March 28, 2016
Earlier this month, an important commentary was issued by the UN Committee on Economic, Social and Cultural Rights (CESCR), containing experts’ guidelines (known as a General Comment), on Article 12 of the International Covenant on Economic, Social and Cultural Rights, which refers to the right to the highest attainable standard of health. A General Comment codifies the CESCR’s views on this issue to give States that have ratified the Covenant a clear understanding of their obligations and to highlight to government officials, legal practitioners, as well as civil society, where policy, laws and programme may be failing and how they can be improved.
The CESCR is the body of 18 independent experts that monitors implementation of the International Covenant on Economic, Social and Cultural Rights by its States parties. Its new General Comment No. 22 states that the right to sexual and reproductive health is not only an integral part of the general right to health, but fundamentally linked to the enjoyment of many other human rights, including the rights to education, work and equality, as well as the rights to life, privacy and freedom from torture, and individual autonomy.
Maternal mortality and abortion
The commentary highlights the numerous legal, procedural, practical and social barriers people face in accessing sexual and reproductive health care and information, and the resulting human rights violations. “For example, lack of emergency obstetric care services or denial of abortion often lead to maternal mortality and morbidity, which in turn constitutes a violation of the right to life or security, and in certain circumstances, can amount to torture, or cruel, inhuman or degrading treatment,” the experts state. One of them, Ms Heisoo Shin said:
“As a Committee we have spoken before about the right to health, but we thought that given, for example, high maternal mortality rates around the world or harmful practices that women and girls especially go through, like female genital mutilation and early child marriage, it was important to specifically address the issue of sexual and reproductive health.” […] “I think, for example, that governments have not allocated enough attention and resources to tackle maternal mortality. In 2016, we should not see women dying as they give birth because of insufficient facilities or because of lack of attention or because they are poor.”
Cultural issues
The General Comment details the importance of sexual and reproductive health for men and boys, but also highlights the issues of gender-based stereotypes and how they play a role in fuelling violations of the right to sexual and reproductive health. Also, special attention is paid to specific groups of people who may face particular challenges and multiple forms of discrimination, including people with disabilities; lesbian, gay, bisexual, transgender and intersex people; adolescents; and single women.
Ideologically based policies or practices, such as the refusal to provide services based on conscience, must not prevent people from getting care, the General Comment states. An adequate number of health care providers willing and able to provide such services should be available at all times in both public and private facilities. “Even in one country, there are wide differences, between different generations, between urban centres and rural areas, differences between men and women, so you cannot say there is always one position, and even culture changes over time,” said Ms Shin. “The ultimate goal should be what is best for people to enjoy the right to sexual and reproductive health.”
Reception
The General Comment was well received by influential organizations such as the IPPF (International Planned Parenthood Association) and the Center for Reproductive Rights. According to Katherine Mayall of the Center, “this is the first general comment to ever focus exclusively on sexual and reproductive health and its adoption speaks volumes about the great strides our movement has made in building out the international human rights framework to fully recognize reproductive rights as fundamental human rights.” However, she added:
“It is worth noting that there are some areas where the general comment could have been strengthened. For example, a number of the elements of the core obligations are quite vague, which in turn will undermine the ability to hold states accountable for these specific obligations. Further, although there is some strong content on sexual orientation and gender identity and expression, overall the general comment would have been significantly strengthened through a greater emphasis on this aspect of sexual and reproductive health. Lastly, the language on criminalization of abortion is a bit contradictory; although the general comment repeatedly recognizes the need for states to reform laws criminalizing abortion, it only explicitly frames the application of the criminal law to women who undergo abortions as a violation of the right to sexual and reproductive health – falling short of calling for the full decriminalization of abortion.”
Advocacy
To help facilitate and encourage the integration of the General Comment into advocacy efforts of various organizations, the Center for Reproductive Rights has put together a reference guide which highlights some of the key content from the General Comment.
Sources and more information: website OHCHR / posting ESCR-Right-to-Health mailing list
Access General Comment No. 22 on the Right to sexual and reproductive health, March 2016
Download Reference guide Center for Reproductive Rights, March 2016