THE AFRICAN COMMISSION ON HUMAN AND PEOPLES’ RIGHTS

The African Charter on Human and Peoples’

Rights establishes the African Commission on Human and Peoples’ Rights, cf. Articles 30-63 of the African Charter. Among its tasks is to consider state reports from the states having ratified the African Charter (53 of the 54 AU member states), somewhat similar to what is done at the United Nations human rights committees. This means that also civil society and NHRIs are invited to provide information directly to the Commis-sion. The states coming up for examination can normally be found on the website of the Commission. States are supposed to report both on the rights set out in the African Charter and, provided they are parties to the Protocol on the Rights of Women, on the rights set out in this Protocol. In the guide-lines for reporting on the Protocol, adopted by the Commission in May 2010, the follow-ing issues are mentioned among issues to

The African Commission prepares conclud-ing observations followconclud-ing examinations.

Regrettably, the publication of these is spo-radic but some can be found on the website of the Commission. In the concluding obser-vations concerning Uganda, adopted in May 2009, Uganda was commended for estab-lishing HIV/AIDS Health Centres in every sub-district and for putting in place an HIV/

AIDS National Policy. Among the concerns mentioned were the prevalence of harmful cultural practices like the ritual sacrifice of children, female genital mutilation and early marriages. The Commission also recom-mended that Uganda ratify the Protocol on the Rights of Women.

Another example is the concluding obser-vation concerning Botswana, adopted in November 2009. The Commission com-mended Botswana for its effort to contain the spread of HIV/AIDS, including by mak-ing anti-retroviral drugs and prevention of mother to child transmission programmes available and for carrying out awareness campaigns, while also raising concern that the requirement that parents accompany minors for HIV testing may discourage test-ing, thus potentially contribute to the spread of HIV/AIDS.

In 2010, the Commission adopted con-cluding observations on Cameroon, which included a recommendation to reinforce efforts in relation to reproductive health “in order to raise the level of access by women and

Furthermore, the Commission issues resolu-tions. In 2001, it issued a resolution on the HIV/AIDS Pandemic, confirming that this is indeed a human rights issue, calling upon states to allocate the necessary resources, ensure human rights protection of persons living with HIV/AIDS, provide support for families caring for the dying, devise health-care programmes of education, carry out awareness-raising campaigns and take necessary medical interventions. The Com-mission also called upon the international pharmaceutical industry and international donors to do their share.

In 2004 the African Commission adopted the so-called Pretoria Declaration on Economic, Social and Cultural Rights in Africa. This Declaration had originally been adopted at a meeting in Pretoria with rep-resentatives of the Commission, 12 African states, NHRIs and NGOs. In the Declaration the participants attempted to flesh out the economic, social and cultural rights con-tained in the African Charter. With respect to health, Article 16 of the African Charter, it is stated that this entails, among other things, accessible and affordable health care for all; access to reproductive, maternal and child health care; and education, prevention and treatment of HIV/AIDS.

The Pretoria Declaration contains individ-ual recommendations to the various actors, including to NHRIs. NHRIs are recom-mended to work on economic, social and cultural rights, including undertaking

stud-In 2008 the African Commission adopted a Resolution on Maternal Mortality in Africa. In it the African Commission refers, among other things, to the ICPD Pro-gramme of Action, the Beijing Declaration and the MDGs. The Commission goes on to declare that preventable maternal mortality is a violation of the rights to life, health and dignity of women in Africa, enshrined in both the African Charter and the Protocol on the Rights of Women, and calls upon the African governments to address this issue in accordance with the recommen-dations attached to the resolution. Among the recommendations are allocating 15% of national budgets to the health sector and to adopt Human Rights Based Approaches to reduce maternal mortality, including ensuring that poor and rural women have access to health services; ensuring “as much as practicable” free, accessible and available antenatal and obstetric services; ensur-ing women and civil society participation in formulating, implementing, monitoring and evaluating policies to secure maternal health; providing maternity centres in rural areas; securing skilled health personal and birth attendants in rural and semi-urban areas; training health workers in emer-gency obstetric care; developing emeremer-gency transport systems; and developing training curricula for educating women and girls on reproductive rights.

The Commission has also adopted a Gen-eral Comment on Article 14(1)(d) and (e) of

the right to be informed of one’s health sta-tus. This General Comment provides more detailed guidance on States’ obligations in this context.

Similar to the United Nations human rights system, the African Commission has estab-lished a number of special procedures in the form of special rapporteurs and work-ing groups. None of them directly targets the issue of reproductive health but there is a Special Rapporteur on the Rights of Women in Africa, and in 2010 the Com-mission established a Committee on the Protection of PLHIV [People Living with HIV]

and Those at Risk. The Special Rapporteur on Women has been dealing with the issue of reproductive rights, see for instance her Intersession Report from May 2009 where she recommends states to take more steps against violence against women, including sensitization campaigns, law reform, and access to justice etc. This Report also rec-ommends states to ensure women access to health, including reproductive health, such as securing access to quality health care and to reproductive health especially in the rural areas; offering more comprehensive health services in the area of sexuality and contra-ception with a view to avoiding illegal abor-tions among adolescents; and promoting sex education for boys and girls, primarily to prevent early pregnancies and combat sex-ually transmitted diseases and HIV Aids, cf.

Paragraphs 72-74.

comprehensive document is the 2005 Con-tinental Policy Framework on Sexual and Reproductive Health and Rights, devel-oped by the African Union Commission in collaboration with, among others, UNFPA.

This was adopted by the African Ministers of Health meeting in October 2005 and endorsed by the AU Executive Council in January 2006.¹ In its endorsement the AU Executive Council specifically recognizes the role of Sexual and Reproductive Health and Rights in the attainment of the Millennium Development Goals (MDGs) and urges the member states to mainstream these rights in their national health programmes by developing linkages between sexual and reproductive health and rights, HIV/AIDS and other primary health care programmes and to draw inspiration from the Continental Policy Framework. On this basis, the Maputo Plan of Action for the Operationalisation of the Continental Policy Framework for Sexual and Reproductive Health and Rights 2007-2010 was prepared and adopted by the Ministers of Health in September 2006.

The Continental Policy Framework is a very extensive document that basically advo-cates for mainstreaming sexual and repro-ductive health and rights in primary health care to accelerate the achievement of the health-related MDGs; addresses the most common causes of maternal and new born child morbidity and mortality and identifies the implementation of the Roadmap for the Acceleration of the Reduction of Maternal

development programmes by facilitating improved women’s health thereby increas-ing their participation in national economic development; and calls for including sexual and reproductive health related medicine in the Essential Drug Lists. The annexed policy framework lists and explains eleven priori-ties, being:

1. Sexual and reproductive health legisla-tion into primary health care;

2. Integration of sexual and reproductive health services;

3. Sexual and reproductive health communication;

4. Budgeting of sexual and reproductive health activities;

5. Mainstreaming gender in development programmes;

6. Youth sexual and reproductive health;

7. Mid-life concerns of both men and women;

8. The fight against the HIV/AIDS pandemic;

9. Strengthening of sexual and reproduc-tive health programme of the AU;

10. Establishment of an African maternal and infant mortality advocacy day; and

1. Increase resources to sexual and repro-ductive health and rights programmes;

2. Translate ICPD commitments into national legislation;

3. Reduce maternal mortality;

4. Reduce infant and child mortality;

5. Young people’s sexual and reproductive health and rights;

6. Combat HIV/AIDS;

7. Expand contraceptive use;

8. Reduce levels of unsafe abortion, 9. Female genital mutilation

10. Gender-based violence

As set out in Paragraph 16, an overarch-ing goal of the Maputo Plan of Action is to achieve universal access to sexual and reproductive health in all African countries by 2015.

Another important recent initiative is

CARMMA, the Campaign on Accelerated Reduction of Maternal Mortality in Africa.

This is an initiative of the AU Commission, supported by the member states (it was launched at a meeting of the African Min-isters of Health in May 2009) and various United Nations agencies (WHO, UNICEF,

society organizations. The main purpose of CARMMA is to promote and advocate for renewed and intensified implementation of the Maputo Plan of Action. CARMMA has so far been launched in more than 20 Afri-can countries. As an example Sierra Leone used the CARMMA initiative to introduce free treatment and medicines for pregnant women, lactating mothers and children under five at all government health facilities.

The theme of the AU Summit of Heads of State and Government in July 2010 in Uganda was “Maternal, Infant and Child Health and Development in Africa”. In its Declaration on Action on Maternal, New-born and Child Health and Development in Africa by 2015, the Heads of State and Government among other things undertook to launch CARMMA in their respective countries, involve all key stakeholders, such as civil society organizations, religious and community leaders, media, etc. and institu-tionalize an annual CARMMA week each year until 2015; strengthen the health care system to provide comprehensive maternal, new born and child health care services and reposition family planning including reproductive health commodities security;

provide sustainable funding, e.g. by reduc-ing out-of-pocket payments; and institute a strong monitoring and evaluation frame-work at country level. NHRIs could con-ceivable play a role in such monitoring and evaluation.

and their reproductive health; establish strong maternal and child health pro-grammes; address unmet family planning needs of adolescent and others; promote the education of men and women on joint responsible parenthood; assure availability and promote the use of contraception and fertility regulation methods to double the contraceptive prevalence rate from about 10 to about 20% by 2000 and to 40% by 2010; and promote research into human reproduction, cf. Paragraph 3. The Decla-ration also recommends giving priority to combating infant, child and maternal mor-bidity and mortality, aiming for an infant mortality rate of less than 50 per 1000 live births and for a reduction of maternal mortality by at least 50% from 1990 levels by 2000 with some of the means being quality family planning services and studies to reduce unsafe abortions, cf. Paragraph 4. The Declaration also mentions the need to establish and strengthen programmes to combat HIV/AIDS, cf. Paragraph 4, and the need to strengthen women’s status within the family, cf. Paragraph 7.

The Dakar/Ngor Declaration on Popula-tion, Family and Sustainable Development, adopted by the relevant ministers, was endorsed by the Heads of State and Govern-ment in the OAU Declaration on Popula-tion and Development in Africa, adopted in June 1994. In this Declaration, the inter-play between population, environment and sustainable development is acknowledged