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	100 million people are being forced into poverty each year due to high cost of health care by Jeanette Vega The Lancet & agencies   Dec 2013   100 million people are being forced into poverty each year due to high out-of-pocket spending on health care, writes Jeanette Vega, Director of the Rockefeller Foundation.   In June 2012, Marly Aparecida Dias Gaya’s life in Sao Paulo, Brazil changed dramatically when she fell down the stairs and hit her head. Her injury had doctors worried she might never walk, talk, or even recognise her family again.   Marly underwent two successful brain operations, as well as treatment for her other injuries, and slowly began to recover. She spent a month in the hospital – including 10 days in intensive care – before she was finally able to return home to her family.   Fortunately, in the wake of such a debilitating event, she will not have to worry about medical expenses. She did not have to pay anything for her treatment because all costs were covered by the Sistema Unico de Saude, Brazil’s health system.   Brazil is one of a number of countries on the path towards universal health coverage. Almost a year ago, the United Nations passed a historic resolution on universal health coverage stating that no man, woman, or child should fall into poverty because he or she cannot afford the necessary health services needed to live a healthy, productive life.   With 1 billion people unable to access high quality basic health services and 100 million being forced into poverty each year due to high out-of-pocket spending on health care, huge challenges remain.   Low- and middle-income countries are increasingly reforming their health systems based on the principles of universalisation, equity, and sustainability. For more than a decade, Rwanda, a low-income country, has implemented health reforms specifically aimed at making quality and affordable health services accessible to all.   When they started, many experts said it was impossible – but Rwanda trained a team of 45,000 community health workers to help their fellow citizens understand the importance of prevention, screening, and early treatment. Rwanda also implemented a community insurance scheme.   Results were not achieved overnight and long-term planning and investment were critical, but Rwanda can now point to several successes. Since 1994, HIV infections have been halved, malaria deaths have been reduced by three quarters, and child mortality is down 70 percent – one of the fastest rates of decline in the world. More than ninety percent of Rwanda’s population is now covered, and Rwanda is one of the only countries on track to meet the Millennium Development Goals.   The experience from Rwanda and Brazil contributes to the ever growing body of international evidence that universal health coverage is necessary to improve health and reduce poverty for people worldwide, particularly those in low- and middle-income countries.   Countries such as Bangladesh, Ethiopia, Ghana, Indonesia, Peru, Thailand, Turkey, Rwanda, and Vietnam all stand at various points on the path towards universal health coverage. We must help empower them to prioritise UHC through efforts that encourage joint knowledge sharing and problem solving, to ensure that they are able to deliver the promise of affordable, quality health care for all their people.   Universal health coverage is a powerful means of increasing equitable access to quality care and bolstering the financial resilience of poor and vulnerable populations.   Improving health has a transformative effect in the battle against poverty – and universal health coverage is a proven way to increase coverage, decrease out-of-pocket expenses, and create a situation where all people can use the critical health services they need without the fear of impoverishment.   As discussions move forward on identifying future global health objectives after the Millennium Development Goals expire, and countries strive to find ways of simultaneously improving health outcomes, reducing poverty and stimulating their economies, one thing is certain: universal health coverage is both a human right and a smart economic choice.   http://www.thelancet.com/commissions/global-health-2035 Visit the related web page
	300 Groups call for Human Rights in Post-2015 Development Plan by CESR, Plan, Amnesty, AWID & many others   10 December, 2013   Human rights have surged to the forefront of the debate about what will succeed the Millennium Development Goals in 2015. As human rights and social justice organizations worldwide, we feel compelled to lay out some of the baseline implications of embedding human rights into the core of the sustainable development agenda this time around.   At its essence, a post-2015 framework anchored in human rights moves from a model of charity to one of justice, based on the inherent dignity of people as human rights-holders, domestic governments as primary duty-bearers, and all development actors sharing common but differentiated responsibilities. Accordingly, the post-2015 framework should be designed as a tool to empower and enable people—individually and collectively—to monitor and hold their governments, other governments, businesses, international institutions and other development actors to account for their conduct as it affects people’s lives within and beyond borders. A sustainable development framework founded in human rights can serve as an instrument for people and countries to help unseat the structural obstacles to sustainable, inclusive and just development, prevent conflict and stimulate implementation and enforcement of all human rights—civil, political, economic, social and cultural rights, the right to development, and to a healthy environment.   The post-2015 framework must then at the very least respect and reflect pre-existing human rights legal norms, standards and political commitments to which governments have already voluntarily agreed. International human rights, environmental and humanitarian law, the Millennium Declaration, as well as related international consensus documents agreed in Rio, Vienna, Cairo, Beijing, Monterrey and Copenhagen and their follow-up agreements must form its non-negotiable normative base.   If it is going to incentivize progress while also preventing backsliding and violations, human rights principles and standards must go beyond the rhetorical, and have real operational significance this time around. Among other things, anchoring the post-2015 agenda in human rights for current and future generations implies that the framework:   1. Upholds all human rights for all. The framework should stimulate improved human rights process and outcomes for all people, especially the most vulnerable, in all countries global North and global South. Along with economic, social, cultural and environmental rights, any successor framework must include commitments to protect freedom of association, expression, assembly and political participation if it is to ensure an enabling environment for an empowered civil society, and protect human rights defenders, including women human rights defenders, as central agents translating international political commitments into lived realities.   2. Stimulates transparency and genuine participation in decision-making at all levels, throughout all policies including budget, financial, and tax policies. Access to information and meaningful and effective participation are not only fundamental human rights, but will also be critical to developing, implementing, and monitoring an effective and responsive post-2015 framework.   3. Integrates meaningful institutions and systems to ensure human rights accountability of all development actors. Lofty aspirations for a post-2015 agenda will surely fail if proper citizen-led systems of monitoring and human rights accountability are not built into the very DNA of the framework, with clear and time-bound commitments of all relevant actors.   While states must remain the primary duty-holder in development, all development actors, including third-party states, the private sector and international financial institutions should be made responsive and accountable for achieving and not undermining global goals. Integrating substantive human rights criteria into assessments of progress towards development goals and commitments means monitoring both the policy and budgetary efforts of governments alongside development outcomes. Any post-2015 monitoring mechanism should complement and reinforce the Universal Periodic Review process for all states.   A framework for ensuring accountability would benefit from constructive interaction with the existing human rights protection regime, as well as other relevant accountability mechanisms. In this context, we call for an accountability framework with binding commitments, supported by effective monitoring and enforcement mechanisms, to be agreed at the global level. This framework should reaffirm the spirit of the 1986 Declaration on the Right to Development and it should be based on three fundamental principles: mutual accountability (donors and partners are equally accountable for development progress); democratic ownership of partner countries (alignment of donor countries to policy objectives set by developing countries, through inclusive and democratic processes); and inclusive partnerships (participation of different varieties of development stakeholders, State and non-State actors).   4. Is backed by national mechanisms of accountability, such as judiciaries, parliaments, national human rights institutions, reinforced by regional and international human rights mechanisms such as the treaty bodies and the Universal Periodic Review mechanism, so as to ensure the implementation of the post-2015 commitments. The post-2015 development agenda is well-placed to encourage governments to improve access to justice for people living currently in poverty by monitoring measures to eradicate existing barriers.   5. Ensures that the private sector, at the very least, does no harm. The post-2015 framework must reflect current international consensus that governments have a duty to protect human rights through the proper oversight and regulation of private actors, especially of business and private financial actors, to guarantee in practice that they respect human rights and the environment, including in their cross-border activities.   At the very least, no governments should allow their territory to be used for illegal or criminal activities elsewhere, such as tax evasion, depositing assets obtained through corruption, environmental crimes or involvement in human rights violations, no matter the perpetrator.   6. Eliminates all forms of discrimination and diminishes inequalities, including socioeconomic inequalities. Human rights can only be realised within socio-economic and environmental boundaries if we also reduce inequalities of wealth, power and resources. Governments have a particular obligation under human rights law to protect the rights of the most marginalized and excluded, and to take additional measures to ensure that they enjoy their rights on an equal basis with others. Protecting decent work, and diminishing unfair wage disparities is also fundamental to reducing socio-economic inequality, as is reforming tax and fiscal policy and promoting human rights alternatives to austerity nationally and globally to unleash the resources necessary to finance human rights fulfillment. The timely collection and disaggregation of data on the basis of various grounds of compound discrimination is essential to identify, make visible and respond to inequalities and violations of human rights and to increase accountability. At a national level, data should be collected and disaggregated based on country-relevant factors as defined by rights-holders.   7. Specifically and comprehensively supports women"s rights. Addressing gender-based violence, guaranteeing sexual and reproductive rights, ensuring women’s rights to and control over land, property and productive resources and their economic independence, recognizing the care economy and ensuring women’s rights to social protection and the equal distribution of paid and unpaid work, and their rights to participation in decision-making are critical, not only to realize women"s human rights and achieve gender equality, but for enabling women’s full and active participation in economic, political and social life.   8. Enables the currently disadvantaged and commonly discriminated against and excluded groups to be effective agents of their own development by drawing on the provisions of human rights standards aimed at eliminating discrimination on grounds such as race, disability, migrant or indigenous status, age, sexual orientation, gender identity, etc.   9. Upholds the legal obligation to fulfill the minimum essential levels of economic, social, and cultural rights, without retrogression. This would imply a focus on universal or “zero” targets, such as the provision of comprehensive social protection floors, universal health coverage, minimum food security guarantees, and other floors below which no one anywhere will be allowed to fall.   10. Tackles structural drivers of inequality, poverty and ecological devastation at the global level. A genuine and balanced global partnership then would enable people and institutions to monitor the common but differentiated responsibilities of all actors to eliminate rather than perpetuate these global obstacles. To be good-faith partners then, governments, business and international institutions must assess the human rights impact beyond their borders of their policies and agreements in areas such as corporate accountability, environment, trade, investment, aid, tax, migration, intellectual property, debt, weapons trade and military cooperation, monetary policies and financial regulation. Existing human rights norms can provide a common set of standards and useful yardstick to assess policy coherence for sustainable development.   At a time of great uncertainty, multiple crises and increasing insecurity and conflict, let us not found the 21st century sustainable development framework on "bracketed rights" and broken promises, but instead on a bold reaffirmation of human rights for all. Visit the related web page
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