Human rights and drug control: access to controlled essential medicines in resource-constrained countries
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Cambridge ; Antwerp ; Portland
Intersentia
[2017]
|
| Schriftenreihe: | School of human rights research series
Volume 80 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis Klappentext |
| Beschreibung: | XXIII, 351 Seiten |
| ISBN: | 9781780684543 |
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Datensatz im Suchindex
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|---|---|
| adam_text | Contents
Acknowledgements v
List of Abbreviations xiii
Table of Instruments xv
Table of Cases xix
List of Figures and Tables xxiii
Part 1 Concept and Problem 1
Chapter 1 Introduction 3
1.1 A bird’s-eye view 3
1.2 Research design 10
1.2.1 State of the art of human rights and drug-control research 10
1.2.2 Research approach 13
1.2.3 Research questions 16
1.2.4 Context of general access to medicines and human rights research 18
1.3 Methodology 19
1.3.1 Law and other disciplines 19
1.3.2 Legal and ethical analysis 19
1.3.3 Country studies 22
1.4 Aims and ambitions 23
1.5 Output and relevance 24
1.6 Structure 25
Chapter 2 Access to Controlled Essential Medicines:
Context, Background, Framing, and Focus 27
2.1 Introduction 27
2.2 Context of a human rights approach to drug control in international law 28
2.2.1 International institutional law 28
2.2.2 Fragmentation of international law and the hierarchy of norms 30
vii
Contents
2.2.3 General rules of treaty interpretation and the principle of systemic
integration 35
2.3 Background of medicines regulation in health systems 38
2.3.1 The pharmaceutical life cycle 38
2.3.2 Access to medicines and pharmaceutical regulation 41
2.3.3 Multifaceted challenges of medicine access in the broader
health system 42
2.4 Framing the concept of essential medicines 46
2.4.1 Development of the WHO Model List of Essential Medicines 46
2.4.2 Developing a national essential medicines list 47
2.4.3 List of controlled essential medicines and treatments 49
2.5 The example of the global crisis of unavailable pain-control medication 50
2.5.1 Patterns in the global burden of pain 51
2.5.2 Standard treatment guidelines and results of inadequate treatment 54
2.5.3 Overview of challenges to access pain-control medication 58
2.6 A specific focus on the international drug-control system as a central
regulatory framework and potential challenge 60
2.6.1 Towards a system of international drug control 60
2.6.2 Normative foundation and the‘principle of balance’ 62
2.6.3 Obligations relevant to the provision of pain-control medication 63
2.6.4 Actors, functions, and monitoring mandates relevant to ensuring
the access to pain-control medication 65
2.6.5 Treaty interpretation, normative guidance and technical support to
comply with the relevant administrative and procedural obligations 68
2.6.6 Overview of administrative and procedural obligations to ensure
access to medicines 70
2.7 Conclusion 71
Part 2 Normative Framework 75
Chapter 3 Access to Controlled Essential Medicines and
Aspects of Drug Control in Human Rights Law 77
3.1 Introduction 77
3.2 The human rights framework in brief 80
3.2.1 Human rights instruments 80
3.2.2 Categories of rights 84
3.2.3 Typology of obligations 85
3.2.4 Universal and interdependent nature 86
Contents
3.3 Implementation and enforcement of human rights 89
3.3.1 Immediate and progressive realization 89
3.3.2 Minimum core rights protection 92
3.3.3 Limitations of rights 94
3.3.4 Monitoring and accountability 97
3.3.5 Overview of findings 100
3.4 The right to health 101
3.4.1 Concept and legal codification 101
3.4.2 The scope and content of Article 12 ICESCR 103
3.4.3 Access to pain-control medicines 104
3.4.4 Access to other controlled essential medicines 106
3.4.5 Protection against the hazardous use of substances 107
3.4.6 Relevant obligations to respect, protect, and fulfil 108
3.4.7 The AAAQ standard of healthcare 109
3.4.8 The principle of non-discrimination 111
3.4.9 Priority realization 112
3.4.10 Limitations of the right to health 115
3.4.11 Access to medicines as a justiciable element of the right to health 119
3.5 The prohibition of torture and CIDT 122
3.5.1 Concept and legal codification 122
3.5.2 Distinction between torture and CIDT 124
3.5.3 Obligations to ensure access to pain-control medicines 125
3.5.4 Obligations to ensure access to opioid-dependency medicines 127
3.5.5 Non-interference with an absolute right 128
3.5.6 Judicial review of access to medicines as part of the prohibition
against torture and CIDT 129
3.6 Conclusion 134
Chapter 4 In Search of a Normative Justification 137
4.1 Introduction 137
4.2 Morality, ethics and human rights 139
4.2.1 Morality and ethics 140
4.2.2 Morality and the law in relation to human rights 141
4.3 Understanding the normative foundation of human rights law 143
4.3.1 Human dignity as the foundation of human rights 143
4.3.2 Ancillary or central principle 146
4.3.3 Different approaches to human dignity 147
4.3.4 A conservative and liberal interpretation of human dignity 149
4.3.5 Different notions of autonomy and human dignity in bioethics 154
IX
Contents
4.4 On the normative content of human dignity as empowerment 155
4.4.1 Capability theory 156
4.4.2 The principle of generic consistency 165
4.5 Conceptual criticism 178
4.5.1 Human dignity as the foundation of human rights and its judicial
potential 178
4.5.2 Autonomy and agency in healthcare settings 180
4.5.3 Agency, political recognition, and universality 181
4.5.4 Criticism of a rational approach 182
4.6 Conclusion 183
Part 3 Country Studies 187
Chapter 5 Bridging Theory and Practice:
Introduction to the Country Studies 189
5.1 Introduction 189
5.2 Research design 190
5.2.1 Research approach and central question 190
5.2.2 Data collection and analysis 193
5.3 Rationale for country selection 196
5.4 Limitations 200
Chapter 6 Country Study I: Uganda 203
6.1 Introduction 203
6.2 Design and methodology 204
6.3 Background of Uganda 206
6.3.1 Geographic, demographic and economic characteristics 207
6.3.2 Legal and administrative context 207
6.3.3 Health system 209
6.4 Results and discussion 212
6.4.1 Implementation of international human rights and drug-control
standards 213
6.4.2 Relevant policies and regulations to implement specific
drug-control requirements 214
6.4.3 Supply/demand chain of liquid morphine 216
6.4.4 Implications of managing a separate administration and specific
trade and distribution requirements 218
x
Contents
6.4.5 Implications of data collection, analysis, and reporting procedures 229
6.4.6 Some key challenges to the provision of controlled medicines 237
6.4.7 Potential reform 240
6.4.8 Particular issues around other (controlled) medicines 242
6.5 Conclusion 243
Chapter 7 Country Study II: Latvia 247
7.1 Introduction 247
7.2 Design and methodology 248
7.3 Background of Latvia 250
7.3.1 Geographic, demographic and economic characteristics 250
7.3.2 Legal and administrative context 250
7.3.3 Health system 251
7.4 Results and discussion 253
7.4.1 Implementation of international human rights and drug-control
standards 254
7.4.2 Relevant policies and regulations to implement specific drug-control
requirements 254
7.4.3 Background and context of the domestic interpretation of
drug-control requirements 257
7.4.4 Supply/demand chain of morphine 259
7.4.5 Implications of managing a separate administration and specific
trade and distribution requirements 260
7.4.6 Implications of data collection, analysis, and reporting procedures 270
7.4.7 Some key challenges to the provision of controlled medicines 274
7.4.8 Potential reform 280
7.4.9 Particular issues regarding other controlled medication 281
7.5 Conclusion 285
Part 4 Conclusions and Recommendations 289
Chapter 8 Conclusions and Recommendations 291
8.1 Recalling the questions and ambitions of this book 291
8.2 Human rights and drug control: normative and empirical findings 294
8.2.1 Human rights foundation of drug control 295
8.2.2 Implementation and practical constraints of service provision in
Uganda and Latvia 299
xi
Contents
8.3 Towards a human rights approach of drug control to improve the access to
controlled medicines 302
8.3.1 Central message and key recommendations 302
8.3.2 Areas of further investigation and broader implications 309
8.4 Final thoughts 311
Appendix I: Interview Protocol Uganda 313
Appendix II: Interview Protocol Latvia 317
Samenvatting (Dutch summary) 321
Selected Bibliography 331
Index by Paragraph 347
Curriculum Vitae 349
Xll
Globally, millions of people suffer health and socio-economic related problems
due to the unavailability of controlled essential medicines such as morphine
for pain treatment, which leaves them in disabling and sometimes degrading
situations. Controlled essential medicines are medicines included in the World
Health Organization’s List of Essential Medicines, and whose active substance
is listed under the international drug-control treaties. Their availability and
accessibility therefore fall within the remit of both human rights and international
drug-control law. Even though the unavailability of controlled essential
medicines is generally caused by a multifaceted and complex interplay of
factors, the current international drug-control framework paradoxically hinders
rather than fosters the access to medicines,
Human Rights and Drug Control analyses a human rights interpretation of
the international drug-control framework with an emphasis on advancing
the access to controlled essential medicines in resource-constrained countries.
Its approach goes beyond the more conventional legal analysis and includes an
ethical analysis as well as two case studies in Uganda and Latvia. It first aims
to identify a human rights foundation of drug control by examining how human
rights norms would balance the underlying tension: some controlled substances
have a clear, evidence-based medical benefit, yet also have the potential to be
misused, which may lead to dependency disorders. This makes it evident that
States should regulate this delicate equilibrium, the challenge being how they
can do so legitimately in light of human rights norms.
Having explored this premise in the context of human rights law and theory,
this book then applies these findings to Uganda and Latvia, - two best practice’
countries - when it comes to improving the accessibility of morphine for pain
treatment. Relying on qualitative research methods, the study explores whether
the human rights basis of drug-control regulation may be adequately integrated
into the structures of the present international drug-control system, It specifically
deals with various technical, administrative and procedural obligations relating to
the import/export and retail trade of controlled medicines. The book concludes
with a proposal on how a human rights approach to drug-control may be
advanced, specifically highlighting the importance of reconciling international
obligations with the local reality in which these obligations come into play.
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| spelling | Gispen, Marie Elske Verfasser (DE-588)1128317818 aut Human rights and drug control access to controlled essential medicines in resource-constrained countries Marie Elske Gispen Cambridge ; Antwerp ; Portland Intersentia [2017] XXIII, 351 Seiten txt rdacontent n rdamedia nc rdacarrier School of human rights research series Volume 80 Drogenhandel (DE-588)4139162-7 gnd rswk-swf Menschenrecht (DE-588)4074725-6 gnd rswk-swf Kontrolle (DE-588)4032312-2 gnd rswk-swf Menschenrecht (DE-588)4074725-6 s Drogenhandel (DE-588)4139162-7 s Kontrolle (DE-588)4032312-2 s DE-604 School of human rights research series Volume 80 (DE-604)BV012740005 80 Digitalisierung UB Passau - ADAM Catalogue Enrichment application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=029613576&sequence=000003&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis Digitalisierung UB Passau - ADAM Catalogue Enrichment application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=029613576&sequence=000004&line_number=0002&func_code=DB_RECORDS&service_type=MEDIA Klappentext |
| spellingShingle | Gispen, Marie Elske Human rights and drug control access to controlled essential medicines in resource-constrained countries School of human rights research series Drogenhandel (DE-588)4139162-7 gnd Menschenrecht (DE-588)4074725-6 gnd Kontrolle (DE-588)4032312-2 gnd |
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| title | Human rights and drug control access to controlled essential medicines in resource-constrained countries |
| title_auth | Human rights and drug control access to controlled essential medicines in resource-constrained countries |
| title_exact_search | Human rights and drug control access to controlled essential medicines in resource-constrained countries |
| title_full | Human rights and drug control access to controlled essential medicines in resource-constrained countries Marie Elske Gispen |
| title_fullStr | Human rights and drug control access to controlled essential medicines in resource-constrained countries Marie Elske Gispen |
| title_full_unstemmed | Human rights and drug control access to controlled essential medicines in resource-constrained countries Marie Elske Gispen |
| title_short | Human rights and drug control |
| title_sort | human rights and drug control access to controlled essential medicines in resource constrained countries |
| title_sub | access to controlled essential medicines in resource-constrained countries |
| topic | Drogenhandel (DE-588)4139162-7 gnd Menschenrecht (DE-588)4074725-6 gnd Kontrolle (DE-588)4032312-2 gnd |
| topic_facet | Drogenhandel Menschenrecht Kontrolle |
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