2016; Volume 17, No 8, August
Policy and Advocacy
Human Rights Council resolutions
Dr. Katherine I. Pettus, PhD, IAHPC Advocacy Officer for Human Rights and Palliative Care
The Human Rights Council (HRC) during its June (32nd) Session, passed a triad of resolutions that directly support recent World Health Assembly (WHA) resolutions, current World Health Organization (WHO) programs, and WHO Global Strategies. The three resolutions are entitled Promoting the right of everyone to the enjoyment of the highest attainable standard of physical and mental health through enhancing capacity-building in public health, Mental Health and Human Rights, and Access to medicines in the context of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. The recent HRC resolutions call for the WHO to take a lead role in developing the reports and panels to be presented at the 35th and 36th Sessions. We expect that IAHPC will be involved in the preparation of these reports and the selection of panel speakers.
The Promoting the Right to Health resolution aligns with WHA69 resolutions on workforce capacity (69/38), shortages of medicines and vaccines (69/25), and medicines for children (69.20). It notes WHA67.22 on essential medicines, and WHA67.19 on palliative care, and “calls upon the international community to continue to promote cooperation on strengthening the public health capacity of all countries, in particular on strengthening the national health systems of developing countries, including through financial and technical support and training of personnel and through access to medicines, including children’s medicine, in particular essential medicines, that are affordable, safe, efficacious and of quality.” Advocates for integration of palliative care into health systems can inform policymakers of this, and the other resolutions, to support their case for improved access to essential controlled medicines for palliative care such as morphine.
The Mental Health resolution acknowledges “the leadership of the World Health Organization in the field of health and also the work it has carried out to date to integrate, inter alia, a human rights perspective in mental health,” and “recalls the commitment of States to achieve this through the implementation of the Organization’s Comprehensive Mental Health Action Plan 2013- 2020.” It also directs the Office of the High Commissioner to prepare a report for the 35th session (summer, 2017), which optimally will include elements of the forthcoming WHO dementia strategy, and encourage countries to take a rights-based approach to dementia care. It is crucial to integrate palliative care into any dementia policy, as under-treatment of physical, spiritual, and psychosocial pain in dementia patients and their caregivers is an ongoing deficit in both institutional and home care.
The Medicines Resolution, although eventually adopted by consensus, was the most controversial of the triad, and attracted the most proposals for amendment. Criticisms from the Netherlands (for the European Union), Switzerland, the UK, and the USA focused largely on protecting intellectual property rights, and emphasized structural causes of medicines unavailability over patent protection.
The resolution’s cosponsors, led by Brazil and other lower- and middle-income countries, said that millions of lives could be saved every year if access to affordable, safe, efficacious and quality medicines were improved. They noted “with deep concern that, according to the World Health Organization in its World Medicines Situations Report of 2011, at least one third of the world population has no regular access to medicines, while recognizing that the lack of access to medicines is a global challenge that affects people not only in developing countries but also in developed countries, even though the disease burden is disproportionately high in developing countries.”
The crisis of unavailability noted in the resolution applies even more acutely to availability of controlled essential medicines such as morphine and methadone for basic palliative care and treatment of substance use disorder. More than three quarters of the world’s population lacks access to these medicines, according to the WHO, a situation IAHPC prioritizes through its advocacy program.
The Human Rights Council access to medicines resolution aligns with the plans of Dr. Suzanne Hill, Director of Essential Medicines and Health Products, to develop a fair pricing model for pharmaceuticals. It complements the most recent WHO focus on the topic, which emphasizes a “patient centered, public health approach.” In their conversations with policymakers and WHO regional staff, advocates for improved access to controlled medicines can point out how this language mirrors the palliative care approach.
All three resolutions describe the social determinants of health in human rights terms, and are framed in the overall context of Agenda 2030 (Sustainable Development Goals: SDGs) particularly Goal 3, “Ensure healthy lives and promote well-being for all at all ages” and Target 3b, “[. . .] provide access to affordable essential medicines and vaccines [. . .]”
The Sustainable Development Goals, Human Rights Council Resolutions, and World Health Assembly Resolutions provide robust multi-lateral legal support for clinicians working at country level to improve access to palliative care and controlled medicines for their patients.
Links
- Katherine Pettus email.
- Read Katherine’s bio on the IAHPC website.
- Read all WHA resolutions here.