Section 27(1)(a) of the Constitution of the Republic of South Africa, 1996, entrenches everyone's right of access to health care services. The purpose of this dissertation is to determine the manner in which this right must be interpreted and implemented in order to alleviate poverty to the optimal extent possible, in South Africa. As a point of departure, the relationship between poverty and health, as well as the theoretical basis of poverty, is addressed in terms of soft law. Thereafter, the theoretical basis of the right of access to health care service is analysed and explained from both an international and a South African perspective. This is followed by an investigation into international law. The manner in which the United Nations International Covenant on Economic, Social and Cultural Rights is interpreted and implemented and whether or not this contributes to poverty alleviation, is investigated. This is followed by an analysis of the right in terms of the Constitution and case law. Particular attention is paid to the manner in which the courts interpret the right of access to health care services. It is then determined whether the state is implementing the right in such a manner as to contribute to the optimal alleviation of poverty, in South Africa. Finally, a conclusion is reached and recommendations are made as to ways in which the right can be interpreted and implemented to reduce poverty to the optimal extent possible, in South Africa. / Thesis (LL.M.)--North-West University, Potchefstroom Campus, 2010.

Section 27(1)(a) of the Constitution of the Republic of South Africa, 1996, entrenches everyone's right of access to health care services. The purpose of this dissertation is to determine the manner in which this right must be interpreted and implemented in order to alleviate poverty to the optimal extent possible, in South Africa. As a point of departure, the relationship between poverty and health, as well as the theoretical basis of poverty, is addressed in terms of soft law. Thereafter, the theoretical basis of the right of access to health care service is analysed and explained from both an international and a South African perspective. This is followed by an investigation into international law. The manner in which the United Nations International Covenant on Economic, Social and Cultural Rights is interpreted and implemented and whether or not this contributes to poverty alleviation, is investigated. This is followed by an analysis of the right in terms of the Constitution and case law. Particular attention is paid to the manner in which the courts interpret the right of access to health care services. It is then determined whether the state is implementing the right in such a manner as to contribute to the optimal alleviation of poverty, in South Africa. Finally, a conclusion is reached and recommendations are made as to ways in which the right can be interpreted and implemented to reduce poverty to the optimal extent possible, in South Africa. / Thesis (LL.M.)--North-West University, Potchefstroom Campus, 2010.

Within the Surinamese jurisdiction the Constitution grants women the right to health and imposes a legal duty on the state to facilitate the realization of this right. Also treaty law, in particular, the ICESCR article 12 and the CEDAW article 12 grant women the right to the highest attainable standard of health and the right to non-discriminatory access to healthcare. But due to the criminal law applicable to abortion women lack non-discriminatory access to reproductive healthcare and therefore do not enjoy the highest attainable standard of pregnancy related health. Despite its decision not to enforce the abortion prohibiting criminal laws, Suriname remains in a state of failure to comply with its legal duties as imposed by the Constitution and treaty law. This, due to the state’s reluctance to repeal the criminal laws on abortion and its failure to enact effective health regulations to facilitate women in need of an abortion.

Within the Surinamese jurisdiction the Constitution grants women the right to health and imposes a legal duty on the state to facilitate the realization of this right. Also treaty law, in particular, the ICESCR article 12 and the CEDAW article 12 grant women the right to the highest attainable standard of health and the right to non-discriminatory access to healthcare. But due to the criminal law applicable to abortion women lack non-discriminatory access to reproductive healthcare and therefore do not enjoy the highest attainable standard of pregnancy related health. Despite its decision not to enforce the abortion prohibiting criminal laws, Suriname remains in a state of failure to comply with its legal duties as imposed by the Constitution and treaty law. This, due to the state’s reluctance to repeal the criminal laws on abortion and its failure to enact effective health regulations to facilitate women in need of an abortion.

Dans cette thèse, il est question de faire une analyse des conséquences de la réforme forestière qui est engagée en RDC depuis 2002 à l’instigation de la Banque mondiale dans le but de favoriser la gestion durable des forêts et le développement des populations forestières. Cependant l’évaluation juridique et économique de cette nouvelle politique forestière, réalisée après quinze ans d’application afin d’en mesurer l’impact sur la gestion durable des forêts, la fiscalité forestière et le développement local des populations forestières, montre que, si la réforme forestière de 2002 a contribué a une légère amélioration de la mobilisation des recettes fiscales forestières, elle n’a pas en revanche favorisé la durabilité des forêts ainsi que la protection des droits des populations forestières. Pour remédier à cette situation, nous suggérons certaines réformes consistant à améliorer cette politique forestière. / In this thesis, it is a question of making an analysis of the consequences of the forest reform which is engaged in the DRC since 2002 at the instigation of the World Bank with the aim to favor the sustainable management of the forests and the development of the forest populations. However, the legal and economic assessment of this new forestry policy, carried out after fifteen years of application to measure the impact on sustainable forest management, forest taxation and local development of forest populations, shows that, if the 2002 forestry reform contributed to a slight improvement in the mobilization of forest tax revenues, but did not favor the sustainability of forests and the protection of the rights of forest peoples. To remedy this situation, we suggest some reforms to improve this forest policy.

Text in Afrikaans / The Convention on the Rights of the Child was adopted by the United Nations General Assembly on 29 November 1989. Included in the inherent rights set out in the Convention is the right to the highest attainable standard of health. In implementing the Convention states parties must refer to the requirements of article 2 of the Convention, which places them under a duty to respect and ensure the rights in the Convention to each child. The term “respect” implies a duty of good faith to refrain from actions which would breach the Convention. The “duty to ensure”, however, requires states parties to take whatever measures are necessary in order to enable children to enjoy their rights. A state party must also review its legislation in order to ensure that domestic law is consistent with the Convention. South Africa showed commitment to protecting and promoting children’s health when it ratified the United Nations Convention on the Rights of the Child in 1995 and subsequently adopted the Constitution of the Republic of South Africa, 1996, which includes provisions guaranteeing the health rights of children. South Africa also showed commitment to give legislative effect to the protection and promotion of children’s health by reviewing the Health Act 63 of 1977 (reviewed as the National Health Act 61 of 2003) and the Child Care Act 74 of 1983 (reviewed as the Children’s Act 38 of 2005). The review of the Child Care Act 74 of 1983 revealed that the act is virtually silent on the issue of child health. This led to the decision to identify and evaluate existing policy and legislation, as well as pending relevant law reform and policy affecting child health in order to assess how well South African legislation addresses the issue. The research showed that although much legislation exists, none provides comprehensively for child health rights. The legislation that does exist contains obvious gaps. Most importantly, there is no reference to the core minimum requirements for the state in providing for the health of children, particularly in the way of health services and nutrition. Further, there is a complete lack of legislation which protects the health needs of disabled children. A comparative study was also undertaken. Legislation of India and Canada were evaluated in order to make recommendations as to how the gaps in South African legislation can be rectified. However, the research showed that South Africa has made far more significant progress in promoting a rightsbased approach to children’s health in legislation. In order to ensure that the health rights of children are protected and promoted, I propose more comprehensive legislative protection. / Private Law / LL.D.

Made available in DSpace on 2011-05-04T12:36:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / O Programa Bolsa Família (PBF) foi criado em outubro de 2003, a partir da unificação de quatro programas federais de transferência de renda (Bolsa Escola, Bolsa Alimentação, Cartão Alimentação e Vale Gás), sendo destinado a famílias pobres e extremamente pobres, no qual o critério de inclusão é a renda per capita. O Programa articula a transferência de renda a condicionalidades da saúde e educação, que são responsabilidades que toda família deve cumprir para se manter no Programa. A exigência dessas contrapartidas tem provocado um intenso debate no campo das políticas públicas. De um lado, pesquisadores e gestores compreendem a estratégia como oportunidade de melhorar o acesso aos serviços públicos. Por outro lado, há a abordagem de que os direitos sociais, incluindo o acesso aos serviços de saúde, são incondicionais. O presente trabalho analisa o processo de implementação do Programa Bolsa Família na região de Manguinhos, no que se refere ao acompanhamento das ações de saúde previstas para a população beneficiária, identificando os limites e as potencialidades no cumprimento das chamadas condicionalidades , em um contexto local marcado por precária infra-estrutura urbana e dificuldades no acesso aos equipamentos públicos. O período desta pesquisa foi de março de 2007 a dezembro de 2008 e a metodologia utilizada foi o estudo de caso, com a análise de documentos oficiais do PBF, entrevistas com gestores e profissionais que atuam nas diversas secretarias (saúde, educação e assistência social) e grupos focais com famílias beneficiárias. Essa experiência revelou fragilidades institucionais como: pouca qualificação dos profissionais, ausência de incentivos, falta de recursos humanos, ênfase na questão burocrática e oferta insuficiente de ações e serviços de saúde. Contudo, um aspecto positivo observado foi a busca de maior integração dos beneficiários às demais ações e iniciativas sociais locais. / The Bolsa Família Program (BFP) was created in October 2003, from the unification of four federal cash transfer programs (Bolsa Escola, Bolsa Alimentação, Cartão Alimentação e Vale Gás), destined to poor and extremely poor families, in which the inclusion criterion is the per capita income. The Program articulates the income transfer with conditionalities of health and education, which are responsibilities that all families must accomplish to continue in the Program. The exigency of these counterparties has been causing an intense debate in the public politics area. On the one hand, researchers and managers understand the strategic as an opportunity to improve the public services access. On the other hand, there’s the approach that the social rights, including the health services access, are unconditional. The present paper analyses the implementation process of the Bolsa Família Program in the Manguinhos region, concerned to the attendance of the health actions, destined to the beneficiaries, by identifying the limits and the potentials in the accomplishment of what is called “conditionalities”, in a local context marked from a precarious urban infrastructure and difficulties in the public equipments access. The period of this search was from March 2007 to December 2008 and the methodology was the case study, with the analysis of BFP official documents, interviews with managers and professionals that work in the different secretariats (health, education and social assistance) and focal groups with beneficiaries. This experience showed institutional fragilities, like: not much qualification of professionals, absence of incentives and of human resources, emphasis in the bureaucratic question and insufficient offer of actions and health services. Nevertheless, a positive aspect observed was the search of higher integration between beneficiaries and the other actions and local social initiatives.

Made available in DSpace on 2011-05-04T12:36:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2010 / A lei brasileira garante o direito à Assistência Farmacêutica, mas ainda há falhas do Estado na efetivação do acesso dos cidadãos aos medicamentos, assim, as ações judiciais de medicamentos têm tido importante papel como via alternativa ao acesso a medicamentos no SUS. Este tipo de ação judicial vem crescendo anualmente e tem como objeto tanto os medicamentos em falta na rede pública como aqueles ainda não incorporados pelo sistema de saúde. O presente trabalho teve como objetivo principal analisar os medicamentos presentes nas demandas judiciais da comarca da capital encaminhadas a Central de Mandados da Secretaria de Saúde e Defesa Civil do Rio de Janeiro, no período de julho de 2007 a junho de 2008, frente às alternativas terapêuticas presentes nas listas de financiamento público e à luz das evidências científicas. Desta forma, foram analisados os medicamentos cadastrados na Central de Mandados da SESDEC/RJ referentes a 281 pacientes demandantes. Foi observado neste estudo uma diversidade de situações dos indivíduos demandantes e dos medicamentos solicitados. Alguns indivíduos eram demandantes de primeira vez, mas foi também identificada a existência de pacientes que já se encontravam recebendo medicamentos pela Secretaria Estadual de Saúde e que recorreram à via judicial para obtenção do mesmo ou de medicamento adicional. No que tange aos medicamentos solicitados, também houve uma miríade de categorias ao se considerarem as evidências disponíveis e as informações existentes. A maior parte dos medicamentos demandados não era financiada pelo sistema de saúde e entre estes, destaca-se: 1) medicamentos solicitados para indicações registradas no órgão sanitário, com evidências científicas e que apresentavam alternativas terapêuticas financiadas pelo sistema; 2)medicamentos cujas evidências em longo prazo ainda não se encontram bem estabelecidas; 3) medicamentos para indicações não aprovadas pela Anvisa; 4) medicamentos sem registro na Anvisa e; 5) medicamentos cujas evidências inexistem ou não recomendam seu uso. Uma vez que as listas de financiamento da Assistência Farmacêutica e os Protocolos Clínicos e Diretrizes Terapêuticas foram construídos com base em evidências, deve-se priorizar a utilização dos medicamentos constantes nestes. Havendo alternativa terapêutica nas listas oficiais para a indicação proposta na prescrição médica àquela demandada, a decisão deve considerareste fato. / The Brazilian law guarantees the right of Pharmaceutical Care, but is falling short of the state in realization of citizens' access to medicines, so, the medicine lawsuits have been important as an alternative route to access to medicines in the SUS. This type of lawsuit is increasing annually and aims medicines missing from the public health system and those not yet incorporated into this system. This study aimed to examine the medicines in the lawsuits of the District Judicial sent to Central Warrants of the Secretary of Health and Civil Defense of Rio de Janeiro, from July 2007 to June 2008, compared to alternative therapies on the lists of public health system and examine the existence of scientific evidence. Thus, was analyzed the medicines registered in the Central Warrants of SESDEC / RJ referring to 281 patients. Was observed in this study a variety of situations of individuals and the plaintiffs requested medication. Some individuals were the first-time, but also was identified the existence of patients who were already receiving medications for the State Health Department and have appealed to the courts to obtain the same or additional medicine. With respect to medicines requested, there was also a myriad of categories when considering the available evidence and existing information. Most of the medications examined was not financed by the public health system and between them stands out: 1) medicines for indication approved by Anvisa with scientific evidence and having alternative therapies financed by the system, 2) medicines for which evidence on long term are not yet well established, 3) medications for indications not approved by ANVISA, 4) medicines not registered in Anvisa and 5) medicines for which the evidence does not exist or recommend its use. Once the lists of funding for Pharmaceutical Care and Clinical Protocols and Therapeutic Guidelines have been constructed based on evidence, we must prioritize the use of these medications listed. If there is an alternative therapy in the official lists for the proposed indication in the prescription to that defendant, the decision should consider this fact.

Made available in DSpace on 2016-03-15T19:35:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-02-14 / The theses is about the control of production, commerce, use and publicity of tobacco by the State, in three ways of performance (state control), according to Federal Constitution of 1988, the Framework Convention on Tobacco Control and the internal Legislation. It is due to the Legislative Power, to elaborate the restritive rules of the using of tobacco; it is due to the Executive Power the planning and the execution of public politics concerning to the prevention of tobacco use; and to Judiciary, to judge the compensation procedure by the healthy damage caused by tobacco use. Because it involves the fundamental right to the health of the smoking and non-smoking citizen (second hand smoking), this work analyses the collision of fundamental rights and the acting of the tobacco industry, for misinformation from the 1920 decade in XX century. At last, it stablishes a comparison between hard cases to judge, taking into account the relationship between right and reality, specially the conclusions of science concerning to the diseases caused by cigarette smoking which can lead to death. / A tese aborda o controle pelo Estado da produção, comercialização, consumo e publicidade do tabaco, numa tríplice esfera de atuação, denominada de dirigismo estatal, de acordo com a Constituição Federal de 1988, a Convenção-Quadro de Controle do Tabaco e a legislação infraconstitucional no Brasil. Cabe ao Poder Legislativo, notadamente, a elaboração de normas restritivas à utilização do tabaco; cabe ao Executivo o planejamento e a execução de políticas públicas voltadas à prevenção do tabagismo; e, ao Judiciário, o julgamento das ações de indenização pelos danos causados à saúde pelo consumo de cigarro. Em razão de envolver direito fundamental à saúde do cidadão fumante e não fumante (fumante passivo), este trabalho analisa a colisão de direitos fundamentais e a conduta da indústria de tabaco, por defeito de informação perpetrado desde a década de 1920, do século XX. Por fim, estabelece um parâmetro de julgamento de casos difíceis, levando-se em conta a relação direito e realidade, especialmente as conclusões da ciência no tocante às doenças causadas pelo cigarro, que podem levar à morte.

Thesis title: Right to health and legitimate expectations in perspective of the standards and above-standards in Czech health care system This diploma thesis deals with the legal regulation of the right to health as a social right. In the first chapter, the genesis of the social rights, their specific characteristics and the social rights' role in relation to civil and political rights are analysed for the purpose of interpretation of the right to health. The actual problematics of legitimation crisis based on the states' inability to fulfil the obligations and expectations rising from social rights are later discussed. In relation to the socio-legal context, the international legislation as well as some specific national legislation of the right to health are analysed in detail within subsequent chapter. With this regard, the practice of the courts as well as the practice of the quasi-judicial bodies is considered in the following chapter, especially with respect to the right to health and its relation to some civil and political rights. The standardization process of right to health within this decision-making practice is also examined. Moreover, the right to health is explored in perspective of the Czech legislation. The diploma thesis deals with the content and the protection of the...