View previous stories
	Rights are being undermined by austerity measures and the economic crisis by Nils Muiznieks Commissioner for Human Rights European Union   Universal access to health care has been undermined by austerity measures and the economic crisis. Cuts in health services and difficult economic and social conditions are beginning to have a measurable impact on the health of the population in many countries. Yet the right to health is guaranteed by international and European human rights instruments. Everyone’s access to health care without discrimination belongs to the core content of this right.   Cuts in health services   Health care spending in Europe began a downward slope in 2010, reversing a long-term trend as documented by the OECD. At the same time, user charges have often gone up, making it more difficult for many population groups to receive the care they need. The WHO has defined universal coverage as access of everyone to health care services without suffering financial hardship in paying for them.   During my visit to Spain in June last year, I reviewed the effects of austerity measures on health services which had previously been based on universal and free access. The crisis had resulted in massive cuts in medical staff and funding of public health centres, the closure of many emergency services and the introduction of co-payment schemes. Undocumented migrants only had access to emergency care. The regional government of Andalusia had set up a mechanism to maintain free and universal access to health care.   In Greece, public health spending was capped at 6% of GDP through the stipulations of international bailout packages, falling clearly below the EU average of 9% in 2010. Recent research on Greece highlights drastic cuts in public hospital budgets, pharmaceutical spending and funding for mental health care along with spiralling out-of-pocket fees. The prevalence of major depression increased 2.5 times between 2008 and 2011 while the number of suicides rose by 45% between 2007 and 2011. Infant mortality increased by 43% from 2008 to 2010 after a long-term fall, raising concerns about access to pre-natal care by pregnant women.   Public health budget cuts in Latvia have also undermined the availability of care. A UN independent expert has pointed out that the number of publicly funded hospitals with inpatient care provision decreased from 88 in 2008 to 39 in 2010 along with increased user fees for services and pharmaceutical products. In 2011, 26.8% of unemployed people and 18.3% of pensioners had to forego the medical treatment or examination they needed on at least one occasion because they could not afford it.   Vulnerable groups   Many vulnerable groups face specific barriers in access to health care. Children’s health was a particular concern during my visit to Spain because of rapidly rising poverty, homelessness and malnutrition among them. The Ombudsman of Catalonia reported that children belonging to disadvantaged social groups faced a six-fold higher risk of mental health problems in comparison with other groups. I have also raised the lack of availability of psychological and psychiatric care for children in Estonia. The WHO has warned of possible life-long effects of extreme poverty on children’s health which may include deficits in cognitive, emotional and physical development.   Discrimination, lack of insurance coverage, homelessness and limited transportation options from remote areas have precluded many Roma from accessing health care, as highlighted by a report published by my Office. In fact, Roma often suffer from significantly lower life expectancy than the national average. Lack of identity documents is another contributing factor as I noted during my visit to “the former Yugoslav Republic of Macedonia”. A programme of health mediators had been put into place for improving the availability of care and promoting preventive measures.   Access to health services is a vital concern to asylum-seekers when the care they need is not available in their countries of origin. I stressed this issue in Denmark where rejected asylum-seekers holding humanitarian status on grounds of their health situation can be expelled once treatment becomes available in the country of origin. Unfortunately, returns may have gone ahead even when it has been unclear whether the medication or treatment required has in fact been within the reach of the persons concerned.   European standards   The “right of everyone to the enjoyment of the highest attainable standard of physical and mental health” is guaranteed by the International Covenant on Economic, Social and Cultural Rights. In Europe, the revised European Social Charter recognises the right to protection of health and the right to social and medical assistance.   In its 2013 conclusions on Spain, the European Committee of Social Rights stressed that the health system must be accessible to the entire population. The Committee also pointed out that the economic crisis could not serve as a pretext for a restriction or denial of access to health care that affects the very substance of this right.   Although the right to health is not part of the European Convention on Human Rights, its provisions on the right to life and the prohibition of torture and inhuman or degrading treatment have been applied in cases related to the quality of care and access to it. For example, the case-law of the European Court of Human Rights on prisoners’ access to health care is quite extensive. The extreme effects of austerity measures on the accessibility of health care could be open to contestation in the Court.   Human dignity   Universal access to health care is about respecting everyone’s human dignity. We should start viewing health inequalities through a human rights perspective by putting the person at the centre of health service delivery. Scotland’s National Action Plan for Human Rights is actively pursuing this approach in on-going reforms of health and social care. By involving the users in the development of care and respecting their right to self-determination we enable individual choices and make services responsive to people’s real needs.   There are good reasons for carrying out reforms to make health services more effective. The rapid demographic changes and technological advances we are currently experiencing will require new responses. It is also important to address wasteful practices and corruption in health care. However, such reforms should not simply amount to cost-cutting exercises. They should always aim to deliver quality care to the entire population without excessive user charges. Governments have a duty to maintain health and social protection floors which are available to everybody at all times.   Protect women’s rights during the crisis   Women and men entered the economic crisis on an unequal footing. The crisis and resulting austerity measures have hit women disproportionately and endangered the progress already made in the enjoyment of human rights by women. A gender-sensitive response is necessary to halt and reverse this trend.   Female poverty on the rise   In most of the countries affected by the economic crisis, an increasing feminisation of poverty has been observed. A study conducted in 2013 on access to food banks in France revealed that the primary beneficiaries were women between 26 and 50 with at least one child. This is emblematic not just of the vulnerability of lone parent families, but also of the gender implications of the crisis. In Europe there are on average 7 times more lone mothers than lone fathers. Moreover, as indicated by Eurostat, “single women over 65 are at substantially higher risk of poverty than single men of the same age”.   In Spain, as recently highlighted by Human Rights Watch, women have been disproportionately affected by housing foreclosures related to excessive mortgages following the housing crisis. In fact, women, and especially younger women, have become more visible among the homeless of Europe as reported by FEANTSA.   These concerns have been further reflected by both the Parliamentary Assembly of the Council of Europe and the European Parliament, which have also stressed that women in poverty or at risk of poverty are more likely to work in low-paid, precarious and informal jobs, including in the field of domestic work, and face the risk of exploitation and trafficking in human beings.   Negative impact of austerity measures   Regrettably, these warnings have largely remained unheard. Many European governments have in fact implemented austerity measures which have exacerbated the negative effect of the economic crisis on women. For instance in the United Kingdom and Greece, a significant number of jobs have been cut and salaries reduced in the public sector, where female workers form the majority.   In addition, as women rely more than men on social benefits, budget cuts in the welfare system have further endangered the enjoyment of social and economic rights by women. An independent audit by the UK Women’s Budget Group has concluded that the total cuts in government spending “represent an immense reduction in the standard of living and financial independence of millions of women, and a reversal in progress made towards gender equality”. This risk of retrogression of women’s rights, and especially social rights, has also come to the fore in other countries, for example in Greece regarding women’s access to health care and in Ireland regarding childcare benefits.   The stagnation of pension rates under austerity puts older women at a higher risk of poverty as women live longer and more often alone than men, as I observed in my report on Estonia.   Women’s rights are also jeopardised by financial cuts made to programmes and infrastructures promoting gender equality, as was the case for instance in Spain where the Ministry of Equality was eliminated in 2010.   Lastly, action against gender-based violence is yet another field negatively impacted by the combination of the crisis and ensuing austerity measures. While demand for assistance among women victims of violence has been on the rise in a number of European states, some women’s shelters have had to close due to budgetary cuts.   Youth human rights at risk during the crisis   Young people have been one of the groups hardest hit by the economic crisis in Europe, with youth unemployment being the most common pathology of many countries implementing austerity measures. However, it is not only the social and economic rights of young people that are being undermined, but also their right to equal treatment, their right to participation, and their place in society, and more broadly, in Europe.   Due to chronic unemployment, many young people are losing hope in the future of their countries, their faith in the political elite, and their belief in Europe. A rights-based approach should replace the current neglect of young people in discussions about the crisis.   Youth unemployment and labour standards   In March 2014, the youth unemployment rate (under 25 years) was 22.8% in the 28 members of the Council of Europe that are also European Union countries. The highest levels were recorded in Greece (56.8%), Spain (53.9%) and Croatia (49.0%). The youth unemployment rate in the EU was more than twice as high as the general average rate of 10.5%. Among other European countries, youth unemployment exceeded the 50% rate in 2013 in Bosnia and Herzegovina, Serbia and “the former Yugoslav Republic of Macedonia” according to the ILO.   While youth unemployment is a major concern, increasing attention is also being paid to the rising number of young people who are not in employment, education or training (so-called “NEETs”). A report by Eurofound put their number in 2011 at 14 million, or 15.4% of the EU population aged between 15-29 years. In Bulgaria, Ireland, Italy and Spain the figures were higher than 20%. A Eurobarometer survey published in April found that more than half of young Europeans felt young people had been marginalised and excluded from social and economic life by the crisis.   The hurdles young people face in their transition from education to work can have long-term negative effects and impact their enjoyment of human rights. We risk producing a “lost generation” of disillusioned young people with serious consequences for inter-generational solidarity, social cohesion and political stability. Measures tackling youth and long-term unemployment should be given priority in labour policies, as I have stated in a recently published Issue Paper on the crisis.   Any temptation to lower labour standards and social protection when employing young people must be resisted. Schemes to work as an intern or an apprentice should not be abused in this respect. The European Committee of Social Rights has upheld a collective complaint against Greece about the rights of apprentices. It found violations of the European Social Charter in the fact that ‘special apprenticeship contracts’ had established a distinct category of workers who were excluded from the general range of protection offered by the social security system. There had also been age discrimination in remuneration as young people’s minimum wage had been set substantially lower than that of the general population, in fact falling under the poverty line.   Rights-based approach   Young people are not only concerned about unemployment, poverty and financial autonomy. The European Youth Forum has also highlighted the rights to education, participation and non-discrimination, the freedoms of expression, religion and movement, and the right to a healthy life and reproductive rights. The European youth movement is advocating a rights-based approach towards young people and raises awareness of the lack of specific attention afforded to young people in most European and international human rights instruments.   Although the European Convention on Human Rights does not have explicit provisions on young people, it protects the human rights of all people, including young persons. The case-law of the European Court of Human Rights has covered many issues of interest to young people. Such cases have related, for example, to university education, access to a professional career, conscientious objection, expulsion of second-generation migrants and forced labour.   In contrast, the revised European Social Charter includes specific references to young people to ensure their social, legal and economic protection along with its general provisions applying to everybody.   In addition to young people’s labour rights, the European Committee of Social Rights has highlighted positive measures regarding young people’s access to adequate housing and the rights to non-discriminatory access to education and professional training, among other issues.   Specific legal instrument   The recent trend in improving protection against age discrimination has highlighted questions about young people’s enjoyment of human rights. New age-based human rights instruments are under consideration following the existing model of the UN Convention on the Rights of the Child. In the UN, the preparation of a convention on the rights of older persons is being discussed and the Council of Europe Committee of Ministers has already adopted a Recommendation on the topic. The Parliamentary Assembly of the Council of Europe has proposed the preparation of a binding legal framework on young people’s access to fundamental rights.   It is essential that young people can exercise their right to participation in the elaboration of legal instruments related to them. At the same time, we have to stress the fact that existing human rights instruments do apply to young people even when they don’t include specific references to young persons.   Empowering young persons   Young people should be empowered to assert their rights. This requires strengthening awareness of human rights and opportunities for effective participation in social, economic, cultural and political life. We have to be sure that being young does not become an obstacle to the full exercise of human rights during the crisis and that young people can participate in national decision-making to voice their needs, hopes and fears. Ombudspersons, equality bodies and human rights commissions should also reach out to young persons so that their concerns and complaints can be addressed. Governments should not only view young people as holding keys to our future but recognise their rights and role in Europe today.   http://wcd.coe.int/ViewDoc.jsp?id=2130915 http://www.oxfam.org/en/pressroom/pressreleases/2015-09-09/increasing-inequality-plunging-millions-more-europeans-poverty http://www.oxfam.org/sites/www.oxfam.org/files/bp174-cautionary-tale-austerity-inequality-europe-120913-en_1.pdf http://www.ohchr.org/EN/Issues/Poverty/Pages/AnnualReports.aspx http://www.escr-net.org/usr_doc/EconomicCrisisHRStatement_ESCR-Net_final_eng_withendorsements.pdf http://cesr.org/section.php?id=139 Visit the related web page
	Mandela Day is a call to put Ubuntu into action! by Phumzile Mlambo-Ngcuka UN Women   July 2014   18 July is Nelson Mandela’s birthday. It is also the first ‘Mandela Day’ to be marked since we lost him after a long illness. Mandela Day is an opportunity for each of us to bring the best out of ourselves by taking some form of action in solidarity with others, to be of service, and to inspire change in our world. As Secretary-General Ban Ki-moon puts it, “Nelson Mandela Day is a call to action.”   For Nelson Mandela, justice and equality were core values to be applied universally. By designating Mandela Day, the UN makes a significant statement: that regardless of our own circumstances or identity, we all have a responsibility to support human rights, the world over. We have a responsibility to promote a humane society, or Ubuntu: I am what I am because of who we all are. As Madiba wrote to the people of South Africa when refusing to accept conditional release from prison in 1985, “Your freedom and mine cannot be separated.”   This universal vision included gender equality and the empowerment of women: “freedom cannot be achieved unless the women have been emancipated from all forms of oppression.” Nelson Mandela said that in his 1994 State of the Nation address, soon after becoming South Africa’s first democratically elected President. Twenty years later, organizations like UN Women continue to make the case that progress for women and girls has massive economic and social benefits for humanity – that gender equality isn’t just a women’s issue. Nelson Mandela always understood this: I am what I am because of who we all are.   In 1992, I watched him stand up for women''s participation at a crucial ANC conference in Durban. In discussing a 30 per cent quota for women MPs, he held firm throughout a five-hour debate, despite sustained opposition from many men. Under his Presidency, women’s representation in parliament increased from 2.7 per cent to 27 per cent, and when it came time to choose his cabinet, he made sure that one-third were women.   The call to action on Mandela Day is for each of us to go out and do something. For men and boys to support gender equality, for those with wealth to support those of lesser means, for collective action on climate justice. For those of us who have had an opportunity to learn, it is a call to teach and share our knowledge. Mandela Day is a call to put Ubuntu into action! Visit the related web page
	View more stories