Social & Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto , Toronto, Canada.
International Centre for Reproductive Health- WHO Collaborating Centre, Department of Public Health & Primary Care, Ghent University , Ghent, Belgium.
Glob Health Action. 2020 Dec 31;13(1):1699342. doi: 10.1080/16549716.2019.1699342.
Access to essential medicines for the world's poor and vulnerable has made little progress since 2000, except for a few specific medicines such as antiretrovirals for HIV/AIDS. Human rights principles written into national law can create a supportive environment for universal access to medicines; however, systematic research and policy guidance on this topic is lacking.
To examine how international human rights law and WHO's essential medicines policies are embedded in national law for medicines affordability and financing, and interpreted and implemented in practice to promote universal access to essential medicines.
This thesis consists of (1) a cross-national content analysis of 192 national constitutions, 71 national medicines policies, and legislation for universal health coverage (UHC) from 16 mostly low- and middle-income countries; (2) a case study of medicines litigation in Uruguay, and (3) a follow-up report of eight right to health indicators for access to medicines from 195 countries.
Some, but not all, of the 12 principles from human rights law and WHO's policy are embedded in national UHC law and medicines policies (part 1). Even the most rights-compliant legislation for access to medicines is subject to the unique and inconsistent interpretation of domestic courts, which may be inconsistent with the right to health in international law (part 2). Many national health systems for which data were available still fail to meet the official targets for eight indicators of access to medicines (part 3).
International human rights law and WHO policy are embedded in national law for essential medicines and practically implemented in national health systems. Law makers can use these findings and the example texts in this thesis as a starting point for writing and monitoring governments' rights-based legal commitments for access to medicines. Future research should study the effect of national law on access to medicines and population health.
自 2000 年以来，除了抗逆转录病毒等少数几种特定药物外，全球贫困人口和弱势群体获得基本药物的情况几乎没有任何进展。将人权原则写入国家法律可以为普及获得药物创造有利环境；但是，这方面缺乏系统的研究和政策指导。
考察国际人权法和世卫组织基本药物政策如何纳入国家法律以实现药物的可负担性和供资，并在实践中进行解释和执行，以促进普及获得基本药物。
本论文包括：(1)对 192 个国家的宪法、71 个国家药物政策以及 16 个中低收入国家全民健康覆盖立法进行跨国内容分析；(2)对乌拉圭药物诉讼的案例研究；以及(3)对 195 个国家普及获得药物的 8 项健康权指标的后续报告。
人权法和世卫组织政策中的 12 项原则，有部分而非全部纳入了国家全民健康覆盖法律和药物政策（第 1 部分）。即使是最符合获取药物权利的立法，也受制于国内法院的独特和不一致的解释，这可能与国际法中的健康权不一致（第 2 部分）。对于可获得数据的许多国家卫生系统而言，仍未达到普及获得药物 8 项指标的官方目标（第 3 部分）。
国际人权法和世卫组织政策已纳入国家基本药物法律，并在国家卫生系统中实际执行。立法者可以利用这些发现和本文中的示例文本，作为编写和监督政府以权利为基础的获取药物法律承诺的起点。未来的研究应研究国家法律对获取药物和人口健康的影响。
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