Human Rights Council begins interactive dialogue with the Special Rapporteur on the right to health

3 July 2020

Concludes Separate Interactive Dialogues with the Special Rapporteur on the Right to Education and the Special Representative of the Secretary-General for Children and Armed Conflict

The Human Rights Council this afternoon began an interactive dialogue with the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.  It also concluded separate interactive dialogues with the Special Rapporteur on the right to education and the Special Representative of the Secretary-General for children and armed conflict.

Dainius Puras, the Special Rapporteur on the right to health, speaking via video message, underlined that a global agenda on mental health was a central component of his tenure.  The dominance of the biomedical model had resulted in an overuse of medicalisation and institutionalisation, ignoring the social, political or existential contexts.  The COVID-19 pandemic had fuelled mental distress, anxiety and fear owing to the spread of the virus, distancing and isolation, economic and social downturns, unemployment, and an increase in domestic and other types of violence.  COVID-19 had also exacerbated the failures of the status quo in mental health care.  He spoke about his visit to Ecuador.

In the ensuing discussion, speakers stated that it was essential to adopt a human rights-based approach to mental health, an approach that centred on the dignity and autonomy of those using health care services.  Mental health was inherently linked to the right to health as well as all other human rights, notably as regarded the realization of the Sustainable Development Goals.  Speakers asked the Special Rapporteur to comment on the specific challenges related to mental health that had emerged in the context of the COVID-19 pandemic, as well as on the best strategies to tackle them.

Speaking in the interactive debate were the European Union, Burkina Faso on behalf of the African Group, Malaysia, Paraguay and Sovereign Order of Malta (video message).

At the beginning of the meeting, the Council concluded an interactive dialogue with the Special Rapporteur on the right to education.  The interactive dialogue with the Special Rapporteur on the right to education started in the previous meeting and a summary can be found here.

Speakers emphasized that school closures due to the COVID-19 pandemic had affected over 60 per cent of students worldwide, according to the United Nations Children's Fund.  Developing countries and small island States felt the debilitating effects of the COVID-19 pandemic the most as it exposed existing climate-change related vulnerabilities and revealed technical difficulties, such as weak or non-existent internet coverage.  Speakers asked if international technological transfer could help remedy these gaps.

Koumbou Boly Barry, Special Rapporteur on the right to education, in her concluding remarks,  thanked countries which recognized the relevance of this issue and the recommendations she had put forward.  She welcomed efforts to ensure the access of pupils to education despite the pandemic.  It was fundamental for decision-makers to put in place prevention mechanisms to ensure resilience in the face of catastrophes, and pay heed to professors' advice and suggestions, as they, like a lot of families, had spared no efforts to uphold the right to education.

Speaking in the interactive debate were Malta, Jordan, Indonesia, Botswana, Morocco, El Salvador, Iraq, Sudan, Egypt, Maldives, Nepal, Marshall Islands, United Arab Emirates, Georgia, Bahamas, Ecuador, Bulgaria, Ukraine, Ghana, Paraguay, Nauru, Timor-Leste, Afghanistan, United Nations Educational, Scientific and Cultural Organization, South Sudan, Cambodia, Tanzania and Cuba.

The following civil society organizations also took the floor : Rutgers (video message), International Organization for the Right to Education and Freedom of Education, Instituto de Desenvolvimento e Direitos Humanos (video message), Istituto Internazionale Maria Ausiliatrice delle Salesiane di Don Bosco (video message), Edmund Rice International Limited, Make Mothers Matter, World Jewish Congress, Society for Threatened Peoples, China NGO Network for International Exchanges (video message) and China Foundation for Poverty Alleviation (video message). 

The Council then concluded the interactive dialogue with the Special Representative of the Secretary-General for children and armed conflict.  The interactive dialogue with the Special Representative started in a previous meeting and the summary can be found here.

In the discussion, speakers asked how the Council could provide added value to the mandate of the Special Representative of the Secretary-General for children and armed conflict.  The fact that the United Nations had identified 25,000 grave violations against children in the context of armed conflict was appalling.  The failure to hold perpetrators to account was a failure to protect children's human rights.  Speakers asked about the impact of the COVID-19 pandemic on children in armed conflict. 

Virginia Gamba, Special Representative of the Secretary-General for children and armed conflict, in concluding remarks, said the Security Council and the Human Rights Council, to better collaborate, could organize informal meetings between their respective presidents.  Greater access for child protection experts was needed, so they may better reach out to children in lockdown in conflict situations.  Stigma, fear, intimidation and impunity of perpetrators had to be addressed for survivors to come forward with their testimonies.

Speaking in the interactive debate were Spain (video message), Iran, Malta, Jordan, Luxembourg, Indonesia, Botswana, Croatia, Iraq, Greece, Azerbaijan, Viet Nam, Nigeria, United Kingdom, Germany, Switzerland, Georgia, Mali, Myanmar, Ukraine, Algeria, Niger, South Sudan, Afghanistan, Italy, Venezuela, Egypt, Tunisia and Morocco. 

The following civil society organizations also took the floor : Colombian Commission of Jurists (video message), Save the Children International, Christian Solidarity Worldwide (video message), Defence for Children International, International Organization for the Elimination of All Forms of Racial Discrimination, Synergie Feminine pour la Paix et Le Developpement Durable, Villages Unis, United Nations Watch (video message), Il Cenacolo (video message) and Institute for NGO Research (video message).

Speaking in right of reply at the end of the meeting were Cuba, China, Bangladesh and Colombia.

The Council will next meet on Monday, 6 July at 10 a.m. to conclude the interactive dialogue with the Special Rapporteur on the right to health.  It will then start an interactive dialogue with the Working Group on discrimination against women and girls.

Interactive Dialogue with the Special Rapporteur on the Right to Education

The interactive dialogue with the Special Rapporteur on the right to education started in the previous meeting and a summary can be found here.

Discussion

Speakers noted that school closures due to the COVID-19 pandemic had affected over 60 per cent of students worldwide, according to the United Nations Children's Fund.  The Special Representative was asked how the exchange of best practices could be stepped up between States to improve remote learning.  Developing countries and small island States felt the debilitating effects of the COVID-19 pandemic the most as it exposed existing climate-change related vulnerabilities and revealed technical difficulties, such as weak or non-existent internet coverage.  It was regrettable that, as a result, millions of young people were placed at a disadvantaged position in the era of digital transformation.   Speakers asked if international technological transfer could help remedy these gaps.  The potential role of the Office of the High Commissioner and other international organizations in coordinating countries' response to the pandemic in the area of education was also raised.  Countries should pay particular attention during students' return to classes, minimising instances of school dropouts.  Some speakers noted that States should consider instituting ceilings on private school tuition.  Multiple speakers emphasised that the role of teachers in the provision of education was fundamental, asking for advice on how to best assist them in the transition from face-to-face to digital provision of education.  The negative effect of digital learning on the most vulnerable, including the disabled, was also raised. 

Speakers recommended that governments include parents, guardians, health providers and educators in providing education services.  They urged the international community to bear in mind the importance of fostering trust between institutions and populations.  To respect and include diversity, guaranteeing education was not sufficient ; opening a dialogue between various social and cultural groups was also necessary, as was adopting an anti-sexist and anti-discriminatory approach.  It was important to regulate the massive arrival of private actors that sought to privatize education for profit through the use of technology.  Some speakers drew attention to the impact of the COVID-19 pandemic on the demand for unpaid care work, which increased gender inequalities.  Some speakers said that the spread of conspiracy theories that were anti-Semitic had shone light on the shortcomings of education which had led to lacking critical thinking and literacy skills.  Quality education was not only crucial to children's life-long development, but also an effective tool to counter inter-generational poverty, speakers said.

Concluding Remarks by the Special Rapporteur

KOUMBOU BOLY BARRY, Special Rapporteur on the right to education, thanked countries which recognized the relevance of this issue and the recommendations she had put forward.  She welcomed efforts to ensure the access of pupils to education despite the pandemic.  It was fundamental for decision-makers to put in place prevention mechanisms to ensure resilience in the face of catastrophes, and pay heed to professors' advice and suggestions, as they, like a lot of families, had spared no efforts to uphold the right to education.

Interactive Dialogue with the Special Representative of the Secretary-General for Children and Armed Conflict

The interactive dialogue with the Special Representative of the Secretary-General for children and armed conflict started in a previous meeting and the summary can be found here.

Discussion

Speakers asked how the Council could provide added value to the mandate of the Special Representative of the Secretary-General for children and armed conflict.  The fact that the United Nations had identified 25,000 grave violations against children in situations of armed conflict was appalling.  The failure to hold perpetrators to account was a failure to protect children's human rights, speakers said, asking how the COVID-19 pandemic had impacted children in armed conflict.  Other speakers welcomed the progress made in terms of the prosecution of the perpetrators of severe violations against children that was facilitated by the office of the Special Representative.  Child integration into peace processes, as well as the reintegration of children into society after armed conflict, must be prioritised by the Council.  Speakers expressed concern with regard to the forced recruitment and deployment of children in armed conflict, recognising that much more needed to be done in order to prevent the use of children in armed conflict.  Young women and girls in armed conflict situations were particularly vulnerable to sexual exploitation, and speakers inquired as to how countries could best address these vulnerabilities and reintegrate victims into society.  The campaign of the Special Representative to promote the Act to Protect Children Affected by Conflict was welcomed.  Some speakers noted that the report had not referred to any children who were victims of protracted conflicts that began decades ago, and were themselves now parents of internally displaced children. 

Some speakers regretted actions that impeded the delivery of humanitarian aid to children.  All parties to a conflict had to abide by international humanitarian law principles.  Speakers underlined the importance of the accession of States to international instruments that protected children from the negative effects of armed conflict.  This year marked the twentieth anniversary of the Optional Protocol to the Convention on the Rights of the Child on the involvement of children in armed conflict, which had led to significant positive outcomes.  Speakers said it was fundamental to include children in peace processes.  They drew attention to the interlinkages between development and conflict ; this nexus required bolstering institutional safeguards, notably the rule of law.  More consideration should be given to gender dynamics.  Attacks against educational institutions that had taken place during armed conflicts were also a source of concern, and the Special Representative should reach out to States to address this issue.  The international community needed new and bold strategies to deal with this topic.  The Secretary-General's decision to remove some violators from his shame list was difficult to understand, several speakers. 

Concluding Remarks by the Special Representative of the Secretary-General

VIRGINIA GAMBA, Special Representative of the Secretary-General for children and armed conflict, thanked Member States and non-governmental organizations for their comments and questions.  The Security Council and the Human Rights Council, to better collaborate, could organize informal meetings between their respective presidents.  Greater access for child protection experts was needed, so they may better reach out to children in lockdown in conflict situations.  Stigma, fear, intimidation and impunity of perpetrators had to be addressed for survivors to come forward with their testimonies.  She underlined the importance of working on prevention and noted that Security Council resolution 2427 on children and armed conflict was useful to that end.

Interactive Dialogue with the Special Rapporteur on the Right to Health

Documentation

The Council has before it the Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (A/HRC/44/48).

The Council has before it the Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health on his visit to Ecuador (A/HRC/44/48/Add.1).

The Council has before it the Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health on his visit to Ecuador – Comments by the State (A/HRC/44/48/Add.2).

Presentation of Reports by the Special Rapporteur on the Right to Health

DAINIUS PURAS, Special Rapporteur on the right to health, speaking via video message, underlined that a global agenda on mental health was a central component of his tenure.  The dominance of the biomedical model resulted in an overuse of medicalisation and institutionalisation, ignoring the social, political or existential contexts.  There were no biological markers for mental health conditions, hence pathophysiology and specific mechanisms by which psychotropic drugs may have been effective were simply unknown.  This legacy of excessive medicalisation reflected an unwillingness to confront human suffering meaningfully and embedded an intolerance towards the diversity of emotions everyone experienced in life, risking the entrenchment of discrimination against marginalised groups such as persons with disabilities, people in poverty, persons who used drugs and more.  A paradigm shift, as a result, was urgently needed.  Treatment and distress must move beyond the biomedical understanding of mental health and acknowledge that, for the majority of mental health conditions, psychosocial and other social interventions were the essential option for treatment.  Mental health care action and investment must be directed to rights-based support and to non-coercive alternatives that addressed the psychosocial determinants of health. 

The COVID-19 pandemic had fuelled mental distress, anxiety and fear owing to the spread of the virus, distancing and isolation, economic and social downturns, unemployment, and an increase in domestic and other types of violence.  COVID-19 had also exacerbated the failures of the status quo in mental health care.  Institutions had become hotspots for the virus : from persons with disabilities in psychiatric institutions, to older persons and children in care homes and people in detention, they had all become more vulnerable to contagion.  Mr. Puras called for the ultimate elimination of segregated psychiatric institutions that reflected the historic legacy of social exclusion, disempowerment, stigma and discrimination. 

Regarding the visit to Ecuador, the Special Rapporteur said the country had made progress by investing in health infrastructure, yet its proposed austerity measures risked affecting the effectiveness of the national health-care system.  The investments must be complemented by improvement in coverage and accessibility in rural areas and in indigenous and Afro-Ecuadorian communities.  Considering the high prevalence of violence, notably against women and girls, and discrimination against certain groups, it was also vital for Ecuador to address discrimination and violence against women and girls, children and adolescents, lesbian, gay, bisexual and transgender persons, people living with HIV/AIDS and people on the move.

Discussion

Speakers said that it was essential to adopt a human rights-based approach to mental health, an approach that centred on the dignity and autonomy of those using health care services.  Mental health was inherently linked to the right to health as well as all other human rights, notably as regarded the realization of the Sustainable Development Goals.  Human rights violations in the mental sector were widespread.  Speakers asked the Special Rapporteur to comment on the specific challenges related to mental health that had emerged in the context of the COVID-19 pandemic, as well as on the best strategies to tackle them.  Some speakers said the pandemic necessitated for greater solidarity.  In that regard, they noted with concern that mental health issues could worsen social exclusion.  Speakers committed to a holistic approach to healthcare, and vowed to combat the stigma attached to mental health issues.  Some of them expressed the will to turn away from hospital-centric mental health care services, and underlined the benefits of community-based care in that regard.

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For use of the information media; not an official record