O teor securitário que compromete a eficiência das políticas migratórias na esfera nacional, a distribuição de competências entre os diversos níveis de governo e a proximidade entre as autoridades locais e os cidadãos fazem das cidades uma importante unidade de análise para a compreensão do fenômeno migratório. A presente dissertação busca verificar de que forma as cidades de São Paulo, no Brasil, e Barcelona, na Espanha, respondem às lacunas das respectivas políticas migratórias nacionais, examinando particularmente o acesso dos migrantes aos serviços de saúde na dimensão local. Ao reconhecer que a interface entre a mobilidade e a saúde humanas tende a expandir-se, eis que tanto as políticas migratórias como a sua ausência causam impacto significativo sobre a saúde dos migrantes e das sociedades de acolhida ou trânsito, a pesquisa investiga o papel das políticas migratórias na efetivação dos direitos humanos dos migrantes, em especial o direito à saúde. Determinadas iniciativas de administrações locais tentam responder às demandas geradas pelo fenômeno migratório, e se mostram comprometidas com uma agenda de proteção dos direitos dessas populações, em claro contraste com a orientação da legislação e da política migratória do plano nacional. Como já demonstra a literatura sobre migrações e governos locais, as cidades de São Paulo e de Barcelona demonstram tal empenho, embora suas respectivas administrações atuem em contextos jurídico-­institucionais distintos: um de escassa consistência jurídica, no caso brasileiro, e outro de extensa legislação de teor restritivo, no caso espanhol. / The securitarian tone hindering the efficiency of migration policies in the national realm, the distribution of competences among several government levels and the closeness between local authorities and citizens, all make cities an important unit of analysis for understanding the migration phenomenon. This Master\'s thesis aims to assess how the cities of Sao Paulo, in Brazil, and Barcelona, in Spain, respond to the gaps of their respective national migration policies, examining particularly the access of migrants to healthcare services at the local level. Admitting that the interplay between human mobility and health tends to expand, since both migration policies and their absence cause a significant impact on the health of migrants and reception and transit societies, this research explores the role of migration policies in making migrants\' human rights effective, notably the right to health. Some initiatives of local administration seek to meet the demands sparked by migration and seem committed to a protective agenda of these population\'s rights, in a clear-cut contrast with the orientation of national migration laws and policies. As the literature on migration and local government exposes, the cities of Sao Paulo and Barcelona display such an effort, although their respective governments work in distinctive legal and institutional contexts: one of scarce legal consistency, in the Brazilian case, and another in an extensive legislation of restrictive contents, in the Spanish case.

Orientador: Soraya Regina Gasparetto Lunardi / Resumo: Com a promulgação da Constituição Federal de 1988, inúmeros direitos fundamentais sociais foram positivados tais como o direito à saúde, que, posteriormente, vieram a ser entendidos como de eficácia imediata pelas cortes judiciais brasileiras, passando estas, quando provocadas, a agirem diante da ineficiência dos outros poderes a fim de efetivá-las. No Brasil, nos últimos anos, constatou-se um aumento do número de decisões judiciais que obrigaram o Poder Público a fornecer medicamentos, insumos, equipamentos e cirurgias. Os juízes, em seus julgados e entendimentos, tendem a desconsiderar o impacto orçamentário de suas decisões e entendem que todos os entes da federação podem ser igualmente responsabilizados pelo fornecimento de qualquer item solicitado pelo paciente (Recurso Extraordinário RE 855.178, de relatoria do ministro Luiz Fux, com repercussão geral reconhecida no Plenário Virtual e a Proposta de Súmula Vinculante nº4). Tendo em vista o cenário que vivenciamos na atualidade, o presente trabalho trata dos desafios existentes relativos aos reflexos econômicos, quanto às decisões judiciais e tutela da saúde, buscando encontrar soluções para a diminuição das demandas judiciais através da pesquisa doutrinária, legal e jurisprudencial. Aborda-se, assim, a prestação da saúde pública no Brasil, bem como os mecanismos para a implementação desse direito e seu controle. Tem-se como foco a observação da divisão de competências e atribuições constitucionais determinadas pelos magi... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: With the publication of the Federal Constitution of 1988, several fundamental provisions in the social area were transformed into a law, one of them being indiscriminate access to health, now understood as of immediate applicability by the Brazilian Judicial Courts, acting, when provoked, when glimpsed inefficiency of the other Powers of the Nation, to finally effect them. In Brazil, in recent years, there has been an increase in the number of judicial orders forcing governments to provide medicines, supplies, equipment and surgeries. The Brazilian judges, in their judgments and understandings, tend to disregard the budgetary impact of their determinations, and understand that all entities of the federation may also be held liable for the provision of any item requested by the patient (Extraordinary Appeal / REsp. 855178 of Minister Luiz Fux, with general repercussion recognized, through the Virtual Plenary and Proposal of Binding Summary 4). Considering the scenario that we are experiencing today, the present work will deal with the existing challenges related to economic reflexes, regarding judicial decisions and health protection, seeking to find solutions for the reduction of judicial demands, through investigations of doctrines, Legislation and jurisprudence, addressing the provision of the public health public service in Brazil, as well as the mechanisms for the implementation of this right and its control. The division of powers and constitutional attributions will be ... (Complete abstract click electronic access below) / Mestre

Thesis (LLM. (Labour Law)) -- University of Limpopo, 2013 / In the 18th years of our young but thriving democracy, several programmes were established to improve access to health care for disadvantaged groups in South Africa. Although numerous studies have been conducted examining trends on access to health care, considerable controversy remains. Nearly all authors concur that important progress has been made, and that gaps in access to health care narrowed considerably. Some however, go further and conclude that the evidence indicates that all significant gaps have been eliminated and access to health care is universally shared. Evidence on access to health care has important policy implications. If the task of assuming access to health care has been largely accomplished, further expansion of South African health care programmes to promote access would be unwarranted. If selected population groups lag behind others in access to health care, targeted policies to close remaining gaps may be warranted. The introduction of the National Health Insurance Scheme call for the health reform in South Africa and it will change the whole health sector and offers equal benefits on access to quality health care services to everyone in South Africa.

Kasmet pasaulyje nuo infekcinių ligų miršta milijonai žmonių. Ironiška, kad dauguma šių ligų yra išgydomos šiuolaikiniais vaistais, tačiau dauguma žmonių neturi priėjimo prie šių vaistų, ypač besivystančiose šalyse. Šią problemą įtakoja daugelis faktorių, tačiau dažnai vaistų prieinamumas būna apribojamas dėl aukštų vaistų kainų, kurios dažnai būna stiprios intelektinės nuosavybės apsaugos pasekmė. Šiame darbe analizuojama vaistų prieinamumo problema intelektinės nuosavybės ir žmogaus teisių kontekste. Ieškoma atsakymo į klausimą, ar išradimų, susijusių su vaistų gamyba, patentinė apsauga, nepažeidžia žmogaus teisių į sveikatos priežiūrą. Ypatingas dėmesys skiriamas Sutarčiai dėl intelektinės nuosavybės teisių prekyboje (TRIPS Sutartis) ir jos daromai įtakai vaistų prieinamumui. Ši sutartis susilaukė didelės kritikos dėl nesugebėjimo išlaikyti pusiausvyros tarp patentinės apsaugos ir vaistų prieinamumo. Išanalizavus problemą, buvo nustatyta, kad egzistuoja paradoksalus ryšys tarp patentų teisės ir vaistų prieinamumo. Patentų teisės suteikiama apsauga veda prie patentuotų vaistų prieinamumo apribojimų dėl išaugusių jų kainų, todėl egzistuoja riba, kurią pasiekus yra tikslinga apriboti išradimų, susijusių su vaistų gamyba, patentinę apsaugą, siekiant užtikrinti vaistų prieinamumą visuomenei. Patento savininko teisės gali būti apribotos pasinaudojant TRIPS Sutartyje įtvirtintomis priemonėmis, tokiomis kaip priverstinis licencijavimas ar lygiagretus importas, o įvykus žmogaus... [toliau žr. visą tekstą] / Each year millions of people die from infecious diseases. Ironically, mosto f these diseases are curable with modern medicines, but most people don‘t have access to these drugs, especially in developing countries. The are many reasons for the lack of access to medicines, but in many cases the high price of drugs is a barrier to needed medicines and the unaffordable prices are often the result of strong intellectual property protection. This paper analyses the problem of access to medicines in the context of human rights and intellectual property. It tries to answer the question whether patents for pharmaceutical inventions infringe on the human right to health. Particular attention is paid to the Agreement on trade related aspects of intellectual property (TRIPS Agreement) and the impact it has on access to medicines. TRIPS is widely criticized for failing to maintain a balance between patent protection and access to medicines. Previously in many countries patents for pharmaceutical inventions were not allowed or they were limited but after TRIPS everything changed. The Agreement widened the scope of patentability and included pharmaceutical inventions. Now patent protection has to be granted for any inventions, whether product or processes, in all fields of technology under the conditions that they are new, involve an inventive step and are capable of industrial application Analysis shows that a paradoxical relationship exists between patent law and access to medicines... [to full text]

Adolescent pregnancy has been associated with adverse health and social outcomes, but it has also been favorably viewed as a pathway to adulthood. In Ecuador, where 20% of girls aged between 15-19 years get pregnant, the adolescent fertility rate has increased and inequalities between adolescent girls from different educational, socio-economic levels and geographical regions are prominent: 43% of illiterate adolescents become pregnant compared to 11% with secondary education. The highest adolescent fertility rates are found in the Amazon Basin.   The overall aim of this study was to explore adolescent pregnancy in the Amazon Basin of Ecuador (Orellana province) from a rights and gender approach. Specific aims and methodologies included: to explore women‟s reproductive health situation, focusing on government‟s obligations, utilization of services, inequities and implementation challenges, assessed through a community-based cross-sectional survey and a policy analysis (Paper I); to examine risk factors associated with adolescent pregnancy, through a case-control study (Paper II); to explore experiences and emotions around pregnancy and motherhood among adolescent girls, using content analysis (Paper III); and to analyze providers‟ and policy makers‟ discourses on adolescent pregnancies (Paper IV).   Reproductive health status findings for women in Orellana indicated a reality more dismal than that depicted in official national health data and policies. Inequities existed within the province, with rural indigenous women having reduced access to reproductive health services. In Orellana, 37.4% of girls aged 15-19 had experienced pregnancy, almost double the national average. Risk factors associated with adolescent pregnancy at the behavioral level included early sexual debut and non-use of contraception, and at the structural level poverty, having suffered from sexual abuse, and family disruption. Gender inequity played a key role through the machismo-marianismo system. Girls were raised to be fearful and ignorant regarding sexuality and reproduction, to be submissive and obedient, to be fatalistic, and to accept the established order of the male and adult dominance. Sexuality was conceptualized as negative, while motherhood was idealized. Those gender structures constrained girls‟ agency, making them less able to make choices regarding their sexual and reproductive lives. Providers‟ discourses and practices were also strongly influenced by gender structures. Adolescent sexuality was not sanctioned, girls‟ access to contraceptives still faced opposition, adolescent autonomy was regarded as dangerous, and pregnancy and reproductive health issues were conceptualized as girls‟ responsibility. However, mechanisms of resistance and challenge were also found both among adolescent girls and providers.   Programs addressing adolescent pregnancies in the area need to look at the general situation of women‟s reproductive health and address the gaps regarding access and accountability. Adolescent pregnancy prevention programs should acknowledge the key role of structural factors and put emphasis on gender issues. Gender inequity affects many of the factors that influence adolescent pregnancies; sexual abuse, girls‟ limited access to use contraceptives, and girls‟ curtailed capability to decide regarding marriage or sexual intercourse, are strongly linked with young women‟s subordination. By challenging negative attitudes towards adolescents‟ sexuality, the encounter between providers and adolescents could become an opportunity for strengthening girls‟ reproductive and sexual agency.

Thesis (M.A.)--Indiana University, 2008. / Includes vitae. Department of Philosophy, Indiana University-Purdue University Indianapolis (IUPUI) Advisor(s): Peter H. Schwartz. Includes bibliographical references (leaves 61-66)

Made available in DSpace on 2016-05-17T16:51:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-08-24. Added 1 bitstream(s) on 2016-05-17T16:54:14Z : No. of bitstreams: 1 000864407.pdf: 992889 bytes, checksum: 8355b984c9bf05485514efd8a66a220e (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A tese problematiza a saúde coletiva a partir dos estudos de Foucault sobre o biopoder e a governamentalidade, tomando como operador de análise os dispositivos de segurança como prática de governo e gestão dos fenômenos das populações. A pesquisa de campo realizou-se na província de Guadalajara, na Espanha, entrevistando profissionais em três centros de saúde da rede de atenção primária. A análise dos enunciados põe em discussão as tecnologias de poder na gestão da saúde e os seus desdobramentos no campo do direito e sua relação com a verdade. O direito à saúde é um universal abstrato sustentado por regimes de verdade que engendram práticas sociais - como os complexos sistemas públicos submetidos à ordem econômica contemporânea - em função da segurança no governo das populações / La tesis problematiza el asunto de la salud colectiva a partir de los estudios de Foucault sobre el biopoder y la gubernamentalidad tomando como fuente de análisis los dispositivos de seguridad como práctica de gobierno y gestión de los fenómenos de la población. El trabajo de campo se realizó en la provincia de Guadalajara en España. Entrevistando profesionales en tres centros de salud de la red de atención básica. El análisis de los enunciados pone en discusión las tecnologías de poder en la gestión de la salud y sus desdoblamientos en el campo del derecho y su relación con la verdad. El derecho a la salud es un universal abstracto sustentado por regimenes de verdad que engendran prácticas sociales - como los complejos sistemas públicos sometidos al orden económico contemporáneo - en función de la seguridad en el gobierno de las poblaciones

Made available in DSpace on 2014-12-17T14:46:54Z (GMT). No. of bitstreams: 1 RaneCPA_DISSERT.pdf: 892716 bytes, checksum: 9924f4c1243c3c933a5bc637ba69e84d (MD5) Previous issue date: 2011-09-30 / The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE n? 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury / O estudo teve como objetivo de identificar a qualidade da assist?ncia e o conhecimento do direito ? sa?de das pessoas com ?lcera venosa (UV) cr?nica no Sistema ?nico de Sa?de (SUS). Trata-se de um estudo descritivo transversal, com abordagem quantitativa, realizado no Hospital Universit?rio Onofre Lopes (HUOL). O estudo obteve parecer favor?vel do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte (CAAE n? 0148.0.051.000-10). A amostra por acessibilidade foi composta por 30 pessoas com UV atendidas no ambulat?rio de Cl?nica Cir?rgica do HUOL. Para coleta de dados foi utilizado um question?rio estruturado composto de duas partes: caracter?sticas sociodemogr?ficas e de sa?de, da assist?ncia e da evolu??o cl?nica da UV; e conhecimento das pessoas com UV acerca dos direitos ? sa?de. Os resultados foram processados no programa SPSS 15.0 e analisados por estat?stica descritiva. Diante das caracteriza??es sociodemogr?ficas e de sa?de apresentadas, identificamos uma clientela de usu?rios com UV predominantemente feminina (76,7%), com faixa et?ria a partir de 60 anos (66,7%), casados/uni?o est?vel (60,0%), com baixo n?vel de escolaridade (83,3%), renda familiar menor que um sal?rio m?nimo (73,3%), desempregados e com doen?as cr?nicas associadas (53,3%), sono maior ou igual a 6 horas (76,7%) e que n?o eram etilistas ou tabagistas (93,3%). Em rela??o ?s condi??es cl?nicas, foram evidenciados a presen?a de uma ou mais recidivas da UV (73,3%), predom?nio de granula??o/epiteliza??o no leito da UV (60,0%), exsudato serossanguinolento (43,3%), em quantidade m?dia/grande (60,0%), sem predom?nio de presen?a ou aus?ncia de odor (50,0%), totalidade dos pacientes com perda tecidual em grau III/grau IV, aus?ncia de sinais de infec??o (73,3%) e presen?a de dor intensa (50,0%). Nos ?ltimos 30 dias o principal local de realiza??o do curativo foi o HUOL (100,0 %), a principal terapia compressiva utilizada era a bota de Unna (60,0%) e, na impossibilidade de se realizar os curativos na unidade, eram os pr?prios pacientes que faziam a troca em domic?lio (40,0%). A maioria dos pesquisados elencou mais fatores positivos associados ? qualidade da assist?ncia (56,7%), mostrou-se satisfeita com o atendimento do SUS (76,7%), afirmou ter conhecimento sobre seus direitos (70,0%), mas ao mesmo tempo eles desconheciam o significado da sigla SUS (90,0%) e classificaram o seu n?vel de obten??o de informa??es como inadequado (70,0%). Percebemos que as pessoas com UV identificaram como boa a qualidade da assist?ncia e demonstraram conhecimento inadequado sobre seus direitos ? sa?de no SUS, por?m mostraram interesse em adquirir mais informa??es. Os direitos b?sicos ao ingresso no SUS encontram-se constitucionalmente garantidos e necessitam ser divulgados de modo a torn?-los conhecidos da popula??o, para que assim possa ser implementada e garantida uma assist?ncia de maior resolutividade no tratamento deste tipo de les?o

Le droit à la santé ne fait pas partie du catalogue des droits garantis par la Convention européenne des droits de l’homme. En raison de sa nature essentiellement libérale, la Convention vise avant tout à assurer une protection effective à l’échelle européenne des droits de nature civil et politique. Il en résulte que la Cour européenne des droits de l’homme se montre particulièrement prudente lorsqu’il s’agit de s’aventurer sur le terrain économique et social, lequel relève essentiellement de la compétence des États et de leur politique législative. Toutefois, sous l’impulsion des requêtes portées devant elle, la Cour a rapidement découvert que les droits conventionnels présentent un volet sanitaire qui en conditionne parfois l’exercice effectif. Forte de son dynamisme interprétatif, la Cour européenne des droits de l’homme a progressivement élaboré un corpus juridique portant sur des questions sanitaires qu’elle distille dans sa jurisprudence au gré des affaires soumises à son contrôle. Afin d’adapter la Convention aux réalités sociales, le juge européen s’est employé dans unpremier temps à consacrer une obligation de protection de la santé des individus les plus nécessiteux. Au-delà de ces aspects, la Cour européenne des droits de l’homme s’est engagée dans une redéfinition du mode d’exercice du droit à la santé. Elle se positionne progressivement sur le terrain de la promotion de la santé, faisant ainsi du juge européen unacteur essentiel à la construction d’un droit européen à la santé. / The European Convention on Human Rights (ECHR) does not guarantee the Right to health. Because of its largely liberal nature, the ECHR aims at ensuring an effective protection of civil and political rights at European level. The European Court of Human Rights (ECoHR) has shown caution when dealing with the economic and social field, which is essentially theresponsibility of States and their legislative policy. With significant cases and applications increasing, the Court has found that conventional rights have a health component, which sometimes conditions the actual exercise of those rights. Thanks to its dynamic interpretation, the ECoHR has built up a significant legal corpus on health issues. In order to reflect socialrealities, the European judge initially developed an obligation to protect the health of the most needy individuals. Beyond these aspects, the ECoHR has committed itself to a redefinition of the way in which the right to health must be exercised. The Court is thus progressively positioning itself in terms of health promotion. By doing this, the European judge becomes an important key player in the development of a European right to health.

The overall objective of this study is to promote the human rights to health of Nigerian women to have access essential medicines, to enhance their human capabilities for human development. This thesis argues for an improvement of women’s access to medicines within the context of patent law and rights in the international IP regime of the Trade Related Aspect of Intellectual Property (TRIPS) Agreement and Nigeria’s national patent system. Towards this goal, the thesis makes the point that patent law and its exclusive rights, both the TRIPS Agreement and national law of Nigeria, do not exist in a social welfare vacuum. The legal text of patent law, which confers rights on inventors when enforced, translates to many other things outside the sphere of property rights; indeed, it can be a matter of life and death. It is argued in this regard that patent right could, in effect, interfere with access to medicines and therefore, the right to health and prospects for human development. The thesis therefore argues that, in the construction, interpretation and enforcement of patent law in Nigeria, there is a need to take into consideration its impact on public health. It is against this backdrop that the research assesses the legal framework of pharmaceutical patents and the implications for women’s access to medicines, from a right to health and human development perspective. This interdisciplinary study is with a view to suggesting ways in which Nigeria’s patent system can be more human development and human rights friendly in the interest of public health, particularly, the use of the TRIPS flexibilities to enhance access to life-saving medicines in Nigeria. Since Nigeria as a member of the World Trade Organisation, is bound by its treaty obligation to adopt the provisions of the TRIPS Agreement, the thesis makes proposals for ways in which the Nigerian government and law-makers, can adapt the patent rules and the flexibilities to suit development objectives and promote public health within the benchmark allowed in TRIPS. In this respect, this thesis critically investigates the practical implications of the available flexibilities and options in the TRIPS Agreement that can be used to address the effects of patents on access to medicines. While this thesis concedes the view that the hindrances to accessibility of essential drugs in Nigeria are multi-faceted and demand a multi-dimensional approach for a lasting solution, it is specifically argued that the TRIPS flexibilities are significant means for addressing the challenges of affordable access to important health treatments within the context of patent law. However, it is emphasised that utilising the flexibilities will require that Nigeria’s patent system is strategically designed to take full advantage of the available safeguards and options. To this end, this study recommends ways to incorporate the flexibilities to enhance access to medicines in Nigeria while avoiding the technical and regulatory pitfalls that have trailed the enforcement of the flexibilities by other developing countries.