Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Anand Grover
The Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health visited Guatemala from 12 to 18 May 2010. The Special Rapporteur held meetings with Government representatives, civil society organizations, health professionals and representatives of indigenous communities in Guatemala City, Malacantacito, Huehuetenango and Ixtahuacán.
During the mission, the Special Rapporteur noted that the health sector in Guatemala is severely under-resourced and concentrated in urban areas. Furthermore, substantial inequalities exist in the enjoyment of the right to health for indigenous communities and women, particularly in the areas of sexual and reproductive health. He also expressed concern over Government policies that restrict access to medicines.
The report has six sections. In section I, the Special Rapporteur introduces the report. In section II, the historical context of the long-standing inequalities and discrimination in Guatemalan society is summarized, and the international and national legal frameworks of the right to health are outlined. In section III, the Special Rapporteur explores issues surrounding indigenous health, including the historical circumstances that led to the challenges currently being faced by these communities. These challenges largely relate to deep-seated inequalities and discrimination, which have had detrimental effects on the underlying determinants of health as well as access to health care. The concentration of health services in urban areas, insufficient funding and substantial language barriers were noted as key barriers to indigenous peoples’ access to health care, in addition to the lack of a comprehensive policy or national plan regarding the health care of indigenous peoples. In section IV, he discusses the right to health of women, particularly sexual and reproductive health. He notes that rural indigenous women remain a marginalized group and severe disparities exist in relation to contraceptive uptake and access to obstetric care. He also expresses concern over the status of abortion laws in Guatemala, and the resulting high rate of procurement of unsafe abortions, as well as the increasing prevalence of violence against women.
In section V, access to medicines is discussed, particularly Government policies concerning drug procurement and the intellectual property provisions of the Central American Free Trade Agreement, both of which curtail access to medicine. In section VI, the Special Rapporteur offers some recommendations pertaining to each of the areas considered throughout the mission.