Uganda Flag Against City Blurred Background At Sunrise Backlight 3D Rendering.

Ugandan Court Decision Enshrines Access to Basic Maternal Health Care as a Right

By Moses Mulumba

On August 19, 2020, the Constitutional Court of Uganda passed a landmark judgment in which it pronounced that the Government of Uganda’s omission to adequately provide basic maternal health care services and emergency obstetric care in public health facilities violates the right to health, the right to life, and the rights of women as guaranteed under the country’s Constitution.

Uganda’s maternal mortality rate is unacceptably high, at 343 per 100,000 live births. This means that Uganda loses 15 women each day from pregnancy and child birth related causes.

In its judgment, the Court directed the Government of Uganda to prioritize and provide sufficient funds in the national budget for maternal health care. The Court also ordered, through the Health Minister, that all the health care workers who provide maternal health care services in Uganda be fully trained and all health centers be properly equipped within the next two financial years (2020/2021 and 2021/2022).

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Political Map of South American Continent.

Regional Insights for Constitutionalizing the Right to Health in Chile

By Alicia Ely Yamin                                                    

Chile is one of the few countries in Latin America that has not amended its constitution post-dictatorship. That is set to change on October 25th when the country will hold a plebiscite on constitutional reform.

Any new Chilean Constitution may well follow the path of constitutional reform elsewhere in the region. These reforms, which occurred in the late 1980s and 1990s, and more recently in Mexico, expanded social rights through expanding enumerations and/or incorporation of international human rights law into the constitutional text through “constitutional blocs” (bloques de constiucionalidad).

In situating what is at stake, it is important to recall that the evolution of health rights in Latin America is closely linked to contestation over boundaries between private morality and public policy, between individual and social responsibility, and between the role of the state and markets.

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Santiago, Chile.

The Democratic Case for Social Rights in Chile’s Constitutional Moment

By Koldo Casla

We live an era of nationalistic, angry, and xenophobic challenges to human rights, a time in which the “will of the people” is maliciously presented as contrary to human rights. We have seen human rights backlashes consistent with this instrumentalization of the so-called popular will in India, Hungary, Poland, Turkey, the Philippines, the U.S., the U.K. — the list, sadly, could go on and on.

Chile, however, presents a test case for the opposite, an opportunity to refresh the democratic case for social rights, not due to natural or international law, but because human rights is what people demand.

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The priorities in the benefit packages vs. the priorities of those who dole out the benefits

In my last post I promised I would provide details about the new piece of statutory legislation that was recently enacted by the Colombian Congress on the right to health, but first I should talk a little more about the prior jurisprudence that set the stage for it–especially since there’s so much of it. Every year, hundreds of thousands of right-to-health cases go before judges in Colombia, and some estimate that up to one out of every five Colombians has used the judicial system to gain access to health services.

By far, most of these cases are won by the plaintiff. And they should be.

Nearly 90% of the cases that involve procedures, and over 30% of the cases for medications, involve benefits that are actually already covered by the public benefit package (plan obligatorio de salud, or POS). And most of these aren’t over particularly expensive, complicated, or scarce benefits in the POS. The most frequently litigated medications are omeprazole (Prilosec) and oxygen. The most frequently litigated procedures aren’t even the procedures themselves, but specific parts of the procedures that aren’t explicitly listed in the bundle of benefits covered by the POS. For example, the POS covers colostomies, but the insurance companies systematically deny the colostomy bags. “We’ll open the hole in your flank, but it’ll be on you to figure out what to do with the excrement that’ll start oozing out. . .”

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A fundamental right to health? So they’re saying in Colombia…

Perhaps surprisingly to some, Colombia has come much further along the path towards universal coverage than many developed countries in the world, including the US. Most of this progress happened precipitously starting in the early 1990’s: while in 1993 fewer than 5% of people in the lowest income quintile had access to any health care that was not paid for entirely out-of-pocket, by 2011 over 85% were covered by a social security system that provides access to a basic package of health benefits. Although there are persisting problems in terms of the effectiveness of coverage, many of us would argue the progress has been real and frankly impressive. But none in Colombia would deny that there is still much room for improvement, and that the government has inexcusably failed to take advantage of numerous opportunities over the past two decades to make those improvements.

These failures led to a landmark decision on the part of the Constitutional Court in 2008, which through its jurisprudence in the T/760 decision of 2008 adjudged the right to health to be a fundamental constitutional right, thereby permitting that specific demands by citizens be submitted for constitutional judicial review through the tutela protection writ (the Colombian version of the amparo). The decision has been seen by many as a trail-blazing approach to protecting the fundamental rights of the most vulnerable individuals in Colombia from the effects of persistent negligence on the part of the Government.

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