Confidential documents related to the World Health Organization (WHO) Expert Working Group on Innovative Financing for Research and Development have been leaked to the public, apparently revealing improper participation by the pharmaceutical industry in preparing WHO policy. The documents appear to have come from the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), and include draft reports on innovative financing mechanisms from the working group as well as an analysis by the IFPMA on the reports’ contents. 'IFPMA was not supposed to have working drafts of the expert working group in their possession and they were not given these documents,' said Precious Matsoso, director of Public Health Innovation and Intellectual Property (PHI) at WHO, under whose auspices the expert working group falls. 'It was understood by the working group that its report is intended for the director general and WHO members [only],' she added. Public health advocates reacted strongly to the leaked documents, raising issues of public accountability and transparency in policymaking.
Values, Policies and Rights
The authors argue that leaving no one behind is the moral issue of our age, and is at the heart the Sustainable Development Goals (SDGs). One specific goal is ‘ending poverty, in all its forms, everywhere’, but the SDGs also aim to tackle marginalisation. The SDG outcome document specifies that the goals should be met for all segments of society, with an endeavour to reach those furthest behind first. Now the focus is on implementation, particularly at the national level. This report makes the case for early action, and quantifies its benefits. The report outlines the actions that governments can take in the first 1,000 days of the SDGs to respond to what poor people want and to deliver for the most marginalised people and groups. The evidence shows that achieving the SDGs and the ambition to leave no one behind will become far more difficult the longer governments delay. The report concludes that early action is critical for the achievement of the SDGs.
To gain a picture of the extent of the health reforms over the first 10 years of the Kenyan constitution, the authors developed an adapted health-system framework, guided by World Health Organization concepts and definitions. The analysis revealed multiple structures (laws and implementing public bodies) formed across the health system, with many new stewardship structures aligned to devolution, but with fragmentation within the regulation sub-function. By deconstructing normative health-system functions, the framework enabled an all-inclusive mapping of various health-system attributes (functions, laws and implementing bodies). The authors believe their framework is a useful tool for countries who wish to develop and implement a conducive legal foundation for universal health coverage. Constitutional reform is argued to be a mobilizing force for large leaps in health institutional change, boosting stakeholder acceptance and authority to proceed.
On 11th March 2014, the legality of the Anti Homosexuality Act was challenged in Constitutional Court by an unprecedented coalition of petitioners and an Injunction against enforcement sought. The petition was filed under the auspices of the Civil Society Coalition on Human Rights and Constitutional Law, a coalition of 50 indigenous civil society organisations that advocates for non-discrimination in Uganda. The petition argues that the Anti Homosexuality Act violates Ugandans’ Constitutionally guaranteed right to: privacy, to be free from discrimination, dignity, to be free from cruel, inhuman and degrading treatment, to the freedoms of expression, thought, assembly and association; to the presumption of innocence, and to the right to civic participation.
This study mapped and reviewed traditional health practitioners (THPs) -related legislation among SADC countries. Four of 14 Southern African countries have legislation relating to THPs. South Africa, Namibia and Zimbabwe have acknowledged the roles and importance of THPs in healthcare delivery by creating a council to register and formalise practices, although they have not operationalised nor registered and defined THPs. In contrast, Tanzania has established a definition couched in terms that acknowledge the context-specific and situational knowledge of THPs, while also outlining methods and the importance of local recognition. Tanzanian legislation; thus, provides a definition of THP that specifically operationalises THPs, whereas legislation in South Africa, Namibia and Zimbabwe allocates the power to a council to decide or recognise who a THP is. This council can prescribe procedures to be followed for the registration of a THP. While South Africa, Tanzania, Namibia and Zimbabwe have legislation that provides guidance as to THP recognition, registration and practices, THPs continue to be loosely defined in most of these countries. Not having an exact definition for THPs are argued to hamper the promotion and inclusion of THPs in national health systems, but it may also be something that is unavoidable given the tensions between lived practices and rigid legalistic frameworks.
In this letter to Kenya's minister for public health, Human Rights Watch (HRW) has called on the Kenyan government to ensure that human rights are protected during the country's national door-to-door voluntary HIV testing and counselling drive. 'We... urge the inclusion of a strong human rights component into this ambitious testing programme. In particular, we are calling for clear attention to principles of counselling, consent and confidentiality,' it said. HRW noted that large-scale home-based testing would likely result in better access to testing and treatment and give a chance to those who could not afford the transport costs to health facilities or lacked information or the willingness to seek a test. But testing also reached into the family, where many abuses occurred, posing challenges for human rights protection, it added. 'Our research on access to testing and treatment in Kenya has shown that HIV-positive mothers and HIV-positive children frequently suffer stigma and abuse when their status becomes known,' the letter said. 'HIV-positive mothers – among them girls under the age of 18 – sometimes suffer violence, mistreatment, disinheritance and discrimination from their husbands, families-in-law or their own families.'
Despite criticism, the MDGs are widely praised for having galvanised national and international development efforts in unprecedented ways. Currently proposed successor Sustainable Development Goals (SDGs) seek to address newly emerged policy issues and include a call to significantly reduce the burden of non-communicable diseases (NCDs). NCDs directly impact health inequality and poverty. Their recognition is timely and to be welcomed categorically. However, ambiguity in the SDGs’ current guidance risks that states’ efforts to reduce NCDs exacerbate socioeconomic and health inequalities, rather than reduce them. The authors urge that more attention needs to be given to improving the situation of the worst off and make three concrete proposals towards this end. Existing policy guidance highlights cost-effective interventions for NCDs, but focusing just on cost-effectiveness risks exacerbating socioeconomic and health inequalities rather than reducing them. The authors suggest that in implementing the SDGs, targets and interventions that benefit the worst off should be prioritised. The United Nations should develop practical guidance to assist policy makers at the country level with incorporating equity considerations.
Beginning with HIV and AIDS cases, the last fifteen years have seen a tremendous growth in the number of health rights cases. Yet questions still persist as to when and how litigation can lead to greater social justice in health and enhance the functioning of health systems, rather than distorting practices. In a number of countries, courts are in effect setting health policy and shaping funding priorities. Yet, little systematic attention has been paid to the equity implications of this litigation. Based on a comprehensive study of litigation in Argentina, Brazil, Costa Rica, Colombia, India and South Africa, this presentation traces the beginnings of health rights litigation; reviews factors leading to judicial activism in health around the world; stresses the importance of differentiating contexts and kinds of interventions; and will discuss different methodologies for measuring impacts of litigation. Health rights litigation is extremely varied around the world. Factors that must be considered in assessing equity implications relate to the legal opportunity structure as well as other dimensions of the legal system, the organization of the health system, and the way in which the executive branch responds to judicial decisions.
Health rights litigation is still an emerging phenomenon in Africa, despite the constitutions of many African countries having provisions to advance the right to health. Litigation can provide a powerful tool not only to hold governments accountable for failure to realise the right to health, but also to empower the people to seek redress for the violation of this essential right. With contributions from activists and scholars across Africa, the collection includes a diverse range of case studies throughout the region, demonstrating that even in jurisdictions where the right to health has not been explicitly guaranteed, attempts have been made to litigate on this right. The collection focuses on understanding the legal framework for the recognition of the right to health, the challenges people encounter in litigating health rights issues and prospects of litigating future health rights cases in Africa. The book also takes a comparative approach to litigating the right to health before regional human rights bodies. This book will be valuable reading to scholars, researchers, policymakers, activists and students interested in the right to health.
This paper explores litigation as a mechanism for the realization of the economic, social and cultural. Though it is often the last resort after all advocacy methods have been rendered futile, it is argued to draw government to the drawing board remembering the obligations in the international human rights instrument that it bonds itself for proper economic and social development. By its self, litigation may not yield the desired result but if backed up by strong advocacy the results are far more reaching.