F: The right to health, the right to life

It was with good reason that Mozambican Prime Minister Pascoal Mocumbi highlighted the poor state of women’s health care in Africa at a conference on women’s reproductive and sexual health rights in 2003.

Referring to what he called an “unfortunate truth”, Mocumbi said: “Across our continent the health status of women remains precarious and in many instances is worsening, not only because of HIV but also because of the many unacceptable inequalities that exist in women’s health, the limited choices that are made available to women and finally, the lack of accountability for their health.” (First conference dedicated to African Women’s Sexual & Reproductive Health & Rights, Johannesburg, South Africa February 4 – 7, 2003, www.amanitare.org/)

In making his statement, Mocumbi would have considered the statistic that 55% of adults with HIV/AIDS in Sub-Saharan Africa are women. Women with HIV/AIDS are less economically secure and are often deprived of their rights to housing, property, inheritance and access to adequate health services. Mocumbi would have been aware that 90 million African women and girls are victims of female circumcision and other forms of female genital mutilation. He would have known that many countries in Africa have restrictive abortion policies, with 11 000 unsafe abortions taking place every day. Apart from these facts, he would have known that women’s rights suffer in the many situations of conflict on the continent. Lastly, he would have known that decades of market reforms and structural adjustment policies in Africa have often marginalised women and had a detrimental impact on their access to health care.

So where does the idea of these rights come from? And how is the idea of women’s sexual and reproductive health rights supposed to improve the situation of women? According to a history of sexual and reproductive health rights on www.choike.org, a website that functions as a portal for civil society worldwide, the term "reproductive rights" first arose during an International Meeting on Women and Health in Amsterdam (1984) which was seen as the starting point of efforts by women to expand the scope of the concept of human rights.

At the World Conference on Human Rights held in Vienna in 1993, participant States agreed to regard any violation of the specific rights of women as a human rights violation. In the Programme of Action of The Cairo Conference in 1994, the acknowledgement of rights enjoyed or denied inside the home won increasing ground in the conception of human rights. It was also established that post-abortion counselling, education and family planning services should be established. The Programme of Action further called on governments to regard unsafe abortions as a major public health concern, improve family planning services to avoid abortions, provide health care and guidance for women who have unwanted pregnancies, and urge the implementation of policies and changes in the approach to abortion.

The Beijing platform for action in 1995 was the most comprehensive document produced by a United Nations conference on the issue of women's rights, as it incorporated the achievements of previous conferences and treaties, such as the Universal Declaration of Human Rights, the CEDAW (Committee on the Elimination of Discrimination Against Women), and the Vienna Declaration. It reaffirmed the definitions adopted at Cairo. The Third Special Session of the UN General Assembly, known as "Women 2000: Gender Equality, Development and Peace in the 21st Century", took stock of the advances made in the implementation of the Beijing Platform for Action's recommendations (WPA or Beijing + 5).

On a regional level, the Protocol on Women's Rights in Africa adopted by the African Union in Maputo in 2003 affirms state responsibility to protect sexual and reproductive health and reproductive choice, and to combat violence against women and discriminatory cultural norms. The Protocol requires states to prohibit and condemn female genital mutilation, while women and men must have equal rights in relation to marriage. The reproductive rights of women must be protected and abortion provided in certain circumstances. Under the Protocol, women must be guaranteed the right to protection against sexually transmitted infections and HIV/AIDS.

This international and regional human rights framework is not sufficient in itself to protect the sexual and reproductive health rights of women. In order to be effective many things need to happen. Laws have to be passed by individual countries so that commitments to international treaties can be enforced. These laws in turn have to be the subject of public awareness and education campaigns so that they are popularized. This education does not only apply to making women aware of their rights, but also involves educating men to treat women as equals. Resources will therefore have to be prioritized for women’s sexual and reproductive health and health services will need to be equipped to be able to deal with the increased needs of their populations and to incorporate a reproductive rights perspective into their daily functioning. Perhaps most importantly, the protections offered to protect rights must be enforced. (Source and further reading: http://www.unfpa.org/intercenter/reprights/needs.htm)

Sadly, the kind of political commitment needed for this kind of action is completely lacking in many countries. Women continue to be treated as unequals in society. In recent years the attitude of the Bush Administration has threatened to erode the gains that the reproductive rights movement has made over the last two decades. A conservative, fundamentalist Christian element in the US has dictated that the US will withhold funds from organizations around the world who are involved in providing abortion services, dealing a blow to the funding of reproductive health services in developing countries.

Governments who haven’t taken the sexual and reproductive health rights of women seriously should wake up. Taking these rights seriously will lead to healthier populations and contribute to the fight against HIV/AIDS. It will reduce poverty and contribute to sustainable development. It makes sense. And besides, in future years, women may well have a case for reparations against their governments and the male population at large for the continued violation of their basic human rights. Perhaps its a case that should be made.

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References and further reading:

http://ipsnews.net/interna.asp?idnews=26492
http://www.whrnet.org/docs/issue-sexualities.html
http://www.eldis.org/hivaids/abstinence.htm
http://www.ipas.org/english/default.asp
http://www.reproductiverights.org/pdf/pdf_BreakingThrough_04.pdf
http://www.choike.org/nuevo_eng/informes/1197.html
http://www.ipsnews.net/interna.asp?idnews=25397
http://www.unfpa.org/intercenter/reprights/reproductive.htm
http://www.wits.ac.za/whp/sexualrights_beijing.pdf
http://www.unfpa.org/rh/index.htm
http://www.unfpa.org/intercenter/reprights/sexual.htm
http://www.feministafrica.org/fa%202/02-2003/amanitare.html