Enabling legal environments for universal health coverage
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Effective and sustainable health responses require legal and policy environments that reduce stigma, discrimination, inequality and violence
Effective and sustainable health responses require legal and policy environments that reduce stigma, discrimination, inequality and violence against all affected populations, and that empower communities to access their health rights and participate in the governance of the national response.
National strategies, plans and proposals, including Global Fund funding proposals, should include interventions aimed to strengthen legal and policy frameworks.
An enabling legal and policy framework that removes human rights and gender-related barriers to health care requires several mutually reinforcing programmes
An enabling legal and policy framework that removes human rights and gender-related barriers to health care requires mutually reinforcing interventions that include:
- Monitoring and reviewing laws, regulations and policies to protect human rights and promote gender equality for all populations at risk of poor health, including key populations at risk of HIV, TB and malaria
- Stigma and discrimination reduction programmes to reduce stigma and discrimination against vulnerable and key populations
- Legal literacy to educate communities about human rights, gender equality and protections in law and policy for their rights in the context of health
- Legal support services to support communities to get legal advice, access legal support, challenge violations and seek redress through litigation and other means
- Training for health care workers to prevent stigma, discrimination and human rights violations during the delivery of HIV, TB and malaria services
- Sensitization of law-makers and law enforcers to strengthen the awareness and understanding of how vulnerable and key populations experience human rights and gender-related barriers to access to health care, and access to justice and the need for rights-based responses and appropriate law enforcement
- Addressing gender inequality, harmful gender norms and gender-based violence that impact on the health rights of affected populations
- Capacity strengthening and mobilisation of civil society and key populations to participate in and advocate for rights-based health responses, and
- Research and monitoring of ongoing human rights issues and violations and progress towards creating protective, enabling frameworks and advocacy to address law, human rights and gender equality issues through strategies such as law review and reform, strategic litigation and integration of rights-based responses in national health responses.
Legal, human rights and gender assessments can help identify how laws, regulations, policies and practice can support or hamper health rights
LEAs, country or national dialogues, gender assessments and other consultations can help to identify and analyse how laws, regulations, policies and practices impact on the health rights of vulnerable and key populations. They provide good guidance on potential ways in which a strengthened legal and policy environment requires law review and reform as well as efforts to strengthen access to justice and improve law enforcement. Engagement scans provide further information on the opportunities for engaging in law and policy review and reform advocacy and strategic litigation. Programmatic responses should build on this information to ensure a holistic response that works at these various levels.
The regulation of health technologies is a critical component of any well-functioning health system, as it enables access and delivery to health technologies of assured quality, safety and efficacy. In some countries, capacity within regulatory systems remains limited, due to inadequate human and financial resources, overburdened staff and incomplete and incoherent policy frameworks.
As a result, many of the national regulatory authorities have limited capacity to approve medicines in a timely manner and to ensure acceptable quality, safety and efficacy standards. With the support of UNDP-lead Access and Delivery Partnership, in 2016 the African Union adopted a Model Law for Medical Products Regulation that provides a comprehensive legislative template for African countries that can be adopted and adapted by national governments and regional economic communities to harmonize regulatory systems and increase South–South cooperation across the region. For more information, ADP issue brief.