Achieving universal health coverage for sexual and reproductive health during the COVID-19 pandemic

15 June 2020 

The current COVID-19 crisis has exacerbated some of the fault lines that had already existed between universal health coverage (UHC) and sexual and reproductive health and rights (SRHR). To further identify gaps and present possible solutions, the journal Sexual and Reproductive Health Matters (SRHM) released a themed issue titled Universal Health Coverage: Sexual and Reproductive Rights in Focus, in collaboration with the Partnership for Maternal, Newborn & Child Health (PMNCH) and other partners.

A webinar, moderated by IAP member Gita Sen, was held on 15 June 2020 to launch the issue and explore a new reality of achieving SRHR in the context of UHC during the current pandemic and beyond. Panelists included PMNCH Executive Director Helga Fogstad, who offered some introductory remarks; PMNCH Board Chair Helen Clark, who spoke on upholding rights as an opportunity to build back better after the COVID-10 crisis; Sundari Ravindran, a Principal Visiting Fellow at the United Nations University Institute for Global Health, who provided a review of recent evidence of SRHR in UHC packages; Allan Maleche, Executive Director of KELIN, who offered observations from a recent UHC experiment in Kenya; Naomi Lince-Deroche, Senior Research Scientist at the Guttmacher Institute, who spoke on a human rights approach for SRHR budgeting in a time of limited resources; and WHO’s Manjulaa Narasimhan, who presented on self-care interventions.

The SRHM journal issue is now available online. More papers are expected to be added to the issue throughout the year.


Human Rights and Coronavirus: What’s at Stake for Truth, Trust, and Democracy?

Alicia Ely Yamin and Roojin Habibi

Health and Human Rights Journal, 1 March 2020

It has scarcely been a month since COVID-19 (then simply known as the disease caused by a novel ‘coronavirus’) was declared a “public health emergency of international concern”. The virus has since travelled to every continent except Antarctica, and prompted at least 80 travel restrictions against China, with many others now targeting secondarily affected countries, such as Iran, Italy, and South Korea.[1]

Although World Health Organization (WHO) Director General Dr. Tedros Ghebreyesus has called for solidarity, not stigma, it is notable that to date WHO has not issued any substantive guidance on how countries can take public health measures that achieve health protection while respecting human rights. Amid growing public fears, confusion, and misinformation, as well as government reactions that may fuel rather than mitigate intolerance, discrimination and exclusion, it is critical to set out some key human rights principles and the guidance they provide. Read more

Do not violate the International Health Regulations during the COVID-19 outbreak

Alicia Ely Yamin and Roojin Habibi

The Lancet, 13 February 2020

The International Health Regulations (2005) (IHR) govern how 196 countries and WHO collectively address the global spread of disease and avoid unnecessary interference with international traffic and trade. Article 43 of this legally binding instrument restricts the measures countries can implement when addressing public health risks to those measures that are supported by science, commensurate with the risks involved, and anchored in human rights. The intention of the IHR is that countries should not take needless measures that harm people or that disincentivise countries from reporting new risks to international public health authorities. In imposing travel restrictions against China during the current outbreak of 2019 novel coronavirus disease (COVID-19), many countries are violating the IHR. We—16 global health law scholars—came to this conclusion after applying the interpretive framework of the Vienna Convention on the Law of Treaties and reaching a jurisprudential consensus on the legal meaning of IHR Article 43. Read more

Legislating for public accountability in universal health coverage, Thailand

Kanang Kantamaturapoj, Anond Kulthanmanusorn, Woranan Witthayapipopsakul, Shaheda Viriyathorn, Walaiporn Patcharanarumol, Churnrurtai Kanchanachitra, Suwit Wibulpolprasert & Viroj Tangcharoensathien

Bulletin of the World Health Organization, Special theme issue: accelerating universal health coverage, February 2020

Sustaining universal health coverage requires robust active public participation in policy formation and governance. Thailand’s universal coverage scheme was implemented nationwide in 2002, allowing Thailand to achieve full population coverage through three public health insurance schemes and to demonstrate improved health outcomes. Although Thailand’s position on the World Bank worldwide governance indicators has deteriorated since 1996, provisions for voice and accountability were embedded in the legislation and design of the universal coverage scheme. We discuss how legislation related to citizens’ rights and government accountability has been implemented. Thailand’s constitution allowed citizens to submit a draft bill in which provisions on voice and accountability were successfully embedded in the legislative texts and adopted into law. The legislation mandates registration of beneficiaries, a 24/7 helpline, annual public hearings and no-fault financial assistance for patients who have experienced adverse events. Ensuring the right to health services, and that citizens’ voices are heard and action taken, requires the institutional capacity to implement legislation. For example, Thailand needed the capacity to register 47 million people and match them with the health-care provider network in the district where they live, and to re-register members who move out of their districts. Annual public hearings need to be inclusive of citizens, health-care providers, civil society organizations and stakeholders such as local governments and patient groups. Subsequent policy and management responses are important for building trust in the process and citizens’ ownership of the scheme. Annual public reporting of outcomes and performance of the scheme fosters transparency and increases citizens’ trust. Read more