This thesis examines the use of the right to health as a legal tool for ensuring access to better health care in Africa and as a means of dealing with threats to human health on the continent. The thesis critically assesses some of the key ways in which the right to health has been used at the local, regional and global levels as part of efforts to improve health on the continent. The aim of the thesis is to assess the utility of the right to health in Africa particularly in light of challenges posed by the power of international economic actors, local and international structural constraints and the paradoxical position of the state as both a potential violator and protector of the right. / As this thesis shows, human rights are a powerful and inspirational language for people struggling against degradation, domination and deprivation for the reason that they give expression to the notion that human dignity, equality and freedom ought to be respected and protected. They are also a tool for resisting oppressive power, in addition to providing legitimacy for the redistribution of material resources necessary to meet basic human needs and to alleviate human suffering. The thesis further shows that these benefits of human rights have been enhanced through legalisation, a process through which human rights have been translated from moral or natural rights into legal rights capable of being enforced through judicial and quasi-judicial processes. But legalisation has its drawbacks, as the thesis demonstrates. / The thesis argues that despite the significant advances that have been made, particularly in the last fifteen years, in the elaboration and clarification of the content and justiciability of the right to health, its limitations as a legal right are particularly evident in light of a number of factors. These include the power of international economic actors, local and international structural constraints and the problematic potential of the state as both a protector and violator of the right to health. By examining concrete instances in which efforts have been made to use the right to health in the context of some or of all these factors, the thesis demonstrates the limits and potential of the right as a legal right. The thesis thus argues that a proper account of the utility of the right to health should not overemphasise the legalisation of the right but must include an analysis of the power relations and structural constraints at play at both the international and local levels, which jeopardise good health in Africa in the first place. It is further argued that such an account offers a better understanding of how the moral, legal and political forms of the right to health might be strategically and productively combined in the struggle for better health in Africa.

"Poverty Reduction Strategy Papers (PRSPs) were born out of the policies of the World Bank (WB) and the International Monetary Fund (IMF). They were introduced 'in the wake of the failure of Structural Adjustment Programmes (SAPs) to reduce the incidence of poverty'. PRSPs have been linked with the IMF and WB Heavily Indebted Poor Countries (HIPC) debt relief initiative. In order to have access to debt relief, countries have had to draw up PRSPs and start moving towards their effective implementation. PRSPs are now meant to be the national guide informing almost every facet of the human development framework. They are being used as benchmarks for the prioritization of the use of public and external resources for poverty reduction. Further, multilateral as well as bilateral donors and lending institutions are using them as an overarching framework from which policies and actions of developing countries are to be gauged and decisions on further assistance or loans made. In that light, PRSPs have become pivotal to the social fabric of the countries concerned as they affect the daily undertakings of the people through, among other things, their allocative and redistributive roles. ... The PRSPs of Malawi and Uganda are not premised on the human rights based approach to poverty reduction. They largely address issues of economic and social rights from a benefactor and beneficiary perspective rather than from a claim-holder and duty-bearer perspective. Further to that, these policies are largely premised on the requirements of the Bretton Woods Institutions (BWIs) that have received heavy criticism for not factoring in human rights considerations, when implementing their policies towards developing countries. This problem thus calls for a harmonisation of PRSPs with the obligations of the states as well as the BWIs to ensure the full realisation of these rights. ... This study is divided into six chapters. Chapter two is a concise analysis of the PRSP processes in Malawi and Uganda. It addresses issues of participation and national ownership, among others, and locates the role of the BWIs in the process. Chapter 3 is a general overview of the international legal obligations that the two governments have in the area of economic and social rights. Chapter four provides an overview of the scope of the rights to health and housing. Chapter five is a critical analysis of the extent to which the PRSPs of the two countries act as effective tools for advancing the rights to health and housing in the two countries. Chapter six concludes the discussion. It makes necessary recommendations in order to strengthen the human rights based approach to poverty reduction within the framework of the PRSPs, with a view to ensuring the progressive realisation of economic and social rights." -- Introduction. / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2004. / Prepared under the supervision of Dr. Baker G. Wairama at the Faculty of Law, Makerere University, Kampala, Uganda / http://www.chr.up.ac.za/academic_pro/llm1/llm1.html / Centre for Human Rights / LLM