Statement by Tlaleng MofokengSpecial Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health

Seventy-five session of the General Assembly
Agenda item 72 (a-d): Promotion and protection of human rights

New York

29 October 2020

Madam Chair,
Excellencies and Delegates,
Distinguished persons,

I am encouraged to address this audience for the first time since I assumed office in August 2020. I am encouraged not only because of the many possibilities brought about by the discharging of functions as Special Rapporteur, but also because I have taken up functions amidst the COVID-19 pandemic which have highlighted more than ever the importance of the right to health and its interconnection with all human rights.

The report that I present today was prepared by Dainius Puras before ending his tenure and elaborates precisely on these matters. Since I am not the author of this report, I will not be in a position to discuss its content in depth. In this opportunity, I will also outline my vision for the mandate, which I hope to present in more detail to the Human Rights Council in June next year.

Distinguished delegates,

The last report by Mr. Puras provides a commentary on COVID-19 through the application of the right-to-health principles that he developed during his 6-year term. This is not a comprehensive analysis of the pandemic and the right to health, but an assessment of the interdependence of rights, power imbalances, corruption, and the overemphasis of the biomedical paradigm as well as the manner in which they all have contributed to COVID-19 spread and impact.

The report sustains that the virus' impact is determined more by public health policy, leadership, socio-economic inequalities, systemic racism, and structural discrimination than by biological factors. It includes a chapter on digital surveillance and immunity documentation that expresses concern over the pervasive and invasive use of technology to govern everyday life.

My predecessor concludes that, realizing the right to physical and mental health –whether before, during or after a public health crisis– requires all human rights to be fully embraced. He also stresses the need to protect people in vulnerable situations against the economic and social impacts of the crisis.

I agree with the report's final remarks in that health inequalities can never be overcome by the health-care system alone. This, as the said inequalities are also determined by the underlying and social determinants of health which extend beyond the health-care sector. Many major causes of poor mental and physical health arise from abuses to dignity and violations of other rights, including the rights to equality, security and equal participation in society.

Madam Chair,

I now turn to the outline of my vision for the next three years. I plan to ensure continuity and build up on the solid work developed by previous mandate holders. Paul Hunt, Anand Grover and Dainius Puras successfully set up a clear framework for the right-to-health analysis of a number of issues.

I will endeavor to take dignity as the pivotal principle that permeates the right to health. As Tlaleng Mofokeng, a Black woman myself, I understand that people are not intrinsically vulnerable, but that these vulnerabilities are rather brought by the obstacles they face in the social, economic and political contexts they live in.

I envision to gain a deeper understanding on the negative impact of coloniality, racism and the oppressive structures embedded in the global health architecture which disproportionately impacts Black people, indigenous peoples and people of colour communities as well as those in developing countries.

I am driven by the ideal of restoration of dignity and the identification of the contextual changes that are needed to remove the obstacles, oppressive systems and conditions that make people vulnerable to right-to-health violations.

I plan to apply this lens to certain topics that I have started to identify as priorities. Firstly, as a medical doctor and health practitioner on sexual and reproductive health, I wish to build on the comprehensive work already developed in this area, as they are an integral element of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. I will apply a gender perspective and identify good practices for the effective operationalization of the right-to-health using new approaches, innovations, and interventions.

An important question is the impact of criminalisation and need for zero discrimination regarding health-related issues such as drug use, sex-work, LGBTA+^[1] and intersex persons, safe abortions, disability health, mental health and adolescent health. I would like to enrich and develop further the very good work advanced by the mandate.

My experience as a first-responder over the years, on matters of gender-based violence and femicide and those violations against persons on the basis of their real or imputed sexual orientation or gender identity continue to be of concern to me. I am further concerned by the insufficient to inexistent support for victims and survivors of gender-based violence and femicide in many countries in respect of their life and the integrity of their person. This is a topic I would like to address as well.

I will pay particular attention to issues of health funding and financing, and the over-reliance on philanthropy and foreign aid in developing countries for essential health services including sexual and reproductive health. I will also address the human rights dimensions of the issues of neglected diseases, Non-Communicable Diseases, co-morbidities, lifespan and quality of life during my mandate.

I am also interested in climate change, migration and the impact on health planning and resources, especially on how innovation, digital technology and tele-health could and should be supported to increase access to health-related information and services.

Last but not least, I would like to continue the work developed previously regarding health-care workers; they are essential to ensure availability, acceptability, accessibility and quality of health care services for all. I wish to elaborate on health-care workers' health, mental wellness, allowances, remunerations and fairness in the workplace so they can deliver quality health services.

Distinguished persons,

These last months have been certainly challenging, but have also prompted us to come together as a world-wide society to jointly face the COVID-19 crisis and cooperatively search for solutions.

I look forward to our mutual collaboration in advancing the right to health of everyone. Thank you.

[1] Lesbian, gay, bisexual, transgender and asexual persons who often experience obstacles in accessing appropriate health care.