Right to sexual and reproductive health indivisible from other human rights

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, UN experts have said in an authoritative new legal commentary*.

Yet, the experts from the Committee on Economic, Social and Cultural Rights (CESCR) note, “the full enjoyment of the right to sexual and reproductive health remains a distant goal for millions of people, especially for women and girls, throughout the world.”

The commentary, adopted by CESCR’s 18 independent members, 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 say in their commentary.

The experts’ guidelines, known as a General Comment, concern Article 12 of the International Covenant on Economic, Social and Cultural Rights which refers to the right to the highest attainable standard of health.

“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,” said Committee member Heisoo Shin.

The General Comment codifies the Committee’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.

“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,” Ms.Shin said.

The General Comment details the importance of sexual and reproductive health for men and boys, but also highlights how the issues are indispensable for women’s right to make meaningful and autonomous decisions about their lives and health. It notes that gender-based stereotypes play a role in fuelling violations of the right to sexual and reproductive health, including assumptions and expectations of women as men’s subordinates and of women’s role as only caregivers and mothers.

The General Comment also pays special attention to other groups of individuals who may face particular challenges and multiple forms of discrimination.

“People with disabilities need more attention and extra sensitivity to their situation; we see examples of doctors and nurses not treating lesbian, gay, bisexual, transgender and intersex people equally; adolescents can be afraid to go to the gynaecologist because they are not supposed to have any sexual encounter; taboos around sex also affect the ability of single women in many countries to access services,” said Ms.Shin. 

The General Comment details the obligations of States regarding sexual and reproductive health, including:

• An obligation to repeal, eliminate laws, policies and practices that criminalise, obstruct or undermine an individual’s or a particular group’s access to health facilities, services, goods and information;
• An obligation to ensure all have access to comprehensive education and information that is non-discriminatory, evidence-based and takes into account the evolving capacities of children and adolescents;
• An obligation to ensure universal access to quality sexual and reproductive health care, including maternal health care, contraceptive information and services, safe abortion care; prevention, diagnosis and treatment of infertility, reproductive cancers, sexually transmitted infections and HIV/AIDS.

The General Comment states that ideologically based policies or practices, such as the refusal to provide services based on conscience, must not prevent people from getting care, and that 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.”

- UN experts

GENEVA (8 March 2016) 
 http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=17168&LangID=E#sthash.dGpOvQiH.dpuf