Health Promotion Through Human Rights Law
What is the innovation and how does it address a pressing problem?
SECTION27 combines social mobilization and the practice of human rights law to address social determinants of health. Focused on the constitutionally entrenched rights to health, basic education and sufficient food, SECTION27 uses law to advance the vision of social justice enshrined in South Africa’s first democratic constitution.
SECTION27 works on multiple levels: First, SECTION27 empowers communities to claim constitutional rights by training community activists as “barefoot lawyers”. Second, SECTION27 engages with policy makers to influence the development of health policy. Finally, SECTION27 provides legal assistance to the poor who seek litigation as a last resort to realize their rights. SECTION27 engages all actors relevant to advancing socio-economic rights, including communities, the government, the business sector, the courts, trade unions, the media and the public.
SECTION27’s approach relies on two distinct elements: (1) demonstrating the practice of law in public and precedent setting challenges around the right to health, (2) operationalizing a human rights based approach to health by training and mentoring community activists, able to understand and express the needs of their communities and to advocate for health as a human right. This way, a mutually reinforcing circle is established where communities catalyze legal cases and legal cases catalyze community organisation.
What existing practices inspired the innovation and how does it represent something new?
The human right to health was first proclaimed in the 1948 Universal Declaration of Human Rights. However, operationalizing a rights- based approach has proved challenging, with many rights based interventions relying on publicizing violations, and shaming government to shape international public opinion.
SECTION27’s innovation is to use human rights law to advocate for systemic policy reform, taking advantage of South Africa’s unique history. Under apartheid, anti- apartheid lawyers established a tradition of linking public interest law to community empowerment to achieve civil and political rights (and helping to end apartheid). In the late 1990s, the AIDS law project built upon this tradition to advocate for the rights of people living with HIV/AIDS. Recognizing that accomplishing health goals requires an approach that encompasses other socio-economic challenges, after 17 years of successful litigation, SECTION27 replaced the AIDS Law Project. SECTION27 shifts the exclusive focus on HIV/AIDS advocacy to one that tackles major social determinants of health.
SECTION27 takes national law, particularly the Constitution and National Health Act, and makes it a living document that community members use to understand the conditions they live in and engage local health services. It is a strategy for lasting change through continually increasing numbers of grassroots activists who fight for their own rights, addressing the causes as well as the symptoms of ill health.
Please describe the social impact to date, as well as potential impact in the future.
SECTION27 has direct impact through litigation. In 2012, litigation led to a ground- breaking judgment on the right to education, resulting in the delivery of 1.2 million school textbooks and a Presidential enquiry into education. The “textbooks case” became the foremost political issue of 2012. In addition, SECTION27 obtained a landmark judgment on proper management of TB in prisons affecting 200,000 prisoners and public health generally.
SECTION27 has indirect impact in communities all over South Africa by seeding activists in different province to campaign for health, education and democratic local government. For example, in Limpopo Province (SA’s poorest rural province), a community organizer enlisted by SECTION27 has established a campaign to improve health and education in schools throughout the district. Currently they are campaigning for adequate sanitation.
SECTION27 also works with rights organizations in Kenya, Uganda and Zimbabwe, who seek to emulate the model. In 2010, SECTION27 co-founded an international partnership researching and campaigning for a new global architecture for the right to health under a post 2015 Framework Convention for Global Health.
By successfully litigating cases, SECTION27 provides a model for transforming the fundamental basis of health policy, both in South Africa and internationally. Each success, in addition to directly impacting people’s lives, strengthens future campaigns relying on a rights-based approach to health.