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应对不平等:被忽视的热带病与人权

Addressing Inequity: Neglected Tropical Diseases and Human Rights.

作者信息

Sun Nina, Amon Joseph J

机构信息

Independent consultant based in Geneva, Switzerland.

Vice president for neglected tropical diseases at Helen Keller International in New York, USA.

出版信息

Health Hum Rights. 2018 Jun;20(1):11-25.

Abstract

Twenty neglected tropical diseases (NTDs) are currently recognized by the World Health Organization. They affect over one billion people globally and are responsible for significant morbidity, mortality, poverty, and social stigmatization. In May 2013, the World Health Assembly adopted a resolution calling on member states to intensify efforts to address NTDs, with the goal of reaching previously established targets for the elimination or eradication of 11 NTDs. The resolution also called for the integration of NTD efforts into primary health services. NTDs were subsequently included in Sustainable Development Goal (SDG) 3, which calls for an end to the "epidemics of AIDS, tuberculosis, malaria and NTDs" by 2030. While both the World Health Assembly resolution and SDG 3 provide a strong framework for action, neither explicitly references the human right to the highest attainable standard of health or describes a rights-based approach to NTDs' elimination. This article identifies key human rights relevant to NTD control and elimination efforts and describes rights-based interventions that address (1) inequity in access to preventive chemotherapy and morbidity management; (2) stigma and discrimination; and (3) patients' rights and non-discrimination in health care settings. In addition, the article describes how human rights mechanisms at the global, regional, and national levels can help accelerate the response to NTDs and promote accountability for access to universal health care.

摘要

世界卫生组织目前确认了20种被忽视的热带病。这些疾病在全球影响着超过10亿人,导致了严重的发病、死亡、贫困和社会污名化。2013年5月,世界卫生大会通过了一项决议,呼吁成员国加大力度应对被忽视的热带病,目标是实现先前制定的消除或根除11种被忽视热带病的指标。该决议还要求将应对被忽视的热带病工作纳入初级卫生服务。随后,被忽视的热带病被纳入可持续发展目标3,该目标要求到2030年终结“艾滋病、结核病、疟疾和被忽视热带病的流行”。虽然世界卫生大会决议和可持续发展目标3都提供了强有力的行动框架,但两者均未明确提及享有能达到的最高健康标准的人权,也未描述基于权利的消除被忽视热带病的方法。本文确定了与控制和消除被忽视热带病工作相关的关键人权,并描述了基于权利的干预措施,这些措施应对:(1)在获得预防性化疗和发病管理方面的不平等;(2)污名和歧视;以及(3)患者在医疗环境中的权利和不歧视问题。此外,本文还描述了全球、区域和国家层面的人权机制如何有助于加快对被忽视热带病的应对,并促进在普及医疗保健方面的问责制。

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