Transcript Pan American Health Organization

Pan American
Health
Organization
• Overview of PAHO’s work on Health and Human Rights
• PAHO’s policies on Health and Human Rights
• Human Rights and access to medicines
• Conference PAHO/WCL : March 2012
Pan American
Health
Organization
“The use of international human rights principles, treaties and
standards is seen in PAHO and WHO not as an optional tool
to promote and protect public health, but as an essential
strategy to improve the health of the people around the
world”
Dr. Mirta Roses
Georgetown Law Center, October 2006
Director Pan American Health Organization/Regional Office of the World Health
Organziation (PAHO/WHO)
Pan American
Health
Organization
Links between Health and Human
Rights Law
• Violations of human rights can affect negatively the physical
and mental health of individuals;
• Health policies, laws, programs and plans can affect
positively or negatively the exercise of the basic human
rights and freedoms of the most vulnerable groups; and
• Enjoyment of health and the exercise of human rights are
both essential requirements to reach well-being and a
healthy
life
Pan American
Health
Organization
Exercise of Basic Human Rights and
the Most vulnerable in the Context of
Public Health
•
•
•
•
•
•
Persons with disabilities;
Persons living with HIV/AIDS;
Persons with mental disorders;
Older persons;
Indigenous peoples;
Health and related human rights and freedoms of women
and children/adolescents in the context of sexual and
reproductive health;
• Access to essential medicines.
Pan American
Health
Organization
SO7
Indigenous Peoples
(Res. CD47/13)
SO3
Oral Health
(Res CD49/13)
SO6
Tobacco Control
(Res. CD50.R6)
SO3
Disabilities
(Res. CD47/15)
SO 7
Indicator 7.4.1
Ethics and Human Rights
Based approaches to health
at a national regional
and global levels
SO3
Mental Health
(Res. CD49.11/11)
Pan American
Health
Organization
SO4 & SO7
Maternal Mortality
and Gender Response
(Res. CD49/13)
SO4
Older Persons
(Res.CD49/8)
SO2
HIV/AIDS
(Res. CD45.R10)
SO4
Adolescents
(Res.CD49.12)
CONSTITUTION OF WHO
“The enjoyment of the highest attainable
standard of health is one of the fundamental
rights of every human being without
distinction of race, religion, political belief,
economic or social condition…”Constitution
of WHO (1946)
Pan American
Health
Organization
PAHO Resolution CD 50 R.8
“Health and Human Rights”
Recently adopted (October 2010) by PAHO’s
Member States
URGES
“health authorities to use human rights treaties and
standards to REFORM their national health policies,
plans, programs and laws in a manner consistent
with universal and regional human rights
instruments (treaties, standards and technical
guidelines)”
Pan American
Health
Organization
PAHO’S RESOLUTION
• Strengthen health authorities to work with human rights
entities;
• Strengthen health authorities to provide support for the
formulation of health policies and plans consistent with h.r.
instruments;
• Support PAHO in the formulation/reform of national
plans/legislation incorporating h .r. instruments;
• Strengthen training programs for health workers;
• Adopt measures to disseminate h.r. instruments in the
legislative
and judicial branches;
Pan American
Health
Organization
• Disseminate applicable human rights instruments among
civil society organizations;
• Facilitate PAHO technical cooperation with UN/OAS treaty
bodies;
• To train PAHO staff and incorporate gradually h.r.
Instruments in the work of technical areas;
• Stimulate collaboration and research with academic actors,
private sector and other social actors; and
• Share good practices and experiences among PAHO
Member States
Pan American
Health
Organization
PAHO Strategic Plan 2008-2012
PAHO Strategic Plan 2008-2012 states that :
“Human rights law, as enshrined in international and regional human
rights conventions and standards, offers a unifying conceptual and legal
framework for these strategies as well as measures by which to evaluate
success and clarify the accountability and responsibilities of the different
stakeholders involved”.
Human Rights is included in PAHO’S Strategic Plan in Regional Expected
Result 7.4:
“Ethics and human-rights based approaches to health promoted within
PAHO/WHO at a national, regional and global levels”
Pan American
Health
Organization
Capacity Building/Training
Resolution CD50R8 “Health and Human Rights”
urge Member States to strengthening technical capacity
Formulation/Review National Health Plans
And Legislation
Resolution CD50R8
“Health and Human Rights" urge Member States
to support PAHO's Technical cooperation
Tools and Research Guidelines
Pan American
Health
Organization
Technical
Collaboration with
Human Rights Treaties Bodies,
Special Rapporteur, Academics
Institutions, Collaborating Center
And Private Sector
International and Regional
Human Rights Instruments
to advance
Access to Medicines
Pan American
Health
Organization
“The enjoyment of the highest attainable standard of health…”
Constitution of WHO
“ …one of the fundamental rights of every human being without
distinction of race, religion, political belief, economic or social
condition…”
International Covenant on Economic and Social Rights protects:
“the right of everyone to the enjoyment of the highest attainable
standard of physical and mental health” (Article 12)
Protocol of San Salvador of the OAS protects:
the “right to health” (Article 10)
Pan American
Health
Organization
General Comment 14
Committee on Economic, Social and Cultural Rights:
“the right to the highest attainable standard of
health…”
The Committee on Economic, Social and Cultural Rights (CESCR)
published General Comment No. 14 to address substantive issues arising
in the implementation of Article 12 of the ICESCR.
The CESCR explained that the right to health is neither the right to be
healthy nor the right to health care. Instead, “the right to health
embraces a wide range of socio-economic factors that promote
conditions in which people can lead a healthy life. “
Elements of the right to health: The right to health is composed of the
following essential elements: (a) availability; (b) accessibility; (c)
acceptability; and (d) quality. These elements are interrelated and legally
enforceable.
Pan American
Health
Organization
(d) good quality: (limited accesibility, with administrative,
geographical, economical, cultural and social barriers, long
waiting lists, no adequate offer of services).
Pan American
Health
Organization
INTERNATIONAL COVENANT ON ECONOMIC,
SOCIAL AND CULTURAL RIGHTS
Article 12
1. The States Parties to the present Covenant recognize the
right of everyone to the enjoyment of the highest attainable
standard of physical and mental health.
2. The steps to be taken by the States Parties to the present
Covenant to achieve the full realization of this right shall
include those necessary for: a) The provision for the reduction
of the stillbirth-rate and of infant mortality and for the healthy
development of the child; b) The improvement of all aspects of
environmental and industrial hygiene; c) The prevention,
treatment and control of epidemic, endemic, occupational and
other diseases; and d) The creation of conditions which would
assure
to all medical service and attention
Pan American
Health
Organization
Article 15
1. The States Parties to the present Covenant recognize the
right of everyone:
…..
(b) To enjoy the benefits of scientific progress and its
applications;
Pan American
Health
Organization
Protocol of San Salvador
Article 10
Article 10
Right to Health
1. Everyone shall have the right to health, understood to mean the enjoyment of the highest
level of physical, mental and social well-being.
2. In order to ensure the exercise of the right to health, the States Parties agree to recognize
health as a public good and, particularly, to adopt the following measures to ensure that right:
a. Primary health care, that is, essential health care made available to all individuals and
families in the community;
b. Extension of the benefits of health services to all individuals subject to the State's
jurisdiction;
c. Universal immunization against the principal infectious diseases;
d. Prevention and treatment of endemic, occupational and other diseases;
e. Education of the population on the prevention and treatment of health problems, and
f. Satisfaction of the health needs of the highest risk groups and of those whose poverty makes
them the most vulnerable.
Pan American
Health
Organization
LEGAL OBLIGATIONS OF STATES
• Respect: States must respect human rights and can not
directly or indirectly violate the human rights and
fundamental freedoms of persons living with HIV/AIDS;
• Protect: States must take measures to prohibit third parties
form violating human rights and fundamental freedoms of
persons living with HIV/AIDS; and
• Fulfill: States must take Positive Legislative, Budgetary,
Administrative
and Judicial measures to fulfill human rights
Pan American
Health
Organization
LIMITATION OF RIGHTS IN THE CONTEXT
OF ACCESS TO MEDICINES
• Right to life;
• Right to personal integrity (moral, physical and psiquical)
• The rights of the child; and
• The rights of the family
Pan American
Health
Organization
The Siracusa Principles in the context of access
to medicines
• Restriction in accordance with the law;
• Compatible with the ratified international instruments;
• Legitimate aim;
• Strictly necessary for promoting well-being;
• Proportional to the aim
Pan American
Health
Organization
Mechanisms of Protection
• Country reports (UN treaty bodies);
• Individual cases (IACHR, under the American Declaration
and the Inter-American Convention on violence against
women and Domestic Tribunals/Ombudspersons);
• On site observations (IACHR and UN Special Rapporteur on
the Right to Health);
• Precautionary measures (IACHR, under the American
Declaration);
• Hearings (NGO’s and speciliazed agencies); and
• Formulation
of specific standards (mental health)
Pan American
Health
Organization
International Jurisprudence
Access to medicines
Jorge Odir Miranda v. El Salvador (2001)
By failing to provide free of charge antiretroviral drugs essential for the treatment of
HIV/AIDS, the State of El Salvador has violated the provisions contained in the
American Convention on Human Rights, together with the provisions of article XI of
the
American Declaration of the Rights and Duties of Man. and Article 10 of the
Additional
"Protocol of San Salvador". In consequence, it has violated the right to health of
Jorge Odir
Miranda Cortez and the [other persons] referred to in the instant case.
In the opinion of the IACHR, the response of the Salvadoran State in this case is
consistent with progressive development of the right to health. Therefore, while the
Commission has determined violation of article 25 of the American Convention
based on the conduct of the judicial authorities, the measures of the administrative
Pan American
Health have accorded with the international obligations provided at 26 of the
authorities
Organization
aforesaid international instrument.
• Amicable setlement: the State agreed to:
•
•
•
•
Authorize the purchase of antirretrovirals;
Measures to prevent HIV transmision
Establish a fund to purchase anti-retroviral treatment
Nowadays around 1,700 receive medication for HIV
treatment through the State.
Pan American
Health
Organization
Life and Health Conditions- Indigenous
Peoples
•
•
•
•
•
•
•
•
•
Poverty and systemic poverty
Low salaries
Unemployment
Migration
School desertion
Illiteracy indexes - female
Lack of land and territory
Epidemiological profile:
Preventive diseases
Pan American
Health
Organization
Two important cases in which the Court used an
“expansive definition” of Article 4 right to life.
1.
Case Yakye Axa v. Paraguay (17 June,2005)
2. Case Sawhoyamaxa v. Paraguay (29 March, 2006)
“adequate medicines...vaccines, latrines, or other type of
sanitary services adequate for communal settlement”.
Pan American
Health
Organization
• Evolutionary interpretation of the “right to life” which
emphasized a positive obligation to protect the conditions
necessary for life.
• States must adopt any measures that may be necessary to create
an adequate statutory framework to discourage any threat to the
right to life to establish an effective system of administration of
justice able to investigate, punish and repair any deprivation of
lives by state agents, or by individuals; and to protect the right
of not being prevented from access to conditions that may
guarantee a [dignified life], which entails the adoption of
positive measures to prevent the breach of such right”.
Pan American
Health
Organization
• Colombia – Tutela No. 505/92 –Constitutional Court
“Right to due process and the right to health are protected by
the Constitution.”
“ protecction againts HIV/AIDS immediate application”
Ximenes Lopes/Brasil and Alban cornejo v. Ecuador
Pan American
Health
Organization
INAUGURAL CONFERENCE
The principal aim of the inaugural conference is to underscore
the relevance of the collaborative effort to improve equity in
health and to identify new leaders for years to come.
Based on the PAHO Resolution on Health and Human Rights
(CD 50 R.8) approved by the PAHO Directing Council on
October
Pan American
Health
Organization
•The white papers will all have a basic structure:
•Overview: situation analysis by region
•Comparative framework
•Trends
•Public health actions needed consistent with international
human rights treaties and standards.
•The papers will be ready by the Feb. 15. On-line discussions
will start by Feb 16.
Pan American
Health
Organization
Example of Targets for Public Health Actions based on Trends in Mental
Health
1.
2.
3.
Awareness-raising,
Training and
Dissemination of
International Human
Rights Norms and
Standards.
Status of National Health
Law, Policies, and Plans
Exercise of Civil,
Political, Economic,
Social and Cultural Rights
and Freedoms
Fundamental
4.
National Monitoring
Mechanism
5.
Policies and Procedures
for Admission
Pan American
Health
Organization
6.
Living Conditions in
Psychiatric Institutions and
Other Mental Health
Facilities
7.
Community-Based Mental
Health Services and Living
Arrangements
8.
Participation of
Consumers/Family
Members in Mental Health
Decision-making
9.
Participation of Civil
Society in Promotion and
Protection of Human
Rights
10. Role of he Media in
Promoting and Protecting
the Rights of Persons
The human right to the highest attainable
standard of health
THANK YOU!
Pan American
Health
Organization