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Right to health in conflict situations 2013, para. 3
- Paragraph text
- Armed conflict is divided into international armed conflict - where there is "resort to armed force between States", and non-international armed conflict - where there is "protracted violence" involving at least one non-State organized armed group. In both situations, international humanitarian law prescribes rules of conduct for States and non-State organized armed groups that are parties to the conflict. These govern circumstances such as the conduct of hostilities, treatment of prisoners, guarantees of fundamental rights such as access to justice and treatment of civilians and civilian property.
- Body
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Document type
- Special Procedures' report
- Topic(s)
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 9
- Paragraph text
- States are obliged to utilize the maximum available resources towards the realization of economic social and cultural rights, including the right to health. An aspect of this obligation is that the right to health is progressively realizable. However, due to the destruction or diversion of resources to military or police needs, conflicts often reduce the availability of resources which may, at times, be detrimental to the right to health. Even where resources are available, States may not be able to make use of them due to the insecurity and poor infrastructure in many conflict environments.
- Body
- Special Rapporteur on 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
- N.A.
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 16
- Paragraph text
- The obligation to fulfil the right to health by facilitating, providing and promoting conditions conducive to its enjoyment may also be difficult in conflict due to resource constraints or security reasons. States should, however, make available essential and minimum levels of health facilities, goods and services. For instance, States may be obliged to fulfil the right to health by making available ambulances during protests or riots. States may also fulfil the right to health by entering into ceasefire agreements with non-State armed groups to ensure delivery of health services such as immunization and vaccination programmes. States could provide information about traditional medicine and support its use by communities who may be unable to access institutional care due to conflict. In the absence of their own capacity, States should request assistance from other States, civil society and humanitarian organizations, especially to fulfil their core obligations. States should not obstruct humanitarian organizations and practitioners of traditional and community-based medicine from providing health-care 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 61
- Paragraph text
- Accountability is an essential aspect of the right to health framework. It requires independent monitoring, prompt investigations, transparent governance, including collecting and disseminating accurate and complete information to the public, and access to remedies for victims of violations. These requirements are also addressed under international humanitarian law, which obliges States to prevent, investigate and punish violations of international humanitarian law. Clear policies and codes of conduct should be in place within the military, police force, and medical institutions to protect the right to health in conflict.
- Body
- Special Rapporteur on 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
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 62
- Paragraph text
- Violations of the right to health in conflict, including attacks on, and interference with, the delivery of health care, are often not fully captured in current monitoring systems. Monitoring of such violations in conflict and post-conflict situations is often poor or incomplete, due to insecurity and lack of systematic data collection and dissemination by States and international organizations. Monitoring mechanisms may focus excessively on high-profile issues such as attacks on international aid workers rather than more common violations such as threats against local workers or damage to underlying determinants. The practice of retaliating against whistleblowers may also mean that health-care workers and affected populations, who are in the best position to report violations of the right to health, may be reluctant to do so for fear of being unable to provide or access medical 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)
- Health
- Humanitarian
- Person(s) affected
- All
- N.A.
- Year
- 2013
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
Paragraph
Right to health in conflict situations 2013, para. 27
- Paragraph text
- Health-care workers are essential for ensuring availability of health-care services. States therefore have an immediate and continuous obligation to provide health-care workers and humanitarian organizations with adequate protection during periods of conflict.
- Body
- Special Rapporteur on 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 38
- Paragraph text
- Communities excluded from social, political and economic institutions are often marginalized and inhabit areas marked by weak infrastructure and poor governance, such as urban slums, ghettos and border areas. The impact of conflict may further devastate underlying determinants, such as food and housing, and disproportionately increase the vulnerability of marginalized communities to ill health. This vulnerability is heightened during conflict when health resources are inappropriately and inequitably distributed prior to and after conflict.
- Body
- Special Rapporteur on 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
Paragraph
Right to health in conflict situations 2013, para. 50
- Paragraph text
- Parties to conflict may also use health services as a strategy to target specific communities. Parties may deliberately deny humanitarian aid and health services to certain individuals or communities based on their ethnic, religious or political affiliation. Destruction of underlying determinants of health, such as by poisoning wells and burning farmland, is another strategy that may deny affected communities a life of dignity and well-being. Such strategies may undermine the ability of targeted groups to respond to serious health needs. Groups thus targeted may be unable to access nutritious food, hygiene or medical care, which may prevent them from enjoying their right to health. They may also be excluded from participation in democratic decision-making, including decisions on health services, which may perpetuate health inequities in post-conflict settings.
- Body
- Special Rapporteur on 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
Paragraph
Work of the mandate and priorities of the SR 2015, para. 57
- Paragraph text
- The Ebola crisis has provided meaningful lessons with regard to many elements of the right to health. It has questioned our preparedness for emergencies at national, regional and global levels. It has raised important issues, such as access to information, trust in public authorities and safety of medical personnel, and it has reminded us of the importance of upholding the human rights of the affected populations in the context of public safety concerns. The Ebola crisis has once again raised issue of the responsibility and social accountability of key actors, including pharmaceutical companies, and the need for strong public leadership in addressing global health challenges.
- Body
- Special Rapporteur on 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2015
Paragraph
Right to health in conflict situations 2013, para. 74b
- Paragraph text
- [The Special Rapporteur urges non-State armed groups:] To comply with agreements that may have been entered into to protect the right to health of affected populations.
- Body
- Special Rapporteur on 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 26
- Paragraph text
- Destruction of health infrastructure by States, or failure to protect against such destruction by third parties, impairs the availability and accessibility of quality health facilities, goods and services. Intentional targeting of health facilities also constitutes a violation of the principle of distinction under international humanitarian law, which obliges parties to the conflict to refrain from attacking medical personnel, units, material and transports unless they are used to commit hostile acts outside their medical and humanitarian functions. Acts that do not involve specific targeting of health facilities may also violate the right to health where the acts increase the risk of damage to the facility or decrease patient access to it, such as by locating military outposts or weapons in the vicinity of a clinic.
- Body
- Special Rapporteur on 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 28
- Paragraph text
- Attacks on health workers including assaults, intimidation, threats, kidnapping, and killings, as well as arrests and prosecutions, are increasingly used as a strategy in conflict situations. Conflict-affected areas have recorded disruption in supply chains, looting of health facilities, demanding of confidential information about patients, intentional and recurrent shelling and bombardment of clinics and hospitals, and shooting at ambulances carrying patients to target civilians and health-care workers as a military strategy. In countries with poor health infrastructure, as may be the case with most conflict-affected regions, destruction of even a single hospital or attacks on already scarce health-care workers can have a devastating impact on the availability and accessibility of health services and therefore on public health. Furthermore, health-care workers may condemn the actions of security forces or may not cooperate in providing information about patients where laws may violate fundamental human rights. Such health-care workers may frequently be harassed, relocated, tortured, arrested and sentenced.
- Body
- Special Rapporteur on 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
- Humanitarian
- Violence
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 52
- Paragraph text
- According to the International Covenant on Economic, Social and Cultural Rights, all States have an obligation to take steps, individually and through international cooperation and assistance, towards the full realization of economic, social and cultural rights, including the right to health. To comply with their international obligations, States must respect the right to health of populations in other countries, protect against violations by third parties where they are able to influence those third parties through legal or political means, and facilitate access to essential health services in other countries, depending on the availability of resources. In particular, States have an obligation to provide humanitarian aid in disasters and emergencies, including conflict and post-conflict situations.
- Body
- Special Rapporteur on 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
Paragraph
Right to health in conflict situations 2013, para. 54
- Paragraph text
- States also frequently impose economic sanctions in conflict to coerce parties to the conflict, or to control the flow of resources to conflict-affected areas. Such sanctions may adversely impact on the right to health of civilian populations, not only by restricting medical supplies, but also by increasing administrative delays for essential goods and services, worsening poverty and reducing the resources available for health, infrastructure and education systems. To ensure the full enjoyment of the right to health of people affected by conflict, medical supplies and equipment, water, food and other essentials important for the health of the population should never be placed under sanctions. Furthermore, all sanctions should be monitored both before and after imposition for their effect on the right to health, and should be transparent and responsive, regardless of their political purpose.
- Body
- Special Rapporteur on 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
Paragraph
Right to health in conflict situations 2013, para. 63
- Paragraph text
- Security concerns should not be used to justify blanket bans on reporting violations, particularly where a less restrictive means of ensuring security is available, such as allowing anonymous reporting of incidents. States should ensure that accurate information is available to independent monitors and should not retaliate against persons who report violations. States should also prevent and investigate threats and attacks against such persons by both State agents and third parties. States should especially promote community-based monitoring initiatives, which ensure that the views of the local population are taken into account, and provide transparent and reliable information to civil society and affected 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)
- Civil & Political Rights
- Equality & Inclusion
- Governance & Rule of Law
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 67
- Paragraph text
- Remedial measures should involve removing discriminatory policies and laws, and formulating and implementing comprehensive national health plans to realize the right to health post-conflict. States should also provide platforms to heal the rifts in society caused by conflict. Mechanisms such as truth and reconciliation commissions, international and hybrid criminal tribunals, international and regional human rights mechanisms and fact-finding missions can provide important complements to judicial and administrative remedies at the national level in this regard. At all levels, the participation of affected communities in remedial processes is essential to ensuring a meaningful and sustainable resolution of the conflict.
- Body
- Special Rapporteur on 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
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 68
- Paragraph text
- A right to health approach to conflict situations obliges States to take continuous and concrete steps towards the realization of the right to health of persons affected by conflict, including those who are actively involved in conflict. The Special Rapporteur recommends that States enact and implement laws and policies which respect, protect and fulfil the right to health of affected populations, especially vulnerable groups, prior to, during and after conflict.
- Body
- Special Rapporteur on 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
Paragraph
Right to health in conflict situations 2013, para. 25
- Paragraph text
- Persons who require continuous care have particular health needs which, if unaddressed, can increase unnecessary deaths during conflict. For example, treatment interruption and lack of availability of treatment may render people living with HIV, tuberculosis and cancer, more vulnerable to ill-health. The lack of availability of medication and psychosocial services can likewise prove especially detrimental to mental health patients, some of whom may require continuous 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 36
- Paragraph text
- Sustainability of donor-aided policies and initiatives is essential for ensuring long-term availability and accessibility of quality health facilities, goods and services in countries recovering from conflict. Ensuring participation and ownership in all phases of decision-making processes by the affected population is essential for the success and sustainability of donor-aided reconstruction of the health system. Such health initiatives could be successful through continuous collaboration and cooperation with the local population, and by sharing technical know-how with them. An understanding of political realities, especially in areas of protracted conflict and transitioning societies is equally important to ensure sustainability of donor-aided initiatives.
- Body
- Special Rapporteur on 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 13
- Paragraph text
- As at other times, States have the obligation to respect, protect and fulfil the right to health in conflict. This includes situations where States occupy or otherwise exercise effective control over foreign territory, where the full spectrum of obligations under the right to health applies. States also have other human rights obligations, including but not limited to the right to life and the obligation to refrain from torture and other forms of cruel, inhuman or degrading treatment or punishment.
- Body
- Special Rapporteur on 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 71c
- Paragraph text
- [The Special Rapporteur urges States recovering from conflict:] To ensure the availability and accessibility of essential and primary health facilities, goods and services, including mental health services, to people affected by and involved in conflict, especially 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 70b
- Paragraph text
- [The Special Rapporteur urges States involved in conflict situations:] To ensure the availability, accessibility and acceptability of quality health facilities, goods and services to all people involved in and/or affected by conflict, without discrimination. Particular attention should be given to 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 30
- Paragraph text
- Militarization refers to the taking over or use of health facilities and services by armed forces or law enforcement agencies for achieving military objectives. Such military use poses a serious risk to the life and health of patients and health-care workers and erodes the role and perception of hospitals as a safe space to access health care. The impartiality of medical facilities is often compromised by the constant presence of security forces in hospitals and intimidation of patients and health-care workers in hospitals and clinics. Hospitals and clinics are sometimes taken over by security forces in order to identify or arrest protestors injured in clashes with pro-Government forces. Those identified with protest-related injuries are often prevented from seeking emergency medical attention, removed from medical care, tortured or arrested (A/HRC/19/69, para. 63). Militarization of health care has also led to undesirable fallouts in respect of access to basic health care in some countries. Widespread fear of persecution leads civilians to avoid seeking treatment at health facilities and resort to treatment in unsafe conditions instead (ibid.). Such persecution violates the right to health of persons by impeding their access to quality health 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 12
- Paragraph text
- A crucial facet of the right to health framework is the effective participation of affected people and communities, especially vulnerable groups. Effective participation should be ensured in all phases of formulating, implementing and monitoring decisions which affect the realization and enjoyment of the right to health in times of conflict. However, policies thus formulated should not be limited to the views of the majority and should take into account the views and needs of the minority within the participating group. Involvement in decision-making processes empowers affected communities and ensures ownership of decisions and resources, which leads to sustainable systems and, potentially, the resolution of conflicts. The participation of affected populations ensures responsive and effective laws and policies by taking into consideration the needs of the people. This is of special significance in protracted conflict situations, in post-conflict situations, in areas with a constant military presence and in areas under occupation. Informed participation can only be ensured when affected populations have the ability to seek and disseminate information 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
- Health
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 66
- Paragraph text
- Remedies should not be limited to punitive actions against perpetrators but should also be directed towards restoring the right to health of affected persons and bridging the divisions in society that may arise from or give rise to continued conflict. As such, the remedies of satisfaction and guarantee of non-repetition, which include measures to cease current violations and prevent future violations as noted by the General Assembly in its resolution 60/147, are particularly important given the ongoing and systemic effects of conflict on the right to health. In the context of the right to health, guarantees of non-repetition include improving protection of health workers in conflict areas; providing clear codes of conduct on the appropriate use of medical facilities in conflict; training of, and awareness-raising among, appropriate actors, including law enforcement, on all aspects of the right to health; undertaking legal reforms including enacting laws that mandate non interference with the impartial provision of health care; and setting up independent dispute settlement and monitoring systems. The remedy of satisfaction includes judicial and administrative sanctions, acknowledgement of wrongdoing, and effective measures to end continuing violations.
- Body
- Special Rapporteur on 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 71d
- Paragraph text
- [The Special Rapporteur urges States recovering from conflict:] To establish access to justice mechanisms to address the violations of rights and provide remedies for such violations, including restitution, compensation, guarantees of non-repetition and satisfaction;
- Body
- Special Rapporteur on 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
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 70d
- Paragraph text
- [The Special Rapporteur urges States involved in conflict situations:] To refrain from obstructing, restricting or limiting access to health facilities, goods and services. In cases where such barriers become necessary, restrictions should be proportionate to the objective sought and should follow the least restrictive alternative;
- Body
- Special Rapporteur on 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
Paragraph
Right to health in conflict situations 2013, para. 51
- Paragraph text
- The primary responsibility for realizing the right to health in conflict lies with States who are involved in the conflict. However, other States and non-State actors, including armed groups, international organizations and humanitarian non governmental organizations, also bear obligations towards the realization of the right to health of affected populations.
- Body
- Special Rapporteur on 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph
Right to health in conflict situations 2013, para. 22
- Paragraph text
- The fear of being reported to law enforcement agencies also prevents access to health facilities and services by patients. This is especially true of people wounded as a result of direct involvement in conflict. However, criminalization also has a chilling effect on people who are not involved in conflict, who may avoid seeking health services because they fear being suspected of involvement in the conflict.
- Body
- Special Rapporteur on 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
- Humanitarian
- Person(s) affected
- All
- Year
- 2013
Paragraph