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Corruption and the right to health 2017, para. 3
- Paragraph text
- In many countries health is among the most corrupt sectors. Health sector corruption, including for example the bribing of health officials and unofficial payments to health-care providers, obstructs the ability of States to fulfil their right to health obligation and to guarantee available, accessible, acceptable and good quality health services, goods and facilities. Yet corruption affecting health also occurs in other sectors and industries, for example, the water sector, and the food and beverages, tobacco and other industries. Moreover, corruption has significant implications for equality and non-discrimination since it has a particularly marked impact on the health of populations in situations of vulnerability and social exclusion, in particular those living in poverty and children.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Poverty
- Personnes concernées
- All
- Children
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 15
- Paragraph text
- The lesser form of corruption, namely, petty corruption, is quite common in the health sector and includes informal payments from patient to health-care provider, absenteeism of health personnel and preferential treatment. These forms of corruption are also sometimes called “survival corruption”, as they are exacerbated by a lack of resources in health-care settings, poor working conditions, low pay, and hierarchical structures, which drive people to engage in such acts. There is evidence that this “microform” of corruption has a particularly negative effect on the poor in society, as they are often unable to pay the bribes necessary for a certain service.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Economic Rights
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 35
- Paragraph text
- Corruption also infringes medical ethics, which are an essential component of acceptable health care. Lastly, in terms of quality, corruption can affect the quality of medicines, for example, when regulators are bribed to carry out less rigorous checks, or when hospital administrators purchase medicines of unknown quality. Quality can also be compromised where bribes are extorted or accepted in decisions on hiring staff, or accrediting, licensing or certifying facilities, in deciding which medicines to include on essential medicines lists, or to market unregulated medicines, which can increase mortality and morbidity among those affected, as well as hampering disease control efforts. Nepotism, cronyism and other forms of favouritism can also compromise the quality of health and health-related services.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- N.A.
- Année
- 2017
Paragraphe
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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Civil & Political Rights
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
The right to mental health 2017, para. 43
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- Health settings must empower users as rights holders to exercise autonomy and participate meaningfully and actively in all matters concerning them, to make their own choices about their health, including sexual and reproductive health, and their treatment, with appropriate support where needed.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
The right to mental health 2017, para. 20
- Paragraph text
- The psychosocial model has emerged as an evidence-based response to the biomedical paradigm.It looks beyond (without excluding) biological factors, understanding psychological and social experiences as risk factors contributing to poor mental health and as positive contributors to well-being. That can include short-term and low-cost interventions that can be integrated into regular care. When used appropriately, such interventions can empower the disadvantaged, improve parenting and other competencies, target individuals in their context, improve the quality of relationships and promote self-esteem and dignity. For any mental health system to be compliant with the right to health, the biomedical and psychosocial models and interventions must be appropriately balanced, avoiding the arbitrary assumption that biomedical interventions are more effective.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
The right to mental health 2017, para. 18
- Paragraph text
- The biomedical model regards neurobiological aspects and processes as the explanation for mental conditions and the basis for interventions. It was believed that biomedical explanations, such as “chemical imbalance”, would bring mental health closer to physical health and general medicine, gradually eliminating stigma. However, that has not happened and many of the concepts supporting the biomedical model in mental health have failed to be confirmed by further research. Diagnostic tools, such as the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders, continue to expand the parameters of individual diagnosis, often without a solid scientific basis. Critics warn that the overexpansion of diagnostic categories encroaches upon human experience in a way that could lead to a narrowing acceptance of human diversity.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 28
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- 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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- N.A.
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 61
- Paragraph text
- Within the health sector, the pharmaceutical industry stands out as being particularly prone to corruption. Corrupt practices take place at all stages of the pharmaceutical value chain, including during research and development, manufacturing, registration, distribution, procurement and marketing. The key problems are a lack of objective data and understanding of corruption in the pharmaceutical sector, a weak legislative and regulatory framework, potential undue influence from companies and a lack of leadership committed to anti-corruption efforts.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
The right to mental health 2017, para. 82
- Paragraph text
- There is no single definition of recovery, often described as a personal journey towards regaining a meaningful life and becoming more resilient. The recovery approach, when implemented in conformity with human rights, has helped to break down power asymmetries, empowering individuals and making them agents of change rather than passive recipients of care. Tremendous strides have been made in this area, with evidence and recovery-based support and services in practice across the world today that restore people’s hope (and trust) in services, as well as in themselves.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Governance & Rule of Law
- Personnes concernées
- All
- Année
- 2017
Paragraphe
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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- N.A.
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 72
- Paragraph text
- Studies have revealed that commercially funded trials are up to four times more likely to report industry-friendly results than trials without such financial conflicts of interest. In addition, there is clear evidence of publication bias in psychotropic drug trials; research demonstrating the ineffectiveness of a drug can be suppressed or written in a way that conveys a positive result. Such publication biases result in an inflated perception of efficacy and an underestimation of the harms of psychotropic medications.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- N.A.
- Année
- 2017
Paragraphe
The right to mental health 2017, para. 30
- Paragraph text
- The Constitution of WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Like all aspects of health, a range of biological, social and psychological factors affect mental health. It is from this understanding that duty bearers can more accurately understand their corresponding obligations to respect, protect and fulfil the right to mental health for all. Most of the current discussions around mental health and human rights have focused on informed consent in the context of psychiatric treatment. While that discourse is deeply meaningful, it has emerged as a result of systemic failures to protect the right to mental health and to provide non-coercive treatment alternatives.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
The right to mental health 2017, para. 14
- Paragraph text
- With the adoption of the 2030 Agenda for Sustainable Development and recent efforts by influential global actors such as WHO, the Movement for Global Mental Health and the World Bank, mental health is emerging at the international level as a human development imperative. The 2030 Agenda and most of its sustainable development goals implicate mental health: Goal 3 seeks to ensure healthy lives and promote well-being at all ages and target 3.4 includes the promotion of mental health and well-being in reducing mortality from non-communicable diseases. How national efforts harness the momentum of the 2030 Agenda to address mental health has important implications for the effective realization of the right to health.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Personnes concernées
- All
- N.A.
- Année
- 2017
Paragraphe
The right to mental health 2017, para. 31
- Paragraph text
- The evolving normative context around mental health involves the intimate connection between the right to health, with the entitlement to underlying determinants, and the freedom to control one’s own health and body. That is also linked to the right to liberty, freedom from non-consensual interference and respect for legal capacity. While informed consent is needed to receive treatment that is compliant with the right to health, legal capacity is needed to provide consent and must be distinguished from mental capacity. The right to health also includes a right to integration and treatment in the community with appropriate support to both live independently and to exercise legal capacity (see, for example, E/CN.4/2005/51, paras. 83-86, and A/64/272, para. 10). The denial of legal capacity frequently leads to deprivation of liberty and forced medical interventions, which raises questions not only about the prohibition of arbitrary detention and cruel, inhuman or degrading treatment, but also the right to health.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
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.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 8
- Paragraph text
- Other definitions distinguish between types of corruption, which among other forms include political and institutional corruption. “Political corruption” means manipulation by political decision makers of, for example, policies and rules of procedure in the allocation of resources, such as a government accepting a bribe in exchange for the construction of a large private hospital in the capital. “Institutional corruption” results from the normalization of behaviours that compromise truth-seeking and lead to the formation of perverse incentive structures, and thus addresses the behaviour of actors who exploit their institutional positions to influence institutional processes and actions.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 40
- Paragraph text
- Discrimination encompasses any distinction, exclusion or restriction that has the purpose or effect of nullifying or impairing the recognition, enjoyment or exercise by all persons, on an equal footing, of all rights and freedoms. Non-discrimination and equality are human rights obligations which are fundamental to realizing the right to health. Not only must health and other goods and services be available to all on the basis of non-discrimination, but broader promotion and protection of equality and non-discrimination are vital in guaranteeing the equitable enjoyment of the right to health.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 2
- Paragraph text
- While corruption manifests at many levels within societies and States, the present report focuses on the links between corruption and the enjoyment of the right to the highest attainable standard of health. Corruption in government, institutions and society at large is a significant obstacle to the enjoyment of the right to health of individuals and groups. In countries with a higher level of perceived national corruption, there is a much higher prevalence of poor health. Corruption in Government and society can reduce the ability of the government to raise resources for health and other social sectors through putting off investors or donors or as a result of tax evasion.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Personnes concernées
- All
- N.A.
- Année
- 2017
Paragraphe
The right to mental health 2017, para. 77
- Paragraph text
- Reductive biomedical approaches to treatment that do not adequately address contexts and relationships can no longer be considered compliant with the right to health. While a biomedical component remains important, its dominance has become counter-productive, disempowering rights holders and reinforcing stigma and exclusion. In many parts of the world, community care is not available, accessible, acceptable and/or of sufficient quality (often limited to psychotropic medications). The largest concentration of mental hospitals and beds separated from regular health care is in higher-income countries, a cautionary note for lower and middle-income countries to forge a different path and shift to rights-based mental health care.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 4
- Paragraph text
- The right to health provides a valuable normative framework and constitutes a legally binding imperative to analyse and address corruption affecting health and occurring in and beyond the health sector. The framework reflects notions of good governance, transparency, accountability and participation, which are key when it comes to combating corruption. It places legal obligations on States to guarantee access to health-related goods and services for all, including individuals and groups in situations of vulnerability, and this requires them to take actions to curb corruption where it occurs.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Governance & Rule of Law
- Health
- Personnes concernées
- All
- N.A.
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 22
- Paragraph text
- In the context of universal health coverage, as one of the important global commitments under the 2030 Agenda, it is critical to strengthen health-care systems so that all segments of population trust primary care and primarily use this level of services for most health conditions. This would be an effective anti-corruption measure to help decrease the prevailing tendency whereby users of health services prefer to bypass primary care and use specialized health-care services. The Special Rapporteur welcomes recent initiatives developed and replicated in some countries through which medical doctors educate the general population against wasteful or unnecessary use of medical tests, treatments and procedures in health care. Such initiatives, inter alia, “choosing wisely”, “realistic medicines” or “preventing over-diagnosis”, should be supported by States as effective measures to develop rational health-care services and thus prevent unnecessary and costly use of specialized interventions.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe
Corruption and the right to health 2017, para. 44
- Paragraph text
- Meaningful participation of people in decisions that affect their health and socioeconomic well-being is a key component of the right to health and crucial when it comes to combating corruption in health care and in society at large. States’ obligations under article 12 of the International Covenant on Economic, Social and Cultural Rights require that the right to participate in decision-making processes affecting their health and development must be an integral component of any relevant policy, programme or strategy. Sustainable Development Goal target 16.7 stipulates the duty to ensure responsive, inclusive, participatory and representative decision-making at all levels.
- Organe
- Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health
- Type de document
- Special Procedures' report
- Thèmes
- Equality & Inclusion
- Health
- Personnes concernées
- All
- Année
- 2017
Paragraphe