Search Tips
sorted by
300 shown of 1866 entities
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 7
- Paragraph text
- The enjoyment of the right to health of all people who use drugs - and are dependent on drugs - is applicable irrespective of the fact of their drug use. It is important that drug use and drug dependence are not conflated: drug dependence is considered a chronic, relapsing disorder involving altered brain function that may require medical treatment, ideally utilizing a "biopsychosocial" approach. By contrast, drug use is not a medical condition and does not necessarily imply dependence. Indeed the majority of people who use drugs do not become dependent and do not require any treatment.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 8
- Paragraph text
- The right to health seeks, inter alia, to ensure access to quality health facilities, goods and services without discrimination, including on the grounds of physical or mental disability, or health status. Article 2, paragraph 2, and article 3 of the International Covenant on Economic, Social and Cultural Rights also prohibit discrimination in achieving realization of all rights within the Covenant. As such, an individual's use of drugs cannot constitute grounds for curtailing her/his rights, irrespective of whether she or he has a recognized dependence syndrome or whether the applicable drug control regime allows for imprisonment or other sanctions. People who use drugs and people who are dependent on drugs possess the same freedoms and entitlements guaranteed by international legal instruments, and both groups experience violations of their rights under the current international drug control regime.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 10
- Paragraph text
- A number of United Nations bodies enforce the three drug control treaties and are required to promote and protect human rights, as identified in Articles 1 and 55 of the Charter of the United Nations. When the goals and approaches of the international drug control regime and international human rights regime conflict, it is clear that human rights obligations should prevail. The General Assembly has consistently adopted resolutions declaring that international drug control must be carried out in conformity with the Charter, and "with full respect for human rights" (see resolutions 62/176 and 63/197).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 12
- Paragraph text
- The International Narcotics Control Board oversees implementation of all three drug conventions. It monitors illicit drug production and trade, as well as access to controlled substances for scientific and medicinal purposes, and has the authority to investigate Governments that do not comply with treaty requirements. The Commission on Narcotic Drugs classifies narcotic and psychotropic drugs under different levels of restriction and serves as the governing body for the United Nations International Drug Control Programme within the United Nations Office on Drugs and Crime (UNODC). The Office is mandated "to contribute to the achievement of security and justice for all by making the world safer from drugs, crime and terrorism".
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 13
- Paragraph text
- Although the drug control bodies rarely have engaged in constructive human rights-related discussions in the past, recently there has been a welcome shift towards incorporating human rights-based approaches into their work. UNODC has examined ways in which drug control can be synchronized better with the protection of human rights, and the President of the International Narcotics Control Board recently met informally for the first time with civil society representatives. The Commission on Narcotic Drugs also adopted a resolution concerning the promotion of human rights in implementing the international drug control treaties, and has considered the issues of HIV/AIDS and access to medicines in other resolutions. Nevertheless, it is clear that significantly more must be done to make human rights central to drug control.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 14
- Paragraph text
- Unfortunately, the current approach to global drug control maintains that drugs are an undisputable "evil", which the international community has a "duty to combat". The concept of a war on drugs is used to justify extreme policies and practices. The links drawn between drug production and the funding of armed groups, for example between opium growers and the Taliban in Afghanistan, have further justified a zero-tolerance approach, even though such policies are increasingly shown to be ineffective in reducing the supply of and demand for drugs. Therefore, this approach not only fails to achieve its primary stated aim - preventing health-related harms of drug use - but also fails to achieve genuine drug control.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 15
- Paragraph text
- The war-on-drugs approach also fails to acknowledge the realities of drug use and dependence and, for that reason, has been unsuccessful in achieving its stated aims. First, people invariably continue using drugs irrespective of criminal laws, even though deterrence of drug use is considered the primary justification for imposition of penal sanctions. Second, drug dependence, as distinct from drug use, is a medical condition requiring appropriate, evidence-based treatment - not criminal sanctions. Finally, punitive drug control regimes increase the harms associated with drug use by directing resources towards inappropriate methods and misguided solutions, while neglecting evidence-based approaches.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 16
- Paragraph text
- Drug use may have harmful health consequences, but the Special Rapporteur is concerned that the current drug control approach creates more harm than the harms it seeks to prevent. Criminalization of drug use, designed to deter drug use, possession and trafficking, has failed. Instead, it has perpetuated risky forms of drug use, while disproportionately punishing people who use drugs. Its ramifications for the health of the wider community, particularly in relation to HIV/AIDS, are no less severe: the 2010 Vienna Declaration notes that the criminalization of illicit drug users is fuelling the HIV epidemic. Millennium Development Goal 6 requires States to commit to halting and beginning to reverse the spread of HIV/AIDS by 2015 (see General Assembly resolution 55/2), but continuing criminalization directly contradicts several multilateral health policies.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 17
- Paragraph text
- Health is a human right that is indispensable for the exercise of other human rights. Countries that are overly punitive in sentencing also violate other rights of people who use drugs. Thirty-two jurisdictions currently retain the death penalty for drug offences, some mandatorily. Article 6 of the International Covenant on Civil and Political Rights allows for imposition of the death sentence only for "the most serious crimes" (General Assembly resolution 2200 A (XXI)). The Human Rights Committee and the Special Rapporteur on extrajudicial, summary or arbitrary executions have confirmed that drug offences do not meet those criteria, and thus executions for drug offences are in violation of international human rights law.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 18
- Paragraph text
- Criminalization of drug use and possession are implicated in violation of several human rights, including the right to health. Other infringements of the right to health are less direct, but occur as by-products of the skewed focus of the international drug control regime: for instance, insufficient access to essential medications. The Special Rapporteur considers that each of these violations is traceable ultimately to a disproportionate focus on criminalization and law enforcement practices at the expense of the enjoyment of the right to health and reduction of harms associated with drugs.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 19
- Paragraph text
- In countries where the "war on drugs" is zealously pursued or drug laws are enforced stringently, those who are dependent on drugs may be, and often are, discouraged from accessing health services. It is reported that in some countries this approach has reinforced the status of people who use drugs as social outcasts, driving drug use underground, compromising the HIV/AIDS response, as well as discouraging people who use drugs from accessing treatment. And where HIV infections occur through unsafe injecting practices, seroprevalence among injecting drug users can be as high as 50 per cent.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 22
- Paragraph text
- People who use drugs are often subjected to discrimination in medical settings. Access to antiretroviral (ARV) therapy can be low for people who use drugs: in Eastern Europe, although 70 per cent of reported cases of HIV occurred among people who injected drugs, this group comprised 39 per cent of the total population of people living with HIV receiving ARV therapy. This may be attributed to structural inequalities that impede access of these groups to the therapy; for instance, lack of targeted interventions. Cases of health-care providers, however, denying ARV treatment to people who use drugs also have been noted, in direct contravention of a right-to-health approach.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 23
- Paragraph text
- Individuals may also be denied access to other medical treatments on the grounds of their prior or current drug use, where evidence does not exist to justify the denial of such treatment. For example, in the United Kingdom of Great Britain and Northern Ireland it is reported that past or current users of drugs have been denied treatment for the hepatitis C virus, contrary to official guidance, on the basis that they would not adhere to treatment. Treatment adherence among people who use drugs is not necessarily lower, and should be assessed on an individual basis.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 26
- Paragraph text
- Criminalization of drug use and possession also may lead to an increased risk of illness among people who use drugs. Higher rates of legal repression have been associated with higher HIV prevalence among people who use injecting drugs, without a decrease in prevalence of injecting drug use. This is a likely result of individuals' adopting riskier injection practices such as sharing of syringes and injection supplies, hurried injecting, or use of drugs in unsafe places (such as needle-shooting galleries) out of fear of arrest or punishment. Hurried preparation of drugs to avoid detection by law enforcement agents also predisposes people who inject drugs to an increased risk of overdose, vascular accident and infections, such as abscesses. These risks may be exacerbated by an individual's reluctance, out of fear, to utilize assistance in preparing and injecting drugs.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 27
- Paragraph text
- Police crackdowns and other interventions associated with criminalization of drug use and possession also result in displacement of drug users from areas serviced by harm-reduction programmes, decreasing their ability to participate in needle and syringe programmes, opioid substitution therapy (OST) and access to outreach workers. Access to emergency assistance in the instance of an overdose also is impeded, and the incidence of overdose may be increased by disrupting access to regular injecting networks and drug suppliers. Those most affected by displacement often are the most marginalized; for instance, the homeless, who cannot necessarily move indoors to use drugs.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Humanitarian
- Movement
- Person(s) affected
- Persons on the move
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 28
- Paragraph text
- Punitive drug policies also disproportionately impact on communities that are already vulnerable. For instance, it has been reported that in the United States of America, African-Americans are arrested at consistently higher rates than white Americans, although the rates of offences committed are comparable between these groups. Additionally, over 80 per cent of arrests are for possession of drugs, rather than sales. Accumulation of such minor offences can lead to incarceration and further marginalization of these already vulnerable individuals, increasing their health-related risks.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 29
- Paragraph text
- Currently over 9 million people are held in penal institutions worldwide. In many prisons, rates of HIV infection are noted to be several times higher than in the mainstream community. This is attributed to injecting drug use prior to imprisonment, as well as risk factors within these populations, such as poverty and marginalization. The prevalence of hepatitis infections within prisons is also high, with hepatitis C infection rates exceeding those of HIV. Once in prison, high rates of injecting drug use, combined with a lack of access to OST and sterile injecting equipment, create enormous risk for inmates. That risk is then passed on to members of the public upon prisoners' release. Failure to implement effective harm-reduction programmes and drug-dependence treatment in those settings violates the enjoyment of the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 30
- Paragraph text
- Some of the most egregious violations of the right to health have occurred in the context of "treatment" for drug dependence. Criminalization of drug use fuels the perception that people who use drugs are unproductive criminals or moral degenerates, which in turn allows disciplinary treatment approaches to proliferate. In place of evidence-based medical management, Governments and enforcement authorities coerce or force drug-dependent individuals into centres where they are subject to ill-treatment and forced labour. This approach discriminates against people who use drugs, denying them their right to access medically appropriate health-care services and treatment.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 31
- Paragraph text
- The present report concerns compulsory treatment programmes that primarily utilize disciplinary interventions, disregarding medical evidence. In such settings, medical professionals who are trained to manage drug dependence disorders as medical illnesses are often inaccessible. Forced labour, solitary confinement and experimental treatments administered without consent violate international human rights law and are illegitimate substitutes for evidence-based measures such as substitution therapy, psychological interventions and other forms of treatment given with full, informed consent.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 32
- Paragraph text
- The enjoyment of the right to health includes, inter alia, access to health facilities, goods and services that are scientifically and medically appropriate and of good quality and the "right to be free from interference, such as the right to be free from torture, non-consensual medical treatment and experimentation". Moreover, article 7 of the International Covenant on Civil and Political Rights declares that "no one shall be subjected without his free consent to medical or scientific experimentation". States are obliged to respect, protect and fulfil the enjoyment of the right to health, including by refraining from using coercive medical treatments, except in the narrowest possible circumstances for the treatment of mental illness or the prevention and control of communicable diseases. The requirements of informed consent must be observed in administering any treatment for drug dependence - including the right to refuse treatment.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 36
- Paragraph text
- Such disciplinary treatments more often than not substitute for evidence-based methods. As a result, many people dependent on heroin and other opioids suffer through unmedicated withdrawal, instead of receiving pharmacologically supported withdrawal or OST. Classifying methadone and buprenorphine as illegal creates an extra barrier to accessing such drug-dependence treatments. Imposition of compulsory treatment, at the expense of OST and other harm-reduction interventions, also increases the risk of disease transmission, particularly HIV/AIDS.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 38
- Paragraph text
- As examined in a previous report of the Special Rapporteur, informed consent to treatment is a cornerstone of the right to health, the requirements of which would be satisfied on extremely rare occasions in forced administration of punitive treatment. Decisions regarding capacity and competence, and the need to obtain informed consent, must be made on a case-by-case basis. Treatment en masse prima facie fails to meet this requirement. In some countries, it is reported that people who use drugs have been arrested en masse and forced into compulsory treatment centres. This approach leads to forced treatment of individuals based on inadequate, cursory medical examinations - if they are undertaken at all.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 44
- Paragraph text
- Emergency obstetric procedures and management of epilepsy also require use of scheduled medications, and remain inadequately resourced. Post-partum haemorrhage results in over 100,000 maternal deaths annually. Oxytocin and ergometrine, two controlled drugs used in obstetric procedures, are difficult to access yet reduce the risk of severe post-partum bleeding by more than half. Similarly, around 75 per cent of people with epilepsy in developing countries and up to 90 per cent of patients with epilepsy in Africa do not receive treatment with essential medicines, including phenobarbital, partly because it is a controlled substance.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 45
- Paragraph text
- Compliance with procedural requirements associated with stocking, supplying and prescribing scheduled medications can be burdensome for health-care institutions and workers, creating a barrier to supply of these medications. Such procedures, for example, include restrictive licensing of controlled medicines within health-care institutions. In some countries, it is reported that only "Level 1" hospitals are allowed to prescribe opioids. Regulations also limit the substances a doctor may prescribe, or the amount that can be prescribed. Certain States require health-care workers to obtain special licences to prescribe morphine, in addition to their professional licences. Restrictive laws are a particular problem in the cases of methadone and buprenorphine, drugs used for OST. In some States use of these drugs is outlawed.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 46
- Paragraph text
- Many myths exist surrounding the use of controlled drugs: that they lead to addiction, do not treat pain adequately, or that chronic or terminal pain is untreatable. Health-care workers themselves often are undereducated in palliative care and feel uncomfortable prescribing opioid analgesics for fear they will lead to dependence, to the contrary conclusions of scores of studies. Where inadequate training is the norm, health-care workers may be unsure of the legal implications of their prescribing practices - especially in relation to patients who use illicit drugs - and may avoid prescribing these medications altogether, which further limits the supply of essential medications.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 48
- Paragraph text
- A human rights-based approach to drug control must be adopted as a matter of priority to prevent the continuing violations of rights stemming from the current approaches to curtailing supply and demand, and to move towards the creation of a humane system that meets its own health-related objectives. Currently, there is a lack of coordination and discussion between the actors involved in drug control and human rights at the international level. Law enforcement approaches are ingrained institutionally in the international drug control regime, as drug control is housed within UNODC, which leads the United Nations efforts on organized crime. This association between law enforcement and drug control, in part, precludes adoption of a human rights-based approach and interaction with the human rights bodies of the United Nations.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 49
- Paragraph text
- The ineffectiveness of the current international drug control system must be understood, and reform undertaken at all policymaking levels. National governments should implement harm reduction programmes and policies, decriminalize or de-penalize drug use and possession, and reform regulations concerning essential medicines. United Nations drug control bodies must ensure system-wide coherence by adopting a human rights-based approach to drug control, which necessarily requires recognition of international human rights as central to their operations, and these changes in the international system should also guide and legitimize domestic reforms.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 51
- Paragraph text
- Needle and syringe programmes involve provision of sterile injection equipment to injecting drug users. The World Health Organization has endorsed the use of such programmes, noting that "compelling evidence" exists that they reduce HIV infections substantially, in a cost-effective manner, without any major negative consequences. The use of needle and syringe programmes is consistent with standard public health principles, in that elimination of a vector (in this case, the contaminated needles) reduces transmission of vector-driven disease.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 52
- Paragraph text
- Opioid substitution therapy (OST) is an evidence-based treatment approach, involving prescription of substitute medications for opioid dependence, such as methadone or buprenorphine. OST decreases the prevalence of injecting drug use and sharing of injecting equipment, thus reducing the risk of contracting HIV and other blood-borne viruses. Global availability of OST could reduce cases of new HIV infections by over 100,000, reduce significantly the prevalence of other blood-borne diseases, and reduce overdose deaths from opioid use by nearly 90 per cent. Where OST is not available, a higher incidence of overdose often is observed following drug dependence treatment, owing to the individual's decreased tolerance for the drug. Additionally, numerous studies indicate that pharmacological support is effective at managing withdrawal from opioids and preventing relapse into drug use.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 53
- Paragraph text
- Interventions such as education programmes are also designed to minimize harm to individuals who use drugs. Currently, little information exists on their effectiveness, often because they are integrated into other programmes, but they are frequently utilized. One meta-analysis concluded that educational programmes result in risk-reducing behaviour change among people who use drugs, but results varied based on programme design. Outreach programmes are used to contact people who use drugs in their own communities, and to provide information, referral to medical testing and services, among other activities. A reduction in risk behaviour of around 27 per cent has been observed following contact with outreach services.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Education
- Health
- Person(s) affected
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 54
- Paragraph text
- Interventions such as first-aid training and administration of Naloxone (an opioid receptor antagonist used to reverse depression of the central nervous system in cases of opioid overdose) are also used to minimize the harm associated with drug overdose, as is the use of drug-consumption rooms, where individuals can use drugs in a supported environment. The potential benefits of drug-consumption rooms include prevention of disease transmission and reduced venous damage, as well as encouraging entry to treatment and other services. Evidence exists that drug-consumption rooms have contributed to reductions in overdose rates, and increased access to medical and social services.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 56
- Paragraph text
- Drug laws and policies impact on HIV control because of the dynamics of drug usage: in particular, the sharing of needles, through which HIV can be transferred. Approximately one in 10 new HIV infections worldwide result from injecting drug use, and up to 90 per cent of infections occur among people who inject drugs in regions such as Eastern Europe and Central Asia. Where harm-reduction interventions are not implemented, HIV prevalence among people who inject drugs can rise to 40 per cent or greater within a year or two of introduction of the virus into their communities.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 57
- Paragraph text
- The risk of virus transmission through needle sharing can be addressed through the principles of harm reduction. Implementation of needle and syringe programmes strongly correlates with a reduction in risk behaviours, which predispose people who inject drugs to HIV infection. Other benefits associated with such programmes include increased entry into HIV-treatment programmes. However, current coverage of needle and syringe programmes, OST and antiretroviral therapy (ART) services is insufficient to prevent HIV transmission in the vast majority of countries where people use injecting drugs. Funding to ensure universal access to HIV prevention services for people who inject drugs currently stands at around one twentieth of that required.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 58
- Paragraph text
- The United Nations has declared that outreach activities, needle and syringe programmes and evidence-based drug dependence treatment (including OST) should be implemented to minimize the risk of transmission of HIV among those who use drugs. The Committee on Economic, Social and Cultural Rights recognized that harm reduction forms a central part of national responses to illicit drug dependence and it has made recommendations to States Parties. The Human Rights Council, in resolution 12/27, also recognized the need for "a comprehensive package of services for injecting drug users, including harm-reduction programmes in relation to HIV".
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 59
- Paragraph text
- States are obliged to respect the right to health by refraining from denying equal access for all persons, including prisoners or detainees, to preventive, curative and palliative health services. Many States have begun to implement harm-reduction programmes within treatment facilities because prior punitive regimes have resulted in the most rapidly increasing rates of HIV incidence in the world. Nevertheless, needle and syringe programmes currently are available only in places of detention in 10 countries, and OST is available in at least one prison in fewer than 40 countries.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- Persons on the move
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 60
- Paragraph text
- The International Covenant on Economic, Social and Cultural Rights imposes a number of immediate obligations on States Parties, including that they guarantee that rights will be exercised without discrimination. If harm-reduction programmes and evidence-based treatment are made available to the general public, but not to persons in detention, that contravenes international law. Indeed, because of the health risks associated with incarceration, the Special Rapporteur considers that greater efforts may be required inside prisons to meet public health objectives. In the context of HIV and harm reduction, this demands implementation of harm-reduction services in places of detention even where they are not yet available in the community, as the principle of equivalence is insufficient to address the epidemic among prisoners.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 61
- Paragraph text
- The 2009 Madrid Recommendation notes that there is "overwhelming evidence" that health-protection measures, including harm-reduction measures, are effective in prisons. The Madrid Recommendation states that treatment programmes for people who use drugs, as well as harm-reduction measures, including needle and syringe programmes, are urgently needed in all prison systems. Drug-dependence treatment is also noted to be "highly effective in reducing crime": treatment and care within prison, or as alternatives to imprisonment, reduce rates of relapse, HIV transmission and reincidence in crime. Effective drug-dependence treatment thus protects not only the individual, but society at large, and combats the negative cycle of recidivism that exposes other detainees to risk. As harm-reduction programmes are cost-effective and relatively easy to operate in closed settings, they should be implemented within places of detention as a matter of urgency.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- Persons on the move
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 62
- Paragraph text
- The Special Rapporteur considers that the continuing imposition of criminal penalties for drug use and possession perpetuates many of the major risks associated with drug use. He advocates for consideration of less restrictive approaches to drug control, including decriminalization or de-penalization. Decriminalization of drug use cannot simply be equated with legalization of drug use. When decriminalized, drug use and possession can remain legally prohibited, but criminal penalties for such offences either are not applied at all or only minor penalties are given. Decriminalization generally entails complete removal of criminal punishment for the conduct in question (administrative penalties may be applied instead), whereas de-penalization requires removal of custodial sentences, although the conduct remains a criminal offence. Legalization, by contrast, involves no prohibitions on the relevant conduct.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 64
- Paragraph text
- Moreover, in 2001, Portugal decriminalized purchase, possession and usage of all illicit drugs for personal use, instead characterizing them as administrative offences. That law allows for imposition of pecuniary or non-pecuniary penalties, and there is a provision for sanctions to be suspended, should the offender undertake treatment. In contrast to the International Narcotics Control Board's reaction to Argentina and Mexico, decriminalization to this extent has been deemed consistent with the 1988 Convention. Decriminalization generally was perceived as the best option for minimizing drug-related problems in Portugal, largely through de stigmatizing drug use and bringing a higher proportion of drug users into treatment, rather than a communication to the public that drug use was condoned.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 65
- Paragraph text
- Several other States have de-penalized various forms of drug use and possession. This has occurred either through legislation to that effect, or de facto de penalization, whereby drug laws are not enforced strictly. Spain maintains criminal sanctions for drug use, although persons tried are never imprisoned for drug consumption alone. In the Netherlands and Germany, possession of drugs for personal use remains de jure unlawful, but punishment is not imposed for breaches of these laws. This, however, is obviously an inadequate solution at best.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 67
- Paragraph text
- It should be noted that, for example in Portugal, decriminalization occurred alongside other efforts, including significant expansion of drug treatment programmes, drug education and refocusing of police efforts on interruption of trafficking operations. This demonstrates how legislative change alone is insufficient to minimize significantly the harms occurring with drug use. Where decriminalization occurs alongside treatment, education and other interventions implemented to the required scale - for instance, to contain the spread of blood-borne viruses - the right to health of all members of society is realized most effectively.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Education
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 69
- Paragraph text
- In addition to legislative change, the importance of re-education and awareness-raising among law enforcement personnel cannot be underestimated, particularly because of the risk created by strict policing practices. For instance, the prevalence of HIV among people who inject drugs was recorded as significantly higher in Edinburgh in the 1980s, where police aggressively enforced laws banning needle possession, as compared to nearby Glasgow, where such strict enforcement was not taken. Any efforts to decriminalize or de-penalize drug use or possession must be coupled with appropriate strategies to ensure that the fear and stigma that were reinforced through excessive policing are ameliorated.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Education
- Health
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
The right to health and international drug control, compulsory treatment for drug dependence and access to controlled medicines 2010, para. 74
- Paragraph text
- The non-prices measures of the Framework Convention on Tobacco Control provide the best examples of the protections and regulations that may replace the existing enforcement-based framework. Such measures include regulation of drug content, education and awareness-building, and measures concerning dependence reduction and cessation. Implementation of these measures would secure the right to health by, inter alia, ensuring supply of unadulterated drugs, increasing individual and community awareness to minimize risk, and ensuring access to appropriate treatment, where necessary. There generally are high levels of implementation among Parties to the Framework Convention on Tobacco Control on nearly all of these measures, suggesting similar possibilities for currently controlled drugs.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 6
- Paragraph text
- Criminal laws concerning consensual same-sex conduct, sexual orientation and gender identity often infringe on various human rights, including the right to health. These laws are generally inherently discriminatory and, as such, breach the requirements of a right-to-health approach, which requires equality in access for all people. The health-related impact of discrimination based on sexual conduct and orientation is far-reaching, and prevents affected individuals from gaining access to other economic, social and cultural rights. In turn, the infringement of other human rights impacts on the realization of the right to health, such as by impeding access to employment or housing.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- LGBTQI+
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 8
- Paragraph text
- Various criminal laws exist worldwide that make it an offence for individuals to engage in same-sex conduct, or penalize individuals for their sexual orientation or gender identity. For example, consensual same-sex conduct is a criminal offence in about 80 countries. Other laws also indirectly prohibit or suppress same-sex conduct, such as anti-debauchery statutes and prohibitions on sex work. Many States also regulate extra-marital sexual conduct through criminal or financial sanctions, which affects individuals who identify as heterosexual but intermittently engage in same-sex conduct. These laws also have a significant impact on individuals engaging in sexual conduct with members of the opposite sex outside of marriage, particularly women, although this is outside the scope of this report.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Gender
- Person(s) affected
- LGBTQI+
- Women
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 11
- Paragraph text
- The European Court of Human Rights has held that discrimination based on sexual orientation or gender identity is in violation of human rights. In 1981, in Dudgeon v. United Kingdom, the European Court of Human Rights determined that the criminalization of private homosexual acts constituted an unjustified interference with the right to privacy enshrined within article 8 of the Convention for the Protection of Human Rights and Fundamental Freedoms. The United Nations Human Rights Committee in Toonen v. Australia subsequently ruled that "sex" discrimination includes discrimination based upon sexual orientation, noting that criminalization was not a reasonable measure to prevent spread of HIV/AIDS. In S.L. v. Austria, the European Court of Human Rights also held that differences in the treatment of heterosexual and homosexual populations based on age of consent had no objective and reasonable justification, and was therefore discriminatory.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- LGBTQI+
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 12
- Paragraph text
- A number of States now prohibit discrimination on the basis of sexual orientation, following judicial decisions or the introduction of legislation concerning this issue. In the landmark 1998 case National Coalition for Gay and Lesbian Equality and another v. Minister of Justice and others, the South African Constitutional Court struck down three separate sodomy laws, noting the right of all people to dignity and equality in concluding that discrimination based on sexual orientation was prohibited under the South African Constitution. The Supreme Court of the United States declared Texan sodomy laws unconstitutional in the case of Lawrence v. Texas, on the basis that it infringed on the liberty protected under the Fourteenth Amendment to the Constitution through the criminalization of intimate, consensual sexual conduct.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Person(s) affected
- LGBTQI+
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 13
- Paragraph text
- In the matter of Naz Foundation v. Government of NCT of Delhi and Others, the High Court of Delhi cited the case of Toonen and considered the reasoning of the South African Constitutional Court in finding section 377 of the Indian Penal Code unconstitutional. This section of the code criminalized, "carnal intercourse against the order of nature with any man, woman or animal" - wording from colonial rule that is still in use in more than half of the jurisdictions criminalizing sodomy worldwide. The Naz Foundation submitted that by criminalizing private, consensual same-sex conduct, section 377 perpetuated negative and discriminatory beliefs towards same-sex conduct, driving activities underground and crippling HIV/AIDS prevention efforts.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- LGBTQI+
- Women
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 15
- Paragraph text
- Despite these recent developments in decriminalization, bringing many States into conformity with international human rights obligations, a significant number of countries maintain criminal penalties for consensual same-sex conduct. Some States have taken steps to broaden the application of existing laws, or to impose harsher penalties for same-sex conduct. Section 365A of the penal code of Sri Lanka formerly prohibited male homosexual acts, but was subsequently amended to be "gender-neutral", resulting in the criminalization of female same-sex conduct. The Parliament of Uganda introduced a bill in October 2009 that would allow for the death penalty as punishment for the violation of certain provisions of the anti-sodomy statute. Uganda, praised by HIV/AIDS activists for its treatment programme and policies, will put its campaign to eliminate HIV in great danger should this bill pass.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- LGBTQI+
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 17
- Paragraph text
- The Special Rapporteur believes that criminalization has adverse consequences on the enjoyment of the right to health of those who engage in consensual same-sex conduct, through the creation of the societal perception that they are "abnormal" and criminals. This has a severe deleterious impact on their self-regard, with significant, and sometimes tragic, consequences on their health-seeking behaviour and mental health. Rates of suicide attempts amongst youth who engage in consensual same-sex conduct have been variously reported as between three and seven times higher than for youth who identify as heterosexual; the rates are similar for adults.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- LGBTQI+
- Youth
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 19
- Paragraph text
- These problems are compounded for persons living with HIV/AIDS. Due to historical circumstances - most significantly, the association of AIDS with the gay community - the enjoyment of the right to health is disproportionately impacted as it pertains to HIV/AIDS diagnosis and treatment. For instance, in the Asia-Pacific region, almost 90 per cent of homosexual men have no access to HIV prevention or care. While this is due to a range of circumstances, a general atmosphere of fear has been the predominant factor in preventing HIV-positive individuals from accessing health services and treatment. This atmosphere of fear also impacts adversely on the wider community. In countries where homosexuality is criminalized, the negative association of HIV/AIDS with homosexuality can result in individuals who do not engage in consensual same-sex conduct avoiding testing and treatment for HIV/AIDS, for fear of being subject to criminal sanctions, violence or discrimination.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- LGBTQI+
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 20
- Paragraph text
- Sanctioned punishment by States reinforces existing prejudices, and legitimizes community violence and police brutality directed at affected individuals. Seven States, or parts thereof, currently retain the death penalty as a possible punishment for sodomy. The Special Rapporteur believes that the imposition of the death penalty for consensual same-sex conduct is not only unconscionable, but further represents arbitrary deprivation of life, constituting an infringement of the right to life recognized in article 6 of the International Covenant on Civil and Political Rights.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- LGBTQI+
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 23
- Paragraph text
- Stigmatization prevents legislative and policymaking institutions from adequately addressing health-related matters in communities that are especially vulnerable to the infringement of the enjoyment of the right to health. Where same-sex conduct is illegal, sexual orientation may be treated as a problem that needs to be corrected, ignored or used to legitimize violence directed towards these individuals. Attempts to "cure" those who engage in same-sex conduct are not only inappropriate, but have the potential to cause significant psychological distress and increase stigmatization of these vulnerable groups.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- LGBTQI+
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 24
- Paragraph text
- As with all human rights, States are required to take steps to respect, protect and fulfil the right to health. The criminalization of private, consensual same-sex conduct creates an environment that is not conducive to affected individuals achieving full realization of their right to health. Health services must be accessible for all, without discrimination, especially for the most vulnerable or marginalized sections of the population. The repeal of laws criminalizing consensual same-sex conduct between adults helps to ensure compliance with this State obligation.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- LGBTQI+
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 25
- Paragraph text
- Criminalization is not only a breach of a State's duty to prevent discrimination; it also creates an atmosphere wherein affected individuals are significantly disempowered and cannot achieve full realization of their human rights. For instance, States are bound to take steps to establish prevention and education programmes for behaviour-related health concerns such as HIV/AIDS. Decriminalization facilitates the achievement of this obligation because a social atmosphere wherein adult consensual same-sex conduct is accepted constitutes an essential part of structural prevention of HIV/AIDS. A legal framework promoting an enabling environment has been noted as one of the most important prerequisites to achieve this goal, along with combating both discrimination and structural violence.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- LGBTQI+
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 27
- Paragraph text
- Sex workers remain subject to stigma and marginalization, and are at significant risk of experiencing violence in the course of their work, often as a result of criminalization. As with other criminalized practices, the sex-work sector invariably restructures itself so that those involved may evade punishment. In doing so, access to health services is impeded and occupational risk increases. Basic rights afforded to other workers are also denied to sex workers because of criminalization, as illegal work does not afford the protections that legal work requires, such as occupational health and safety standards.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Gender
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 28
- Paragraph text
- The Joint United Nations Programme on HIV/AIDS (UNAIDS) defines sex workers as "female, male and transgender adults and young people who receive money or goods in exchange for sexual services, either regularly or occasionally, and who may or may not consciously define those activities as income-generating". It is noted, however, that no single term adequately covers the range of transactions worldwide that involve sex work (the term "sex worker" is increasingly used within the sector, as it is considered less stigmatizing and a better descriptor of workers' experiences than the word "prostitute").
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Gender
- Health
- Person(s) affected
- LGBTQI+
- Youth
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 30
- Paragraph text
- Alongside the right to health, the International Covenant on Economic, Social and Cultural Rights protects the right to freely chosen, gainful work (art. 6), which the State must take steps to safeguard. Article 6 of the Convention on the Elimination of All Forms of Discrimination against Women does not require States to suppress consensual, adult sex work. Rather, it calls for the suppression of "all forms of traffic in women and exploitation of prostitution of women". The term "exploitation of prostitution" has not been defined within the Convention, but is interpreted to refer to exploitation in the context of prostitution. Additionally, the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families applies to a significant number of sex workers who travel between States to engage in sex work.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Persons on the move
- Women
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 34
- Paragraph text
- Globally, there have been periods where sex work has been highly regulated or decriminalized, generally to manage certain aspects of sex work or to achieve control of disease, particularly within the military. However, prohibitions against sex work are regarded as "notoriously difficult to enforce" and of questionable utility where enforcement is accompanied by extortion and brutality. In recent times, significant opposition has arisen to the imposition of criminal sanctions against sex workers, and certain nations have amended laws to decriminalize sex work.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 38
- Paragraph text
- In one study, about 45 per cent of a sample of sex workers operating in illegal circumstances were assessed with negative mental health scores, as compared to 12 per cent of the sample of "legal" sex workers. Although differences in physical health outcomes were not observed, significant patterns of disadvantage and vulnerability were noted amongst the former group. This not only highlights the impact of criminalization, both in terms of the impact of sex work and entry into sex work, but also draws attention to the importance of differentiating between the various types and settings of sex work in devising effective health interventions.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 39
- Paragraph text
- Stigmatization has been cited as the major factor preventing sex workers from accessing their rights. Laws criminalizing or onerously regulating sex work compound the stigmatization experienced by sex workers, adversely affecting health outcomes, often without justification on the grounds of public health. The Geschlechtskrankheitengesetz, a law in Germany designed to combat venereal disease, required prostitutes to undergo mandatory medical examinations. This law legally stigmatized sex workers as being almost solely responsible for the spread of venereal disease, despite the absence of epidemiological studies to support this. The law has since been amended to provide for voluntary, anonymous testing.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 42
- Paragraph text
- The criminalization of sex work often means that sex workers feel unable to enforce their basic rights, as their status and work are illegal. They "live in fear" of police and clients, and feel unable to report crimes against them due to fear of arrest. Sex workers have reported that they are highly vulnerable to police harassment, particularly in the forms of (a) sex by deception and coercion, (b) extortion and (c) discrimination (including moral punishment, public humiliation and extreme violence driven by contempt). Policing has also been noted as a key issue in shaping the vulnerability of sex workers to HIV.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Gender
- Violence
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 43
- Paragraph text
- The criminalization of sex work infringes on the enjoyment of the right to health, by creating barriers to access by sex workers to health services and legal remedies. When sex workers are not recognized as engaging in legitimate work, they are not recognized by standard labour laws in many countries. Sex workers often cannot gain access to State benefits, and are not protected by occupational health and safety regulations that routinely protect employees in other industries. The criminalization of selling sex also renders any agreement concluded for sex work illegal or unenforceable by law on the grounds of being contrary to public policy, resulting in no legal recourse for sex workers.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 44
- Paragraph text
- Moreover, the criminalization of practices related to sex work can create barriers to the realization of safe working conditions. For instance, where laws exist prohibiting the running of a brothel, those who invariably subvert the law and run such a business can impose unsafe working conditions without difficulty, as sex workers themselves have no recourse to legal mechanisms through which they can demand safer working conditions. Where criminalization in any form exists, the protection offered by a brothel or a manager may become increasingly desirable or necessary, but this also comes at a price: fiscally, through the opportunities created for extortion, and in terms of health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 45
- Paragraph text
- Sex workers should have the right to legal protection, with regard to various hazards such as violence, general occupational risks and labour exploitation. Judicial decisions have, in some instances, resulted in such protection being directly realized. For instance, a court in The Hague found in favour of a Czech immigrant who had been denied permission to reside in The Netherlands for the purposes of prostitution, concluding that prostitution is considered labour according to domestic law, and that the petitioner was therefore entitled to a permit.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Health
- Violence
- Person(s) affected
- Persons on the move
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 46
- Paragraph text
- The decriminalization or legalization of sex work with appropriate regulation forms a necessary part of a right-to-health approach to sex work, and can lead to improved health outcomes for sex workers. Any regulation of the sex sector should be implemented in accordance with a right-to-health framework, and should satisfy the requirement of safe working conditions as incorporated into the right to health. Decriminalization, along with the institution of appropriate occupational health and safety regulations, safeguards the rights of sex workers. Where sex work is legally recognized, the incidence of violence may also be reduced, through the enforcement of laws against abuse and exploitation.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 48
- Paragraph text
- It is vital that those designing interventions to assist victims of trafficking differentiate between those persons working in the sex sector against their will and those who consensually participate in sex work. Brothel raids that are designed to assist victims of trafficking but fail to discriminate between these individuals can impede the realization of the right to health of both groups in some circumstances. Conversely, evidence from one study indicates that individuals consensually engaging in sex work are well placed to assist trafficked and underage persons engaging involuntarily in this industry. This demonstrates the benefits of participation as part of a right-to-health approach.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Violence
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 49
- Paragraph text
- The right-to-health approach necessarily requires that the aforementioned legislative changes be accompanied by non-legal measures designed to achieve the realization of the right to health, such as adequate education, access to legal aid, and so forth. For instance, one African study found that two thirds of respondent sex workers were unaware that they were at risk of contracting HIV or other sexually transmitted infections if they engaged in unprotected sex. Decriminalization can facilitate the exchange of information, which combats such situations, particularly by reducing fear and stigma, so that health promotion projects that allow for open and frank discussions around sexual risk can be implemented.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 51
- Paragraph text
- The Special Rapporteur notes that the criminalization of HIV transmission has formed a part of the global response to the HIV/AIDS crisis since its inception. Unfortunately, the public health goals of legal sanctions are not realized by criminalization. In fact, they are often undermined by it, as is the realization of the right to health. The criminalization of HIV/AIDS transmission also infringes on many other human rights, such as the rights to privacy, to be free from discrimination and to equality, which in turn impacts upon the realization of the right to health. The criminalization of HIV transmission, or behaviours around transmission, is generally recognized as counterproductive, and should be reconsidered in the context of any comprehensive HIV/AIDS response framework.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 52
- Paragraph text
- The criminalization of HIV transmission predominately takes two forms: first, laws specifically criminalizing transmission of HIV and, second, through the application of existing criminal law to cases involving exposure to or the transmission of HIV (such as assault). Such legislation has included, inter alia, the criminalization of exposure to HIV (including mother-to-child exposure), attempted transmission and failure to disclose HIV status to potential sexual partners. Certain statutes also mandate the imposition of harsher sentencing in cases involving sexual violence where HIV transmission has occurred, essentially treating HIV as an aggravating factor.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Children
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 54
- Paragraph text
- In paragraph 58 of the Declaration of Commitment on HIV/AIDS, Member States pledged to: by 2003, enact, strengthen or enforce, as appropriate, legislation, regulations and other measures to eliminate all forms of discrimination against and to ensure the full enjoyment of all human rights and fundamental freedoms by people living with HIV/AIDS and members of vulnerable groups, in particular to ensure their access to, inter alia, education, inheritance, employment, health care, social and health services, prevention, support and treatment, information and legal protection, while respecting their privacy and confidentiality; and develop strategies to combat stigma and social exclusion connected with the epidemic. Despite these commitments to adopt and enact appropriate legislation concerning HIV, States continue to introduce statutes criminalizing HIV transmission and exposure, thereby undermining HIV prevention, treatment, care and support.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 55
- Paragraph text
- As the AIDS response developed, coercion and discrimination were noted to undermine the effectiveness of prevention programmes, and the prevention of discrimination against persons living with HIV/AIDS became central to formulating an effective public health response. Recently, laws criminalizing HIV transmission have again proliferated, generally in response to the perception that HIV prevention strategies are largely failing, and in line with the continued stigma associated with having HIV. However, the imposition of criminal punishment on those who transmit HIV or expose others to the virus fails to achieve the aforementioned aims of the criminal law, and has not been shown to have any public health benefit.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 58
- Paragraph text
- The criminalization of HIV transmission in the instance of intentional, malicious transmission is the only circumstance in which the use of criminal law in relation to HIV may be appropriate. In such cases, the alleged perpetrator should have acted autonomously, with full knowledge of relevant surrounding circumstances, including but not limited to their HIV status, effectiveness and attempted use of prophylaxis, and so forth. However, the utility of enacting legislation specifically dealing with this circumstance is questionable. In contrast, criminalization is inappropriate where there is a lack of such culpability.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 59
- Paragraph text
- However, the delineation between intentional and unintentional transmission is often not clearly made by States - legislation may be unintentionally drafted with such breadth as to allow for the criminalization of unintentional transmission or exposure. For instance, in Zimbabwe the law stipulates that if anyone who realizes "that there is a real risk or possibility" that she or he might have HIV intentionally does anything which he or she realizes involves a real risk or possibility of infecting another person with HIV, he or she "shall be guilty of deliberate transmission of HIV". This implies that a crime can be committed even with an HIV-negative status, that is, based merely on the realization that "there is a real risk or possibility" of a positive status.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 60
- Paragraph text
- Similarly, the model law for sexually transmitted infections and HIV/AIDS for West and Central Africa criminalizes the transmission of HIV virus "through any means by a person with full knowledge of his/her HIV/AIDS status to another person". This provision does not require that the person intends to transmit HIV; rather, it requires only that he or she has knowledge of his/her status and fails to take into account relevant circumstances, such as whether the accused individual had knowledge of how HIV is transmitted or used effective precautionary methods, in establishing either the offence or the availability of relevant defences. This law been implemented in at least 15 African countries as of 2009, occasionally with amendments.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 62
- Paragraph text
- The Special Rapporteur notes that criminal laws that explicitly regulate the sexual conduct of people living with HIV have not been shown to significantly impact on sexual conduct, nor do they have a normative effect in moderating risk behaviours. Criminal law does not influence the circumstances in which most HIV transmission occurs. In many regions, the majority of people living with HIV are unaware of their positive status and most cases of HIV transmission occur through consensual sex. Private sexual conduct invariably persists in the face of possible prosecution, but when prosecution actually occurs, these behaviours are driven underground, providing less opportunity for regulation and inhibiting access to preventive activities, diagnostic services, treatment and support.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 64
- Paragraph text
- In jurisdictions where HIV transmissions have been prosecuted, of the very few cases that are prosecuted out of the many infections that occur each year, the majority have been noted to involve defendants in vulnerable social and economic positions. Although laws criminalizing HIV transmission and exposure were, on occasion, enacted to provide women with greater protection, applying these laws broadly has also resulted in women being disproportionately affected. For instance, a woman was prosecuted under section 79 of the Zimbabwe Criminal Law (Codification and Reform) Act 23 of 2004 for having unprotected sex while HIV-positive, despite HIV not even being transmitted to the "victim" in question.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Women
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 65
- Paragraph text
- Women often learn they are HIV-positive before their male partners because they are more likely to seek access to health services and are consequently blamed for introducing the infection into communities. For many women, it is also difficult or impossible to negotiate safer sex or to disclose their status to a partner for fear of violence, abandonment or other negative consequences. Women may therefore face prosecution as a result of their failure to disclose, despite having valid reasons for non-disclosure. These laws do not provide women with any additional protection against violence or assurance of their rights to sexual decision-making and safety, and do not address the underlying socio-economic factors that increase women's vulnerability.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Women
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 66
- Paragraph text
- Some countries have enacted laws that criminalize mother-to-child transmission explicitly (see paragraph 54 above) or implicitly due to overly broad drafting of the law. Where the right to access to appropriate health services (such as comprehensive prevention of mother-to-child transmission services and safe breastfeeding alternatives) is not ensured, women are simply unable to take necessary precautions to prevent transmission, which could place them at risk of criminal liability. In 2008, only 45 per cent of pregnant women living with HIV in sub-Saharan Africa and only 25 per cent in South and East Asia had access to prevention of mother-to-child transmission services.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Children
- Infants
- Women
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 67
- Paragraph text
- In Sierra Leone, a person infected with HIV (and aware of the fact) must "take all reasonable measures and precautions to prevent the transmission of HIV to others and in the case of pregnant women, the foetus", with criminal sanctions imposed for failure to do so. It is unclear what "all reasonable measures and precautions" in the case of prevention of mother-to-child transmission would include, and whether such standards are clearly articulated and understood by health-care providers and pregnant women themselves to ensure that an informed decision can be made. Given the complexity of guidance on the suitability of breastfeeding, decisions on infant feeding options involve a complex balancing of risks and benefits, and require that the mother be provided with accurate, comprehensible information. In this instance, the criminal law has the potential to punish women for the inadequacy of the government in providing appropriate services and education.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Children
- Infants
- Women
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 68
- Paragraph text
- Stigma represents a major impediment to the implementation of successful interventions in respect of HIV/AIDS. Applying criminal law to HIV exposure or transmission can reinforce the stereotype that people living with HIV are immoral and irresponsible, further entrenching HIV-related stigma. People living with HIV/AIDS may, in turn, internalize the negative responses of others. This self-stigmatization affects the sense of pride and worth of individuals, which can lead to depression and self-imposed withdrawal, hampering access to HIV/AIDS treatment and interventions. In this way, criminalization impedes the right to health by constructing barriers to access by creating an environment in which individuals feel as if they are not deserving of treatment.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 70
- Paragraph text
- The Special Rapporteur notes that individuals living with HIV have been convicted of crimes that did not actually inflict physical harm, damage any property or otherwise cause injury. Disproportionate severity in sentencing of those convicted of "HIV crimes" has become evident in a number of cases, the inference being that the defendants' HIV status played a significant role in conviction and imprisonment. Criminal prosecutions, and the publicity stemming from them, have been found to increase stigmatization and have been perceived by people living with HIV as undermining public health efforts encouraging safer sex.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 72
- Paragraph text
- The Special Rapporteur emphasizes that any domestic legislation concerning HIV transmission should be based on a right-to-health approach; that is, States must comply with their obligations to respect, protect and fulfil the right to health through the enactment of such legislation. Most relevantly, the obligation to protect requires States to take measures to protect all vulnerable or marginalized groups of society, and the obligation to fulfil similarly requires steps to assist individuals and communities to enjoy the right to health - particularly those who are unable to realize the right themselves.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 73
- Paragraph text
- Any law concerning HIV transmission should therefore be directed at issues around public infrastructure, access to medicines, information campaigns concerning HIV/AIDS and so forth. The criminalization of HIV transmission should not form the mainstay of a national HIV/AIDS response, and its necessity is questionable in any event. Informed individuals take steps to prevent HIV transmission irrespective of criminal laws around transmission, and there is little evidence that specific laws criminalizing HIV transmission deter or modify the behaviour of individuals. With little benefit demonstrated in terms of achieving the aims of the criminal law or public health, and a corresponding risk of alienation, stigmatization and fear, it is difficult to see why the criminalization of HIV transmission is justified at all. Laws that are unnecessarily punitive will undermine any public health response to HIV, rather than assist it.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 74
- Paragraph text
- As such, criminalization should be considered permissible only in cases involving intentional, malicious transmission. The criminalization of any lesser mens rea is not only inappropriate, but also it is counterproductive in the struggle against the spread of HIV. In the view of UNAIDS: Criminal law should not be applied where there is no significant risk of transmission or where the person: Did not know that he/she was HIV-positive Did not understand how HIV is transmitted Disclosed his/her HIV-positive status to the person at risk (or honestly believed the other person was aware of his/her status through some other means) Did not disclose his/her HIV-positive status because of fear of violence or other serious negative consequences Took reasonable measures to reduce risk of transmission, such as practising safer sex through using a condom or other precautions to avoid higher risk acts Previously agreed on a level of mutually acceptable risk with the other person
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Right to health and criminalization of same-sex conduct and sexual orientation, sex-work and HIV transmission 2010, para. 75
- Paragraph text
- Finally, domestic laws prohibiting the deliberate spread of any disease or assault, or laws concerning the age of consent, adequately cover intentional transmission of HIV should the need arise to prosecute cases where this has occurred. The use of these pre-existing laws provides a legal safeguard to potential victims, without unnecessarily stigmatizing and further marginalizing those affected by HIV within the jurisdiction. States should, in addition to using pre-existing laws, issue guidelines to ensure that these laws are only utilized in cases of intentional transmission and that the relevant mens rea is to be established beyond a reasonable doubt.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2010
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 55
- Paragraph text
- The obligation to respect the right to health requires that States abstain from limiting access to contraceptives and other means of maintaining sexual and reproductive health. States should therefore remove criminal laws and other legal restrictions, including parental consent laws and other third party authorizations, to ensure access to family planning and contraceptive goods, services and information. The obligation to protect requires States ensure that neither third parties nor harmful social or traditional practices interfere with access to prenatal and post-natal care and family-planning (see E/C.12/2000/4, para. 35), or curtail access to some or all contraceptive methods. Finally, the obligation to fulfil includes adopting and implementing a national public health strategy, which includes the provision of "a wide range of sexual and reproductive health services, including access to family planning (...) and access to information (see E/CN.4/2004/49, para. 29)".
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Families
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 56
- Paragraph text
- The provision of comprehensive education and information on sexual and reproductive health is an essential component of the right to health and to the realization of other rights, such as the right to education and access to information. Criminal and other laws restricting access to comprehensive education and information on sexual and reproductive health are thus incompatible with the full realization of the right to health and should be removed by States (see E/C.12/2000/4, para. 11). Both women and men are adversely affected by these barriers. Women, however, are disproportionately impacted.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Education
- Equality & Inclusion
- Health
- Person(s) affected
- Men
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 58
- Paragraph text
- The International Guidelines on Sexuality Education of the United Nations Educational, Scientific and Cultural Organization (UNESCO) describe optimal sexual education as "an age-appropriate, culturally sensitive and comprehensive approach … that include programmes providing scientifically accurate, realistic, non-judgmental information". Moreover, comprehensive sexual and reproductive health education and information should provide "opportunities to explore one's own values and attitudes and to build decision-making, communication, and risk reduction skills about all aspects of sexuality". The Special Rapporteur on the right to education has further emphasized that a comprehensive curriculum requires sensitivity to sexual diversity and a gendered perspective (see A/65/162, para. 23).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Education
- Equality & Inclusion
- Gender
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 60
- Paragraph text
- Even in jurisdictions where sexual and reproductive health education is permitted in some form, its quality and effectiveness can be severely diminished by policy prescriptions. States have assisted in the dissemination of misinformation on condom use either by distributing materials that contain inaccurate information or by remaining silent on the topic, which allows for the proliferation of contradictory and inaccurate information. Similarly, abstinence-only campaigns that focus only on abstaining from sexual intercourse as a means to avoid sexually transmitted infections and unintended pregnancies provide a narrow and incomplete rather than a comprehensive perspective. Such programmes, which often lack accurate and evidence-based information, have been shown to have a minimal or no effect on reducing the transmission of sexually transmitted infections.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 64
- Paragraph text
- States that implement and enforce criminal or other laws to restrict access to sexual and reproductive health information actively reduce access to information and therefore do not meet their obligation to respect the right to health. As a consequence of such laws and the stigma they generate, third parties, such as teachers, publishers, or booksellers may also deny women and girls access to necessary sexual and reproductive health materials. The obligation of States to fulfil the right to health requires that they develop strategies to ensure that comprehensive sexual and reproductive health education and information is provided to everyone, especially women and young girls.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Girls
- Women
- Youth
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 65f
- Paragraph text
- [In applying a right-to-health approach, States should undertake reforms toward the development and implementation of policies and programmes relating to sexual and reproductive health as required by international human rights law. In that context, the Special Rapporteur calls upon States to:] Formulate policies to ensure that existing criminal laws, such as those concerning pornography, are not applied to restrict access to, or punish those who provide, evidence-based sexual and reproductive health information and education;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 65i
- Paragraph text
- [In applying a right-to-health approach, States should undertake reforms toward the development and implementation of policies and programmes relating to sexual and reproductive health as required by international human rights law. In that context, the Special Rapporteur calls upon States to:] Consider, as an interim measure, the formulation of policies and protocols by responsible authorities imposing a moratorium on the application of criminal laws concerning abortion, including legal duties on medical professionals to report women to law enforcement authorities;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 65k
- Paragraph text
- [In applying a right-to-health approach, States should undertake reforms toward the development and implementation of policies and programmes relating to sexual and reproductive health as required by international human rights law. In that context, the Special Rapporteur calls upon States to:] Establish policies and programmes to ensure the accessibility and availability of safe, reliable and good quality services for abortion-related complications and post-abortion care, in line with WHO protocols, particularly in jurisdictions where abortion is criminalized;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 65l
- Paragraph text
- [In applying a right-to-health approach, States should undertake reforms toward the development and implementation of policies and programmes relating to sexual and reproductive health as required by international human rights law. In that context, the Special Rapporteur calls upon States to:] Ensure that accurate, evidence-based information concerning abortion and its legal availability is publicly available and that health-care providers are fully aware of the law related to abortion and its exceptions;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 65m
- Paragraph text
- [In applying a right-to-health approach, States should undertake reforms toward the development and implementation of policies and programmes relating to sexual and reproductive health as required by international human rights law. In that context, the Special Rapporteur calls upon States to:] Ensure that conscientious objection exemptions are well-defined in scope and well-regulated in use and that referrals and alternative services are available in cases where the objection is raised by a service provider;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 65n
- Paragraph text
- [In applying a right-to-health approach, States should undertake reforms toward the development and implementation of policies and programmes relating to sexual and reproductive health as required by international human rights law. In that context, the Special Rapporteur calls upon States to:] Suspend/abolish the application of existing criminal laws to various forms of conduct during pregnancy, such as conduct related to treatment of the foetus, most notably miscarriage, alcohol and drug consumption and HIV transmission.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 6
- Paragraph text
- The right to sexual and reproductive health is an integral component of the right to health. The International Covenant on Economic, Social and Cultural Rights emphasizes aspects of the right to sexual and reproductive health in article 12.2 (a). General Comment No. 14 of the Committee on Economic, Social and Cultural Rights states that the right to health includes measures to improve child and maternal health, sexual and reproductive health services, including access to family planning, prenatal and post-natal care, emergency obstetric services and access to information, as well as to resources necessary to act on that information (E/C.2/2000/4, para. 14). Moreover, it notes that women's right to health requires the removal of all barriers interfering with access to health services, education and information, including in the area of sexual and reproductive health (ibid., para. 21). The recommendations of the Committee have consistently supported that approach.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Children
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 7
- Paragraph text
- The Convention on the Elimination of All Forms of Discrimination against Women requires States to take action to ensure that women are afforded broad equality in, inter alia, education, employment and access to health care. The Convention specifically provides for a proper understanding of maternity as a social function, access to family planning information, and the elimination of discrimination against women in marriage and family relations. Furthermore, article 16.1 (e) mandates that women be provided the same rights to decide freely and responsibly on the number and spacing of their children and to have access to the information, education and means to enable them to exercise those rights.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Children
- Families
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 8
- Paragraph text
- The Convention on the Rights of the Child provides for the protection of the right to health of young persons under the age of 18. Article 24 of the Convention affirms the right to health as established in the International Covenant on Economic, Social and Cultural Rights, which is especially relevant given the importance of sexual and reproductive health to the lives of young women and men. The Convention urges States to ensure prenatal and post-natal care for mothers, develop family planning education and services and ensure the elimination of traditional practices that are "prejudicial to the health of children".
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Children
- Men
- Women
- Youth
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 9
- Paragraph text
- Reproductive health rights also feature prominently in the Programme of Action of the 1994 International Conference on Population and Development, the 1995 Beijing Platform for Action and the Millennium Development Goals, which affirm the rights of women to control all aspects of their health, to respect bodily autonomy and integrity and to decide freely in matters relating to their sexuality and reproduction, free of discrimination, coercion and violence. The Beijing Platform for Action states that States should consider removing punitive measures related to sexual and reproductive health. The relationship between improved sexual and reproductive health for women and poverty reduction is particularly emphasized. Unfortunately, the Millennium Development Goals Report 2010 declared that progress in parts of the world in some indicative areas, such as adolescent pregnancy and contraceptive use, had slowed and that aid for family planning as a proportion of total aid to health had declined sharply between 2000 and 2008.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Adolescents
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 12
- Paragraph text
- The use of overt physical coercion by the State or non-State actors, such as in cases of forced sterilization, forced abortion, forced contraception and forced pregnancy has long been recognized as an unjustifiable form of State-sanctioned coercion and a violation of the right to health. Similarly, where the criminal law is used as a tool by the State to regulate the conduct and decision-making of individuals in the context of the right to sexual and reproductive health the State coercively substitutes its will for that of the individual.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 14
- Paragraph text
- In their application, criminal laws and other legal restrictions may prevent access to certain sexual and reproductive health-care goods, such as contraceptive methods, directly outlaw a particular service, such as abortion, or ban the provision of sexual and reproductive information through school-based education programmes or otherwise. In practice, these laws affect a wide range of individuals, including women who attempt to undergo abortions or seek contraception; friends or family members who assist women to access abortions; practitioners providing abortions; teachers providing sexual education; pharmacists supplying contraceptives; employees of institutions that are established to provide family planning services; human rights defenders advocating for sexual and reproductive health rights; and adolescents seeking access to contraception for consensual sexual activity.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- Adolescents
- Families
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 18
- Paragraph text
- States most frequently cite two grounds for implementing criminal or other restrictive laws in relation to the right to sexual and reproductive health: public health and public morality. Public morality cannot serve as a justification for enactment or enforcement of laws that may result in human rights violations, including those intended to regulate sexual and reproductive conduct and decision-making. Although securing particular public health outcomes is a legitimate State aim, measures taken to achieve this must be both evidence-based and proportionate to ensure respect of human rights. When criminal laws and legal restrictions used to regulate public health are neither evidence-based nor proportionate, States should refrain from using them to regulate sexual and reproductive health, as they not only violate the right to health of affected individuals, but also contradict their own public health justification.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 19
- Paragraph text
- Securing the rights of women is crucial to improving health outcomes for both sexes. However, substantial underreporting of reproductive and sexual health problems is a serious challenge and probably arises for a variety of political, social, and cultural reasons. By generating a chilling effect on the open exchange of information and data collection, criminalization further exacerbates the underreporting of important health indicators. As a result, effectively addressing poor health outcomes is rendered impossible, and difficulties faced by the international community in meeting core development goals are compounded. Moreover, development indicators do not capture the full impact of criminalization because they only address specific quantifiable public health data and exclude deprivations of dignity and autonomy.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 21
- Paragraph text
- Criminal laws penalizing and restricting induced abortion are the paradigmatic examples of impermissible barriers to the realization of women's right to health and must be eliminated. These laws infringe women's dignity and autonomy by severely restricting decision-making by women in respect of their sexual and reproductive health. Moreover, such laws consistently generate poor physical health outcomes, resulting in deaths that could have been prevented, morbidity and ill-health, as well as negative mental health outcomes, not least because affected women risk being thrust into the criminal justice system. Creation or maintenance of criminal laws with respect to abortion may amount to violations of the obligations of States to respect, protect and fulfil the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 23
- Paragraph text
- In States where abortion is criminalized, particular grounds for seeking an abortion may be exempt from criminalization. In the most severe cases, however, abortion is completely criminalized without exception - a situation that exists in only a handful of States - or allowed only to save the life of the woman. Approximately 25 per cent of the world's population lives under legal regimes that prohibit all abortions except for those following rape or incest, as well as those necessary to save a woman's life. Slightly less restrictive legal regimes permit abortion on a number of physical health, mental health and socio-economic grounds, such as poverty and number of children. Finally, abortion is unrestricted on any grounds in 56 States, though limits still exist with respect to how late in pregnancy an abortion will be permitted.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 25
- Paragraph text
- The World Health Organization (WHO) has confirmed that legal grounds largely shape the course for women with an unplanned pregnancy towards a safe or an unsafe abortion. As legal restrictions primarily influence whether abortion is safe or not, more unsafe abortions are likely to occur in legal regimes that are more restrictive of abortion. The rate of unsafe abortions and the ratio of unsafe to safe abortions both directly correlate to the degree to which abortion laws are restrictive and/or punitive. Unsafe abortions are estimated to account for nearly 13 per cent of all maternal deaths globally. A further 5 million women and girls suffer short- and long-term injuries due to unsafe abortions, including haemorrhage; sepsis; trauma to the vagina, uterus and abdominal organs; cervical tearing; peritonitis; reproductive tract infections; pelvic inflammatory disease and chronic pelvic pain; shock and infertility.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- Girls
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 26
- Paragraph text
- The conditions under which unsafe abortions occur include: limited access to information, particularly concerning when and how legal abortions may be obtained; abortion induced by an unskilled provider in unhygienic conditions or by a health-care worker outside of appropriate facilities; abortion induced by the woman herself or a traditional medical practitioner through insertion of an object into the uterus, drinking of a hazardous substance or violent massage; and incorrectly prescribed medicine with no follow-up or further information provided. Criminalization of abortion creates and perpetuates these unsafe conditions. In more liberal regimes, women are able to legally seek service and treatment through professional health-care providers under safe and medically appropriate circumstances, including the use of medical abortion pills, which allow for safe, self-induced early abortions.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 28
- Paragraph text
- States are also obliged to protect against infringement of the right to health by third parties. In States where abortion is prohibited, public health and safety regulations regarding abortion, such as provisions for the training and licensing of health-care workers, cannot exist, thus increasing the potential for unsafe abortion practices. Decriminalization, coupled with appropriate regulation and the provision of accessible, safe abortion services, is the most expeditious method of fully protecting the right to health against third-party violations. Additionally, States should take measures to protect those who provide abortions and related services from harassment, violence, kidnappings and murder perpetrated by non-State actors (religiously motivated or otherwise).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 30
- Paragraph text
- Women are entitled to equal health protection afforded by the State as part of the right to health. Regardless of the legal status of abortion, women are entitled to receive access to goods, services and information related to sexual and reproductive health. In particular, they are entitled to have access to quality health services for the management of complications, including those arising from unsafe abortions and miscarriages. Such care must be unconditional even where the threat of criminal punishment is present, and it should not be contingent on a woman's cooperation in any subsequent criminal prosecution, or used as evidence in any proceeding against her or the abortion providers. Laws must not require health-care personnel to report women for abortion-related care to law enforcement or judicial authorities.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 31
- Paragraph text
- Absolute prohibition under criminal law deprives women of access to what, in some cases, is a life-saving procedure. Even where a clandestine abortion can be performed in a relatively safe, hygienic setting, it may be financially inaccessible for the most vulnerable women. Poor and marginalized women may instead turn to unsafe, self-induced abortions. Where narrow exceptions to the criminalization of abortion exist, such as to save the life of a woman, criminalization may effectively block access to information about legal abortion services. Women often remain unaware of these exceptions because the stigma surrounding the issue of abortion prevents dissemination and discussion of such necessary information. Legal restrictions on the availability of information relating to abortions also exist because criminal laws often include explicit provisions prohibiting the production and distribution of the information.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 32
- Paragraph text
- The provision of health-care goods and services that are of poor quality is a major problem arising from legal regimes criminalizing abortion. In these circumstances, the lack of State and professional regulation of medical practices means that abortions are performed by unskilled practitioners, in unhygienic conditions, in order to evade law enforcement. On the contrary, when performed by trained health-care providers under appropriate conditions, abortion is one of the safest medical procedures available. Criminalization further prevents practitioners from accessing accurate health information and, where exceptions to criminalization exist, the chilling effect created by its associated stigma may prevent health-care workers from seeking training and information on abortion. Health-care workers who choose to perform abortions under these circumstances may accordingly be uninformed and untrained on appropriate abortion procedure and post-abortion care, reducing the quality and availability of legal abortions.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 34
- Paragraph text
- The marginalization and vulnerability of women as a result of abortion-related stigma and discrimination perpetuate and intensify violations of the right to health. Abortion-related stigma prevents women from seeking abortions and prevents those who undergo abortions from requesting treatment for resulting medical complications. The gross underreporting of abortion - only 35 to 60 per cent are reported - is one indicator of the magnitude of the stigma attached to abortion. Although many social and cultural factors generate and exacerbate the stigma attached to abortion, criminalization of abortion perpetuates discrimination and generates new forms of stigmatization. For example, a woman's infertility may be misunderstood to be the result of a previous abortion, placing "culpability" on the woman as a result of the stigma associated with abortion rather than acknowledging that her infertility may be due to various unrelated health conditions.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 37
- Paragraph text
- Maternal health, prenatal and post-natal care, and access to information, are all elements of the right to health elaborated under General Comment No. 14. Additionally, article 10.2 of the International Covenant on Economic, Social and Cultural Rights provides that special protection should be accorded to mothers. The Convention on the Elimination of All Forms of Discrimination against Women also recognizes that women should be provided with appropriate services in connection with pregnancy. In chapter VII.A., the Programme of Action of the International Conference on Population and Development observes that reproductive health includes access to services that enable women to go through pregnancy and childbirth safely. Despite these positive obligations to support women during pregnancy and post-birth, certain States have proposed or enacted criminal laws or other legal restrictions prohibiting certain forms of conduct, which infringe the right to health of affected women.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Infants
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 38
- Paragraph text
- In certain jurisdictions, pregnant women have been prosecuted for various types of conduct during pregnancy. A number of prosecutions have occurred in relation to the use of illicit drugs by pregnant woman, including under pre-existing laws relating to child abuse, attempted murder, manslaughter and criminally negligent homicide. Criminal laws have also been used to prosecute women for other conduct, including alcohol use during pregnancy, the birth of stillborn babies or the miscarriage of a foetus (see A/HRC/17/26/Add.2, para. 68), failing to follow a doctor's orders, failing to refrain from sexual intercourse, and concealment of the birth.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Violence
- Person(s) affected
- Children
- Infants
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 39
- Paragraph text
- In some instances, civil legislation related to child welfare has been expanded to include punitive sanctions for prenatal drug exposure, where such exposure may provide a ground for the termination of parental rights and the removal of the child upon birth. A pregnant woman's positive toxicology report or clinical signs of drug exposure in newborns, may be regarded as proof of child abuse or neglect under these legislative schemes. In some jurisdictions, health professionals are required to test pregnant women or newborns for drug exposure or may do so provided the woman is given notice. Others have enacted legislation authorizing the institutionalization of women who have used drugs during pregnancy. Health professionals may also be obliged to report positive drug-screening results to the Government.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Children
- Infants
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 40
- Paragraph text
- Some States have also criminalized perinatal HIV transmission. For example, in one jurisdiction, a person infected with HIV (and aware of the fact) must "'take all reasonable measures and precautions to prevent the transmission of HIV to others and in the case of pregnant women, the foetus', with criminal sanctions imposed for failure to do so" (see A/HRC/14/20, para. 67). In this case, no exception or defence is allowed in relation to unavailability or lack of access to preventive health-care goods, services and information. Statutes from other jurisdictions, which criminalize HIV transmission generally, may also be applied to perinatal transmission.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 41
- Paragraph text
- Criminalization of conduct during pregnancy impedes access to health-care goods and services, infringing the right to health of pregnant women. Where women fear criminal prosecution, they may be deterred from accessing health services and care, as well as pregnancy-related information. For example, women may not seek antenatal services if they are faced with the risk of prosecution from transmitting HIV, which poses a risk to their health and the health of the foetus. This undermines public health objectives related to HIV, because women may refuse testing entirely if they face criminal penalties for transmission.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 42
- Paragraph text
- While public health goals can justify some degree of interference with personal freedoms, it has been well documented that the public health goals are not realized through criminalization; rather, they are often undermined by it (see A/HRC/14/20, para. 51). The application of criminal law to regulate conduct such as alcohol consumption during pregnancy is a disproportionate response and an ineffective deterrent. A number of professional medical associations oppose use of the criminal law as a means to address substance abuse by pregnant women, on the grounds of ineffectiveness and disproportionality. In order to realize public health outcomes effectively and simultaneously promote the right to health of women, States should not criminalize such conducts during pregnancy, but rather ensure the provision of health-care goods, services and information that promote health throughout pregnancy and childbirth.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 43
- Paragraph text
- Certain criminal laws effectively shift the burden of realizing the right to health away from States onto pregnant women, punishing women for the lack of effective provision of health-care goods, services and education by the Government. For instance, where a woman living with HIV must take all reasonable measures and precautions to prevent the transmission of HIV to the foetus but there is limited or no access to health-care services and antiretroviral treatment, the State fails to provide what is needed for a woman to avoid criminal prosecution. The Special Rapporteur has observed that "where the right to access to appropriate health services … is not ensured, women are simply unable to take necessary precautions to prevent transmission, which could place them at risk of criminal liability" (see A/HRC/14/20, para. 66). As availability of, and access to, health-care goods and services is the responsibility of States, it is particularly perverse that the criminal law has the potential to punish women for the inadequacy of the Government in this respect.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 44
- Paragraph text
- WHO defines family planning as a process that allows people to attain their desired number of children and determine the spacing of pregnancies which is achieved through use of contraceptive methods and the treatment of infertility. Use of family planning methods is an integral component of the right to health. Contraception is a method of fertility control by which family planning is affected. Some forms can also be used for the prevention of sexually transmitted infections, primarily through physical barrier methods of contraception such as condoms. Various other forms of contraception exist, ranging from surgical sterilization to pharmaceutical methods, such as the oral contraceptive pill, which do not protect against sexually transmitted infections.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- Children
- Families
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 45
- Paragraph text
- Family planning empowers women to make autonomous and informed choices about their sexual and reproductive health. It reduces maternal mortality by delaying pregnancies in young women who would otherwise face an increased risk of health problems and death from early childbearing. Evidence shows that access to voluntary family planning can reduce maternal deaths by between 25 and 40 per cent. Family planning also reduces the number of unsafe abortions and the perinatal transmission of HIV. Condom use not only results in lower incidences of sexually transmitted infections but, when used correctly and consistently, male condoms are 98 per cent effective toward preventing pregnancy.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- Children
- Families
- Women
- Youth
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 46
- Paragraph text
- The global unmet need for family planning remains a significant barrier to achieving rights-related and development goals. WHO estimates that 200 million couples in developing countries would like to delay or stop childbearing but are not using any method of contraception. In 2009, 24 per cent of women of reproductive age in the least developed countries, who were married or in a union, reported not wanting any more children or wanting to delay the birth of their next child. Reasons for the global unmet need included limited access to contraception; limited choice of contraceptive methods; fear or experience of side-effects; cultural or religious opposition; poor quality of available services; and gender-based barriers.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Gender
- Health
- Person(s) affected
- Children
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 47
- Paragraph text
- Family planning allows women to choose whether and when to reproduce and is thus integral to development and the full participation of women in society. In parts of sub-Saharan Africa, contraceptive use is four times higher among women with a secondary education than among those with no education, and is almost four times higher among women in the richest households than those in the poorest households. One cross-national survey suggests that the percentage of women in the labour force is directly related to national birth rates. Strong links have also been observed between contraception use by women and opportunities to work outside of the home; in one country, the average income growth for women with one to three pregnancies was twice that of women who had been pregnant more than seven times.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Gender
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 48
- Paragraph text
- Criminal laws and other legal restrictions that reduce or deny access to family planning goods and services, or certain modern contraceptive methods, such as emergency contraception, constitute a violation of the right to health. The Convention on the Elimination of All Forms of Discrimination against Women calls upon States to ensure access to specific educational information to help to ensure the health and well-being of families, including information and advice on family planning, as well as access to adequate health-care facilities, including information, counselling and services in family planning. In General Comment No. 14, the Committee on Economic, Social and Cultural Rights calls upon States to take measures to "improve child and maternal health, sexual and reproductive health services, including access to family planning … and access to information, as well as to resources necessary to act on that information" (see E/C.12/2000/4, para. 14).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Children
- Families
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 49
- Paragraph text
- In chapter II, principle 8, of the Programme of Action of the International Conference on Population and Development confirms that States should take all appropriate measures to ensure, on a basis of equality of men and women, universal access to health-care services, including those related to reproductive health care, which includes family planning and sexual health. It also stresses the need for participation and notes that family planning programmes are most successful when women are fully involved in the design, provision, management and evaluation of services. It further adds that Governments should remove all unnecessary legal, medical, clinical and regulatory barriers to information and to access to family-planning services and methods. In paragraph 96, the Beijing Platform for Action declares that the human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Families
- Men
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 51
- Paragraph text
- For example, some States have criminalized the distribution and use of emergency contraception, justifying such laws with claims that emergency contraception is abortifacient. WHO, however, confirms that emergency contraception is a valid form of contraception. Women who carry an unplanned pregnancy to term as a result of such laws also might face adverse physical and mental health outcomes. At the same time, women who lack access to emergency contraception as a result of criminal prohibitions may ultimately be forced to seek clandestine abortions, thus exposing themselves to the associated health risks.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Criminalisation of sexual and reproductive health 2011, para. 52
- Paragraph text
- Restricting access to surgical methods of contraception also contravenes the obligations of States to ensure that quality services are available and accessible. For instance, tubal ligation, a safe and effective sterilization procedure for women, is prohibited by law in some countries except under narrow circumstances where the procedure is therapeutically necessary. Read in conjunction with laws criminalizing violence causing permanent damage to a limb, this law exposes health professionals who perform the procedure to criminal liability, thus restricting women's access to this method of contraception. Women may instead seek tubal ligation procedures in unlicenced health facilities, potentially placing them at the risk of experiencing health complications and effectively denying access to poor women who cannot afford such procedures.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 59
- Paragraph text
- The need to incorporate human rights into development is important for the long-term sustainability and legitimacy of development as an enterprise. Many models of development failed to address basic human needs, and further, neglected the rights of people whilst pursuing development outcomes supposedly designed to benefit them. Human rights-based approaches to development are particularly useful in this regard, and their use should be promoted. The right to health can be a particularly powerful reference in that regard because of its close links to a full range of other rights and the crucial role that health plays in development, both human and economic.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 7
- Paragraph text
- The relationship between development and human rights has undergone numerous changes over the past five to six decades. While each began as, and largely remains, an independent approach to addressing problems of human welfare, there has been an inexorable shift within the development sphere of late towards a more humanistic model of advancement and the recognition that health has an impact on economic development. This has necessarily come to include human rights, although the form in which human rights-based concepts and approaches are incorporated has varied, and there have been differing levels of acceptance of such concepts within the development sphere.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 8
- Paragraph text
- Earlier, narrower conceptions of development largely focused on indicators such as growth in GNP, rise in personal incomes, industrialization, technological advance, or social modernization. This left little room for the inclusion of human rights, despite the fact that the overall aim of development was the improvement of the human condition, and in that respect development and human rights have always intersected. Significant evolution occurred in the 1980s to 1990s, alongside acknowledgement of the right to development as a stand-alone right, as will be discussed in Section III. Over this time, growing acceptance of human rights discourse within the development community took place. In particular, the human development, or "capabilities" approach to development pioneered by Amartya Sen and Martha Nussbaum appeared against the backdrop of the relative backlash against purely economic models of development that previously dominated this arena.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 9
- Paragraph text
- In 1987, the landmark study by the United Nations Children's Fund (UNICEF) "Adjustment with a Human Face" spurred global debate on the negative social impacts, including on health, of structural adjustment programmes prescribed by the international financial institutions as a means to achieve economic development. Three years later, in 1990, the United Nations Development Programme (UNDP) published the first Human Development Report. Alongside the report, UNDP created the Human Development Index, a summary measure of various human development indicators, such as maternal mortality, childhood education, gender disparities, poverty, etc. The index and report represented a major progression in development theory, which aimed to "[put] people back at the center of the development process" by going beyond income to assess people's long-term well-being. This broader and holistic reconceptualization of development has been increasingly favoured and has facilitated efforts to recognize and incorporate human rights in development work.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Gender
- Governance & Rule of Law
- Health
- Person(s) affected
- Children
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 10
- Paragraph text
- The evolved concept of development, which underwrites the MDGs and the contemporary development paradigm, represents a significant departure from these earlier views, making more evident the close overlap between development and human rights. This close interrelationship between development and human rights is clearly spelled out in the 2000 Millennium Declaration and was underlined at the 2010 High-level Plenary Meeting of the United Nations General Assembly on the MDGs. As the outcome document states, respect for and promotion and protection of human rights is an integral part of effective work towards achieving the Millennium Development Goals.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 11
- Paragraph text
- The "capabilities" approach first articulated by Sen and developed by Nussbaum, which underlies the concept of human development, at its core requires removal of major sources of "unfreedom" in order for development to occur, including poverty, poor economic opportunities, tyranny, neglect of public facilities, and social deprivations. This very acknowledgement allows a clear space in which human rights-based discourse can guide development. The capabilities approach recognizes rights as both "constitutive" of and "instrumental" to the overall process of development; that is, rights and freedoms are not only necessary tools in achieving the goals of development, but that realization of rights should constitute an end-goal of development itself. More particularly, this approach holds that human rights are entitlements which make up a part of a set of central capabilities: a core set of freedoms, or rights, which form the basis of the very opportunities necessary to achieving a requisite level of human development.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 12
- Paragraph text
- When development is perceived in terms of human development and capabilities, it is evident that the right to health has both constitutive and instrumental relevance in respect of development and poverty reduction. The right is constitutive insofar as ill health and inadequate protection of the right to health are symptoms and constituent parts of inadequate human development and poverty, and instrumental in that the enjoyment of the right to health is instrumental in securing other human rights, such as the right to education and work, which are essential to the achievement of human development.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 13
- Paragraph text
- In other words, the new conception of development recognizes that the realization of human rights, including the right to health, is a central aspect of development itself. This connection has been elaborated in many forums, including the United Nations: the centrality of human rights in poverty reduction has been well recognized, and elaborated through a conceptual framework and guidelines on human rights and poverty reduction. However, as previously discussed, health is also implicated in many other conceptions of development besides that involving poverty reduction, and it is this centrality of health to all aspects of development which makes it essential that a right to health approach be used in all development programmes and policies which seek to address health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 15
- Paragraph text
- Of the eight Millennium Development Goals subsequently developed to reflect the objectives agreed upon in the Millennium Declaration in 2000, Goals 4, 5 and 6 deal with health directly and others deals with underlying determinants of health. At least 8 of the 16 MDG targets, and 17 of the 48 related indicators, are health-related. As the MDGs have become a major focus of health-related development work, it was an important step for these goals to place health at the very centre of the development enterprise. Moreover, at the 2010 high-level plenary meeting of the General Assembly, States committed to promoting global public health for all to achieve the MDGs and to ensure "respect for human rights, promote gender equality and the empowerment of women as essential means of addressing the health of women and girls, and to address the stigmatization of people living with and affected by HIV and AIDS". The normative framework that is now well developed and understood for the right to health is well placed to inform the efforts towards achieving the MDGs.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Gender
- Health
- Person(s) affected
- Girls
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 17
- Paragraph text
- Comprehensive incorporation of human rights into development work necessitates changes in the practical approach taken to development work itself. The advancement of human rights through development work - as opposed to simply avoiding rights violations - is an important step, and one which largely remains a work in progress. The adoption of a right to health framework, in respect of health, and of human rights-based approaches more generally is one method by which genuine synchronicity can be achieved in respect of health-related development work and human rights.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 18b
- Paragraph text
- [The right to health framework complements current development approaches by underlining the importance of aspects such as participation, community empowerment and the need to focus on vulnerable populations. The right to health analytical framework "unpacks" the right to health, making it easier to understand and apply in practical settings. Its key elements are as follows:] Recognition that the right to health is subject to resource constraints and progressive realization, requiring the identification of indicators and benchmarks to measure progress over time;
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 18i
- Paragraph text
- [The right to health framework complements current development approaches by underlining the importance of aspects such as participation, community empowerment and the need to focus on vulnerable populations. The right to health analytical framework "unpacks" the right to health, making it easier to understand and apply in practical settings. Its key elements are as follows:] Developing countries have a responsibility to seek international assistance and cooperation, while developed States have some responsibilities towards the realization of the right to health in developing countries; and
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 19
- Paragraph text
- Development and the full realization of the right to health both require long-term strategies and planning. At the same time, the right to health framework demands that immediate steps be taken to ensure the core obligations of the right to health, and that special attention be given to the situation of vulnerable and marginalized groups. Whereas some elements of the right to health allow for progressive realization in accordance with available resources, others must be realized immediately. The realization of these aspects of the right to health cannot be conditioned through prioritization in development planning, policies and programmes. [...]
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 20
- Paragraph text
- In respect of human rights more broadly, it has been noted that there was historically a lack of clarity concerning the content of human rights-based approaches. This was mitigated by the Common Understanding agreed upon by United Nations agencies in 2003. This document represents the achievement of conceptual consensus; however, it lacks detail and has been difficult to operationalize. United Nations agencies have employed the Common Understanding in inconsistent ways, and, outside the United Nations system, the definitions and uptake of human rights-based approaches vary even more widely. However, common elements can still be distilled from most approaches taken, and can be used to inform implementation of a right to health approach to development.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 23
- Paragraph text
- In practical terms, this approach does not simply require that the goals and outcomes of development are loosely aligned with those of human rights. More is necessary; in particular, it is vital that the processes around development and implementation of programming adopt a human rights-based approach, as will be discussed further. Similarly, use of human rights in development requires the use of good programming practices, but adoption of such practices in and of itself does not constitute adoption of a right to health, or human rights-based approach. For instance, use of monitoring and evaluation is not uncommon in development practice, and yet its inclusion does not constitute use of a human rights-based approach without an attendant careful analysis of both the rights and duties of the parties involved in the programme, and an examination of their capacity to claim their rights and fulfill their obligations, respectively.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 24
- Paragraph text
- The actual content of a right to health approach as applied to development programming may vary in individual circumstances, and the Special Rapporteur believes that adaptation and flexibility are necessary depending on the nature of the development initiatives undertaken, the context, and so forth. However, in the Special Rapporteur's opinion, adoption of a right to health approach should at least require: (1) the clear and explicit placement of human rights at the centre of health-related programming strategies, and (2) inclusion of some or all of the core elements of a right to health approach in a methodical manner. The framework should be considered in its entirety, and if elements of the framework are not adopted, it should be clear that their inclusion has at least been considered, rather than individual elements being cherry-picked in an ad-hoc manner. Operationalization of a rights-based approach to health should also reflect the Common Understanding.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 28
- Paragraph text
- The right to development is a self-standing right, which includes all other human rights. As the Declaration on the Rights to Development states in its article 1, it is a right "by virtue of which every human person and all peoples are entitled to participate in, contribute to, and enjoy economic, social, cultural and political development, in which all human rights and fundamental freedoms can be fully realized." Accordingly, the right to development includes the right to health guaranteed in ICESCR and other international human rights treaties.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 29
- Paragraph text
- The right to development is a right of individuals and of peoples. It is distinguishable from the right to health in this respect, which is more related to the individual citizen's relationship with the State. Nevertheless, overlap exists. General comment No. 14 of CESCR confirms that the right to health, as outlined in Article 12 of the ICESCR, has both collective and individual dimensions, and that collective rights are critical in the field of health, as modern public health policy relies heavily on prevention and promotion, approaches directed primarily towards groups. Similarly, both the right to health and the right to development underline the imperative of ensuring transparency, equality, participation, accountability and non-discrimination.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 30
- Paragraph text
- The right to health extends to the underlying determinants of health, embracing a wide range of socio-economic factors that promote conditions in which people can lead a healthy life, which necessarily incorporates other rights. Yet a distinct feature of the right to development is its focus on a process of simultaneously advancing the full range of human rights. In this regard the words of former independent expert on the right to development and former chairperson of the Working Group on the Right to Development, Arjun Sengupta, are illustrative. As he notes: "the right to health could be implemented on its own, but when treated as a component of the right to development, its realization must include policies to expand resources as well as institutions over time, taking into account competing claims of other rights which must be coordinated with the right to health. Such exercise might imply a much larger claim on resources and much greater inputs from international cooperation than would be the case for the fulfilment of the right to health by itself."
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 32
- Paragraph text
- Moreover, the right to development focuses specifically on the duty of States to act jointly towards the realization of human rights. While the obligation of international cooperation is also recognized under ICESCR and other human rights treaties, this aspect of both rights can be more comprehensively addressed through use of the right to development. In this regard, the high-level task force on the implementation of the right to development (HTF) developed a set of criteria for the evaluation of global partnerships (Millennium Development Goal 8). The criteria were developed around three attributes of the right to development: comprehensive and human-centred development policy; participatory human rights processes; and social justice in development. They include a number of sub-criteria and indicators, several of which relate to the right to health. In developing and testing these criteria, the Task Force inter alia examined partnerships relating to access to medicines and the fight against AIDS, tuberculosis and malaria.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 33
- Paragraph text
- The right to health can help operationalize the right to development. The right to development is not contained in a legally binding instrument at the international level, and thus, although it draws its foundations from binding human rights treaties, it is not directly enforceable in most countries. However, the Special Rapporteur notes that, in a recent landmark ruling, the African Commission determined that a State had violated the right to development enshrined in article 22 of the African Charter on Human and Peoples' Rights. In this respect, the right to health may provide support in achieving development goals through judicial enforcement where the right to development currently lacks the legal tools to do so. Along with addressing longer-term, underlying determinants relating to development outcomes, narrower interventions should simultaneously be pursued to address immediate rights infringements that impact on development.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 34
- Paragraph text
- For example, individuals are increasingly bringing cases before national courts concerning breaches of their right to health. This approach has been particularly successful in securing access to essential medicines, a core aspect of development progress. Such cases may be brought by a particular litigant, but may result in provision of medicines to affected communities, thereby demonstrating the fact that enforcement of the right to health need not occur only for the benefit of one individual. Such litigation represents a powerful tool, not only to achieve a particular legal outcome, but to significantly strengthen and empower a social movement around the cause forming the subject matter of the litigation in question, further ensuring realization of the right.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 35
- Paragraph text
- The operationalization of the right to development can also be informed by the significant amount of work undertaken in respect of the collective aspect of the right to health. For instance, the World Health Organization (WHO) has long recognized the importance of social justice for health; the Commission on Social Determinants of Health has highlighted the importance of domestic legislation enshrining the right to health, and recognition of the rights of citizens to participate in public policy and budgeting, which has the potential to strengthen health systems.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 37
- Paragraph text
- Around 33.3 million people worldwide are currently living with the human immunodeficiency virus (HIV), a retrovirus which causes acquired immunodeficiency syndrome (AIDS), a universally fatal syndrome causing failure of the human immune system. One of the most pressing health and human rights conundrums of modern life, it has been described as a "health threat of massive proportions" and an "extraordinary challenge", and represents the first illness that has essentially required the introduction of a public health response that gave heed to human rights. The relationship between HIV and development has also been clearly recognized over time. The pernicious effect of HIV on human development is being tackled through its prioritization as one of the eight Millennium Development Goals, and UNDP has noted that "mainstreaming" HIV into development processes is effective. The connections between HIV/AIDS and human rights were articulated by the International Guidelines on HIV/AIDS and Human Rights ("Guidelines"), which recognize the central role played by human rights in addressing, limiting and attempting to eradicate HIV/AIDS.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 39
- Paragraph text
- The second phase of the response, in which the international community promoted the prevention of discrimination under the "public health rationale", is a clear example of recognition of the impact of human rights on health, and vice versa. It became increasingly clear that violations of the right to health, such as the State's failure to prevent discrimination towards people living with HIV and AIDS (or, indeed, discrimination perpetrated by the State itself) actually reduced the effectiveness of HIV prevention programmes. Conversely, where rights were protected by the State, through clear preservation of anonymity in the context of HIV testing, participation in testing and counseling increased. The elimination of discrimination and protection of basic freedoms not only upheld rights but furthered public health aims concurrently.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 40
- Paragraph text
- The relationship between the law, public health and human rights has thus been seen as of particular importance in relation to HIV. In an attempt to control the virus and the social practices that result in its spread, laws may be hastily enacted that are only partially successful in achieving behavioural change. The "AIDS paradox" is that: "…one of the most effective laws we can offer to combat the spread of HIV which causes AIDS is the protection of persons living with AIDS, and those about them, from discrimination." Indeed, this paradox does not exist only in respect of laws. Any development intervention designed to combat the spread of HIV which respects the human rights of those directly affected by and those most at risk of HIV, will ultimately be more effective in achieving its stated goals.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 41
- Paragraph text
- HIV thus represents a good example of the multi-faceted relationship between health and human rights. It shows how health policies and legislation can impact detrimentally on human rights, while violations of human rights can detrimentally affect health. Thus, policies and legislation which allow for the quarantining of a person who has contracted HIV would infringe on the right to liberty and security of person, while "naming and shaming" people who test positive to HIV, in violation of their right to privacy and confidentiality, creates stigma and deters others from seeking out testing and counselling. This close interrelationship also means that human rights and health-related policies and programmes have a great potential to be mutually reinforcing in the realization of health-related development and the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 43
- Paragraph text
- As noted, in the initial, panicked response to HIV, there were calls for quarantine, compulsory notification, and even branding of those people living with HIV. As knowledge grew, and the hysteria surrounding its modes of transmission gradually abated, the extremity of the responses decreased, but identification of the symbiotic relationship between achieving public health and development outcomes, and protecting and promoting human rights, took longer to gain widespread acceptance. It remains overlooked in certain spheres of development, and the lessons learned regarding the effectiveness of responding to HIV using human rights are being increasingly forgotten. Nevertheless, where approaches utilizing human rights have been employed to address HIV, outcomes have been extremely encouraging.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 44
- Paragraph text
- The experience of the Sonagachi Project, started by the All India Institute of Hygiene and Public Health in Kolkata, India in 1992, is indicative of the potential of right to health-based interventions. While the project began as a traditional STD/HIV intervention amongst sex workers in the red-light areas within the district, it soon evolved into one that had at its core central facets of the right to health framework - most importantly, community participation - in an effort to empower the sex worker community to realize their own rights, and ultimately prevent the spread of HIV. The programme noted successful outcomes in respect of health and development; its most quantifiable effects included significantly improved condom usage, and reduced HIV rates amongst the Sonagachi sex worker population. However, its processes and their effects have also been thoroughly researched, reflecting its successes in advocacy and community leadership.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 46
- Paragraph text
- The Special Rapporteur notes that this set of interventions, which has ultimately resulted in significant development of affected communities, successfully applied core elements of the right to health framework, including participation and non-discrimination. The interventions also acknowledged and promoted the fundamental freedoms and entitlements of the sex workers involved in the project; particularly, the right to control one's health and body, including sexual and reproductive health. The programme moreover secured health services for sex workers, most notably through improving their acceptability and accessibility.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 47
- Paragraph text
- Similarly, the experience of the UNIFEM South Asia Partnership with the Positive Women Network (PWN+) and Centre for Advocacy and Research (CFAR) is a good example of how a rights-based, gender-sensitive response to HIV added significant value to pre-existing programming strategies in this area. The PWN+ has over 5,000 members throughout India, and works to support women living with HIV/AIDS by destigmatizing the illness; educating affected women; and establishing support, referral and empowerment systems. The partnerships' activities included initiation of national consultations of HIV-positive women; establishment of partnerships to support research, advocacy and lobbying; documentation of the experiences of HIV-positive women; engagement with the media around gender-sensitive reporting concerning HIV; creation of mechanisms of accountability through public hearings; and formulation of targeted strategies to address the vulnerability of women to HIV/AIDS at national and international levels.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Gender
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 48
- Paragraph text
- The major improvements in the outcomes of the project attributable to the adoption of a human rights-based approach were largely due to the efforts around facilitating and securing the agency of women living with HIV/AIDS, which led to significant improvements in monitoring and accountability, a core element of the right to health framework. This is particularly evident in the continuing high-level participation of positive women in national and international initiatives relating to HIV, and the strong networks formed within India to allow for provision of technical assistance to these women. Ultimately, the advantage of this programmatic design is not only evident in terms of improved development outcomes; the changes in process demonstrate the inherent benefits in recognizing the dignity and equality of these women in the context of pursuing a broader development aim. Nevertheless, in not only ensuring their empowerment through participation, but in further utilizing it to achieve meaningful policy change, the practical benefits of adoption of various elements of a right to health framework in the development context are also seen. The approach taken also facilitated the identification of relevant national human rights laws, norms and standards that should be utilized in order for the State to respect, protect and fulfil the right to health of women living with HIV/AIDS, and the role of those women in holding the State accountable in this regard. This example demonstrates that United Nations agencies are in a unique position to facilitate capacity-building and education around human rights in pursuance of particular development aims.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 49
- Paragraph text
- One key benefit of integrating human rights into development is the way it re-frames development, presenting its constituent components as entitlements and embracing the indivisibility and equal importance of all human rights. This has also been described as a creation of "claims and not charity". In redefining the nature of the problem through incorporation of human rights, and the right to health framework in particular, a shift occurs to a more self-sustaining approach that imbues the former targets of development with genuine agency, and allows for realization of rights previously considered secondary, or less realizable. Member States of the United Nations have directly observed the value added by human rights in respect of development, noting, for instance, that development efforts "had become more systematic and meaningful, contributing to the enhancement of human dignity by encouraging people to become active participants in the development process".
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 50
- Paragraph text
- Another benefit which human rights bring to development is guidance concerning the design and practical implementation of development programmes. For instance, one of the core requirements of a human rights-based approach is the requirement that processes are guided by human rights principles, as stated in the Common Understanding. For example, an increase in the number of people undergoing HIV testing may be a good outcome, but if achieved through coercive testing rather than a voluntary campaign, it is clear that human rights have failed to be integrated into the strategy. Moreover, simply achieving a positive result in a given field, such as health, will not automatically promote respect for the corresponding right, and thus imbue rights-holders and duty-bearers with a long-term "guarantee [or] set of structural claims". Put simply, more needs to be done to ensure that long-term realization of rights occurs as a result of any development interventions. In respect of health, this is best achieved through undertaking the process of identifying the relevant human rights laws, norms and standards that apply, as part of the right to health framework, and continuing on to identify rights-holders and duty-bearers in that context. It has been noted that the "quality, legitimacy and sustainability" of outcomes depend on the process used to achieve them, and human rights may help secure those desirable elements, as well as addressing structural problems that ultimately perpetuate the very conditions that development programming seeks to address.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 52
- Paragraph text
- Evidence of the positive effects of human rights at the practice level of development ultimately provides an additional impetus for reframing both human rights and development as described above. Ultimately, shifting the process through which development actions are implemented, even if goals and outcomes are only subtly altered, may prove the defining means through which the potential of human rights-based approaches become most apparent, even in the absence of rigorous empirical evidence. In fact, a relentless pursuit of evidence for human rights-based approaches has its own shortcomings, as will be discussed presently.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 53
- Paragraph text
- Harmonizing the practical and operational aspects of human rights and development without compromising the essential values and philosophies of both domains is a challenge. Divergence stems from a number of factors, including practical disciplinary differences; development is largely the domain of economists and human rights that of lawyers and advocates. Additionally, there exists the long-standing contention that human rights are more prescriptive than operational, while development projects have focused on implementation and are more programmatic in nature.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 54
- Paragraph text
- These issues are partly addressed by the work of actors such as the Office of the High Commissioner for Human Rights (OHCHR), which developed, at the request of the human rights treaty bodies, a framework for indicators to monitor compliance with international human rights instruments, which takes into account the various ways in which human rights relate to development. The framework establishes three sets of indicators: structural, process, and outcome, and a list of illustrative indicators on the right to health have been developed. However, monitoring and evaluation of human rights-related issues in the development field has thus far been largely limited to outcome indicators. This raises some key concerns with respect to the way indicators are used in development and their impact on human rights.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 55
- Paragraph text
- Effective monitoring and evaluation is a core component of any human rights-based approach, and like other phases of the programming process it should be guided by human rights principles. Moreover, rights-based approaches, including those concerning the right to health, require transparency and accountability in decision-making processes, actions or omissions, for which effective monitoring and evaluation are necessary requirements. However, monitoring and evaluation must be undertaken carefully, to avoid the potential pitfalls associated with a "culture of evaluation", wherein an overreliance on the use of easily quantifiable data and evidence-based evaluation practices can lead to neglect or disregard of development strategies whose effects are more difficult to quantify: for instance, those relating to capacity-building.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 56
- Paragraph text
- In many cases, it is very difficult to conduct evidence-based evaluations of human rights-based health interventions with the same level of methodological rigour applied to, for instance, clinical drug trials. As evaluation unavoidably feeds back into, and threatens to dictate, strategy, this can lead to distortion of prioritization in relation to interventions that can be more easily based on available evidence. Human rights-based interventions may be especially susceptible to this distortion precisely because they are less amenable to evidence-based evaluations. Given the difficulty of plainly illustrating the cause and effect relationship between the realization of human rights and intended health outcomes (for instance, the empowerment of sex workers, their increased use of condoms, and the resultant lower levels of HIV infection) it is imperative that a broad range of evidence-informed practices are used when evaluating human rights-based interventions.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 57
- Paragraph text
- Thus, overreliance on easily quantifiable data threatens to erode the core concept of the realization of human rights as ends in and of themselves. The instrumental value of the incorporation of human rights into development practice must not overshadow the proper understanding of human rights as constitutive components of human development. The United Nations Secretary-General Ban Ki-Moon has noted that the MDGs "embody basic human rights," including the right to health. An understanding of the intrinsic value of human rights and the promotion of human dignity as a necessary end of development must not be sacrificed in order to facilitate data-intensive evaluation.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The right to health and development 2011, para. 58
- Paragraph text
- Nevertheless, these concerns and challenges do not detract from the potential for human rights, and specifically the right to health, to provide a set of norms for development to reorient itself further in a more "human-centric" manner, drawing on legal and institutional frameworks that are crucial to human rights. They have potential not just to "add value", but to achieve the core goals of development itself, as it has been most recently conceived in terms of the right to development and of human development as reflected in the MDGs. In this way development and human rights function symbiotically, as achieving gains in development through methods which utilize human rights will also achieve realization of rights.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Report on expert consultation on access to medicines 2011, para. 44
- Paragraph text
- The right of everyone to the enjoyment of the highest attainable standard of health encompasses access to medical services and the underlying determinants of health, such as water, sanitation, non-discrimination and equality. As access to medicines is an integral and fundamental part of the right to health, Governments and the international community as a whole have a responsibility to provide access to medicines for all. Yet massive inequalities remain in access to medicines around the world, as up to 2 billion people (or one third of the world's population) lack access to essential medicines. Most of them live in low- and middle-income countries, where the needs of persons living in poverty, women, children and undocumented migrants, as well as other marginalized and vulnerable groups who are often discriminated against in terms of access to medicines, are ignored or underestimated.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Poverty
- Water & Sanitation
- Person(s) affected
- Children
- Persons on the move
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Report on expert consultation on access to medicines 2011, para. 45
- Paragraph text
- States have the primary responsibility for enhancing access to medicines; as the Millennium Development Goals recognize, however, this is a shared responsibility. If there is to be an increase in access to medicines, numerous national and international actors have a role to play. Pharmaceutical companies are among those who share this responsibility owing to their evident impact on the ability of Governments to realize the right to the highest attainable standard of health. The expert consultation identified the need for a reliable system for the supply of good-quality medicines that are affordable to all, including those living in poverty and other disadvantaged groups.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 26
- Paragraph text
- States should take measures to ensure that older persons receive age-friendly health care of a quality commensurate with that of other age groups. Examples of improved quality goods, services and facilities for older people would include greater numbers of geriatricians and improved training in geriatrics across all specialties to ensure that needs of older persons are recognised and attended to. There is also a need for improved communication across specialties, including allied health professions such as dentists, pharmacists etc in order to adequately address the treatment needs of older persons with multiple chronic illnesses.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 27
- Paragraph text
- General comment No. 14 notes that the right to health should be understood in broader terms, which include the underlying determinants of health, such as access to water and sanitation, food and nutrition, education and housing. An example of this would be the sub-optimal nutrition of older persons, which is commonly linked to circumstances under which older persons are isolated, immobile and live in poverty. Education is another relevant determinant for the health of older persons. A recent study in the United States of America showed that older persons with limited literacy had a higher risk of death, compared to those with adequate literacy.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Poverty
- Water & Sanitation
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 28
- Paragraph text
- International human rights law proscribes discrimination and ensures equality on a number of grounds and for a variety of groups, including older persons. Older persons are further identified by general comment No. 14 as a group especially vulnerable to violations. Treaty bodies, including CESCR, have identified older persons as a vulnerable or marginalized group, one that is potentially more susceptible to discrimination and violence. According to general comment No. 14, it is important to ensure the functionality and autonomy of older persons (E/C.12/2000/4, para. 25). This implies promotion of individual choice with respect to models of care, insofar as this is possible.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 29
- Paragraph text
- Older women are often more disadvantaged because they may suffer from a combination of both gender and age discrimination. Ageing women make up a significant proportion of the world's population, with the majority of older women living in developing countries. A number of life-course events adversely affect the health of women in older age, including discrimination against infant girls in the provision of food and care, barriers to education, low incomes and poorer access to decent work, care-giving responsibilities as mothers and wives, domestic violence (during childhood, adulthood and elder abuse), widowhood, and cultural traditions and attitudes towards health care. Lower incomes, disruptions to work due to family responsibilities, and discrimination in access to the labour force during women's working life mean that women often have less retirement savings and are therefore more financially vulnerable in older age.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Gender
- Health
- Person(s) affected
- Girls
- Older persons
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 32
- Paragraph text
- Accountability is one of the central features of the right to health. It requires effective, transparent and accessible monitoring and accountability mechanisms. Accountability requires the incorporation of continuous monitoring into all aspects of policy development and implementation. In the context of the right to health, accountability is the process that provides individuals and communities with an opportunity to understand how the government has discharged its right to health obligations, while providing the government with the opportunity to explain what it has done and why (A/63/263, paras. 8-18). There are many different types of accountability mechanisms, including national human rights institutions, health commissioners, democratically elected local health councils, public hearings, patients' committees, impact assessments, judicial proceedings and others (see A/63/263, para. 11). And when mistakes have been made, accountability requires redress.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 35
- Paragraph text
- WHO defined primary health care in 1978 as "essential health care; based on practical, scientifically sound, and socially acceptable method and technology; universally accessible to all in the community through their full participation; at an affordable cost; and geared toward self-reliance and self-determination". The defining features of primary care - continuity, coordination and comprehensiveness - are well suited to manage chronic illness, although more remains to be done to ensure that care of sufficient quality is provided. WHO noted the importance of incorporating evidence-based, cost-effective primary and secondary prevention interventions into the health system, with emphasis on primary health care, which is the most appropriate forum through which these can be integrated.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 36
- Paragraph text
- Chronic illnesses and disability increase in prevalence with advancing age. Around half of deaths due to non-communicable diseases occur in persons aged over 70. It is estimated that 35.6 million people lived with dementia worldwide in 2010, which will increase to 65.7 million by 2030 and to 115.4 million by 2050. In light of the increasing proportion of the population who are elderly, it becomes vital that these conditions are managed in an equitable and resource-effective manner. Health systems throughout the world are generally designed to deal with acute medical conditions. They have struggled to re-model and adapt to prevent or manage the increasing number of chronic illnesses. One should also note the importance of the use of evidence-based guidelines and establishment of minimum standards of health care for common chronic conditions, and integration of their management into primary health care.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 37
- Paragraph text
- The Committee on Economic, Social and Cultural Rights reiterated that primary health care essentially falls under the core obligations accrued by States in fulfilling the right to health (E/C.12/2000/4, para. 43). General Comment 14 places special emphasis on the care of older persons as a vulnerable group, which requires an "integrated approach combining elements of a preventative, curative, and rehabilitative health treatment" (ibid, para. 25). It also specifies that such measures ought to include periodic check-ups and measures aimed at maintaining physical and psychological functionality. Thus, the right to health requires a constellation of activities, programs, and interventions to address primary health care of older persons as a core obligation under that right. Improving availability, accessibility, acceptability and quality of primary care is essential in particular in achieving better results in the management of chronic illnesses.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 40
- Paragraph text
- Access to primary healthcare services is also impeded by both physical and financial obstacles. Healthcare facilities might be situated too far from older persons' place of residence, with transport proving to be too expensive, inadequate, or simply unavailable. Compounding this problem is the limited mobility of older persons. They may be unable to drive, have no access to transportation, or have physical impairments that reduce their movement. Physical difficulties to access health for older persons are further reinforced by their socio-economic vulnerability, especially as access to health care is often subject to receiving a pension or to paying out-of-pocket fees. Living in poverty can also be a root cause of deterioration of older persons' health: with limited access to safe drinking water or adequate nutrition, older persons face a high risk of contracting diseases. Even where health services are accessible to older persons, they are not always adapted to their needs.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Poverty
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 6
- Paragraph text
- Although the growth of the older population is affecting the whole world, most of the increase is taking place in the developing world. More than half of the elderly (400 million) live in Asia, while Europe is the region with the second-largest number of older persons (nearly 161 million), followed by North America (65 million), Latin America and the Caribbean (59 million), Africa (55 million) and Oceania (5 million). On average, it is estimated that 29 million older persons will be added to the world's population each year between 2010 and 2025, and over 80 per cent of those will be added in the developing countries. By 2050, it is further projected that around 80 per cent of the elderly will live in the developing world.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 7
- Paragraph text
- The Special Rapporteur considers these compelling figures a harbinger of a quiet demographic revolution. It owes much to the significant gains achieved in many areas which have substantially increased longevity but will have far-reaching and unpredictable consequences for all countries, developed and developing alike. A rapidly ageing population presents significant challenges for the global community, in a world that is already affected by various social, economic, cultural and political challenges. The immediate consequences of longer life expectancy include increases in the prevalence of chronic and non-communicable diseases and disabilities, which, if unaddressed, could place significant burdens on health systems, strain pension and social security systems, increase demand for primary health care and put pressure on the availability and affordability of long-term care.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Persons with disabilities
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 8
- Paragraph text
- Developing countries will be predominantly affected by the resulting epidemiological transition, when non-communicable diseases amongst older persons increase. The broader population will however continue to struggle with communicable diseases, particularly infectious diseases and other illnesses related to poverty. Developing age-friendly services and settings, and promotion of health care and preventive medicine among older persons will strengthen the efforts of developing countries to deal with the complications of chronic and terminal non-communicable illnesses. In order to address the challenge adequately, it is essential for States to prepare themselves to meet the needs of older persons, train health professionals in old-age care, and formulate sustainable policies for long-term care.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 9
- Paragraph text
- However, the ageing world's most important challenge is to ensure the enjoyment of human rights of older persons. It is critical that measures be put in place to eradicate discrimination and exclusion of older persons and to ensure access to services according to their needs. In a statement marking the International Day of Older Persons, the United Nations High Commissioner for Human Rights, Ms. Navi Pillay, pointed to the urgent need for better legal protection of older persons, a growing sector of society that is often most vulnerable and neglected, and she emphasized that "the human rights community has been slow in realizing that the global agenda and the advocacy efforts at the national level can no longer ignore the rights of older persons".
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Gender
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 10
- Paragraph text
- The Special Rapporteur believes that the right-to-health approach is indispensable for the design, implementation, monitoring and evaluation of health-related policies and programmes to mitigate consequences of an ageing society and to ensure the enjoyment of this human right by older persons. Such an approach to health-related issues includes human dignity, the needs and rights of this vulnerable group, and puts emphasis on ensuring that health systems are accessible, available and affordable to all. Integrating human rights into health systems also means ensuring the principles of equality and freedom from discrimination and the empowerment of all, including the poor, allowing for their participation in decision-making processes and incorporating accountability mechanisms which they can access.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 11
- Paragraph text
- The Special Rapporteur believes that the promotion and protection of human rights of older persons is not only in the interest of senior persons, but should also be of concern to everyone, because every person ages. The right to health will not provide a magic solution to these multifaceted challenges, but it will allow shifting the discourse on older persons from a needs-based approach to a rights-based one, and enable greater articulation of the rights of older persons. Health is a fundamental human right, indispensable for the exercise of many other rights. It is necessary for living a life in dignity. This is especially true for older persons, who are often perceived as a "lapsed" segment of society and are particularly vulnerable to infringements of their right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 12
- Paragraph text
- The Special Rapporteur concedes that in order to be fully successful the right-to-health approach to older persons should be accompanied by a paradigm shift with respect to how society perceives ageing and older persons. The World Health Organization defines ageing as the "process of progressive change in the biological, psychological and social structure of individuals". Throughout the course of one's life, the human body's functional capacity declines from early adulthood to old age. However, increases in longevity also mean that older persons may stay active for a longer part of their lives than ever before, both in terms of occupational and non-occupational activities. Encouraging older persons to remain physically, socially and economically active for as long as possible will have benefits not only for the individual, but for society as a whole.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 19
- Paragraph text
- The right to the highest attainable standard of health is a fundamental human right, legally enshrined at the international, regional and national levels. The enjoyment of the right to health is recognized by numerous international human rights instruments, including those that have been created to protect the human rights of particular groups, such as children, women, persons with disabilities and those who are subject to discrimination on the basis of race (E/CN.4/2003/58, paras. 10-21). The most important formulation of the right to health is contained in article 12 of the International Covenant on Economic, Social and Cultural Rights, which provides the cornerstone protection of the right to health in international law.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Children
- Persons with disabilities
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 20
- Paragraph text
- Internationally recognized human rights standards and principles as contained in core international human rights treaties cover and protect older persons. Despite this tacit protection, it has increasingly been argued that there is a gap in the international human rights system because there is currently no specific universal human rights instrument on the rights of older persons. Specific provisions focusing on older persons, such as those which exist for some other categories of vulnerable persons such as women, children, persons with disabilities, and migrant workers, are also lacking.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Children
- Older persons
- Persons on the move
- Persons with disabilities
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 23
- Paragraph text
- General comment No.14 describes legal obligations of States. The three primary obligations are to respect, protect and fulfil the right to health. The obligation to respect refers to the States' duty to refrain from interfering directly or indirectly with the right to health. In many cases, older persons are the object of State policies which may infringe upon their right to health. Examples include restrictions on the autonomy of older persons in terms of definitions of capacity without an individual determination. The obligation to protect deals with States' duty to prevent third parties, such as corporations, from interfering directly or indirectly with the right to health. This may be relevant, for example, where there is systematic abuse of the elderly in private long-term care facilities. Finally, the obligation to fulfil requires States to adopt appropriate legislative, administrative, budgetary, judicial, promotional and other measures to fully realize the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 24
- Paragraph text
- According to general comment No. 14, the right to health contains both freedoms and entitlements. The freedoms include the right to make independent decisions about one's health, which is to say freedom from State interference. For older persons, freedoms regard issues such as informed consent, autonomy and guardianship. Entitlements, which concern positive obligations of the State may, for example, include the provision of primary health care and social protection which recognizes and takes into account age-related elements, States should recognize that ageing is a lifelong process; State policy and legislation should reflect this reality. Investment in health services should be made at various stages of the life course, when risks to well-being and windows of opportunity are greatest.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 41
- Paragraph text
- Improving the quality of care provided by primary care physician to older patients remains a challenge which is exacerbated in rural areas, where rural general medical practitioners have fewer opportunities to partner with geriatricians to deliver care to their catchment area. Dissemination of information from specialty areas into primary care should be encouraged in all areas, but is particularly important in respect of older persons, given the suitability and cost-effectiveness of the management of chronic diseases within the primary care setting.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 42
- Paragraph text
- It is also important that primary care and prevention of chronic illness is promoted and strengthened in the developing world. A paradigm shift is necessary to detect diseases early and mitigate their effect, rather than wait until the onset of health problems. More needs to be done to stress the importance of prevention efforts, regular contact with a general practitioner or other primary health-care provider, and early diagnosis and treatment. Prevention is extremely important, as it allows reaching the individual before the disease takes hold. It needs to be emphasized that early diagnosis and prevention, long before a person grow older and preferably at the primary health-care facility, is one of the key elements in ensuring good health in old age.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 43
- Paragraph text
- Due to resource constraints, particularly in developing countries, "best-practice" care may not always be possible. This should not deter States from taking steps to achieve the best possible outcomes for older patients in any given situation. Moreover, it has been acknowledged that personalization of care may, at times, require eschewing of more intensive services and accepting clinical outcomes that are less than the best possible health and function. Although this may still look like an anathema to some medical professionals, a shift in focus from curing to caring, particularly in older population, could be necessary to better meet the patient's personal goals. Presenting patients with options and ensuring that their desired outcomes are achieved through collaborative decision-making should be paramount in the professional-patient relationship.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 44
- Paragraph text
- Long-term care includes a variety of services (medical or otherwise) that help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods of time. Long-term care is manifested in the provision of help with daily tasks such as bathing, dressing up, cooking and so on. According to the Organization for Economic Cooperation and Development (OECD), long-term care can be defined as "a range of services for people who depend on ongoing help with the activities of daily living caused by chronic conditions of physical or mental disability". In the context of the right to health, long-term care must also be understood as the intervention of skilled practitioners to provide assistance in dealing with syndromes associated with chronic diseases or disabilities impeding personal capacities. They are, nonetheless, medical conditions affecting older persons disproportionately.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Persons with disabilities
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 47
- Paragraph text
- It is essential that appropriate recognition be given to those who care for older persons in informal settings, which has both benefits and risks. Informal care may allow older persons to remain in their homes, and be cared for by a familiar person, an option often preferred by the patient. It also reduces reliance on formal or institutional care, minimizing the burden on these limited resources. However, older persons are often placed, or find themselves, in informal care without a thorough assessment, exposing them to risk. Such risks include inadequate care by a person who is not equipped to provide the necessary care, as well as the risk of abuse by a caregiver. Numerous States have introduced initiatives to provide support to carers, such as financial support in lieu of lost income, and respite care, which allow older persons to stay at home as long as possible, whilst receiving good-quality care.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 48
- Paragraph text
- Formalized long-term care of both types is already prevalent in much of the developed world. In the developing world, traditional social dynamics are also undergoing changes due to various globalizing factors. Families play a steadily less prominent role as primary health-caregiver of older persons, and government institutions and medical professionals are assuming a bigger role in care-giving. The situation is exacerbated in developing countries by the lack of adequate institutional mechanisms and absence of measures to protect the rights for older persons in the context of external and non-family care. Developed countries, where infringements on the rights of older persons also take place, feature only relatively better in developing such mechanisms.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- Families
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 49
- Paragraph text
- The Special Rapporteur stresses the impact of institutionalization on the autonomy of older persons and its often harmful effect on their dignity. Loss of full independence, restricted freedom of movement and lack of access to basic functions would cause feelings of deep frustration and humiliation to any individual. Older persons are no exception to this. It is essential that complaints mechanisms are put in place to address practices that unnecessarily restrict liberty and autonomy of older persons and to enable them to reclaim their dignity.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 50
- Paragraph text
- The Special Rapporteur is particularly concerned about unreported violence directed against older persons in care. As with other vulnerable and marginalized groups, special attention is needed to protect older persons from abuse and to ensure that their rights are not violated in settings where they might be especially prone to violations. Abuse of older persons is defined as a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person. It is important to note that abuse is often insidious, limiting the autonomy of older persons in subtle ways. It can take various forms, including physical, psychological, emotional, sexual or financial abuse, or be affected by neglect.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Violence
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 51
- Paragraph text
- The abuse of older persons can be complex when the abusing caregiver is a relative or a family member. The frequency of elder abuse in the domestic setting, including abuse perpetrated by family members, was estimated by one study as occurring in anywhere between 2 and 10 per cent of all cases. In an institutional setting incidences of abuse are even harder to ascertain Abuse may also take the form of prejudicial and discriminatory attitudes and acts, which manifests itself through paternalism towards older persons in care, leaving them feeling humiliated, infantilized, and robbing them of the identity they otherwise have as human beings.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Violence
- Person(s) affected
- Families
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 52
- Paragraph text
- In some instances, health-care workers themselves may not even recognize instances of abuse. Health-care workers should therefore be trained and assisted in identifying possible cases of abuse. Models of such training and intervention are used in cases of domestic abuse and may serve as workable models for dealing with recognition and treatment of the abuse of older persons. Health-care workers need to become aware of the possibility that a patient may be a victim of abuse and be able to manage health-related interactions, in a way which would make the abused individuals feel comfortable discussing their particular situation.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Violence
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 53
- Paragraph text
- Various initiatives have been adopted in the area of domestic violence, particularly in respect of violence towards women, which could be drawn upon to raise awareness of abuse of older persons amongst medical professionals and the wider community. In addition to increased training, procedures need to be put in place for reporting abuses and addressing the consequences. For example, the 2006 Older Persons Act of South Africa, inter alia, requires a person who may witness the abuse of an older person, not only physical but also psychological, sexual, and economic abuse, to report the violation. The Act also establishes a system in which abusers of older persons are investigated and registered with a view to prohibiting them from operating or being employed in a residential facility or community-based care for older persons.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Violence
- Person(s) affected
- Older persons
- Women
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 55
- Paragraph text
- Palliative care has grown significantly in the last 30 years and is progressively implemented within national health systems, although this has been done to varying extents. The wide range of measures taken in different States shows the growing importance of ensuring quality of life of older persons towards the end of their lives and providing support for their families. In some countries palliative care is recognized only in the context of certain chronic diseases such as cancer. Other States have integrated palliative care into their national health legislation and plans of action and created institutions which are devoted to palliative care. Some other countries have placed obligations on health institutions to have staff qualified in palliative care or have established group of experts on the issue.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Families
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 56
- Paragraph text
- Several issues arise with respect to the provision of palliative care to older persons, one of which concerns availability of palliative care and in particular, medicines utilized in such care. Moderate to severe pain is a common by-product of illnesses requiring palliative care, for which opioid-based analgesics are commonly prescribed. State parties to the International Covenant on Economic, Social and Cultural Rights are required, as a core obligation under the Covenant, to ensure provision of essential drugs as defined under the WHO Action Programme on Essential Drugs. Despite this and the fact that oral morphine and other narcotic preparations are inexpensive and should not be difficult to obtain, the availability of such medications used in palliative care is often limited. That is due to a number of factors, such as restrictive drug regulations, failure to implement a properly functioning supply and distribution system, and inadequate health-care system capacity. Particularly concerning is the complex international narcotic control framework that severely inhibits access to medicines regulated under the framework. Even when such medications are available, there often remains a lack of understanding of palliative care and the use of narcotics in pain relief amongst medical practitioners. More comprehensive training on palliative care and the use of narcotic drugs is needed. These barriers to availability of good quality palliative care are not unique to older persons as a group, but older persons are disproportionately affected due to the increased incidence of chronic and terminal illness amongst them.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 57
- Paragraph text
- Older persons may also be less likely to receive palliative care services than other, younger age groups. More research is needed to determine whether this distribution is inequitable or whether the needs of older persons are being met through other services. The right to health clearly proscribes discrimination in respect of age, including within palliative health care services. States are obliged to respect the right to health by refraining from denying or limiting equal access for all persons to palliative health services (E/C.12/2000/4, para. 34). Age-based discrimination that is sanctioned on the basis of risk/benefit profiling cannot under any circumstances be considered appropriate in the context of palliative care, which aims to improve quality of life, rather than its length.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 58
- Paragraph text
- The biomedical approach to ageing, combined with increased longevity, has resulted in additional ethical dilemmas. The increasing difficulty or impossibility of refusing life-extending interventions has been seen as a challenge confronting both patients and medical practitioners, which has been linked to three factors: the gradual move away from "choice" about interventions towards routine treatment; the connection of clinical interventions with expressions of care; and the increasing availability of interventions creating high expectations in respect of health outcomes, which results in blurring of the boundaries between curative interventions and those which simply prolong life.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 59
- Paragraph text
- The Special Rapporteur is of the view that a holistic approach to health should also address the process of dying. While this report does not consider issues of patient autonomy in respect of deciding to end life, it is nonetheless necessary to ensure that patients be able to make autonomous, informed decisions regarding the quality of health during the process of dying. That includes choices about access to adequate pain relief and other necessary interventions, location of death, and the ability to refuse treatment designed to prolong life when it is not desired by the patient. This requires clear, candid and non-judgmental discussion with medical practitioners, who should be adequately trained to deal with these delicate issues in order to enable older persons to "die with dignity", as required from a human rights prospective.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 60
- Paragraph text
- The Special Rapporteur believes that the end of life of persons forms an integral part of their life. Consequently, he stresses that older persons must be treated with as much dignity during the process of dying as they should have been in the earlier phases of their life course. Palliative care requires important funding and mobilisation of numerous actors and stakeholders within the medical sector, and it is absolutely crucial in order to prolong the lives of older persons affected by life-threatening diseases and to ensure their death in dignity.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 62
- Paragraph text
- Health information needs to be of the highest quality, freely available on a non-discriminatory basis, accessible to the individual's particular communication needs (including special physical or cultural circumstances), and presented in a manner culturally and otherwise acceptable to the person consenting (ibid., para. 23). Informed consent requires that communication is cognizant of varying levels of comprehension and not be too technical, complex, hasty, or in a language, manner or context that the patient does not understand. This is particularly true and necessary for vulnerable populations, such as older persons, who may require additional attention, explanation, or assistance in receiving and adequately understanding the health information that is imparted by the caregiver to the patient prior to treatment.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 63
- Paragraph text
- Evaluations have consistently found a deficit in the information provided to older persons to help them make an informed decision, in particular those with less formal education. Some healthcare workers can be dismissive of the particular vulnerabilities of older persons, failing to adequately obtain informed consent because it may be more complex than usual to do so. A one-size-fits-all approach is often inappropriate with respect to older persons, A more customized, individualized, age-friendly approach is required to better address the needs of this group. This will imply moving beyond basic health literacy, which does not adequately secure the right to health, into greater health information awareness and education, possibly through peer networks.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Education
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 65
- Paragraph text
- The role of health-care providers is crucial for ensuring informed consent. In many cases, there is a lack of training for health-care workers in communicating health information to older persons, who may have special needs that are often left unaddressed. Medical education and training institutions must incorporate education regarding informed consent for vulnerable populations and their particular needs into curricula. Structural problems further frustrate efforts to obtain informed consent, such as the amount of time available to doctors and health-care workers to consult with patients. Older persons may require additional attention and assistance to fully understand the implications of the health-related information with which they are presented and which may render them particularly affected by scarcity of available consultation time. In general, each person should receive an individualized treatment, and his/her state of health should be regularly reviewed, including his/her medication.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 66
- Paragraph text
- Persistent denial of the right to informed consent could constitute a form of physical and psychological abuse of older persons, who are much more prone to treatment and care without consent. This is compounded by discrimination directed against older persons, who in some cases may have a diminished capacity to consent to treatment. The Special Rapporteur previously pointed out that older persons are taken advantage of due to perceived ignorance and helplessness, as well as actual physical or mental frailty such as that caused by degenerative diseases resulting in decreased ability to provide informed consent (A/64/272, para. 51). They face more frequently situations in which informed consent is necessary, and the possibility of infringement and abuse is therefore greater.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 67
- Paragraph text
- Domestic jurisdictions often fail to enact legislation or design policies in order to address and resolve problems particular to informed consent and older persons. The problem of legislation on older persons and the right to health is particularly acute in developing countries, which often lack an adequate legal framework concerning guardianship or consent. In some countries, the legal requirement for informed consent is circumvented by guardianship proceedings even in partial incapacitation, replacing patient's consent with that of the guardian. The right to health requires that States respect, protect, and fulfil the right to health, and it is incumbent upon States to develop policies and frameworks through which the right to health of older persons can be addressed to meet these requirements. It is important to establish safeguards to ensure the informed consent of older persons in the context of guardianship and build the capacity of older persons to fully understand and make use of health information.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 68
- Paragraph text
- The Special Rapporteur believes that the issue of informed consent of older persons is increasingly important given global ageing and the consequent societal challenges. He further believes that international guidelines and national systems should be developed to regulate practices and ensure that older people are supported in making informed health-care decisions. It is also desirable to establish peer groups who would provide older persons with information before their visit to a doctor or other care provider for treatment, which might help overcome immediate problems such as lack of training.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 69
- Paragraph text
- The Special Rapporteur points to the importance of increasing awareness and empowering of older persons in order to strengthen their participation in health policymaking and build networks of older persons through which health information can be more easily accessed. It is also important that older persons are in a position to fully understand health information and make voluntary and informed decisions based on that information. It is the duty of the State to find and implement new and innovative ways to reach out to older persons, identify age-friendly means to disseminate health-related information and encourage their participation.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
The realization of the right to health of older persons 2011, para. 70
- Paragraph text
- In a report of this length, it is impossible to address all of the important issues, but the Special Rapporteur notes with urgency the present demographic changes leading to a rapidly increasing number of older persons. Society should move beyond seeking simply healthy ageing for its citizens, and begin working towards active and dignified ageing, which should be planned and supported just like any other stage of the individual's life course. Planning for old age implies putting in place diagnostic and prevention services at the primary healthcare level long before ageing sets in. The pursuit of active and dignified ageing for older persons requires re-framing society's concept of ageing to focus on the continued participation of older persons in social, economic, cultural and civic affairs, as well as their continuous contributions to society longer into their lives. The promotion and protection of the human rights of older persons should be of concern to everyone because ageing is a process which everyone will undergo. Older persons are especially vulnerable as a group because of stereotyped perceptions of the group as a "lapsed" segment of society. However, as life expectancy increases and medicine improves, older persons stay active longer than ever before, both in terms of occupational and non-occupational activities. Encouraging older persons to remain physically, politically, socially and economically active for as long as possible will benefit not only the individual, but also the society as a whole.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Older persons
- Year
- 2011
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 3
- Paragraph text
- The right to health approach to health financing recognizes that an appropriate balance must be achieved between public and private financing for health, as well as between public and private administration of health facilities, goods and services. However, the global trend towards privatization in health systems poses significant risks to the equitable availability and accessibility of health facilities, goods and services, especially for the poor and other vulnerable or marginalized groups. In many cases, privatization has led to increased out-of-pocket payments for health goods and services, disproportionate investment in secondary and tertiary care sectors at the expense of primary health care, and increased disparity in the availability of health facilities, goods and services among rural, remote and urban areas.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 6
- Paragraph text
- States have an obligation under the right to health to ensure that adequate funds are available for health and to prioritize financing for health in their budgets. That obligation is a necessary prerequisite to the realization of nearly every aspect of the right to health and required under States' obligation to make use of maximum available resources to ensure full realization of the right (General Comment No. 14, para. 33). As elaborated in General Comment No. 14, the right to health includes numerous entitlements, such as the availability of good quality health facilities and access to essential medicines, which require positive outlays by the State. Adequate public funding is necessary in order to realize these positive entitlements. Insufficient expenditure or misallocation of public resources may result in the lack of enjoyment of the right to health by individuals or groups, particularly the vulnerable or marginalized, and amount to a violation of the State's obligation to fulfil the right to health (General Comment No. 14, para. 52).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 8
- Paragraph text
- The obligation to prioritize funding or health in State budgets is closely linked to the principle of progressive realization, which establishes a specific and continuing obligation for States to move as expeditiously and effectively as possible towards the full realization of the right to health of all persons, without discrimination and taking into account constraints due to the limits of available resources (General Comment No. 14, paras. 30 and 31, and General Comment No. 3, para. 9). In order to facilitate progressive realization of the right to health for all persons, States should make use of the maximum available funds and resources to realize the right to health, which requires successfully raising funds and ensuring that they are allocated to health through budget prioritization. States unwilling to utilize the maximum of their available resources towards realization of the right to health are in violation of their obligations under the right (General Comment No. 14, para. 47).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 11
- Paragraph text
- Equitable allocation of funds and resources for health may be achieved through the pooling of health funds collected through prepayment schemes. Pooling allows for the cross-subsidization of financial risks associated with health care among different groups across large populations and the transfer of health funds from the rich to the poor and the healthy to the sick. Cross-subsidization of financial risks thus protects vulnerable or marginalized groups, such as the poor, from catastrophic health expenditures and ensures access to good quality health facilities, goods and services that may otherwise be financially inaccessible. Pooling of funds for health in order to facilitate the cross-subsidization of health and financial risks is thus an essential method by which States may ensure the equitable allocation of health funds and resources as required under the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 13
- Paragraph text
- States should allocate health funds and resources towards ensuring good quality health facilities, goods and services are available and easily accessible for rural and remote populations. The significant disparity in health outcomes among rural and remote populations and their urban counterparts in many States is well documented. This is due to a number of factors, including inadequate investment in health infrastructure and the lack of qualified health workers in rural and remote areas. This problem is compounded by the fact that rural and remote populations often comprise vulnerable or marginalized groups, such as the poor, ethnic and racial minorities, and indigenous populations, who tend to be poorer than those in urban areas. In accordance with the right to health approach, States must therefore ensure health funds and resources are equitably allocated among rural, remote and urban areas.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Ethnic minorities
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 15
- Paragraph text
- Taxation is a common method through which States raise public funds for health by prepayments, as opposed to out-of-pocket payments at the point of service delivery. Several States have achieved universal (or near universal) access to health facilities, goods and services through the utilization of tax revenue to finance health. Taxation provides States access to a variety of sources from which to fund health care, including taxes on personal income, property, wages, manufacturing, sales, trade, capital gains and financial transactions. Taxation allows States to pool funds and spread financial risks associated with health care across the entire population. Taxation is thus an instrument with which States may ensure adequate funds are available for health through progressive financing, as required under the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 16
- Paragraph text
- The right to health approach to health financing requires that taxation to fund health be levied progressively in order to ensure equitable revenue generation. Progressive taxation requires taxpayers to contribute according to their ability to pay. For example, progressive income taxation requires wealthy taxpayers to contribute a higher percentage of their income than poorer taxpayers. In contrast, regressive taxation involves greater proportional contributions from those with less financial resources than from wealthier taxpayers. Regressive taxation is thus an inequitable financing mechanism for health and not in accordance with the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 17
- Paragraph text
- Many States utilize consumption taxes, such as excise and valued-added taxes (VAT), to raise general revenue and provide funds for health. VAT has been adopted in close to 140 States and now accounts for substantial proportions of revenue collection in many States, particularly in the developing world. Some States have experienced success in setting aside specific portions of revenue raised from VAT for spending on health. The so-called sin taxes - excise taxes levied on socially harmful goods such as alcohol, junk foods or tobacco - are also used to raise funds for health, and may be specifically earmarked for health spending. Sin taxes may serve a secondary purpose of discouraging unhealthy behaviours by raising the cost of consumption, which may promote overall public health in some circumstances.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 18
- Paragraph text
- Under the right to health, consumption taxes must not disproportionately burden the poor. However, VAT may operate regressively, with the poor spending larger portions of their income on VAT than the wealthy. Raising the threshold for profits below which enterprises are not subject to VAT and distinguishing between luxury and necessity goods has been shown to increase the progressivity of VAT. Sin taxes may also be regressive and should be applied proportionately so that less expensive products used by the poor are taxed less than more expensive products used by the wealthy. Attention must also be paid to the financial impact sin taxes have on poor communities, who may purchase taxed products with greater frequency. VAT, sin taxes and other forms of consumption taxes that are primarily regressive are not in accordance with the obligation of States to respect the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Health
- Poverty
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 19
- Paragraph text
- International tax competition has proliferated as a result of globalization and the increasing mobility of capital and its corresponding elasticity in response to taxation. Tax competition triggers a race to the bottom, wherein States attempt to attract foreign direct investment through tax incentives and other tax abatements for foreign investors and low or non-existent trade and capital gains taxes. Tax competition reduces tax revenue in developing States and weakens their ability to raise sufficient funds to finance health. In some developing countries, revenue lost from tax incentives amounted to nearly twice the budget for health. High-income States have also experienced diminished tax revenue from taxation of capital income as a result of tax liberalization in developing States. Multinational corporations have shifted their assets offshore to take advantage of tax havens and engaged in transfer pricing in order to claim profits in low-tax jurisdictions and avoid paying higher taxes in the States in which they are domiciled.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 20
- Paragraph text
- States should ensure that tax liberalization policies resulting from international tax competition do not result in reduced public funding for health. However, lower tax revenue and diminished tax bases resulting from tax abatements for foreign investors and low or non-existent trade and capital gains taxes are likely to weaken States' ability to raise adequate funds for health, as required by the right to health. States and international financial institutions should therefore avoid promoting tax competition through free-trade agreements, investment treaties and conditional lending if such instruments and policies threaten to reduce the availability of tax-based funding for health in developing States.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 22
- Paragraph text
- Under the right to health, States have an obligation to cooperate internationally towards ensuring the availability of sustainable international funding for health. International assistance is among the main sources of funding for health in many developing States. Many of these States lack sufficient health funds and resources to meet domestic health needs and thus depend heavily upon international assistance. Moreover, given the level and rate of development in some low-income States, they will be unable to raise adequate funds domestically to meet domestic health needs in the near future. Realization of the right to health in the developing world is thus also dependent upon the availability of sustainable international funding for health, which should ultimately be realized through an obligatory, treaty-based regime founded upon the principle of global solidarity.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 23
- Paragraph text
- Existing international funding practices present a number of problems. Donor States, multilateral donor institutions, international financial institutions and other funders continue to engage in practices that undermine full realization of the right to health. In many instances, funders fail to focus their activities on the health needs of recipient States and direct assistance towards health systems development, inadequately incorporate the inputs of affected communities in their activities, and attach conditionalities to the receipt of funding for health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 24
- Paragraph text
- International funders should ensure that their activities respect the right to health. The activities of funders should therefore be directed towards meeting domestic health needs and promoting the development of self-sustaining interventions and health systems. Towards that end, donors should incorporate the participation of civil society and affected communities in their activities in order to ensure health interventions are responsive and sustainable and in accordance with the right to health. Donors should also abstain from attaching pernicious conditionalities to the receipt of international assistance.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 25
- Paragraph text
- International donors tend to focus on short-term interventions addressing specific health issues without adequate focus on strengthening health systems. In some States, this has resulted in an overdependence on international funding and the underdevelopment of domestic health systems, many of which are incapable of meeting even basic health needs in the absence of international assistance. Moreover, States that have become overdependent on international funding for health may be less likely to prioritize health in their budgets, which is critical to the long-term sustainability of domestic health systems.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 26
- Paragraph text
- Many low-income States lack adequate funds and resources for health in absolute terms. Other States may at times face severe resource shortfalls that require international funding to resolve. However, in many cases, even low-income States may mobilize funds beyond those currently allocated for health through budget prioritization. Moreover, some States possess sufficient resources but have simply failed to mobilize and allocate adequate funds for health equitably. While the right to health approach requires States to cooperate internationally towards ensuring the availability of sustainable international funding for health, recipient States should also take all possible steps to ensure domestic resource self-sufficiency in order to avoid overdependence on international funding.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 27
- Paragraph text
- International assistance is often conditioned on recipient States adopting policies in line with the social, political or economic interests and ideologies of donors. Conditional aid may require recipient States to implement specific health strategies preferred by donors in order to obtain funds. Donor-driven strategies, however, may not be aligned with the health needs of recipient States and may instead distort domestic health priorities. For example, donor funds earmarked for abstinence-only programmes in AIDS-affected countries promote the benefits of abstaining from sexual activity until marriage, but are required to withhold valuable information about the health benefits of condoms and contraception on the premise that such information contradicts the message of abstinence. Studies have found abstinence-only programmes to be ineffective in preventing HIV and that withholding information about contraceptives places young people at increased risk of pregnancy and sexually transmitted infections.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Youth
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 28
- Paragraph text
- Another bilateral assistance fund directed towards combating HIV/AIDS, does not grant funds to organizations that do not have a policy explicitly opposing sex work. However, sex workers are among the most high-risk groups for HIV and have played a critical role in combating HIV transmission. They must therefore be fully integrated into all HIV prevention efforts in order to ensure that interventions are responsive, sustainable and in line with the right to health. Donor States should therefore not be driven by social, political or economic ideologies when designing and implementing health interventions. In accordance with the right to health, donors should instead ensure that they implement the most effective health strategies available given the needs of the recipient State as articulated by local stakeholders.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 29
- Paragraph text
- In many instances, as a result of macroeconomic conditions attached to loans from international financial institutions, international assistance for health does not result in increased public spending on health, but is instead used by States to build up reserves. Studies indicate that each additional $1 of aid for health adds only approximately $0.37 to health budgets in recipient States, and less than $0.01 in States under the advice of the International Monetary Fund. For example, in order to meet health-related Millennium Development Goals, one State would have needed to increase its total revenue by 20 per cent and allocate 15 per cent of the increased amount towards health. However, conditions attached to macroeconomic loans required the Ministry of Health to freeze health budgets moving forward. Restrictions on State health spending of this nature infringe upon the right to health because they disproportionately impact the poor, who rely more heavily on the availability of public health facilities, goods, and services than other groups.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 30
- Paragraph text
- International funding for health is inconsistent and insecure. Donor interventions are often fragmented and poorly coordinated. The insecurity of international funding has been highlighted by the recent global financial crisis, which led, in part, to the cancellation of Round 11 of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Inconsistent international funding for health places States that rely heavily on international assistance at risk of severe funding shortfalls during global economic downturns. Fragmentation of donor interventions is illustrated by the situation in one State, where 50 donors operate, 19 of which directly provide assistance to the Government through budget support and 31 of which provide aid through isolated individual mechanisms or agreements. Poorly coordinated donor interventions lead to redundant spending, inefficient allocation of health funds and resources, and the failure of initiatives to address domestic health needs effectively.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Humanitarian
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 31
- Paragraph text
- In order to cooperate towards ensuring the availability of sustainable international funding for health as required by the right to health, States should pool funds for health internationally. International cooperation in the form of a single global pool or multiple coordinated pools would facilitate the cross-subsidization of health systems in developing States and allow for the coordination of donor activities in recipient States. International cooperation in the form of global pooling of funds for health is critically needed at this time in order to meet the global disease burden and promote the development of sustainable domestic health systems.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 35
- Paragraph text
- The primary financial barrier to accessing health care in most States is out-of-pocket payments. Out-of-pocket payments are payments for health goods and services made by the user at the point of service delivery. In 2007, in 33 mostly low-income countries, out-of-pocket payments represented more than 50 per cent of total health expenditures. Out-of-pocket payments may also lead to catastrophic health expenditures. Every year approximately 100 million people, in mostly low-income countries, are pushed into poverty owing to excessive or catastrophic spending on health care. At a minimum, the right to health requires States to reduce out-of-pocket payments for health and eliminate those payments that disproportionately impact on the poor. The pooling of prepayments for health goods and services reduces out-of-pocket payments for all users and may eliminate these payments for the poor. Pooling thus insulates users against catastrophic health expenditures through the cross-subsidization of financial risks associated with expenditures on health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Poverty
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 37
- Paragraph text
- Private health-care providers may also operate alongside single payer systems. Private hospitals and doctors may be allowed to opt out of the publicly funded system and collect private fees from patients. As a result, the public system may be left underfunded, if users are exempt from contributions upon exit from the system, and understaffed, if large numbers of health workers exit the public system for higher pay in the private sector. This, in turn, may reduce the overall quality of public health facilities, goods and services. The poor and other groups who are unable to exit the public system because they cannot afford private care are the most negatively affected under those circumstances. A parallel private health system may thus result in infringements of the right to health because it may reduce overall access to and quality of health facilities, goods and services in the public sector.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 39
- Paragraph text
- In order to reduce the negative effects of regressive premiums and adverse selection within a multiple payer system, participation in a health insurance pool should be compulsory. Compulsory participation ensures universal insurance coverage and allows for the use of equalization mechanisms, or risk adjusters, to facilitate cross-subsidization between different pools. For instance, a percentage of the funds of low-risk pools may be required by law to be transferred to high-risk pools under particular circumstances. States may also directly regulate private insurers by, among other measures, limiting the information they are permitted to collect about potential pool members, restricting the manner in which premiums are calculated, and prohibiting the exclusion of individuals with pre-existing health conditions from insurance pools. Government insurance programmes should also provide coverage for the poor or other vulnerable or marginalized groups who are excluded from private pools owing to their inability to pay, because of pre-existing health conditions or because they are high-risk of poor health. For example, individuals employed in dangerous work may be denied health insurance because of increased health risks and workers in low-paying jobs may be unable to afford high premiums charged by private insurers. Under the right to health, States have an obligation to ensure that these individuals have access to health services through health insurance. This obligation may be met through appropriate regulation of private health insurers, the subsidization of private insurance premiums or the availability of government-run insurance programmes.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 40
- Paragraph text
- At a more targeted level, community-based health insurance pools funds collected from members of small communities and includes a variety of financing mechanisms, such as community health funds, mutual health organizations and rural health insurance. Community-based health insurance programmes may operate in complement or supplement to single or multiple payer systems. These programmes generally exist in poor and other vulnerable or marginalized communities and may increase access to health facilities, goods and services for vulnerable or marginalized groups and facilitate the participation of communities in decision-making processes affecting their health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 43
- Paragraph text
- Social health insurance programmes must be funded through compulsory contributions in the form of prepayments in order to achieve universal access to good quality health facilities, goods and services and robust cross-subsidization of financial and health risks. Voluntary contribution schemes may help raise funds in the absence of widespread payment and pooling, familiarize individuals with the benefits of insurance, and serve as an intermediate funding mechanism that eases the transition towards a more inclusive compulsory contribution scheme, but they do not necessarily increase rates of insurance coverage because enrolment is not compulsory. In contrast to a system of voluntary contributions, compulsory contribution schemes prevent wealthy and healthy members from opting out of the programme and diluting the size of the pool at the expense of poorer and sick members. Compulsory schemes also prohibit individuals from buying into the programme only during times of medical need. While voluntary contributions may help raise funds in the absence of widespread payment and pooling, familiarize individuals with the benefits of insurance, and serve as an intermediate funding mechanism that eases the transition towards a more inclusive compulsory contribution scheme, they do not necessarily increase rates of insurance coverage because enrolment is not compulsory. Voluntary schemes are thus ineffective in increasing access to health facilities, goods and services for the poor because they do not generate large enough pools to facilitate robust cross-subsidization.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 45
- Paragraph text
- Social health insurance programmes often rely on compulsory wage-based contributions, which may fail to identify and include those whose incomes are not formally reported or easily assessed, such as informal workers, self-employed persons and workers in rural and remote areas. For example, informal workers who may qualify for absolute exemptions or reduced contributions are difficult or impossible to identify through compulsory wage-based social health insurance programmes and thus may not be enrolled in these programmes. Such individuals may be unable to access good quality health facilities, goods and services owing to unaffordable out-of-pocket payments. Under the right to health approach, States should use innovative strategies to include the informal sector in social health insurance programmes. For example, associational taxes, in which an association representing a particular group of workers collects funds and pays into the tax system, have been shown to increase the participation of informal sector employees in formal benefits programmes.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 46
- Paragraph text
- The right to health approach requires the equitable allocation of health funds and resources towards achieving universal access to good quality health facilities, goods and services, in accordance with the principle of non-discrimination. In all allocative decisions, special attention must be paid to the needs of vulnerable or marginalized groups, including, among others, ethnic, racial, religious and sexual minority groups, women, children and the poor. Better overall health outcomes and more effective health systems result from eliminating inequalities in access to health facilities, goods and services. States should therefore allocate health funds and resources to ensure that good quality health facilities, goods and services are financially accessible for the poor, physically accessible for rural and remote populations, and responsive to primary health-care needs for all, rather than specialized care for the few.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Children
- Ethnic minorities
- Women
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 47
- Paragraph text
- Under the right to health approach, in order to provide health goods, services and facilities to all persons in a non-discriminatory manner, States should ensure equitable and efficient allocation of health funds and resources between primary, secondary and tertiary health care, with particular emphasis on primary care. Primary health care is defined as essential and preventative health care universally accessible in the community at a cost the community can afford. In contrast to primary health care, secondary and tertiary health-care services typically address illnesses that cannot be managed at the community level and are usually provided by specialized doctors and health workers in facilities such as hospitals at comparatively higher costs, using special equipment and sometimes in-patient care.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 48
- Paragraph text
- Primary health-care goods and services include routine health check-ups, preventive screenings, immunizations and vaccinations, services for the management of chronic illnesses, family planning services, nutrition services, maternal care and childbirth services and mental health counselling, all of which serve basic health needs at low cost and reduce the need for secondary and tertiary health care. Primary health care also includes health awareness-raising and educational services, such as sanitation and public hygiene campaigns, which have both preventative and promotional effects and empower community members to improve and maintain their health on their own.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Social & Cultural Rights
- Water & Sanitation
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 49
- Paragraph text
- Primary health-care goods and services do not require specialized training for health-care workers, sophisticated diagnostic equipment or significant physical infrastructure. Primary health care is provided in the community setting in small clinics or in homes by doctors, nurses and other health-care workers and may therefore be administered in a more socially and culturally acceptable manner. Primary health care is thus more geographically adaptable and less costly to administer and make use of, which increases the availability of health goods and services for rural and remote communities and the poor.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Social & Cultural Rights
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 50
- Paragraph text
- In addition to achieving more equitable health outcomes, allocating health funds and resources with a focus on primary health care also promotes efficiency within health systems. Primary health care has been demonstrated to be more cost-efficient over the long term because it prevents illness and promotes general health, reducing the need for advanced levels of curative care, which tend to be more costly. Savings resulting from investment in primary health care may be reinvested in the health system and utilized to increase access to health care for the poor, which in a virtuous cycle should further improve health outcomes. While a comprehensive and balanced health system must include available and accessible secondary and tertiary care services, States should prioritize primary health care in the allocation of health funds and resources.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 51
- Paragraph text
- In order to achieve equitable health outcomes and full realization of the right to health, States must allocate health funds and resources towards ensuring that good quality health facilities, goods and services are available and easily accessible for rural and remote populations. Populations in rural and remote areas have poorer health than their urban counterparts globally. Many otherwise preventable and treatable illnesses are prevalent in rural and remote areas, infant and maternal mortality rates are higher than in urban areas, and children experience higher levels of malnutrition. Moreover, people in rural and remote areas often have to travel significant and difficult distances and spend large sums of money in order to access health care, which is often not available in their communities owing to a lack of investment in physical health infrastructure in rural and remote areas.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Children
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 52
- Paragraph text
- For example, the right to health requires that States take steps towards improving maternal health and reducing maternal mortality. However, owing to inadequate allocation of health funds and resources to rural and remote areas, maternal health-care services, trained maternal health-care workers and good quality health facilities are often unavailable in those areas. Women are thus unable to access maternal health-care services in their communities, and instead must travel considerable distances at significant costs to obtain care. As a result, women in rural and remote areas experience lower rates of live births attended by skilled health workers and significantly higher levels of maternal mortality and maternal morbidity than women in urban areas.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Women
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 53
- Paragraph text
- The right to health also requires that States ensure that good quality health facilities, goods and services are available and accessible on a non-discriminatory basis. In many States, rural and remote populations largely comprise vulnerable or marginalized groups, such as the poor, ethnic and racial minorities, and indigenous populations. These groups often already face difficulties in accessing health care because they lack the social and political means to challenge the inequitable allocation of public resources. Inequitable allocation of health funds and resources between rural, remote and urban areas may thus lead to structural discrimination of vulnerable or marginalized groups within the health system who, unlike their urban counterparts, lack access to good quality health facilities, goods and services in their communities.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Ethnic minorities
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Health financing in the context of the right to health 2012, para. 54
- Paragraph text
- The situation of indigenous populations around the world demonstrates this problem. In many States, indigenous communities are vulnerable as a group owing to persistent poverty, historical marginalization and political disempowerment. These challenges are exacerbated by the fact that indigenous populations traditionally live in rural and remote areas that often lack public infrastructure, including health facilities. Indigenous populations in all parts of the world experience worse health outcomes than non-indigenous populations as a result. For example, indigenous populations in three different countries faced infant mortality rates 3 times higher, suicide rates 11 times higher and the prevalence of poor sanitation 7 times higher than non-indigenous populations. The right to health approach requires States to allocate health funds and resources between rural, remote and urban areas equitably in order to respect and fulfil the right to health of vulnerable and marginalized groups living in these areas.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Poverty
- Water & Sanitation
- Person(s) affected
- Ethnic minorities
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 6
- Paragraph text
- The right to occupational health is an integral component of the right to health. The International Covenant on Economic, Social and Cultural Rights addresses occupational health in article 12.2(b) and (c) and establishes that States must take steps towards the full realization of the right to health, including the improvement of all aspects of industrial hygiene and the prevention, treatment and control of occupational and other diseases. General comment No. 14 of the Committee on Economic, Social and Cultural Rights interprets article 12.2(b) of the Covenant to include safe and hygienic working conditions, preventive measures in respect of occupational accidents and diseases and the minimization, so far as is reasonably practicable, of the causes of health hazards inherent in the working environment (para. 15). General comment No. 14 states that article 12.2(c) of the Covenant requires States to make available relevant technologies, using and improving epidemiological surveillance and data collection on a disaggregated basis (para. 16).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 7
- Paragraph text
- A number of international human rights instruments address the right to occupational health in a variety of contexts. The Universal Declaration of Human Rights provides for the right of everyone to "just and favourable conditions of work" (art. 23). The Convention on the Elimination of All Forms of Discrimination against Women establishes women's "right to protection of health and to safety in working conditions, including the safeguarding of the function of reproduction" (art. 11.1(f)) and requires States to "provide special protection to women during pregnancy in types of work proved to be harmful to them" (art. 11.2 (d)). The International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families obliges States to "take measures not less favourable than those applied to nationals to ensure that working and living conditions of migrant workers and members of their families in a regular situation are in keeping with the standards of fitness, safety, health and principles of human dignity" (art. 70).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- Families
- Persons on the move
- Women
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 10
- Paragraph text
- The informal economy can be defined as a diversified set of economic activities, enterprises and workers that are not regulated or protected by the State. As defined by the ILO, the informal sector consists of "private unincorporated enterprises" which are not registered under specific forms of national legislation. Informal employment, however, is broader in scope and consists of all employment in the informal sector, plus those workers employed informally within the formal sector. The informal economy includes both the black economy, which seeks to avoid taxation and regulation, and the criminal economy, which deals in illegal goods and services. However, the black and criminal economies account for only a small share of the informal workforce. Most informal enterprises and workers deal in legal goods and services, and operate in a semi-legal, but not deliberately illegal manner.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Governance & Rule of Law
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 11
- Paragraph text
- The informal economy stands in contrast to the formal economy in a number of critical ways, the most important being the relative absence of State regulation. The lack of regulation results in numerous insecurities and vulnerabilities for informal workers, such as the lack of collective bargaining and anti-discrimination protections. Further, informal workers are also often subjected to volatile, insecure work schedules and long hours. Many informal workers are involved in piece work, which encourages unsafe work habits and shifts the burden of responsibility to protect occupational health from employers to workers. Although there are some very high earners within the informal economy (such as self-employed professionals), the vast majority of informal workers come from marginalized backgrounds and work without adequate training, technology and health precautions for a small, insecure wage. Although not all persons involved in the informal economy are poor, and not all of the working poor are informal workers, there is a substantial overlap between poverty and the informal economy.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Health
- Poverty
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 12
- Paragraph text
- The informal economy constitutes more than 50 per cent of the economy in many developing countries. When the agricultural sector is included in assessments, in some countries the informal economy approaches between 80 to 90 per cent of the total economy. However, the existence of the informal economy is certainly not limited to the developing world; the informal economy also makes up a sizeable portion of developed economies. Studies suggest that the informal economy may be a fall-back or buffer during times of economic downturn, when the informal economy often grows. In light of the magnitude of the recent global financial crisis and subsequent recession, it is likely that the informal sector has grown substantially. As the informal economy has grown, so have its related occupational health concerns. Considering the size and nature of the informal economy, it is impossible for States to fully realize the right to health without addressing concerns related to occupational health in the informal economy.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 13
- Paragraph text
- Informal employment consists of both self-employment in informal enterprises and wage employment in informal jobs. Self-employment in informal enterprises consists of self-employed persons in small unregistered or unincorporated enterprises, including employers (who hire others), own-account operators (who do not hire others), unpaid contributing family workers and members of unregistered co-operatives. Wage employment in informal jobs consists of wage workers who lack social protection through their work and who are employed by formal or informal firms (and their contractors), by households, or by no fixed employer, including non-standard employees of informal enterprises, non-standard employees of formal enterprises, casual or day labourers, and industrial outworkers (also called homeworkers).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Social & Cultural Rights
- Person(s) affected
- Families
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 15
- Paragraph text
- The right to health requires States to pay special attention to the needs of vulnerable and marginalized groups. Most workers in the informal economy face significant social and economic difficulties. These include lack of legal protection, lack of access to formal financial services, lack of social protection or social health insurance afforded to formal sector employees, exposure to harsh law enforcement, lack of job security, discrimination and others. Moreover, many workers in the informal economy often face increased risk of occupational disease and injury as compared to formal workers. In some cases when informal workers are injured, they are not granted compensation for their injuries. As a result, informal workers are amongst the least secure and most vulnerable of all workers, and thus require special attention under the right to occupational health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 17
- Paragraph text
- More research about the informal economy and informal workforce is needed at the local and national levels. The lack of disaggregated data, in particular, prevents States from understanding the demographic landscape of the informal economy and the particular vulnerabilities faced by informal workers. States must systematically engage informal workers in order to effectively conduct human rights and health impact assessments and risk surveillance, with a view to identifying and controlling known risks, as well as epidemiological and disease surveillance to detect and manage disease and prevent long term risks.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 18
- Paragraph text
- Informal work and workplaces do not fall under the purview of existing national occupational health laws therefore the employer-employee relationship in the informal economy goes unregulated. States have an obligation to fulfil workers' right to health through direct occupational health interventions in the informal economy. In some instances, this may require formalization through the introduction or extension of occupational health regulations into the informal economy. The ILO and other organizations have attempted to address the occupational health vulnerability of informal workers by implementing programmes in coordination with national governments aimed at reaching informal workers. These include the integration of occupational health services into primary health-care services; participatory health and safety training programmes for informal street vendors initiated by local governments and various efforts to extend social health insurance coverage in the informal sector. A number of interventions tailored to the needs of specific industries have also been implemented.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 19
- Paragraph text
- There are additional means by which States can address the right to health in the informal sector. These include social health insurance schemes tailored to address the sector-specific health risks faced by workers throughout the informal economy; occupational health service provision at work sites; and primary health care interventions designed to educate and train workers about occupational health. The obligation to fully realize the right to occupational health for workers in the informal economy falls directly on States. In some instances, this may require formalization through the introduction or extension of occupational health regulations in the informal economy. Where this is not possible or feasible, States should then take all necessary steps (short of those that would eliminate these jobs) to mitigate harm stemming from such employment.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 20
- Paragraph text
- The obligation to fulfil the right to health requires States to formulate and implement a national health policy towards realizing the right to health. General comment No. 14 of the Committee on Economic, Social and Cultural Rights explains that it is a core obligation to formulate, implement and periodically review a coherent national policy to minimize the risk of occupational accidents and diseases, as well as to provide a coherent national policy on occupational safety and health services (para. 36). ILO conventions on occupational safety and health and on occupational health services call on States to do the same. General comment No. 14 states that a national policy on occupational health, amongst other things, should include the identification, determination, authorization and control of dangerous materials, equipment, substances, agents and work processes; the provision of health information to workers and the provision, if needed, of adequate protective clothing and equipment; and the enforcement of laws and regulations through adequate inspection (para. 36, ftn. 25).
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 21
- Paragraph text
- The right to health requires the participation of those affected in all decision-making processes affecting their health during the formulation, implementation, monitoring and evaluation of all health laws and policies. This means that workers must participate in the formulation, implementation, monitoring and evaluation of laws and policies affecting their occupational health. While established trade unions must also participate fully in this process, in some instances, they may not adequately represent the interests of some communities of affected workers. Moreover, workers in the informal economy are seldom organized, and may not be recognized by employers or by the State when they are. Thus the right to health requires the direct participation of informal workers, which may be achieved through the recognition and promotion of member-based organizations.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 22
- Paragraph text
- Participation is essential to ensuring that health laws and policies affecting workers' occupational health are effective, responsive and sustainable. Workers' participation in the right to health process prevents top-down formulation of occupational health laws and policies, while ensuring regulation and health interventions do not become removed from the people that they are meant to serve. Participation empowers workers by ensuring that their views and experiential knowledge play integral roles in shaping laws and policies that impact their occupational health. This provides law and policymakers insight into the social context of occupational diseases, including the nature of employer-employee power relations and knowledge of specific risk factors and environmental hazards. Such knowledge is crucial to formulating laws and policies that effectively address workers' day-to-day concerns, as well as to monitoring and evaluating the implementation of such laws and policies.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 23
- Paragraph text
- Participation under the right to occupational health establishes direct State obligations vis-à-vis workers, as the State has the ultimate obligation to ensure realization of the right to health. States thus have a positive obligation to facilitate the active and informed participation of workers' in the formulation of State laws and policies impacting their occupational health. This includes ensuring that workers participate in defining research priorities that inform policy formulation. It also includes an obligation to raise workers' awareness of occupational hazards, the manner in which workplace environments produce poor health outcomes and the prevalence of work-related diseases and contributing psychosocial factors. Local law- and policymakers and health authorities may be best placed to ensure the meaningful participation of workers, particularly those in the informal economy. Raising the awareness of workers requires that they have access to relevant and accurate information relating to their occupational health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 25
- Paragraph text
- The right of workers to access information pertaining to their occupational health must be realized at each stage in the development of occupational health laws and policies. Notably, States must make relevant and accurate information available to workers at the very outset of the policy formulation process and during the reformulation of existing laws and policies so they may identify and prioritize areas of concern related to their occupational health before policy agendas are set. States must also ensure workers have a sufficient understanding of all relevant information. This includes technical information pertaining to harmful substances, dangerous equipment and machinery, and all relevant laws and regulations. In addition, workers must also be apprised of all health risks in the workplace in a clear, comprehensible manner so they may themselves determine whether to engage in dangerous or unsafe work.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 26
- Paragraph text
- States must also not interfere, through its laws and policies or the acts of its officials, with communication and interactions amongst workers and between workers and the civil society regarding occupational health concerns. States must further facilitate the transmission of information pertaining to occupational health from affected workers directly to State officials. This may take the form of a complaint mechanism or a forum in which affected workers engage directly with relevant State officials or bodies in order to address violations of the right to occupational health. In some cases, these communications are barred by non-disclosure laws and mandatory contractual provisions between workers and their employers. States should ensure whistle-blower provisions or similar protections that supersede contractual obligations are in place to allow workers to disclose information regarding their occupational health publicly and directly to the State without fear of reprisal.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 27
- Paragraph text
- States must also guarantee that the process of law and policy formulation is fair and transparent and inclusive of all affected workers. Fair participation requires States to facilitate a law and policy formulation process in which workers' views and experiential knowledge are given equal consideration along with that of employers and government officials. For example, workers or their representatives must be included on policymaking bodies, and mechanisms must be available by which workers can provide direct and immediate input into the law- and policymaking processes. Transparency requires that information about all aspects of the process of law and policy formulation be made available and accessible to workers and their representatives. It further requires that the rationale and basis for all decisions made by the State at each stage in the process be made available and accessible to workers. State decisions affecting workers' occupational health must not be made behind closed doors.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 28
- Paragraph text
- For example, processes surrounding the negotiation of free trade agreements have lacked transparency and have not involved the participation of affected communities. As discussed earlier, the proliferation of free trade agreements is an element of globalization, which directly impacts the occupational health of workers. The right to occupational health requires States to incorporate workers' views and experiential knowledge into processes surrounding the negotiations of free trade agreements. Additionally, transparency requires States to make publicly available and accessible all draft agreements, negotiation proposals, minutes from negotiation meetings, and all other relevant information.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 31
- Paragraph text
- The right to health requires robust participation of workers: in defining research priorities; in collecting epidemiological data prior to law and policy formulation; and in monitoring and evaluating occupational health laws and policies. In all instances, the State must ensure that the processes of monitoring and evaluation are not captured by private interests. For example, in many cases employers fund epidemiological research and exert undue influence on the findings. The State must not allow these studies to impact policy formulation.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 32
- Paragraph text
- Public health professionals have traditionally taken an approach to epidemiological research that focuses on the population as an object to be studied, thereby failing to recognize and utilize the population's experiential knowledge. In contrast, more recent approaches utilize participatory research methods that broaden the epidemiological investigation from the individual to the population level and emphasize the role of the socio-political context in which disease occurs. For example, community-based participatory research conducts 'research with, rather than on communities, affirms the value of communities' experiential knowledge and stresses a collaborative process'.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 33
- Paragraph text
- Community-based participatory research is a joint-learning process in which researchers and community members contribute equally. It empowers community members through building local capacity, promotes their dignity by increasing the control they exert over their lives, and achieves a balance between research and community-level action. The approach employs a variety tools in the formulation and implementation of health laws and policies and systematizes workers' collective experiences concerning occupational health risks and outcomes as a means of identifying and controlling risks in the work environment.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 34
- Paragraph text
- Right to health indicators and benchmarks must play an integral role in the periodic review of occupational health laws and policies in order to monitor and evaluate these laws and policies. There are three categories of human rights indicators: structural, process and outcome indicators. Structural indicators are used to determine whether key structures or mechanisms necessary for the realization of the right to health are in place. Process indicators measure discrete aspects of State policies and interventions toward realizing the right to health; whereas outcome indicators measure the impact of such interventions on the health of populations. Benchmarks are the national targets with respect to each indicator. They create a standard against which States can be held accountable, and allow for monitoring progress over time.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 36
- Paragraph text
- The right to health requires States to take steps to prevent, treat and control diseases related to work. Despite the well-established connection between work and disease, the nexus between factors in the work environment and workers' health outcomes is not always clear or easily defined. This is particularly the case with regard to diseases caused by multiple factors. The complex relationship between work and disease is recognized in the ILO classification of diseases related to work as "occupational diseases," which have a specific link to a causal agent within the work environment; "work-related diseases," which have multiple causal factors, one of which may include a factor in the work environment; and "diseases affecting working populations," which lack a causal relationship with work but may be aggravated by factors in the work environment.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 37
- Paragraph text
- For example, in extractive industries, exposure to dust, fumes and particulates places workers at increased risk of being affected by a number of diseases, including occupational diseases, such as coal miner's pneumoconiosis; work-related disease, such as chronic obstructive pulmonary disease; and diseases affecting working populations, such as asthma. The right to health requires States to prevent, control and treat these diseases. Primary prevention is considered the most effective means of reducing the burden of disease, and as such prevention of disease should be the principal aim of States. States are required to ensure adequate research and monitoring of the relationship between work conditions and health; dissemination of information to educate workers about work and health; and improvement of occupational and environmental conditions within the workplace, including the prevention and reduction of hazards in the workplace.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Environment
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 38
- Paragraph text
- The right to a healthy workplace environment is an integral component of the right to health. It requires States to improve all aspects of environmental and industrial hygiene, including housing, sanitation, nutrition and access to safe water. For example, there are significant concerns regarding environmental and industrial hygiene in agricultural work. These concerns are exacerbated by fact that many agricultural workers, particularly migrant workers who are involved in agricultural work in large numbers, are socially and economically disadvantaged and often lack adequate resources to protect their own health. The improvement of environmental and industrial hygiene is therefore critical to achieving the full realization of the right to occupational health, especially for agricultural workers. In many instances, the work environment is indistinguishable from the home environment. As a result, many agricultural workers reside in crowded and substandard accommodation with poor sanitation and inadequate access to safe and potable water. Many of them are also exposed to environmental hazards such as pesticides or other pollutants because of the proximity or overlap of their homes to their worksites. These conditions significantly contribute to the increased rates of infectious diseases seen amongst these workers. The right to health requires that States give particular attention to the needs of vulnerable and marginalized groups in the formulation and implementation of occupational health laws and policies. This includes an obligation to monitor and evaluate occupational health risks and diseases affecting vulnerable groups.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Environment
- Equality & Inclusion
- Health
- Social & Cultural Rights
- Water & Sanitation
- Person(s) affected
- Persons on the move
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 40
- Paragraph text
- The right to health also requires States to address the prevention and reduction of the population's exposure to harmful substances, such as pesticides, and to assess their health impacts on workers. This is particularly important with respect to migrant workers because they may have limited access to health facilities, goods and services, and may lack access to the justice system. Where there is a real and confirmed hazard, the obligation to protect the right to occupational health requires States to prohibit production, sale and use of these substances. Where there is a reasonable potential for risk, States have a duty to take appropriate measures to reduce or prevent exposure, taking into consideration both the likelihood that harm will result and the extent of that harm. This includes requiring that pesticide labels are printed in all relevant languages, and agricultural workers are provided with adequate training and information regarding the use of pesticides.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Environment
- Equality & Inclusion
- Health
- Person(s) affected
- Persons on the move
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 41
- Paragraph text
- Exposure to pesticides has been linked to various acute and chronic toxic illnesses, including a number of cancers. Despite this, in many countries the law does not require pesticide use labels to be printed in languages understood by migrant workers in the jurisdiction. As a result, migrant agricultural workers suffer from high rates of toxic chemical injuries and skin disorders compared to other workers. Moreover, there are strong indications that efforts to regulate the distribution, application and disposure of such pesticides have been ineffective in reducing exposure. Such regulations are deficient in scope and under-enforced in both the developed and the developing world.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- Persons on the move
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 42
- Paragraph text
- Emerging technologies pose a unique challenge to the prevention and reduction of exposure to harmful substances. The rapid development of new substances and market pressures have meant that extensive testing and study of these materials for long-term effects is often impractical. As a result, workers may be exposed to as yet undetected health risks. Emerging risks in the nano-technology field have received much needed attention in light of studies suggesting that exposure to nano-particles may have toxic and carcinogenic effects on lung tissue. In accordance with the precautionary principle, States must restrict the use of such technologies in the workplace until their health effects have been accurately assessed and communicated to workers.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 43
- Paragraph text
- The right to occupational health additionally requires States to work towards the minimization of hazards in the workplace. This recognizes that some hazards may be inherent to the occupation or workplace environment. For example, work in the textile and apparel industry is often laborious and of a highly repetitive nature, predisposing workers to musculoskeletal disorders, particularly repetitive strain injuries. Similarly, agricultural workers are exposed to harsh natural conditions and have heavy physical workloads, which may lead to thermal stress and musculoskeletal disorders. States must take steps to minimize, as far as reasonably practical, the resulting harm. Where hazards exist they should be identified and workers should be made aware of the risks of exposure. Workers should be empowered to determine when hazards pose a risk to their health that they deem unacceptable. In these circumstances, the right to health requires that workers, at all times, retain the right to refuse dangerous or unsafe work without fear of losing their job.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 44
- Paragraph text
- The duty of States to minimize hazards in the workplace includes both physical and psychosocial hazards. There is a growing body of evidence linking psychosocial hazards, such as stress and work overload, with psychological disorders such as anxiety, depression and burnout, and physical conditions such as cardiovascular disease, musculoskeletal disorders, gastro-intestinal disorders and impaired immune competence. Ongoing reports linking high rates of attempted and completed suicide amongst workers in the technology industry with requirements to work extremely long hours are of particular concern.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Gender
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 45
- Paragraph text
- The right to health further requires that occupational health services are available, accessible, acceptable and of good quality. These services must be tailored to the needs of workers. For example, services must be made available at easily accessible locations and during hours that accommodate workers schedules; they must include the rehabilitation of affected individuals back into the workplace; health workers must be aware of the specific health risks faced by workers, and they must be trained to detect, prevent and treat occupational diseases. The ILO Occupational Health Services Convention No. 161 also states that occupational health services are essential to maintaining a safe and healthy working environment in order to facilitate optimal physical and mental health, and to adapting work to the capabilities of workers in the light of their health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 46
- Paragraph text
- The obligation to ensure access to occupational health services may be met through the direct provision of services by the State or through social health insurance that covers all workers against occupational diseases and injuries. In most cases, social health insurance must be provided by the employer. Where this not possible, States must provide direct coverage or subsidize the purchase of private insurance based upon the economic needs of each worker. In all cases, insurance benefits must include preventative, promotive and curative health services, and must be tailored to address the specific occupational health risks faced by workers in their respective work sectors.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 48
- Paragraph text
- In many respects, women are particularly vulnerable to negative health impacts resulting from conditions of work. The majority of women who work are employed in the informal sector, particularly in the lowest paid, lowest skilled jobs, where they are more likely to be exposed to hazardous working conditions. Women are on average paid less than men for the same work, and are more likely to experience violence and harassment in the workplace. Further, many occupational exposures are hazardous to reproductive organs, having serious implications for the sexual and reproductive health of female workers. For example, women of childbearing age, as well as pregnant women working in agriculture, are exposed to highly hazardous pesticides that risk not only their health but also the health of their children. Children born with congenital disorders due to in utero exposure to toxic chemicals endure disabilities for life. These problems are compounded by the fact that work-related diseases affecting women are often underdiagnosed and undercompensated as compared to men.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Economic Rights
- Equality & Inclusion
- Health
- Person(s) affected
- Children
- Men
- Women
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 49
- Paragraph text
- Accountability is a central feature of the right to health. It requires States to demonstrate and justify the manner in which it is meeting its obligations under the right to health, and to provide adequate remedies to redress any failures to meet these obligations. Accountability is critical to achieving full realization of the right to health; as indicated by the previous Special Rapporteur, 'without accountability, human rights can become no more than window dressing'. The role of the State in ensuring accountability under the right to occupational health for workers in the informal economy is particularly critical, as these workers do not have access to accountability mechanisms under existing occupational health regimes.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 50
- Paragraph text
- Accountability may have both prospective and retrospective components. Prospective accountability means that at all times the State must be able to demonstrate and justify how it is discharging its obligations. States are accountable to explain to all affected parties what steps they are taking to achieve the full realization of the right to health, and why these steps are being taken. For example, in the mining industry, this means that a worker concerned about exposure to asbestos should have access to information detailing the steps that the State has taken to prevent or reduce exposure to this harmful substance. In order to assess whether these steps are effective, and therefore whether States are meeting their obligations under the right to occupational health, the results of the monitoring of exposure levels and the incidence of asbestos-related diseases must be available and accessible. In this manner, prospective accountability is closely linked to monitoring and evaluation, both of which are critically necessary to determine whether the actions of States are consistent with its obligations under the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 51
- Paragraph text
- Retrospective accountability focuses on appropriately addressing prior violations of the right to health. Violations of the right to health must be addressed through effective judicial or other appropriate remedies. In order to achieve this, effective remedies must be available, and effective accountability mechanisms must be in place to identify both the right to health violation and the appropriate remedy to redress that violation. A number of accountability mechanisms may function at the national level, including judicial, quasi-judicial, administrative, political, and social mechanisms. General comment No. 14 explicitly endorses the use of judicial mechanisms to address violations of the right to health, and promotes the use of quasi-judicial bodies and social mechanisms of accountability (para. 59) These include national ombudsmen, human rights commissions, consumer forums and patient's rights associations.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 52
- Paragraph text
- Judicial accountability is one of the most critical and secure methods to achieving the full realization of the right to occupational health. Judicial review of violations of the right to health grants courts the power to subject State laws, policies, decisions and omissions affecting workers' occupational health to rights-based review. This also grants the judiciary the power to determine the normative content and scope of the right to health and promotes a national occupational health policy that is open, accountable, comprehensive, coherent and cooperative. Judicial accountability may therefore provide aggrieved workers with appropriate and adequate remedies and promote recognition of the right to occupational health by subjecting State laws and policies to judicial review.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 53
- Paragraph text
- Other accountability mechanisms may be used to ensure States meet their obligations under the right to occupational health. Quasi-judicial bodies, such as occupational health and safety commissions, may receive complaints about unsafe or unhealthy workplaces, investigate occupational health and safety in various work sectors, and conduct reviews of employer compliance with occupational health and safety standards. Commissions may also have the ability to hold hearings and make binding decisions imposing various sanctions. Social bodies such as workers' rights associations may similarly promote accountability through social mobilization and utilization of the media to pressure States to uphold their obligations under the right to health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 54
- Paragraph text
- Administrative mechanisms, such as human rights impact assessments, may be used to facilitate prospective accountability. Human rights impact assessments require policymakers to examine the human rights effects of proposed laws, policies or programmes prior to finalization in order to ensure that they are compliant with human rights. Such assessments prioritize concerns of the most vulnerable groups and ensure they are included in the law- and policymaking process. In the context of occupational health, this requires States to work together with workers to ensure occupational health laws and policies comply with the right to health prior to implementation.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 57
- Paragraph text
- The right to health entitles all victims of violations to adequate remedies. States must ensure workers are afforded access to adequate reparation, including restitution, compensation, satisfaction or guarantees of non-repetition, and that statutes of limitations do not interfere with access to remedies. Restitution requires that States restore the situation that existed prior to the violation. For example, if a statute regulating the use of hazardous materials in the workplace is repealed, resulting in workers falling ill, a remedy of restitution would require States to reinstate the law or draft a new law to address the lacunae. Monetary compensation should cover the cost of medical care, including rehabilitation, and any lost income arising from inability to work due to injury. Satisfaction includes a formal commitment by States, such as legislation or an executive order, to fulfil its obligation to realize the right to health of an individual or a specific population.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 58
- Paragraph text
- The obligation to provide adequate remedies requires that workers must have access to courts and other adjudicatory bodies where they may obtain financial compensation and other remedies for violations of their right to occupational health. If a worker's right to occupational health is violated and the State has failed to put in place effective mechanisms to ensure that the employer provides the worker with an adequate remedy, the State has a direct obligation to remedy the violation. This responsibility accrues from the obligation to protect workers from violations of their right to health by third parties. Further, failure of the State to protect workers' right to occupational health in this circumstance may require an additional remedy of satisfaction and/or guarantee of non-repetition.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 59
- Paragraph text
- States have a direct obligation to provide workers in the informal economy with remedies for violations of their right to occupational health. Violations of the right to health subject to direct State remediation include the failure of the State to implement components of the right to occupational health and claims arising from prior State commitments to implement the right. For example, if States fail to implement components of the right to occupational health, such as the inclusion of informal workers in the national occupational health policy, an appropriate remedy would be to reformulate the policy to address the occupational health of informal workers. Alternatively, if States have established a national social health insurance scheme covering workers in the informal economy, informal workers must have a private right of action to ensure that they are covered and that they receive appropriate benefits under the scheme.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 60a
- Paragraph text
- [The Special Rapporteur recommends that States take the following steps in order to realize the right to occupational health:] Extend existing occupational health laws and policies to cover the informal workforce, and establish innovative laws and policies to support direct occupational health interventions in the informal economy, with special attention paid to its gendered aspects. This should include: Social health insurance programmes that cover all informal workers, which, to the greatest extent possible, must be tailored to address the specific occupational health risks faced by informal workers in their respective sectors; Occupational health services that are provided where informal workers work; Primary healthcare interventions that are designed to educate and train informal workers about occupational health.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 60d
- Paragraph text
- [The Special Rapporteur recommends that States take the following steps in order to realize the right to occupational health:] Ensure mechanisms are in place to monitor and evaluate occupational health prior to the formulation and implementation of occupational health laws and policies. These should include: Disease and epidemiological surveillance, including the collection of disaggregated data; Human rights and health impact assessments and risk surveillance; Development, with the direct participation of workers, of the right to health indicators and benchmarks, against which occupational health laws and policies must be measured.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- N.A.
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Occupational health 2012, para. 60g
- Paragraph text
- [The Special Rapporteur recommends that States take the following steps in order to realize the right to occupational health:] Prevent, control and treat occupational diseases, with special attention to vulnerable groups. In order to do so, States must ensure that: The relationship between the work environment and health is monitored through State-led inspections of worksites and production facilities; Information is disseminated in order to educate workers about work and occupational health in a manner that can be easily understood by workers; Exposure to harmful substances in the workplace and home environments that overlap with the workplace is restricted or prohibited, including agricultural pesticides; Occupational health services are available at easily accessible locations and during hours that accommodate workers schedules, and include rehabilitation of affected individuals back into the workplace; Health workers are aware of the specific health risks faced by workers and are trained to detect, prevent and treat occupational diseases.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Person(s) affected
- All
- Year
- 2012
- Date added
- Aug 19, 2019
Paragraph
Right to health in conflict situations 2013, para. 21
- Paragraph text
- States may enact laws that impose a duty on health-care workers to report persons who may have committed a crime. However, some States have enacted laws and policies restricting or criminalizing provision of medical care to people opposing the State, such as political protestors and non-State armed groups. Laws criminalizing support for terrorists or others opposing the State may also be inappropriately applied to the provision of medical care. Consequently, doctors and other health-care workers have been arrested, charged and sentenced for acting within their professional duty of ensuring medical impartiality. Such laws may deter health-care workers from providing services in conflict situations due to fear of prosecution, thus creating a chilling effect on health-care providers.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Governance & Rule of Law
- Health
- Year
- 2013
- Date added
- Aug 19, 2019
Paragraph
Right to health in conflict situations 2013, para. 23
- Paragraph text
- Availability and accessibility of functioning hospitals and clinics are essential to the enjoyment of the right to health. States are under the obligation to ensure that health facilities are not harmed as a consequence of conflict. However, a number of physical barriers are deployed in times of conflict which severely affect access to health facilities and services. Obstacles such as forcible detours, arbitrary stops at checkpoints, imposition of travel permits and interrogation of patients result in worsening medical conditions of patients. Other measures such as blockades (S/2012/376, para. 11), long or indeterminate curfews and roadblocks also restrict movement of people and transport, thereby negatively effecting access to and delivery of essential health-care services in conflict-affected areas. States have also prevented civilian groups from accessing medical goods, especially life-saving medicines and supplies by obstructing, restricting, limiting or diverting medical supplies.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Equality & Inclusion
- Health
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
- Date added
- Aug 19, 2019
Paragraph