The Human Rights Commission is deeply disturbed by recent revelations arising from the Auditor General’s report and further scrutiny by the Parliamentary Accounts Committee that defective condoms as well as gloves were distributed to the general public and have been in circulation since September, 2020. This revelation is a serious indictment on the part of the State and greatly undermines its obligation to ensure that every citizen enjoys the highest attainable standard of health.
The right to health is a fundamental human right and an important part of the right to life which has been recognized or articulated in many international human rights treaties which Zambia has ratified including the International Covenant on Economic, Social Cultural Rights (ICESCR). Zambia being a signatory to ICESCR which she ratified on 10th April, 1984 has the obligation to respect, protect and fulfil economic, social and cultural rights including the right to health. The ICESCR which is widely considered as the core International Human Rights Instrument on protection of the right to health, recognizes “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health” under Article 12.
According to the Committee on Economic, Social and Cultural Rights in their General Comment No. 14 of 2000, “health is a fundamental human right indispensable for the exercise of other human rights.” Therefore, the right to health reinforces the interdependency, interconnectedness and interrelatedness of human rights whether civil and political rights or economic, social and cultural rights. This means that violating the right to health also impairs the enjoyment of other human rights dependent on it, such as the rights to life, to an adequate standard of living, to education or to work.
The implications of violating the right to health are far-reaching for individuals and groups particularly in vulnerable situations, such as women, adolescents, persons with disabilities and persons living with HIV/AIDS who often face significant barriers to the enjoyment of the highest attainable standard of health due to discrimination, among other factors.
It is worth to note that the Committee on Economic, Social and Cultural Rights in their General Comment No. 14 of 2000 emphasized under paragraph 12 that the right to health encompasses the following four pillars: (i) availability; (ii) accessibility; (iii) acceptability and (iv) quality.
Therefore, the full realization of the right to health imposes three core obligations on the State which are:
i. The obligation to respect- this requires States to refrain from interfering directly or indirectly with the right to health. In this regard it is the considered view of the Commission that the Government failed in its obligation to respect the right to health by allowing the procurement and distribution of substandard condoms and gloves to the public.
ii. The obligation to protect- this requires States to ensure that private actors conform with human rights standards when providing health care or related services. With regard to the current case of Honeybee Pharmacy, there was an omission on the part of the Government in enforcing laws and regulations
that protect citizens from being supplied with substandard health commodities which violate their enjoyment of the right to the highest attainable standard of health.
iii. The obligation to fulfill – this requires States to adopt appropriate legislative, administrative, budgetary, and other measure to fully realize the right health. It was expected that the State, through its Agencies, including the Ministry Health, Medical Stores Limited and Zambia Medicines Regulatory Authority, should have taken measures to effectively regulate the procurement and distribution of quality health commodities to the public. The Commission notes that the potential impact of distributing defective condoms and gloves have lifelong impact which may include the following:
1. Violation of the Right to Life
Owing to the interdependency and interrelatedness of human rights, the distribution of defective condoms and medical kits directly impacts on the protection of the right to life.
2. Violation of the Right to Health
The distribution of defective condoms and gloves has great potential to negatively impact on the enjoyment of the right to health particularly efforts aimed at fighting the AIDS pandemic. There is a huge risk that some people could have contracted HIV/AIDS on account of using such defective medical supplies. It is estimated that the prevalence of HIV among adult’s ages 15 to 59 years in Zambia is estimated at 12.3 %, 14.9 percent among females and 9.5 % among males. This accounts for approximately 980,000 people living with HIV 1 who may have been exposed to health risks arising from the supply and distribution of the defective medical kits and unsafe medicines. This may reverse the gains made in the fight against HIV/AIDS and other sexually transmitted diseases and, in turn, impair the enjoyment of the right to health.
3. Efforts to fight COVID – 19 Pandemic undermined
The health workers and other front-line staff in the prevention and control of the spread COVID – 19 pandemic make use of protective gloves among other Personal Protective Equipment (PPE) to protect themselves and others from contracting COVID – 19. It is worrying that during the time of the deadly COVID – 19 pandemic which is increasing posing a serious public health threat the distribution of defective gloves was allowed potentially undermining the efforts to prevent the spread of COVID-19
4. Compromised safety of health workers and frontline staff
Health professionals and other frontline staff play a critical role in the realization of the right to health. It is expected that health commodities made available to health workers for their use, such as gloves, should be of high quality and standard in order to guarantee their safety and that of the members of the public. It is of great concern that the Government allowed the distribution and use of substandard gloves in health facilities which undermined the occupational safety of health workers and other frontline staff and, in turn, endangering their lives as well safety of members of the public who could have accessed health service.
5. Impact on sexual reproductive health and rights
The distribution of defective condoms directly impacts on the enjoyment of sexual reproductive health rights considering that the availability and accessibility of quality-assured condoms is are a key component in the fulfilment of sexual
reproductive health and rights in the country. Therefore, the distribution of defective condoms to the public compromised not only the safety of people at risk of HIV and other Sexually Transmitted Infections (STIs), but also the protection for individuals against unintended pregnancies. It is the responsibility of Government to ensure that quality-assured condoms are available to those who need them and when they need them for their reproductive health needs.
It is important to note that the award of the USD 17 million contract to Honeybee Pharmacy who supplied substandard health commodities also raises issues of lack of transparency and accountability in the procurement of life-saving drugs and medical supplies.
The Commission calls on the Government to ensure that all those who played a role in facilitating the procurement, supply and distribution of unsafe drugs and medical supplies to the public should be held to account.
The Government should also put in place a strict accountability mechanism and curb corruption in the procurement of medical supplies. This is because corruption is leads to human rights violation. It severely deprives the State of capacity to meet its obligations to respect, protect and fulfil all the human rights of its citizenry.
The Commission is aware that the Anti-Corruption Commission is already carrying out investigations into the matter which have reached an advanced stage. The Commission wishes to call upon the public to allow for lawfully mandated institutions such as the Anti-Corruption Commission to carry out their mandate effectively.
Further, it is unfortunate that unsafe drugs and medical kits were allowed to be distributed to the public despite failing the quality test and the authorities failed to act proactively to remove them from circulation in order to protect the citizens’ rights to health and life. Although psychological and other harm have already been occasioned, it is important that the drugs and defective medical kits are immediately withdrawn from market and should be destroyed forthwith.
The Commission is calling upon the Government to ensure that there is effective tracing of, and support to the victims in order to avoid putting their health and that of other people at any further risk. Over and above, there should be adequate reparations for all victims.
Mudford Z Mwandenga
HUMAN RIGHTS COMMISSION