WUNRN
UN SPECIAL RAPPORTEUR ON HEALTH REPORT TO THE HUMAN RIGHTS COUNCIL 2015
Multiple gender dimensions and intersectionalities including Violence as an Obstacle to the Right to Health
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United Nations |
A/HRC/29/33 |
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General Assembly |
Distr.:
General 2 April
2015 Original:
English |
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Human Rights Council
Twenty-ninth session
Report of the Special Rapporteur on the right of everyone to the enjoyment of
the highest attainable standard of physical and mental health, Dainius Pűras
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Summary |
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In the present
report, submitted pursuant to Council resolution 24/6, the Special Rapporteur
provides a brief account of his activities since he took office in August
2014. |
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The main focus of
the report is on the work of the mandate of the Special Rapporteur on the
right to health, focusing on the right to health framework, and
the development of the contours and content of the right to health. He then
reflects on how he sees the way forward, based on the current context,
challenges and opportunities for the full realisation of the right to health.
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The Special
Rapporteur provides his conclusions and observations. |
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Contents
Paragraphs Page
I.
Introduction.........................................................................................................
1–3
3
II. Activities during the reporting
period..................................................................
4–12
3
A. Communications transmitted to States.............................................................. 4 3
B. Country visits................................................................................................ 5–6 3
C. Cooperation with the United Nations system and
intergovernmental
organizations...............................................................................................
7–11
3
D. Cooperation with non-governmental organizations.......................................... 12 4
III. Overview of the work of the mandate (2003–2014)........................................... 13–31 4
IV. The way forward: context, challenges and opportunities................................... 32–63 7
A. The policy approach to the right to health................................................... 37–48 8
B. Right to health policies: power asymmetries,
unbalanced approaches and other challenges............................................
49–63
9
V. Themes as priorities........................................................................................ 64–118 11
A. Global health in the post-2015 agenda........................................................ 64–67 11
B. The right to health and public policy........................................................... 68–73 12
C. Mental health and emotional well-being.................................................... 74–85 13
D. The life-cycle approach to the right to health.............................................. 86–92 15
E. The right to health of persons with disabilities.......................................... 93–100 16
F. Violence as a major obstacle for the realization of the right to health 101–109 17
G. The role of stakeholders......................................................................... 110–118 18
VI. Conclusions and observations........................................................................ 119–122 20
A. Conclusions............................................................................................ 119–121 20
B. Observations................................................................................................. 122 20
F. Violence as a
major obstacle for the realization of the right to health
1. Protection from all forms of violence is considered by the Special Rapporteur as a cross-cutting issue present in all key elements of the realization of the right to health. As the United Nations High Commissioner for Human Rights has recently underlined, violence and human rights violations are often rooted in the deprivation and discrimination of individuals and communities. Such violations are not generated spontaneously but “result from policy choices which limit freedoms and participation, and create obstacles to the fair sharing of resources and opportunities”.[1] Violence needs to be addressed in a comprehensive and proactive way, not only as a cause of serious violations of human rights, but also as a consequence of a lack of political will to effectively invest in human rights, including the right to health.
2. It was not until the end of the twentieth century that the close link between violence and health
began to be sufficiently understood. Interestingly, as health and human rights came closer, a similar
tendency could be
observed by the turn of century when violence was
finally seen as a
public health concern. In 1996, the World Health
Assembly declared violence as “a leading worldwide public health problem”.[2]
Since then, the burden of violence has been documented and the effectiveness of programmes, with particular attention
devoted to women and
children and community-based
initiatives, has been
assessed.
3. Evidence has shown that, when violence is addressed proactively
as a public health issue, there are more opportunities to break the cycle of violence, poverty
and helplessness and, in the longer run, to significantly reduce the prevalence
of all forms of violence, including collective violence.[3]
4. All forms of violence are harmful
and detrimental to the health and development of human beings, starting from the youngest children. Early childhood
adversities, including all
forms of violence
against children,
such as physical and emotional abuse and chronic neglect, if they are not
timely addressed by healthy public policies, can result in chronic diseases
in the adult affecting both
physical and mental health.
5. The human rights approach, together with the modern understanding of public health, warns against typifying violence into severe forms and those forms
which are considered to be “milder” and thus perceived as not harmful. That can lead to the proliferation of practices which are
justified as being “mild” forms of
violence and thus tolerated
or even recommended, such
as domestic violence against women, female genital mutilation or the
institutional care of young children.
6. From the public health
perspective, the cumulative effect of a large number of “mild cases” generates
a heavier burden for the
health of population
than a smaller number of “severe cases”.[4] The practice of tolerating and
justifying milder forms of violence can pave the
way to severe violations of human rights, which can amount to grave violations
and even atrocities.
7. Any form of violence, including collective violence, does not originate in a vacuum. Violence has roots in unhealthy relationships amongst individuals, and is reinforced by the failure to promote and protect good-quality human relations, starting with relationships between an infant and the primary caregiver. The cycle of violence is reinforced when children grow up — whether in families or in institutions — without having their basic needs satisfied, which include not only the need to survive, but the need to feel secure and thus to enjoy the right to healthy development.
8. The most powerful way of preventing the epidemics of violence and
different forms of insecurity in the modern world is the provision of holistic support to all forms of family unit, including
access to food, shelter, health care and education, but also the provision of
basic parenting skills. The quality of relationships between individuals in
society is an increasingly important element in the realization of the right to
health and the prevention
of the cycle of violence. The right to a healthy environment should include not only the physical environment, but also the emotional
and psychosocial environment in all settings, family units, schools, workplace, communities and
societies at large.
9. The resilience and the protective
factors in individuals, families communities
and societies need to be promoted, and more investment in healthy human
relationships, emotional and social well-being and social capital is required.
The empowerment of all stakeholders — without
exception — is an effective way of addressing
major public health threats and violations of human rights, including the right to health.
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