeting, remedies and redress. It is also obligated to provide women with autonomous, effective and affordable access to health care. The State has a responsibility to ensure that barriers to women’s enjoyment of the right to the highest attainable standard of physical and mental health are dismantled, including by exercising due diligence. 21. A number of other factors and developments which have serious implications for women’s health and safety are not tackled in the present report owing to space restrictions. These include climate change and other environmental catastrophes and degradation and gender-based violence in armed conflicts. B. Meaning of equality in women’s health and safety 22. In the area of health, the distinctly different biological and reproductive functions of women and men necessitate differential treatment and proper algorithms are required to make sure that women have equal access to and enjoy the highest achievable level of health treatment. An identical approach to treatment, medication, budgeting and accessibility would in fact constitute discrimination. 23. Central among women’s and girls’ health needs are those relating to their reproductive and sexual health. Substantive equality requires that States attend to the risk factors that predominantly affect women. For instance, since only women can become pregnant, a lack of access to contraceptives is bound to affect their health disproportionately. Equality in reproductive health requires access, without discrimination, to affordable, quality contraception; maternal health care, including during childbirth and the post-partum period; access to safe termination of pregnancy; access to effective screening and early treatment for breast and cervical cancer; and special attention to the high rate of HIV infections among young women and treatment to prevent mother-to-infant transmission. 24. Equality also requires health policy to be based solely on women’s health needs and not to be influenced by instrumentalization and politicization. Political contestation around rights to reproductive and sexual health remains a global challenge, resulting in women paying a high price in terms of their health and lives. In adopting the 2030 Agenda for Sustainable Development, States committed to ensuring universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes. A strong commitment to women’s sexual and reproductive rights in international and national law, 6

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