FUNDAMENTALS OF HEALTH LAW IN UGANDA Ben Kiromba Twinomugisha School of Law, Makerere University, Uganda 2015 Fundamentals of health law in Uganda Published by: Pretoria University Law Press (PULP) The Pretoria University Law Press (PULP) is a publisher at the Faculty of Law, University of Pretoria, South Africa. PULP endeavours to publish and make available innovative, high-quality scholarly texts on law in Africa. PULP also publishes a series of collections of legal documents related to public law in Africa, as well as text books from African countries other than South Africa. This book was peer reviewed prior to publication. For more information on PULP, see www.pulp.up.ac.za Printed and bound by: BusinessPrint, Pretoria To order, contact: PULP Faculty of Law University of Pretoria South Africa 0002 Tel: +27 12 420 4948 Fax: +27 12 362 5125 pulp@up.ac.za www.pulp.up.ac.za Cover: Yolanda Booyzen, Centre for Human Rights ISBN: 978-1-920538-39-2 © 2015 iii TABLE OF CONTENTS Preface vii Dedication viii Table of cases ix Table of principal legislation xii Table of subsidiary legislation xiii Table of international instruments and documents xiii Abbreviations xvii Nature, scope and sources of health law 1 Introduction 1 1.1 Understanding the concepts ‘health’ and ‘law’ 1 1.2 The scope of health law 4 1.3 Sources of health law 6 1.3.1 The 1995 Constitution of the Republic of Uganda 6 1.3.2 Principal legislation 8 1.3.3 Subsidiary legislation 9 1.3.4 International human rights law 11 1.3.5 Common law and equity 15 1.3.6 Customary law 15 1.4 Policy frameworks 17 1.5 Chapter synopsis 17 The right to health 1 Introduction 19 2 The normative content of the right to health 20 2.1 The right to health at the international level 20 2.2 The right to health at the regional level 25 2.3 The right to health at the domestic level 27 3 Conclusion 31 Challenges to realisation of the right to health 1 Introduction 33 2 Mapping out the challenges 34 2.1 Muted recognition of the right to health and a reluctant judiciary 34 2.2 Criminalisation of sexual and reproductive health rights (SRHR) 43 2.2.1 What are SRHR? 43 2.2.2 How are SRHR criminalised? The examples of sex work and abortion 45 2.3 The intellectual property regime and access to medicines 54 2.4 Commercialisation of health related services 61 2.5 Inequitable gender relations 64 3 Conclusion 65 Strategies for tackling challenges to realisation of the right to health 1 Introduction 67 2 Mapping out the strategies 67 2.1 Lobbying for legislative measures 67 2.1.1 Lifting restrictions on abortion 67 2.1.2 Balancing the rights of a fetus and a woman’s rights 71 2.1.3 The right to freedom of conscience in the context of abortion 73 1 2 3 4 iv 2.2 Claiming health rights through the courts 76 2.3 Using the Uganda Human Rights Commission 79 2.4 Utilising mechanisms at the regional level 80 2.5 Utilising TRIPS flexibilities 82 2.6 Claiming the right to health through participation 84 2.7 Tackling inequitable gender relations 86 2.8 Providing free health care to those unable to afford 86 3 Conclusion 86 Public health law and human rights 1 Introduction 89 2 What is public health law? 90 3 Public health and human rights 92 4 Public health legislation and infectious or communicable diseases 98 4.1 General public health 98 4.2 Venereal diseases 104 4.3 HIV and AIDS 106 4.3.1 Giving credit where it is due: Does the Act meet public health and human rights goals? 106 4.3.2 HIV and AIDS control strategy: The use of criminal law 107 4.3.3 Disclosure and mandatory testing 111 5 Conclusion 114 Mental health law 1 Introduction 117 2 Mental health situation 118 3 Understanding mental health disabilities 119 4 The normative framework for realisation of mental health at the international level 122 4.1 The mainstream international human rights instruments 122 4.2 The pre-CRPD situation: Soft law instruments recognising disability as a human rights issue 125 4.3 The CPRD: A transformative paradigm shift 130 5 The normative framework for realisation of mental health at the regional level 133 6 The normative framework for realisation of mental health at the domestic level 135 6.1 General disability rights law 135 6.2 Mental health legislation 136 7 Conclusion 140 Regulation of health care professionals 1 Introduction 143 2 Medical and dental practice 143 2.1 The Medical and Dental Practitioners’ Council 143 2.2 Registration of medical and dental practitioners 145 2.3 Inquiry into professional misconduct 148 2.3.1 Examples of complaints to the council 150 2.3.2 Appeal against decisions of the council 152 3 Nursing and midwifery 157 3.1 The Nurses and Midwives Council 157 3.2 Registration and enrolment of nurses and midwives 159 3.3 Inquiry into professional misconduct 161 4 Allied health profession 163 5 6 7 v 4.1 The Allied Health Professionals Council 163 4.2 Registration of AHPs 164 4.3 Inquiry into professional misconduct 165 5 Pharmacy 167 5.1 The Pharmaceutical Society of Uganda 167 5.2 Inquiry into professional misconduct 168 5.3 The scope of a pharmacist’s responsibility 169 6 Traditional medical practice 172 6.1 Understanding traditional medicine 172 6.2 Regulation of traditional medical practice 173 7 Conclusion 174 Malpractice litigation 1 Introduction 177 2 What the plaintiff must prove in a malpractice action 178 2.1 The duty of care 178 2.2 Breach of the duty of care 179 2.3 Damage suffered 182 3 Vicarious liability 184 4 The burden of proof 186 5 Defences to a malpractice action 188 5.1 Denial 188 5.2 Peer acceptance: Invoking the Bolam test 189 5.3 Contributory negligence 189 5.4 Voluntary assumption of risk 189 5.5 Where the action is time barred 190 6 Remedies 191 6.1 Damages 191 6.2 Alternative dispute resolution (ADR) 192 7 Criminal liability for negligence 193 8 Conclusion 195 Patients’ rights: The question of consent to treatment 1 Introduction 197 2 Patients’ Charter: Patient’s rights and responsibilities 197 3 Why consent to treatment? 199 4 Capacity to consent to treatment 200 5 Form of consent 206 6 Treatment without consent 207 7 The position of children 208 8 Factors that vitiate consent 210 8.1 Coercion and undue influence 210 8.2 Fraud 211 9 Conclusion 212 Research involving humans as participants 1 Introduction 213 2 Understanding research involving humans as participants 214 3 The international framework 214 3.1 International human rights instruments 215 3.2 The Declaration of Helsinki 216 3.3 The UNESCO Declaration 217 3.4 The CIOMS International Ethical Guidelines 219 8 9 10 vi 3.4.1 General ethical principles 219 3.4.2 The Guidelines: An overview 220 3.5 UNAIDS/WHO Guidance Document 223 4 The national framework 224 4.1 The Uganda National Council for Science and Technology Act 224 4.2 The National Drug Policy and Authority Act 225 4.3 The HIV and AIDS Prevention and Control Act 2014 225 4.4 The UNCST National Guidelines 226 4.5 The Uganda Guidelines for AIDS Research 228 5 Liability in research involving human as participants 228 6 Conclusion 231 Bibliography 233 vii PREFACE I am glad to present this publication, Fundamentals of health law in Uganda I wrote my Doctor of Laws (LLD) thesis on maternal health rights in Uganda. During the period of conducting research, I realised the importance of teaching a health law course at university. Dr Esther Kisakye, then a senior lecturer at the School of Law, Makerere University and now a judge of the Supreme Court of Uganda, and I started a Health and the law course at the school. As an elective, the course has been popular: it attracts a big fraction of the fourth year LLB students every year. Indeed a good number of our former students who offered the course have used the knowledge and skills acquired to advocate for health law and policy reform. Some have established Civil Society Organisations (CSOs) engaged in health and human rights advocacy. However, both my former and current students have always complained of a lack of a local text on health law. Thus, this book is my humble response to these complaints. The goal of this book is to examine health law within the broader legal and policy frameworks with a bearing on human health. Health law is a multi-disciplinary field that covers the relationship between law and health and teases out critical legal and ethical issues concerning public health and health care. It stresses the crucial role played by law in the protection of health, which is critical for an active and productive life. A question that may be asked by a potential reader of the book is: why a book on health law? Although certain courses such as constitutional law, human rights, international law, environmental law, and the law of torts, which are offered in universities and other institutions of higher learning, contain topics with a bearing on health, health law as a distinct subject is relatively young in Uganda. In spite of the growing recognition of the important role played by law in the promotion of good health, there is no specific book addressing the interface between health and the law in the Ugandan context. The few available books and other relevant materials are foreign in the sense that they cover British, American, Canadian, Australian and other settings outside Uganda. In my view, there is a need for a local book, which may act as a reference for students of health law. It is hoped that the book will be helpful to students and staff of the schools, faculties and institutes of Law, Public Health, and Medicine in Uganda. The book will also be a critical source of information for health professionals, CSOs, practicing lawyers, policy makers, legislators, activists and all people whose interest is in law, health and human rights. The book is meant for both legal and non-legal audiences. It is hoped that the book will serve a broad range of people who are passionate about human health. Given that the book only tackles fundamentals of health law in the country, I welcome constructive criticism so that in future I will be able to expand on it. Ben Kampala, 2015 viii DEDICATION To my beloved wife, Anne, and my children, Faith, Brenda, Rhona and Jenkins and all my former and present students of ‘Health and the law’. ix TABLES Table of cases Abdalla v Health Professions Council (2009) EWHC 3948 Abdullahi v Pfizer 77 Fed App 48 (2d Cir 2003) Abuki v Attorney General Constitutional Petition 2/1992 (CC) Achutrao Haribhau Khodowa v State of Maharshtra AIR 1996 SC 23777 AIDS Law Project v Attorney General & Others Petition 97/2010 Alcock v Chief Constable of the South Yorkshire Police (1992) 1 AC 310 Alex Wanigina v Attorney General (1985) HCB 102 (HC) Appleton v Garett 34 BM 60 Article 19 v Eritrea (2007) AHRLR (ACHPR 2007) Attorney General v Susan Kigula & 417 Others Constitutional Appeal 3/2006 (CC) Barnett v Chelsea & Kensington Hospital Management Committee (1968) 1 All ER 1068; (1969) 1QB 428 Baker v Carr (369) USB186 (1962) Bedford v Ag , Canada 2010 ONCA 0814 Bitumuka Apolinali v The Trustees of Uganda (1974) HCB 96 (HC) Bikwatirizo v Uganda Railways Corporation (1971) EA 82 Bolam v Friern Hospital Management Committee (1957) 2 All ER 118; (1957) 1 WLR 582 Bolitho v City & Hackney Health Authority (1997) 4 All ER 771; (1997) 3 WLR 115 C v Minister of Correctional Services 1996 (4) SA 292 (T) Canterbury v Spence (1972) 464 F 2d 722 Cassidy v Ministry of Health (1954) 2 QB 66; (1951) 2 All ER 132 Centre for Health, Human Rights and Development & 3 Others v the Attorney General Constitutional Petition 16/ 2011 (CC) Centre for Health Rights and Development & Others v Nakaseke District Local Administration Civil Suit 111/ 2002 (Unreported) Certification of the Constitution of the Republic of South Africa Case 1996 1996 (4) SA 744 (CC) Charles Onyango Obbo & Anor v Attorney General (2004) AHRLR 256 Chatterton v Gerson (1981) 1 All ER 257; (1981) QB 432; (1980) WLR 1003 Chester v Afsher (2004) 4 All ER 587 Christian Lawyers’ Association of South Africa & Others v Minister of Health 1998 (11) BCLR 1434 (T) Col (Rtd) Dr Kiiza Besigye v Yoweri Museveni Kaguta Electoral Petition 1/2001 (SC). Collins v Wilcock (1984) 1 WLR 1172 Consumer Education and Research Centre v Union of India (1995) 3 SCC 117 Cortex & Others v El Salvador Case 12.249 (20 March 2009) Report 27/ 2009 Cottam v CVS Pharmacy (2002) 764 NE 2d 814 Decision C-355/2006 (10 May 2006, Columbia) Decision T-388/09 Gaceta de la Corte Constitucional (Columbia) Denloye v Medical and Dental Practitioners Disciplinary Tribunal (1969) 1 All NLR 306 De Souza v Tanga Township (1961) EA 337 Diamond Bank Ltd v Partnership Investment Co Ltd (2010) WRN 42 Donoghue v Stevenson (1932)AC 562 Embu Public Road Services Ltd v Riimi (1968) EA 22 Enhorn v Sweden (2005) ECHR 5652 Environmental Action Network v Attorney General & NEMA Miscellaneous Application 39/2001 (HC) x F v West Berkshire Health Authority (1989) 2 All ER 545; (1990) 2 AC 1; (1989) 2 WLR 938 Fairland v Glenhaven Funeral Services (2002) UKHL 22 Faulkne v Nursing and Midwifery Council (2009) EWHC 3349 (Admin) Francis Coralie Mullin v the Administrator Union Territory of Delhi & Others (1981) 2 SCR 516 Free Legal Assistance Group v Zaire (2000) AHRLR74 (ACHPR 1995) Gelsinger v Trustees of the University of Pennsylvania Phila Cnty Ct of CP filed 29 January 2001 George Ongom & Another v Attorney General & 2 Others (1974) HCB 267 Gillick v West Norfolk & Wisbech AHA (1985) 3 All ER 402 Government of the Republic of South Africa & Others v Grootboom & Others 2000 (11) BCLR 1169 (CC) Government of the Republic of Namibia v LM & Others (2014) NASC 19 Haluska v University of Saskatchewan & Others (1965) 53 DLR 2d 436 Happel v Wal-Mart Stores (2002) 766 NE 2d 1118 Health Professional Council of South Africa v Dewald de Bruin 2004 (4) All SA 392 (SCA) HL v UK (2005) EHRR 32 Hoffman v South African Airways 2001 (1) SA 1 (CC) Hooper v Capoblanco 99 A S01792 (Cal Sup Ct 15 November 2000) Horner v Spalitto 1 SW 3d 5 (1999) Hutchinson v General Dental Medical Council (2008) EWHC 2896 (Admin) Independent Medico Legal Unit v Attorney General of Kenya 29 June 2011, EACJ First Instance Division Ref3/2010 Ireland v United Kingdom (1978) 2 EHRR 162 Ismail Serugo v Kampala City Council & Another Constitutional Appeal 1/1998 (Unreported) Jack Busingye & 2 Others v TMK (1992-1993) HCB 171 James Katabazi v Secretary General of the EAC 20 November 2007, EACJ First Instance Division, Ref1/2007 Jatta v Nursing & Midwifery Council (2010) EWHC 2549 (Admin) Jenkins v Bogalusa Community Medical Centre (1976) 340 So.2d 1065 Jones v Manchester Corporation (1957) 2 All ER 132 Joyce Nakacwa v Attorney General & 3 Others Constitutional Petition 2/2001 (CC) Kampe v Howard Stark Professional Pharmacy (1992) 841 SW 2d 223 Keshavananda Bharati v State of Kerala (1993) 4 SCC 225 Kiyutin v Russia ECHR Application 2700/10 (10 March 2011) KL v Peru Communication 1153/2003, adopted 24 October 2005, UN Doc. CCPR/ C/85/D/1153/2003 (22 November 2005) Kylie v Commission for Conciliation, Mediation and Arbitration & 2 Others 2008 (9) BLLR 870 Lanphier v Phipos (1838) 8 C & P 475 Laxim Mandal & Others v Deen Harinagar Hospital & Others WP (C) 8853/2008 Marbury v Madson 5 US 137 (1803) Marko Matovu v Mohamed Sseviri (1979) HCB 174 Maynard v West Midlands Regional Health Authority (1985) 1 All ER 635; (1984) 1 WLR 634 McGhee v National Coal Board (1973) 1 WLR 1 Media Rights Agenda & Others v Nigeria 2000 AHRLR 191 (ACHPR 1998) Medical and Dental Practitioners Disciplinary Tribunal v Okonkwo (2002) AHRLR 159 (NgSC 2001) Mehar Singh Bansel v R (1959) EA 813 Minister of Health v Treatment Action Campaign (No 2) 2002 (5) SA 721 (CC) xi Miramago v Attorney General (1979) HCB 24 Monteoli v Woolworths(Pty) Ltd 2000 (4) SA 735 (W) Morgan v Wal-Mart Stores No 03-99-00700 (Tex App Dist 3 (8 October 2000) Mukalazi v Davis Kisule (1995) III KALR 42 (HC) Muwonge v Attorney General (1967) EA 17 MX v ZY AIR 1997 Bom 406 (High Court of Bombay) National Confederation of Health Workers (CNTS) v Courts of Justice of the States ADPF 54 (Supreme Court, 12 April 2012) Naude v Transvaal Boot and Shoe Manufacturing Co 1983 AD 379 NB v Slovakia Application 29518/10 (12 September 2012) Nevil & Another v Cooper & Another (1958) EA 594 Nicola Mc Donald v Dr Graham Wroe 2006 (3) All SA 565 Obiga v Electoral Commission & Another Election Petition 4/2001 (Unreported) Olaye v Chairman, Medical & Dental Practitioners Disciplinary Tribunal (1977) NMLB 506 P & S v Poland (2012) ECHR 1853 Parxades Okutoyi v Medical Practitioners and Dentists Board (2008) EKR 16 Paschim Banga Khet Sanity v State of West Bengal (1996) 4 SCC 37 Patricia Asero & 2 Others v The Attorney General & Another Petition 409/2009 Plaxeda Rugumba v Secretary General of the EAC & Attorney General of Rwanda 1 December 2011, EACJ First Instance Division, Ref8/2010 Pope John’s Hospital & Another v Baby Kasozi (1974) EA 220 President of the Republic of South Africa v Hugo 1997 (4) SA 1 (CC) Price v United Kingdom (2001) EHRR 1285 Purohit & Moore v The Gambia (2003) AHRLR (ACHPR 2003) Rail Commuters Action Group v Transnet Ltd t/a Metrorail 2005 (2) SA 359 R v Adamako (1994) 3 All ER 79; (1995) 1 AC 624 R v Bateman (1925) 19 CR App R 8 R v DICA 92004) EWCA Crim 1103 (CA) R v Jones (Anthony) (2003) 1 AC 1; (2002) UKHL 5 R v Oakes ( 1986) 1 SCR 103 R (Raheem) v Nursing & Midwifery Council (2010) EWHC 2549 (Admin) R (Thompson) v General Chiropractic Council (2008) EWHC 2499 (Admin) R (Johnson) v Professional Conduct Committee of the Nursing and Midwifery Council (2008) EWHC 885 (Admin) Re Abortion Law Challenge in Colombia C-355/2006 (10 May 2006) Re (Adult: Refusal of Treatment) (1992) 4 All ER 649; (1992) 3 WLR 782; (1992) 3 Med LR 306 Re C (1994) 1 All ER 819 Regina Nalukwago v Dr Phillip Byaruhanga & 2 Others (1995) III KALR 106 Re MB (1997) 2 FCR 541 Re O (A Minor) (Medical Treatment) (1993) 2 FLR 149 Re Polemis: The Wagon Mound (1961) UKPC 1 Republic of Kenya v Nyamu & Others Case 81/2004 (Unreported) Republic v Thompson Books Ltd & Others (1996-7) SCGLR 484 Re R (A Minor) (Blood Transfusion) (1993) 2 FLR 757; (1993) FCR 544 Re S (A Minor) (Medical Treatment) (1993) 1 FLR 396 Re T (1992) 4 All ER 649 Re W (1992) 4 All ER 6217 Rex v Bourne (1938) 1 KB 687; (1983) 3 All ER 612 Robertson v Mc Ghee No 01CV00G0H (M) (N.D. Okla, Filed 29 January 2001) Roe v Minister of Health (1954) 2 All ER 132; (1954) QB 66 Roe v Wade 419 US 113 (1973) Rosemary Nalwadda v Uganda AIDS Commission Misc Cause 45/2010 (Unreported) xii Rosenberg v South African Pharmacy Board 1981 (1) SA 22 (A) S v Jordan 2002 (6) SA 642 (CC); 2002 11 BCLR 1117 (CC) S v Makwanyane & Another 1995 (3) SA 391 (CC) Samuel Mukira v Attorney General of Uganda 17 May 2013, EACJ First Division Ref 5/2011 Sheikh Kateregga & Another v UEB (1995) III KALR 143 Shiva v Ministry of Health & Another (2008) TZHC 10 Sidaway v Bethlem Royal Hospital Governors (1985) 1 All ER 643; (1985) 1 AC 871 Simman v South African Pharmacy Board 1980 (1) SA 764 (T) Simon v South African Pharmacy Council & Others (2006) ZAWHC 14 Soobramoney v Minister of Health , Kwazulu-Natal 1998 (1) SA 765 (CC) State v Mashumpa & Another 2008 (1) SACR 126 (E) Sudan Human Rights Organisation & Centre for Housing Rights and Evictions (COHRE) v Sudan (2009) AHRLR 153 (ACHPR 2009) Sunday Times v United Kingdom (No 1) (1979-1980) EHRR 245 Tinyefuza v Attorney General , Constitutional Petition 1/1996 (Unreported) Tumukurate Espildon v Uganda Medical & Dental Practitioners’ Council , High Court Civil Appeal No 65 of 1999 (Unreported) Uganda v Namubiru Rosemary HCT-00-CR-CN-0050-2014 (Unreported) Vaccination case, Decision (Sentencia) SU-225/98, May 20, 1998. Van Vuuren & Another v Kruger 1993 (4) SA 842 (A) Verma v General Medical Council (2008) EWHC 753 (Admin) Victor Rosario Congo The Inter-American Commission on Human Rights Report 29/99, case 11, 427, adopted in sess 1424 OEA/ser/L.V/110 Doc 26 (9 March 1999) Villagram Morales & Others IACHR (19 November 1999) Ser C No 63 Ward v Nursing & Midwifery Council (2014) EWCA 1158 (Admin). Weiss v Solomon (1988) AQ 312 (Sup Ct). Whitehouse v Jordan (1981) 1 All ER 267 Wisher v Essex Area Health Authority (1988) 1 AC 1074 XX v Gun Corporation & Others (Constitutional Court JudgmentSU-256/1996) Yusuf v Pharmaceutical Society of Great Britain (2009) EWHC 867 (Admin) Zachary Olum & Another v Attorney General , Constitutional Petition 6/1999 (Unreported) Zimbabwe Lawyers for Human Rights & Another v The Government of Zimbabwe (2008) AHRL (ACHPR 2008) Table of principal legislation Allied Health Professionals Act, Cap 274 Anti-Counterfeit Act, 2008 (Kenya) Anti-Homosexuality Act, 2014 Anti-Pornography Act, 2014 Choice of Termination of Pregnancy Act, 92 of 1996 (South Africa) Civil Procedure and Limitation (Miscellaneous Provisions) Act, Cap 272 Constitution of the Republic of Kenya, 2010 Constitution of the Republic of South Africa, 1996 Constitution of the Kingdom of Swaziland Act, 2005 Constitution of the Republic of Uganda, 1995 Criminal Code (Amendment) Act, 646 of 2003 Criminal Code of the Federal Republic of Ethiopia, Proclamation 414/2004 East African Community HIV/AIDS Prevention and Management Act 2012 Evidence Act, Cap 6 Foods and Drugs Act, Cap 278 HIV and AIDS Prevention and Control Act, 2014 xiii Industrial Property Act, 2014 Judicature Act, Cap 13 Limitation Act, Cap 80 Local Government Act, Cap 243 Magistrates Courts Act, Cap 16 Medical and Dental Practitioners Act, Cap 272 Mental Treatment Act, Cap 279 Mental Treatment Act, 2012 (Ghana) Mental Treatment Act, 2000 (South Africa) National Drug Policy and Authority Act, Cap 206 National Environment Act, Cap 153 National Medical Stores Act, Cap. 207. Nurses and Midwives Act, Cap 268 Occupational Safety and Health Act, 2006 Organic Law Instituting the Penal Code, 1 of 2012 (Rwanda) Penal Code Act, Cap 120 Pharmacy and Drugs Act, Cap 280 Private Hospitals (Regulations) Act, Cap 151 (Tanzania) Public Health Act, Cap 281 Public Health Act, 2012 (Ghana) Ratification of Treaties Act, Cap 124 Traditional and Alternative Medicine Control Act, 2002 (Tanzania) Venereal Diseases Act, Cap 284 Water Act, Cap 152 Witchcraft Act, Cap 124 Table of subsidiary legislation National Environment (Control of Smoking in Public Places) Regulations, 2004 National Environment (Noise Standards and Control) Regulations, 2003. Rules of Procedure of Parliament of Uganda, 2006. 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A/8429 (1971) Doha Declaration on the TRIPS Agreement and Public Health WT/MIN(01)/ DEC/2, 20 November 2001 Ethical Principles for Medical Research Involving Human Subjects, adopted by the World Medical Assembly, Helsinki, June 1964 http:www.wma.net/en/ 30publications/10policies/b3/ (accessed 20 January 2014) European Convention for the Protection of Human Rights and Fundamental Freedoms, opened for signature 4 November 1950, 213 UNTS 5 European Social Charter http://www.coe.int/T/DGHL/monitoring.Social (accessed 10 May 2015) Extension of the Transition Period under Article 66.1 of the TRIPS Agreement for Least Developed Country Members for Certain Obligations with Respect to Pharmaceutical Products IP/C/25 (2002) Framework Convention on Tobacco Control, Geneva, 21 May 2003, 2302 UNTS 166 General Comment 20: Article 7 (Prohibition of Torture, or Other Cruel, Inhuman or Degrading Treatment or Punishment), 10 March 1992 http:// www.refworld.org/docid/453883fb0.html (accessed 15 May 2015) General Comment 6: Article 6 (Right to Life), 30 April 1982 http:// www.refworld.org/docid/45388400a.html (accessed 14 May 2015) General Comment 20: Non-discrimination in economic, social and cultural rights (article 2, para 2 of the International Covenant on Economic, Social and Cultural Rights) E/C. 1/GC/20 (2 July 2009) General Comment 2 on article 14(1)(a), (b), (c) and (f) of the Protocol to the African Charter on Human and Peoples Rights on the Rights of Women in Africa http://www.ahcpr.org/instruments/general-comment-two-rights- women (accessed 14 May 2015) General Comment on article 14(1)(d) and (e) of the Protocol to the African Charter on Human and Peoples Rights on the Rights of Women in Africa http:// www.achpr.org/news/2012/11/d65 (accessed 14 May 2015) General Comment 3: ‘The nature of states parties’ obligations (Art 2 Para 2 of the Covenant)’, 14 December 1990 http://www.refworld.org/docid/ 4358838e10.html (accessed 12 March 2014) General Comment 17: The Right of Everyone to Benefit from the Protection of the Moral and Material Interests Resulting from any Scientific, Literary or Artistic Production of Which He or She is Author (Article 15(1)(c) of the ICESCR) General Comment 15: ‘The right of the child to the highest attainable standard of health’ http://www.refworld.org/docid/51ef9e134.html (accessed 20 March 2015) General Comment 14: The Right to the highest attainable standard of health (Art 12 of the International Covenant on Economic and Cultural Rights), UN Doc E/ C.12/2000/4 (2000) General Comment 25: The Right to Participate in Public Affairs, Voting Rights and the Right of Equal Access to Public Servicehttp://www.umn.edu/humanrts/ hrcom25.htm (accessed 10 March 2014) xv General Recommendation 24: Article 12 of the Convention (Women and Health) A54/38/Rev. 1 (5 February 1999) Guidance Document: Ethical Considerations in Bio-medical HIV Prevention Trials http://www.who.int/rpc/research-ethics/jc072-eyhicalcons_en_pdf.pdf (accessed 14 May 2015) Implementation of Paragraph 6 of the Doha Declaration on the TRIPS and Public Health WT/L/540 (2003) International Conference on Primary Health Care, Alma-Ata, USSR 6-12 September 178 http://www.who/int/publications/almata_declaration_en.pdf (accessed 21 April 2014) International Covenant on Civil and Political Rights, GA Res 2200A (XXI), 21 UN GAOR Supp. (No 16) 52, UN Doc A/6316 (1966), 999 UNTS 3 International Covenant on Economic, Social and Cultural Rights, adopted 16 December 1966, GA Res 2200 (XX1) UN Doc A/6316 (1966) 993 UNTS 3 International Guidelines for Bio-medical Research Involving Human Subjects 2002 http://www.cioms.ch/publications/layout_guide2002.pdf (accessed 14 May 2015) International Guidelines on HIV/AIDS and Human Rights, July 2006, HR/PUB/ 06/9 Libreville Declaration on Health and the Environment in Africa http:// www.idrc.ca/EN/Documents/LibrevilleDeclarationEN.pdf (accessed 19 March 2015) Maastricht guidelines on violations of economic, social and cultural rights, para 22- 23, CESCR, General Comment No 14 (UN. 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E/C. 12/2000/4) Maputo Plan of Action for the Operationalization of the Continental Policy Framework on Sexual and Reproductive Health Rights http:// www.pdafrica.org/docs/policy/maputo-e.pdf (accessed 9 April 2015) Ottawa Charter for Health Promotion http://www.who.int/healthpromotion/ conferences/pevious/ottawa/en/ (accessed 14 May 2015) Political Declaration on HIV/AIDS: Intensifying our Efforts to eliminate HIV/ AIDS, a/65/1.77. 8 July 2011 Political Declaration on HIV/AIDS, UNGA A/RES/60/262, 15 June 2006 Programme of Action of the International Conference on Population and Development, Report of the International Conference on Population and Development, 5-13 September 1994, UN Doc A/CONF.171/13 Protection of Human Rights in the Context of Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) UN Doc A/HR/ RES/16/28 (2011) Protection of Persons with Mental Illness and the Improvement of Mental Health Care, A/RES/46/119 (17 December 1991) Protocol on the 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Provisions in the International Covenant on Civil and Political Rights, 28 September 1984, E/ CN.4/1985/4 Standard Rules on the Equalization of Opportunities for Persons with Disabilities http://www.un.org/esa/socdev/enable/disre00.htm (accessed 8 March 2015) Treaty for the Establishment of the East African Community http:// wwwjus.uio.no.english/services/library/treaties/o9.9.05/ east_africa_economic.xml (accessed 15 May 2015) Universal Declaration of Human Rights, adopted and proclaimed by the United Nations Assembly in Resolution 217 A (III) 1948 Universal Declaration on Bioethics and Human Rights, adopted by UNSECO General Conference on 19 October 2005 Vienna Declaration and Programme of Action, Vienna 14-25 June 1993, A/ CONF.157/23 xvii ABBREVIATIONS AAAQ Availability, Accessibility, Acceptability and Quality AC Appeal Cases ACRWC African Charter on the Rights and Welfare of the Child ACT Artemisinin-based combination therapy ADR Alternative Dispute Resolution AHP Allied Health Professional AHRLR African Human Rights Law Reports AIDS Acquired Immune Deficiency Syndrome All ER All England Law Reports All NR All Nigeria Law Reports ANC Antenatal care CC Constitutional Court CEDAW Convention on the Elimination of all Forms of Discrimination against Women CEHURD Centre for Health, Human Rights and Development CESCR International Covenant on Economic, Social and Cultural Rights CIOMS Council for International Organizations of Medical Sciences CMR Child Mortality Rate CRC Convention on the Rights of the Child CRPD Convention on the Rights of Persons with Disabilities CSO Civil Society Organisation DSMB Data and Safety Monitoring Board EA East Africa EAC East African Community EACA East African Court of Appeal ELISA Enzyme Linked Immuno Sorband Assay EmOC Emergency Obstetric Care EPRC Economic Policy and Research Centre FCR Federal Court Reports FCTC Framework Convention on Tobacco Control FGM Female Genital Mutilation FLR Family Law Reports GA General Assembly GDP Gross Domestic Product HCB High Court Bulletin HIV Human Immunodeficiency Virus HL House of Lords HRBA Human Rights Based Approach xviii HRC Human Rights Committee HSSP Health Sector Strategic Plan HURIPEC Human Rights and Peace Centre ICCPR International Covenant on Civil and Political Rights IFC International Finance Corporation ILO International Labour Organisation IMF International Monetary Fund IMR Infant Mortality Rate IRB Institutional Review Board J Justice JSC Justice of the Supreme Court KALR Kampala Law Reports KB King’s Bench LDC Least Developed Country LJ Lord Justice MFN Most Favoured Nation Clause MHP Mental Health Policy MI Mental Illness MSM Men who have Sex with Men NACOTHA National Council of Traditional Healers and Herbalists Associations of Uganda NCD Non Communicable Disease NDA National Drug Authority NDP National Development Plan NEMA National Environmental Management Authority NODPSP National Objectives and Directive Principles of State Policy OHCHR Office of the High Commissioner for Human Rights P President PEAP Poverty Eradication Action Plan PEP Post Exposure Prophylaxis PIL Public Interest Litigation PLHA Persons Living with HIV/AIDS PLHIV Persons Living with HIV PMA Plan for Modernization of Agriculture PRSP Poverty Reduction Strategy Paper PWDs Persons with Disabilities PWMI Persons with Mental Illness QB Queen’s Bench R&D Research and Development SAP Structural Adjustment Programme SC Supreme Court SGBV Sexual and Gender Based Violence xix SRHR Sexual and Reproductive Health Rights STI Sexual Transmitted Disease TB Tuberculosis TBA Traditional Birth Attendant TM Traditional medicine TRIPS Trade Related Aspects of Intellectual Property TZHC Tanzania High Court UAC Uganda Aids Commission UBOS Uganda Bureau of Statistics UDHR Universal Declaration of Human Rights UDHS Uganda Demographic and Health Survey UHRC Uganda Human Rights Commission UKHL United Kingdom House of Lords UKPC United Kingdom Privy Council UMDPC Uganda Medical and Dental Practitioners Council UN United Nations UNAIDS Joint United Nations Programme on HIV/AIDS UNCST Uganda National Council for Science and Technology UNDP United Nations Development Programme UNGA United Nations General Assembly UNTS United Nations Treaty Series UPIAS Union of the Physically Impaired Against Segregation USA United States of America USAID United States Agency for International Development VD Venereal Disease WHA World Health Assembly WHO World Health Organisation WLR Weekly Law Reports WTO World Trade Organisation