These short videos provide an overview of the history of human rights; health and human rights; and health, human rights and development. They were developed to make human rights more accessible to non-lawyers and non-academics. The videos are accompanied by tools for further learning, including an annotated bibliography, glossary of terms, timeline of key events, and fact sheet on universal health coverage. The first video provides an explanation on what human rights are and why they are important. The second video offers a brief history of health and human rights since World War II. The third video gives a description of how health-related human rights developed during the era of the Millennium Development Goals (2000-2015) and the Sustainable Development Goals (2016-2030). The series concludes by considering the vital role that human rights plays in diverse political environments.
Values, Policies and Rights
A teenager whose botched abortion was at the centre of a high court case in Kenya has died. The girl, who was raped aged 14 and then left with horrific injuries after a backstreet termination, had been the subject of a controversy over the liability of the Kenyan government in her case. The girl’s mother and a group of campaigners had filed a case against the government, claiming it had failed to offer the girl – known as JMM – adequate post-abortion care. They called for the government to reinstate guidelines on safe abortions. JMM’s mother, as well as the Federation of Women Lawyers-Kenya and two human rights advocates, filed the case in the Kenyan high court in 2015. Campaigners say that if successful it could save the lives of thousands of women a year. The hearings are expected to conclude in July 2018. Access to abortion was widened under Kenya’s 2010 Constitution, which allowed for the procedure in cases where the health or life of a pregnant woman is at risk, and in cases of emergency. But the government has since withdrawn standards and guidelines designed to make legal abortions safer and banned health workers from undergoing training on abortion. In 2012, nearly 120,000 women were admitted to public health facilities for abortion-related complications. The author reports that women seeking post-abortion services face stigma and discrimination in health facilities, particularly poor or young women. The court decision is expected before the end of the year.
This document presents ten reasons why exposing or transmitting HIV to someone else should not be criminalised. It argues that criminalising HIV transmission is justified only when individuals purposely or maliciously transmit HIV with the intent to harm others. In these rare cases, existing criminal laws can and should be used, rather than passing HIV-specific laws. Furthermore, applying criminal law to HIV exposure or transmission does not reduce the spread of HIV, undermines HIV prevention efforts and promotes fear and stigma. Instead of providing justice to women, applying criminal law to HIV exposure or transmission endangers and further oppresses them. It points out that laws criminalising HIV exposure and transmission are drafted and applied too broadly, and often punish behavior that is not blameworthy. They are often applied unfairly, selectively and ineffectively, and ignore the real challenges of HIV prevention. Rather than introducing laws criminalising HIV exposure and transmission, legislators must reform laws that stand in the way of HIV prevention and treatment, and instead take a human-rights position in response to the problem.
This paper explored the relationship between abortion law, policy and women’s access to safe abortion services within the different legal and political contexts of Ethiopia, Tanzania and Zambia. Semi-structured interviews were carried out with study participants differently situated vis-à-vis abortion, exploring their views on abortion-related legal- and policy frames and their perceived implications for access. The abortion laws have been classified as ‘liberal’ in Zambia, ‘semi-liberal’ in Ethiopia and ‘restrictive’ in Tanzania, but what the authors encountered in the three study contexts was a paradoxical relationship between national abortion laws, abortion policy and women’s actual access to safe abortion services, and that the texts that make up the three national abortion laws are highly ambiguous. While Zambian and Ethiopian laws are more liberal on paper, they in no way ensure access, while the strict Tanzanian law does not prevent young women from seeking and obtaining abortion. The authors observe that the findings demonstrate that the connection between law, health policy and access to health services is complex and dependent on contexts for implementation. They suggest that broad contextualized studies rather than classifications of law along a liberal-restrictive continuum provide better evidence of real access to safe abortion services.
Written during the final illness of Hugo Chavez, who died of cancer on 5 March 2013, this article considers the achievements of this visionary leader of Venezuela. Chavez used Venezuela’s abundant oil revenues to build needed infrastructure and invest in the social services: during the last ten years, the government increased social spending by 60.6%, a total of $772 billion. During Chavez’s term of office impressive health gains were made, such as a drop in infant mortality from 25 per 1000 (1990) to only 13/1000 (2010), while 96% of the population now has access to clean water, one of the goals of the revolution. In 1998, there were 18 doctors per 10,000 inhabitants, currently there are 58, and the public health system has about 95,000 physicians. It took four decades for previous governments to build 5,081 clinics, but in just 13 years the Bolivarian government built 13,721 (a 169.6% increase). Barrio Adentro (a primary health care partnership with 8,300 Cuban doctors) has saved approximately 1,4 million lives in 7,000 clinics and has given 500 million consultations. In 2011 alone, 67,000 Venezuelans received free high cost medicines for 139 pathologies conditions including cancer, hepatitis, osteoporosis, schizophrenia, and others. Venezuela now has the largest intensive care unit in the region. A network of public drugstores sell subsidised medicines in 127 stores with savings of 34-40%. Over the past few years, 51,000 people have been treated in Cuba for specialized eye treatment and the eye care programme ‘Mision Milagro’ has restored sight to 1.5 million Venezuelans.
The Africa Mining Vision (AMV) signed in 2009 by African Ministers responsible for mineral resources development throughout the continent, and its accompanying policy framework, Minerals and Africa’s Development, provide a comprehensive strategy for mineral and other natural resource extraction to be used in manufacturing within the continent, rather than exported from Africa for the industrial development of other continents. The authors note that while comprehensive and bold, it does not incorporate the effects of such a development strategy on African women, even though extraction primarily affects rural populations and particularly women. They note the mounting drought in the continent and other consequences of climate change attributing it in part to excessive, worldwide extraction and combustion of minerals and fossil fuels. Showcasing seven community based studies in sub-Saharan Africa, this paper aims to fill this gap. The authors argue from the evidence in the case studies that mineral and oil-based development undervalues community wealth, food production systems and female labour. They make two policy recommendations: Firstly in order to enable meaningful public participation in the policy framework and vision provided in the AMV they call on the African Union to make public the number of displacements estimated for the African continent over the next half-century. They estimate that as many as 90 million displaced across the continent. Secondly, they call on African states to carry out national studies of the socioeconomic, environmental and thus human impacts of existing and abandoned mineral and oil-based development projects post-independence period, with active participation of women’s organisations, mining affected communities, policy think tanks, and academics in the fields of social and human development.
Ministers of Health and Heads of Delegation of the WHO African Region, having convened at a Regional Consultation on the Prevention and Control of Noncommunicable Diseases (NCDs) in Brazzaville, Congo, from 4-6 April 2011 in preparation for the 28-29 April 2011 Moscow Ministerial Meeting on Healthy Lifestyles and NCDs; and the United Nations High-Level Summit on NCDs, to be held in New York, USA, in September 2011; made this statement on Noncommunicable Diseases prevention and control in Africa.
Recently, there has been a growing push for countries to achieve universal health coverage (UHC) in order to strengthen health systems and improve health equity and access to health services. Importantly, not all potential paths to a universal health system are consistent with human rights requirements. Simply expanding health coverage, especially if it continues to exclude poor and vulnerable communities, is not sufficient from a human rights perspective. The author in this paper presents the requirements that a human rights approach to UHC imposes. These include locating UHC within the context of a national effort to provide equitable access to the social determinants of health; making access to essential health services and public health protections a legal entitlement, with redress for failures to provide these benefits; paying explicit attention to equity in the design of the universal health system, including in health financing. There should be opportunities for consultation with and the participation of the population in the design of the path to UHC and the determination of benefits packages. The process for pursuing the progressive realisation of UHC should first expand coverage for high-priority services to everyone, with special efforts to ensure that disadvantaged groups are reached. The author notes that the goal of achieving UHC can generally be realised only in stages, through a long process of gradual realisation, given limitations in resource availability and administrative capacity, and that this imposes difficult trade-offs along the way.
Human rights and the domains of health system responsiveness share a common goal: furthering the rights of individuals and communities in the context of the health system. If a health system is responsive, it is possible that the interactions which people have within the health system will improve their well-being, irrespective of improvements to their health. This brief report from the World Health Organisation’s Evidence and Information for Policy cluster discusses the human rights context to the provision of health services to the public.
The author of this article examines the availability and strength of evidence on climate change, economics and health outcomes for policy makers to draw on in making health policy decisions. Eighteen available economic studies were included in the study. The author found that in those studies that put a value on the predicted increased mortality from climate change, the health damages represented an important fraction of overall economic losses. Equally health impacts were important in considering broader measures affecting the economics of climate change beyond the health sector such as agriculture and water supply. Global adaptation cost studies carried out so far indicate costs to the health sector of roughly US$2-5 billion annually (mid-estimates). However, these costs are argued to be an underestimate of the true costs, due to omitted health impacts, omitted economic impacts, and the costs of health actions in other sectors. No published studies compare the costs and benefits of specific health interventions to protect health from the negative effects of climate change. The authors suggest that until further climate change-specific economic studies have been conducted, decision makers should selectively draw on published studies of the costs and benefits of environmental health interventions.