Summary

The Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Dainius Pūras, visited Fiji from 28 November to 5 December 2019.

Fiji has a strong political will to realize the right to health. It has modernized outpatient and hospital care, invested in infrastructure and increased doctors’ salaries. While Fiji has initiated public-private partnerships in the health sector, the delegation of State’s duties to private providers does not absolve the State of its human rights obligations. Any public-private partnership should provide sufficient guarantees for the protection, respect and realization of the right to health, ensure transparency and participation and be backed by strong regulatory, monitoring and accountability mechanisms.

Fiji has the opportunity to develop modern rights- and evidence-based mental health care and to integrate mental health care in primary care, general health and social services. The actual realization of the right to physical and mental health will depend on addressing violence, discrimination and inequalities (through, inter alia, community-based psychosocial interventions) as much as on investments in the health-care system. Despite progress in many areas, paternalistic practices and attitudes among health-care workers continue to pose a challenge to the realization of the right to health on such issues as antenatal and postnatal depression, breast cancer and cervical cancer, teenage pregnancy, access to contraception and abortion services, and gender-based violence. More efforts will also be needed to address health care for diabetes and to improve health-care facilities.