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Corruption and the right to health 2017, para. 20
- Paragraph text
- Although many everyday practices in health-related services may not be considered as corruption, legally speaking, their accumulation and their acceptance by various stakeholders have a detrimental cumulative effect on the performance of health-care systems and, indirectly, on individual and societal health. It is for that reason that the present report is focused not only on those forms of corruption that are legally defined as breaking the law and should be brought to justice, but also on those practices which undermine principles of medical ethics, social justice, as well as effective and transparent health-care provision. When such practices are not properly addressed, they pave the way to non-transparent decisions at all levels of policymaking, policy implementation and services provision and thus lead to corrupt environments and foster institutional corruption.
- Body
- Special Rapporteur on 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
- 2017
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Corruption and the right to health 2017, para. 48
- Paragraph text
- Where there is opacity surrounding decisions at the political, macro or micro levels, corruption can flourish, go undetected and occur with impunity. Transparency unveils corruption and is inextricably linked to the right to access information, participation and accountability. Access to information and transparency laws provide a framework for addressing corrupt practices, while the regulations and monitoring arrangements are also vital. Transparency can often be enhanced by the participation of rights holders and civil society organizations in decision-making processes that may be prone to corrupt practices.
- Body
- Special Rapporteur on 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
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 50
- Paragraph text
- There is a significant demand from civil society for accountability of Governments and other institutions. Sustainable Development Goal 16 includes a commitment to create effective, transparent and accountable institutions at all levels. Accountability is at the heart of human rights and central to the fight against corruption. Human rights-based accountability for corruption helps reveal where corruption has taken place and resulted in human rights abuses. Effective accountability processes are also important for the reason that they can have a deterrent effect in relation to corruption. It is therefore troubling that research suggests that accountability for corruption is rare, indicating a need for governments to take concerted steps to strengthen accountability mechanisms and processes.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
The right to mental health 2017, para. 64
- Paragraph text
- Justification for using coercion is generally based on “medical necessity” and “dangerousness”. These subjective principles are not supported by research and their application is open to broad interpretation, raising questions of arbitrariness that has come under increasing legal scrutiny. “Dangerousness” is often based on inappropriate prejudice, rather than evidence. There also exist compelling arguments that forced treatment, including with psychotropic medications, is not effective, despite its widespread use. Decisions to use coercion are exclusive to psychiatrists, who work in systems that lack the clinical tools to try non-coercive options. The reality in many countries is that alternatives do not exist and reliance on the use of coercion is the result of a systemic failure to protect the rights of individuals.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 47
- Paragraph text
- Patients’ organizations and other more empowered interest groups may exert influence on health decision-making by lobbying in favour of the prescription and reimbursement of expensive drugs or particular programmes or treatments in a health service at the expense of other treatments or programmes. Paradoxically, these activities can reinforce imbalances and power asymmetries, as they too often result in undue pressure on policymakers to invest in specialized care and vertical programmes of treatment for certain diseases at the expense of primary care and holistic medicine. Thus participation has to be carefully planned, balanced and accompanied by open and transparent planning mechanisms to ensure representation of a broad range of civil society and other key 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)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 11
- Paragraph text
- Both corruption occurring in society at large (general corruption), as well as corruption specifically occurring in the health or other health-related sectors, have a negative impact on the enjoyment of the right to health. These forms are intertwined. Corruption in society at large may affect the regulatory environment and the efficiency of State institutions. It hinders economic growth and sustainable development as well as equitable distribution of resources. It undermines public confidence in the State and may obstruct attainment of the commitments made through Sustainable Development Goal 16 to create effective and accountable institutions.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 87b
- Paragraph text
- [The Special Rapporteur urges States to:] Ensure the integration of the right to health as a standard in anti-corruption laws and policies aimed at regulating the health 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)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 52
- Paragraph text
- Health systems are complex and a wide range of monitoring and review processes have a role to play in enhancing accountability for the right to health in the context of corruption. In terms of monitoring, budget monitoring, effective and accurate accounting, audits and public expenditure tracking surveys are ways of monitoring how funds have been allocated and whether they have been distributed as intended, or whether corruption may have occurred. Yet in many low-income countries, Governments lack financial and technical capacity to operate such systems in an effective way. As well as monitoring of funds, monitoring of health professionals’ practice and supplies is also important. The establishment of well-resourced and independent anti-corruption and fraud agencies to prevent and detect corruption, including in the health sector, can also support the monitoring dimension of accountability.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 45
- Paragraph text
- Participation in health decision-making leads to improved health outcomes and is essential for ensuring the distribution of policies and programmes to broader segments of the population, thus making governance more accountable. Participation goes beyond merely being educated, informed or consulted. It implies a human right to actively engage individuals and groups in the development, implementation and review of policies, standards, indicators, benchmarks or legislation, particularly aimed at including the voices and needs of more vulnerable or otherwise underrepresented and especially 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)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 53
- Paragraph text
- Judicial, quasi-judicial, political and administrative mechanisms at the local, national and international levels can all play an important review function. It is essential that rights holders are aware of their entitlements and that complaints procedures are simple and accessible. Independent complaints procedures are often valuable. Rights holders must be able to participate in review procedures carried out by quasi-judicial, political or administrative bodies. Moreover, whistle-blower protection in the public and private sectors for individuals in procurement bodies, health authorities, health service providers and suppliers of medicine and equipment supports review through encouraging the reporting of corruption. Domestic human rights bodies, such as national human rights institutions, as well as international mechanisms such as the United Nations treaty bodies and the universal periodic review, can provide an important contribution to enhancing accountability for the right to health, including in the context of corruption.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 54
- Paragraph text
- Governments must take action where monitoring and review have revealed corrupt practices. Not only should sanctions be applied, but remedies must also be awarded and implemented. Accountability should not be exclusively equated with a blame and punishment model that puts front-line workers in the firing line. Rather it is better understood as reinforcing the rule of law, including the promotion and protection of the right to health in the health system. Court judgments, as well as recommendations from other review bodies, can lead to actions by governments and other duty bearers producing transformative changes in the health 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)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 58
- Paragraph text
- The medical profession has a responsibility to abstain from unethical and unprofessional behaviour under its professional codes, which often emphasize a commitment to integrity and non-corrupt behaviour. Among other acts, the medical profession is to refrain from favouritism and other forms of preferential treatment for well-connected individuals; accepting bribes; using hospital equipment for private business; and referring public hospital patients to their private practices. They should remain independent from outside organizations that have vested interests in their clinical activities. They should avoid conflicts of interest that compromise their decisions regarding the care of patients.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 26
- Paragraph text
- Moreover, since the right to health includes not only a right to health care but also to the determinants of health, it offers a road map and tools for addressing corrupt action in the health sector as well as corruption affecting the social, environmental and other determinants of health. Measures to address the right to health should be holistic and integrated, go beyond the provision of health services and be underpinned by cross-departmental commitment (see A/HRC/32/32, para. 37). It requires the improvement not only of outcomes but also of processes, for example with governance and health systems required to operate on the basis of principles including transparency, participation, accountability and non-discrimination, all of which have a particular importance for addressing corruption.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 28
- Paragraph text
- When it comes to addressing corruption and a lack of transparency, the right to health is closely related to and dependent upon other human rights and fundamental freedoms that are critical to the fight against corruption, including the right to life; freedom of expression including the right to seek, receive and impart information; freedom of association; and the right to a fair trial. For example, freedom of expression offers a basis for protecting whistle-blowers, which is of key importance in combating corruption, while the right to information is vital to access information including on financial transactions and decision-making processes that may reveal corruption. The promotion and protection of these rights will also therefore be vital tools to address corruption affecting 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 1
- Paragraph text
- Corruption can have a devastating effect on good governance, the rule of law, development and the equitable enjoyment of all human rights, including the right to health. Corruption has been the subject of international legal commitments as well as recent political commitments. The 2030 Agenda for Sustainable Development and the Sustainable Development Goals (targets 16.5 and 16.6) stipulate that corruption and bribery, in all their forms, should be substantially reduced by 2030 and that effective, accountable and transparent institutions should be developed at all 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)
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- N.A.
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 68
- Paragraph text
- Thus, the framework of institutional corruption highlights both the harm done and what is lost, namely, harm to patients; loss of public trust and confidence in the integrity of academic medicine; and distortion of the scientific evidence base. It exposes the economies of influence that contribute to those harms and losses and it is a call for action to neutralize those influences. Below, the Special Rapporteur reviews three main areas in the mental health field using this framework, namely, the process of development and promotion of diagnostic categories for mental health conditions, psychotropic drug research and clinical practice guidelines.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 86
- Paragraph text
- Applying a human rights-based approach to health and related policies and avoiding selective approaches to human rights and the production and use of evidence in the realization of the right to health are the most effective measures for combating corruption.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
The right to mental health 2017, para. 37
- Paragraph text
- Some obligations are not subject to progressive realization and must be implemented immediately, including certain freedoms and core obligations. Core obligations include the elaboration of a national public health strategy and non-discriminatory access to services. In terms of the right to mental health, that translates into the development of a national mental health strategy with a road map leading away from coercive treatment and towards equal access to rights-based mental health services, including the equitable distribution of services in the community.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 85
- Paragraph text
- In accordance with their legal obligations under international human rights law, as well as high-level political commitments made in the Sustainable Development Goals to address corruption and develop effective, accountable and transparent institutions by 2030, States should provide leadership to confront the domestic and global causes of corruption and its impact on the right to health through legal, policy and programming measures in the health and related 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)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 87j
- Paragraph text
- [The Special Rapporteur urges States to:] Ensure monitoring and accountability in the health sector and related sectors through the establishment of well-resourced and independent anti-corruption and fraud agencies, as well as accessible and effective accountability procedures for health system users who encounter corrupt practices;
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 88e
- Paragraph text
- [The Special Rapporteur also urges other relevant stakeholders to:] Address the production and dissemination of biased outcomes of research in psychiatry and prevent, through transparent changes in medical education, research and practice, institutional corruption in psychiatry and mental 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)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 87q
- Paragraph text
- [The Special Rapporteur urges States to:] Create awareness among health system users of their rights as well as identifying and reporting corrupt acts;
- Body
- Special Rapporteur on 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
- 2017
Paragraph
The right to mental health 2017, para. 94c
- Paragraph text
- [To ensure that international cooperation secures the right to mental health and the 2030 Agenda, States and multilateral and international institutions should:] Advance global mental health in all monitoring activities of the Sustainable Development Goals, including high-level political forums.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 57
- Paragraph text
- Organizations administering health insurance schemes and insurance regulators have a responsibility to prevent embezzlement, theft and illicit enrichment from the health insurance budget and bias in favour of certain procedures, medical professionals or products due to conflicts of interests. They should avoid adverse selection practices leading to patients being refused on the basis of their health status, age, financial capacity or other factors.
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 14
- Paragraph text
- Corruption is a significant challenge to the delivery of quality health care, which is central both to the right to health and to the commitment under Sustainable Development Goal 3 to universal health coverage. The health sector is extremely vulnerable to corruption at all levels — grand and petty, political and institutional — and occurring in both the public and private sectors. It is estimated that every year 180 billion euros are lost to fraud and corruption in health care globally. Health sector corruption negatively affects the (financial) resources available for health care; resources that are drained through embezzlement and procurement fraud are no longer available for paying salaries, funding health-care delivery or maintenance. For example, there is evidence suggesting that health sector corruption has a negative effect on cancer care and care for HIV/AIDS. While these trends are visible in countries at all levels of development, it is evident that lower-income countries are more deeply affected by health sector corruption and a lack of transparency. In some countries, the health sector is considered to be the most corrupt sector of 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
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 88b
- Paragraph text
- [The Special Rapporteur also urges other relevant stakeholders to:] Address, through legal, policy and other measures, corrupt practices taking place in all stages of the pharmaceutical value chain, including during research and development, manufacturing, registration, distribution, procurement and marketing of medicines;
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 27
- Paragraph text
- In recent years, a number of United Nations human rights bodies have acknowledged the negative impacts of corruption on the enjoyment of human rights. By its decision 2002/106, the Sub-Commission on the Promotion and Protection of Human Rights appointed a Special Rapporteur on the impact of corruption on human rights, in particular economic, social and cultural rights. In her reports, the Special Rapporteur established that the enjoyment of both civil and political and economic, social and cultural rights are seriously undermined by corruption. In a report published in 2015, the Advisory Committee to the Human Rights Council explained that a human rights perspective on the impact of corruption can move the victims to the centre of the fight against corruption by highlighting the negative impacts of corruption on the individuals and groups concerned. The human rights perspective also reveals that the State bears the ultimate responsibility for such acts. Establishing the links between corruption and human rights can promote access to human rights mechanisms to combat corruption, thus creating new opportunities for monitoring and litigation (see A/HRC/28/73, paras. 27-28 and 32).
- Body
- Special Rapporteur on 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
- 2017
Paragraph
Corruption and the right to health 2017, para. 56
- Paragraph text
- Private hospital and insurance boards and other institutions responsible for the financing and provision of health care or underlying determinants have an important role to play in combating corruption and lack of transparency within their organizations. They must ensure that they comply with national laws and regulations regarding corruption and human rights. They may adopt an anti-corruption strategy, including internal regulations aimed at prohibiting and preventing the diversion of budgets, medicines or medical supplies for personal advantage; the acceptance of informal payments by their health personnel; preferential treatment for well-connected individuals; the use of hospital equipment for private business; the improper referral of public hospital patients to private practices; and illegitimate absenteeism of medical personnel while being paid. When it comes to preventing informal payments, the creation of individual contracts with personnel and increased pay scales while sanctioning poor performance are recommended. In the case of whistle-blowers, hospital boards and other actors should refrain from punitive actions and provide adequate protection and guarantees to safeguard their personnel and 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)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 87d
- Paragraph text
- [The Special Rapporteur urges States to:] Progressively build resilient health systems, with a special focus on health promotion and primary care, so as to root out the problem of systemic incentives for corruption in health 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
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2017
Paragraph
Corruption and the right to health 2017, para. 87k
- Paragraph text
- [The Special Rapporteur urges States to:] Ensure judicial and other forms of review of violations of anti-corruption legislation; and effective remedies where corruption leads to a violation 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)
- Governance & Rule of Law
- Health
- Person(s) affected
- All
- Year
- 2017
Paragraph