[afro-nets] Right to Health Campaign in South Africa

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

Right to Health Campaign in South Africa
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A global campaign for the right to health
by L Reynolds, L London, D Sanders
People's Health Movement, South Africa

The People's Health Movement, a global network of civil society
groups, researchers, activists and teachers involved in health,
proposes the launch of a global campaign on the Right to Health.

PHM would like to invite civil society organizations, interested
individuals and groups to participate in discussing the possi-
bility of hosting such a campaign in South Africa. It would also
contribute to building civil society for the Third People's
Health Assembly, planned for 2010 at an African venue (to be de-
termined). This edition of Critical Health Perspectives sketches
the background to the campaign and some of the thinking behind
it.

Background

Although the Alma Ata Declaration declared health as a human
right almost four decades ago, the intervening years have seen
health status and access to health care decline in many develop-
ing countries despite great advances in medical technologies
worldwide.

Recent developments in international human rights law have
opened up new opportunities to give effect to the provisions of
the International Covenant on Social, Economic and Cultural
Rights with regard to the right to health.[1] In line with our
national commitment to human rights, post-apartheid South Africa
ratified the ICESCR in 1994. When a country ratifies a UN cove-
nant, it becomes legally binding in that country. Rights to
health care are also enshrined in our Constitution.

Article 12.1 of the ICESCR specifies 'the right of everyone to
the enjoyment of the highest attainable standard of physical and
mental health'. To achieve this, the government must at least
take the steps 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 indus-
trial hygiene;

c. The prevention, treatment and control of epidemic, endemic,
occupational and other diseases;

d. The creation of conditions which would assure access to all
medical service and medical attention in the event of sickness.

In August 2000, General Comment 14 further clarified these core
obligations of the state in regard to health.[2] It interprets
the right to health "as an inclusive right extending not only to
timely and appropriate health care but also to the underlying
determinants of health, such as access to safe and potable water
and adequate sanitation, an adequate supply of safe food, nutri-
tion and housing, healthy occupational and environmental condi-
tions, and access to health-related education and information,
including on sexual and reproductive health".

It highlights the following interrelated and essential elements
of health care:

a. Availability. Functioning public health and health-care fa-
cilities, goods and services, as well as programmes, have to be
available, including hospitals, clinics and other health-related
buildings, trained personnel receiving domestically competitive
salaries, and essential drugs (defined by WHO Action Programme
on Essential Drugs).

b. Accessibility. Health facilities, goods, services and infor-
mation about health have to be accessible and affordable to all,
without discrimination, especially the most vulnerable or mar-
ginalized sections in the population, such as ethnic minorities
and indigenous populations, women, children, adolescents, older
persons, persons with disabilities and persons with HIV/AIDS.

c. Acceptability. All health facilities, goods and services must
respect the culture of individuals, minorities, peoples and com-
munities, and be sensitive to gender and life-cycle require-
ments. They must observe medical ethics including confidential-
ity.

d. Quality. As well as being culturally acceptable, health fa-
cilities, goods and services must also be scientifically and
medically appropriate and of good quality.

A key aspect of the right to health is the participation of the
population in health-related decision-making at the community,
national and international levels.

Why campaign for the Right to Health?

As part of our constitutional commitment to realizing rights,
the promotion of the right to health is a key obligation for the
state and civil society. Health is one of a range of socio-
economic rights, all interdependent and indivisible, essential
for human well-being and development. For example, any attempts
to meet the objectives of the Millennium Development Goals will
have to do so by advancing the right to health, without which
its ambitious targets cannot be met.

Unfortunately, we continue to see incidents where people's
rights to health are violated. A campaign that focuses on the
right to health will help to identify system failures, secure
redress for those unfairly treated, and prevent future abuses
from taking place.

Who would host the campaign?

Although the campaign has been initiated by the People's Health
Movement, we believe that it should be owned by a coalition of
civil society and other groups who believe in its objectives and
philosophy. We are therefore starting a process of consultation
involving as wide a range of organizations as possible. Like the
Poverty Hearings, hosted jointly by the SA Human Rights Commis-
sion and SANGOCO in 1998, we believe partnerships between civil
society groups and state bodies responsible for human rights can
play an important role in advancing the realization of socio-
economic rights in South Africa.

What form would the campaign take?

We envisage that the campaign would take a similar approach to
the Poverty Hearings held some years ago. We would work to so-
licit testimony from ordinary South Africans who have experi-
enced violations of their right to health both within the health
care system and outside. We would also solicit accounts of posi-
tive steps taken to advance the right to health across a range
of settings. The campaign would require careful planning, be
timed to raise awareness prior to the hearings stage, and have
sufficient broad-based participation to make it a powerful voice
to policy makers.

The objectives of the campaign

1. The campaign would aim to raise awareness in South Africa of
what the right to health entails and advance people's under-
standing of how this right can be made a reality, not just in
health care, but also in the provision of services that generate
the conditions necessary for good health.

2. We also anticipate that the campaign might spur the strength-
ening of civil society organizations in health. Currently, civil
society in the health sector is much weaker than in the 1980's
when organizations campaigning for the right to health were a
central component of the mass democratic movement. The campaign
will help to re-establish vibrant civil society groups in the
health sector.

3. The campaign would enable South African organizations to link
up with international networks of like-minded health groups as
part of the campaign, thereby building international solidarity
and capacity to advance the right to health.

--
Claudio Schuftan
mailto:claudio@hcmc.netnam.vn