Title: Pan American Health Organization
1 2- Overview of PAHOs work on Health and Human
Rights - PAHOs policies on Health and Human Rights
- Human Rights and access to medicines
- Conference PAHO/WCL March 2012
3- 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/Regiona
l Office of the World Health Organziation
(PAHO/WHO)
4Links 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
5Exercise 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.
6SO6 Tobacco Control (Res. CD50.R6)
SO7 Indigenous Peoples (Res. CD47/13)
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
SO4 SO7 Maternal Mortality and Gender
Response (Res. CD49/13)
SO3 Oral Health (Res CD49/13)
SO3 Mental Health (Res. CD49.11/11)
SO4 Older Persons (Res.CD49/8)
SO2 HIV/AIDS (Res. CD45.R10)
SO4 Adolescents (Res.CD49.12)
7CONSTITUTION 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 conditionConstitution of WHO (1946) -
8PAHO Resolution CD 50 R.8Health and Human
Rights
- Recently adopted (October 2010) by PAHOs 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)
9PAHOS 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
10- 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
11PAHO 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 PAHOS 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
12Capacity 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
Technical Collaboration with Human Rights
Treaties Bodies, Special Rapporteur, Academics
Institutions, Collaborating Center And Private
Sector
Tools and Research Guidelines
13 International and Regional Human Rights
Instruments to advance Access to Medicines
14The 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)
-
15General Comment 14Committee 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. - Â
16- (d) good quality (limited accesibility, with
administrative, geographical, economical,
cultural and social barriers, long waiting lists,
no adequate offer of services).
17INTERNATIONAL COVENANT ON ECONOMIC, SOCIAL AND
CULTURAL RIGHTSArticle 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
18- 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
19Protocol of San SalvadorArticle 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.
20LEGAL 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
21LIMITATION 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
22The 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
23Mechanisms 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 (NGOs and speciliazed agencies) and
- Formulation of specific standards (mental health)
24International JurisprudenceAccess 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. - Â 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 authorities have accorded with the
international obligations provided at 26 of the
aforesaid international instrument.
25- 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.
26Life 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
27- 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.
28- 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.
29- 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
30INAUGURAL 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
31- 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. Â - The papers will be ready by the Feb. 15. On-line
discussions will start by Feb 16.
32 Example of Targets for Public Health Actions
based on Trends in Mental Health
- Living Conditions in Psychiatric Institutions and
Other Mental Health Facilities - Community-Based Mental Health Services and Living
Arrangements - Participation of Consumers/Family Members in
Mental Health Decision-making - Participation of Civil Society in Promotion and
Protection of Human Rights - Role of he Media in Promoting and Protecting the
Rights of Persons
- 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 - National Monitoring Mechanism
- Policies and Procedures for Admission
33The human right to the highest attainable
standard of healthTHANK YOU!