[afro-nets] Food for a thought to be enshrined in law (2)

[Claudio Schuftan <claudio@hcmc.netnam.vn>]

Food for a thought to be enshrined in law (2)
---------------------------------------------

Human Rights Reader 99

A Primer for a National Action Plan to Operationalise the Right
to Health Care (within the broader framework of the Right to
Health) Part 2 of 3

Specific actions under the Action Plan

A. Government and Ministry of Health actions (as prime duty-
bearers):

A1. Enactment of a National-Public-Health-Services-Act that rec-
ognizes and delineates the Health Rights of citizens (claim
holders), the duties of the Public health system, the public
health obligations of private health care providers (duty bear-
ers) and the specifying broad legal and organisational mecha-
nisms to operationalise these rights. [The Act is to make the
actions under this Action Plan mandatory, and is to make more
accountable/ justiciable the denial of health care. It will also
include special sections recognising and legally protecting the
health rights of various sectors of the population with special
health needs, i.e.,  women, children, persons affected by HIV-
AIDS, persons with mental health problems, disabled persons,
persons in conflict situations, persons facing displacement,
workers in various hazardous occupations including unorganised
and migrant workers].

A2. Definition of packages-of-essential-health-services at dif-
ferent levels (village/dispensary/community health center/ dis-
trict and provincial hospital) to be made public to all citizens
as their right.

A3. Substantial increase-in-central-budgetary-provisions-for-
public-health [to be increased to 2-3% of the GDP in the next
three to four years].

A4. Setting up a Central-Council-on-the-Right-to-Health to de-
velop a consensus among various state agencies and civil society
towards operationalising the Right to Health Care across the
country.

A5. Enacting a National-Clinical-Establishments-Regulation-Act
that ensures citizen's health rights concerning the private
health sector and includes the right to emergency services, as
well as ensuring minimum quality of care standards, adherence to
standard treatment protocols and ceilings on diagnostic tests
and essential health services prices.

A6. Issuing of a Health-Services-and-Drugs-Price-Control-Order,
as well as the  formulation of a Charter-of-Patients-Rights.

A7. Setting up a Health-Services-Regulatory-Authority that will
broadly define and sanction what constitutes rational and ethi-
cal practice, as well as set and monitor quality standards and
prices of services. [This is not to be a representative body of
doctors alone, but is to include representatives of health care
providers, public health experts, legal experts, representatives
of consumers, health and human rights groups and elected public
representatives].

A8. Issuing of National-Operational-Guidelines-on-Essential-
Drugs that specify: a) the right of all citizens to access good
quality essential drugs at all levels in the public and private
health system; b) the promotion of generic drugs over brand name
drugs; c) the inclusion of all essential drugs under the Drug
Price Control Order; and, d) the elimination of irrational for-
mulations and combinations. [The Government is also to take
steps to publish and consolidate a National Drug Formulary based
on the morbidity pattern of the people in the country].

A9. Taking measures to integrate-national-health-programmes-
with-the-Primary-Health-Care-system in a way that decentralizes
planning, decision-making and implementation. [Focus to be
shifted from bio-medical and individual-based measures to so-
cial-, ecological- and community-based measures that will, among
other, include the compulsory health impact assessment of all
development projects, as well as a decentralized and effective
compulsory surveillance system of  notification of prevalent
diseases by all health care providers, including private practi-
tioners].

A10. Reversal of all coercive-population-control-measures that
violate basic human rights, are not effective in stabilising
population, and draw away significant resources and energies of
the health system from public health priorities. [Steps to be
taken to eliminate and prevent all forms of coercive population
control measures which target the most vulnerable and marginal-
ized sectors of society].

A11. Setting up by the Ministry of Health of a-functioning-
national-mechanism-of-health-services-monitoring that periodi-
cally reviews the implementation of health rights and the re-
spective underlying structural and policy issues responsible for
health rights violations. [Health sector civil society organiza-
tions to be involved].
(contd.)

--
Claudio Schuftan
Ho Chi Minh City, Vietnam
mailto:claudio@jgmc.netnam.vn

Adapted from National Public Hearing on the Right to Health Care
organised by the National Human Right Commission & JSA (PHM In-
dia) in New Delhi, 16-17 December 2004. (courtesy of Abhay
Shukla at CEHAT, Mumbai).