Condensed: The right to health obliges States to take necessary steps for the prevention, treatment and control of epidemic, endemic, occupational and other diseases. In meeting this obligation, States must ensure that appropriate goods, services and information for the prevention, treatment and control of diseases are sufficiently available and both physically and economically accessible for all without discrimination. States must develop and implement awareness campaigns and prevent the spread of inaccurate information with regard to behaviour-related concerns such as sexually transmitted diseases and the tobacco, narcotics, alcohol and other harmful substances The right to treatment includes the creation of a system of urgent medical care in cases of accidents, epidemics and similar health hazards, and the provision of disaster relief and humanitarian assistance in emergency situations. Furthermore, States should carry out regular immunization exercises against major infectious diseases.
Comprehensive: According to article 12(2)(c) of ICESCR steps States are to take to achieve the full realization of the right to health include, ‘those necessary for the prevention, treatment and control of epidemic, endemic, occupational and other diseases.’ [1] States must ensure that appropriate goods, services and accurate information for the prevention, treatment and control of diseases are available and accessible for all without discrimination, especially for the vulnerable or marginalized groups.[2] According to the Committee on Economic, Social and Cultural Rights,[3] States must give priority ‘to provide education and access to information concerning the main health problems in the local communities including methods of prevention and controlling them.’[4] This obliges States to develop and implement effective prevention programmes, such as awareness campaigns for behaviour-related concerns, such as sexually transmitted diseases, including in particular HIV/AIDS;[5] the use and abuse of tobacco, alcohol and other substances;[6] as well as the determinants of good health, such as safe drinking water, adequate and nutritious feeding, child breastfeeding, hygiene and environmental safety, and the prevention of accidents.[7] States must remove all barriers hindering access to accurate information and effective measures for the prevention, control and treatment of diseases. Such barriers include the failure to regulate, prohibit or take effective measures against the promotion of misleading information on the production, advertisement, marketing and consumption of tobacco, narcotics, alcohol and other harmful substances,[8] or to protect consumers and workers from practices detrimental to health and the environment, by employers and manufacturers of medicines or food,[9]or failure to promote and enforce laws against water, air and soil pollution.[10] The failure to prohibit or act against stigmatization, criminalization or discrimination on health status or sexual orientation constitutes a barrier to prevention, control and treatment of diseases.[11]Stigmatization or criminalization of consensual same-sex conduct not only impedes the right to health through discrimination but also deny equality of access to prevention, treatment and care for affected persons.[12] In relation to children, the CRC Committee notes that prevention programmes in relation to HIV/AIDS are generally designed for adults with little regard for the best interests of the child.[13] The Committee recommends that effective prevention programmes should take account of the realities of the lives of adolescents while addressing sexuality by ensuring equal access to appropriate information, life skills, and to preventive measures.[14] Prevention and treatment programmes should also take account of the needs of vulnerable individuals. The right to treatment includes ‘the creation of a system of urgent medical care in cases of accidents, epidemics and similar health hazards, and the provision of disaster relief and humanitarian assistance in emergency situations’.[15] States must take measures to prevent and control the spread of contagious diseases by carrying out regular immunization exercises against the major infectious diseases throughout the country and ensuring that people have unhindered access to vaccines, drugs, essential medicines, and urgent medical care in cases of accidents, epidemics and similar health hazards.[16] In order to control diseases, States must endeavour to fund scientific and medical research and ensure that appropriate technologies for the prevention or control of diseases are universally available and accessible. Prevention, treatment and control programmes should take account of the needs of vulnerable individuals. In Minister of Health and Others v Treatment Action Campaign (TAC), a case that dealt with government’s policy for the prevention of mother-to-child transmission of HIV, the Constitutional Court of South Africa found the government’s policy to restrict access to Nevirapine to be unreasonable and therefore non-compliant with the constitutional right to health.[17] The implementation of the prevention programme was confined to pilot sites. The Court held that this policy was not reasonable as it failed to address the needs of women and children who did not have access to the pilot sites, most of whom were poor, thus differentiating between those who could afford to pay and those who could not afford to access the services.[18]
[1] See also Additional Protocol ACHR (Protocol of San Salvador) art 10(c),(d); art 11(3) ESC; CERD art 5(e)(iv). [2] CESCR General Commen 14 para 8. [3] CESCR General Comment 14 para para 11. [4] CESCR General Comment 14 para 44(d) [5] CRC General Comment 4 para 30; See also various concluding observations by treaty bodies that recommend that states take measures to ensure prevention of early pregnancies and the control of sexually transmitted diseases eg CEDAW Committee Concluding Observations: Netherlands (2007) para 38; CRC Committee, Concluding Observations: Lithuania (2001) para 39. [6] CESCR General Comment 14 para [7] CESCR General Comment 14 para 16 [8] CESR General Comment 14 para 51 [9] CESCR General Comment 14 para 34. [10] CESCR General Comment 14 para 51. [11] Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health Anand Grover, UN Doc.A/HRC/14/20 (2010) para 25 [12] Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health Paul Hunt, UN Doc. E/CN.4/2003/58 para 68 [13] CRC General Comment 3 para 10. [14] CRC Committee, General Comment 3 para 11. [15] CESCR General Comment 14 para 16. [16] CESCR General Comment 14 para 16. [17] 2002(5) SA 721; 2002 (10) BCLR 1033.6. [18] TAC case paras 67-73.
The right to health obliges States to take necessary steps for the prevention, treatment and control of epidemic, endemic, occupational and other diseases. In meeting this obligation, States must ensure that appropriate goods, services and information for the prevention, treatment and control of diseases are sufficiently available and both physically and economically accessible for all without discrimination. States must develop and implement awareness campaigns and prevent the spread of inaccurate information with regard to behaviour-related concerns such as sexually transmitted diseases and the tobacco, narcotics, alcohol and other harmful substances
The right to treatment includes the creation of a system of urgent medical care in cases of accidents, epidemics and similar health hazards, and the provision of disaster relief and humanitarian assistance in emergency situations. Furthermore, States should carry out regular immunization exercises against major infectious diseases.
Comprehensive:
According to article 12(2)(c) of ICESCR steps States are to take to achieve the full realization of the right to health include, ‘those necessary for the prevention, treatment and control of epidemic, endemic, occupational and other diseases.’ [1]
States must ensure that appropriate goods, services and accurate information for the prevention, treatment and control of diseases are available and accessible for all without discrimination, especially for the vulnerable or marginalized groups.[2] According to the Committee on Economic, Social and Cultural Rights,[3] States must give priority ‘to provide education and access to information concerning the main health problems in the local communities including methods of prevention and controlling them.’[4] This obliges States to develop and implement effective prevention programmes, such as awareness campaigns for behaviour-related concerns, such as sexually transmitted diseases, including in particular HIV/AIDS;[5] the use and abuse of tobacco, alcohol and other substances;[6] as well as the determinants of good health, such as safe drinking water, adequate and nutritious feeding, child breastfeeding, hygiene and environmental safety, and the prevention of accidents.[7]
States must remove all barriers hindering access to accurate information and effective measures for the prevention, control and treatment of diseases. Such barriers include the failure to regulate, prohibit or take effective measures against the promotion of misleading information on the production, advertisement, marketing and consumption of tobacco, narcotics, alcohol and other harmful substances,[8] or to protect consumers and workers from practices detrimental to health and the environment, by employers and manufacturers of medicines or food,[9]or failure to promote and enforce laws against water, air and soil pollution.[10] The failure to prohibit or act against stigmatization, criminalization or discrimination on health status or sexual orientation constitutes a barrier to prevention, control and treatment of diseases.[11]Stigmatization or criminalization of consensual same-sex conduct not only impedes the right to health through discrimination but also deny equality of access to prevention, treatment and care for affected persons.[12]
In relation to children, the CRC Committee notes that prevention programmes in relation to HIV/AIDS are generally designed for adults with little regard for the best interests of the child.[13] The Committee recommends that effective prevention programmes should take account of the realities of the lives of adolescents while addressing sexuality by ensuring equal access to appropriate information, life skills, and to preventive measures.[14] Prevention and treatment programmes should also take account of the needs of vulnerable individuals.
The right to treatment includes ‘the creation of a system of urgent medical care in cases of accidents, epidemics and similar health hazards, and the provision of disaster relief and humanitarian assistance in emergency situations’.[15]
States must take measures to prevent and control the spread of contagious diseases by carrying out regular immunization exercises against the major infectious diseases throughout the country and ensuring that people have unhindered access to vaccines, drugs, essential medicines, and urgent medical care in cases of accidents, epidemics and similar health hazards.[16] In order to control diseases, States must endeavour to fund scientific and medical research and ensure that appropriate technologies for the prevention or control of diseases are universally available and accessible.
Prevention, treatment and control programmes should take account of the needs of vulnerable individuals. In Minister of Health and Others v Treatment Action Campaign (TAC), a case that dealt with government’s policy for the prevention of mother-to-child transmission of HIV, the Constitutional Court of South Africa found the government’s policy to restrict access to Nevirapine to be unreasonable and therefore non-compliant with the constitutional right to health.[17] The implementation of the prevention programme was confined to pilot sites. The Court held that this policy was not reasonable as it failed to address the needs of women and children who did not have access to the pilot sites, most of whom were poor, thus differentiating between those who could afford to pay and those who could not afford to access the services.[18]
[1] See also Additional Protocol ACHR (Protocol of San Salvador) art 10(c),(d); art 11(3) ESC; CERD art 5(e)(iv).
[2] CESCR General Commen 14 para 8.
[3] CESCR General Comment 14 para para 11.
[4] CESCR General Comment 14 para 44(d)
[5] CRC General Comment 4 para 30; See also various concluding observations by treaty bodies that recommend that states take measures to ensure prevention of early pregnancies and the control of sexually transmitted diseases eg CEDAW Committee Concluding Observations: Netherlands (2007) para 38; CRC Committee, Concluding Observations: Lithuania (2001) para 39.
[6] CESCR General Comment 14 para
[7] CESCR General Comment 14 para 16
[8] CESR General Comment 14 para 51
[9] CESCR General Comment 14 para 34.
[10] CESCR General Comment 14 para 51.
[11] Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health Anand Grover, UN Doc.A/HRC/14/20 (2010) para 25
[12] Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health Paul Hunt, UN Doc. E/CN.4/2003/58 para 68
[13] CRC General Comment 3 para 10.
[14] CRC Committee, General Comment 3 para 11.
[15] CESCR General Comment 14 para 16.
[16] CESCR General Comment 14 para 16.
[17] 2002(5) SA 721; 2002 (10) BCLR 1033.6.
[18] TAC case paras 67-73.