With the release of new guidance from the World Health Organization (WHO) on “Ensuring human rights in the provision of contraceptive information and services,” there is renewed discussion around shaping and implementing family planning policies and programs that respect, protect and fulfill human rights. It’s an important conversation to have, but we also know that many people don’t know the ins-and-outs of human rights doctrine, and may not fully understand what we mean when we talk about respecting, protecting and fulfilling rights.
So, what are we talking about? Over time, government obligations around human rights have been separated into three types: the duty to respect, the duty to protect, and the duty to fulfill. Jonathan Wolff, an esteemed professor of philosophy and director of the Centre for Philosophy, Justice and Health at University College London, defines it this way:
- Duty to respect: governments should not impede or discriminate in offering health services
- Duty to protect: governments have a responsibility to ensure that no other parties interfere with an individual’s right to health
- Duty to fulfill: governments have a set of positive responsibilities beyond respect and protection; they must actually establish national, political and legal systems that promote and ensure rights
This set of duties is a continuum. Of course, as an international community, we want every country to fulfill the human rights of its citizenry, including reproductive rights. However, it is critical to acknowledge the reality of the global community. Many countries are just beginning to engage with the role of government in respecting reproductive rights. Global policy discussions, family planning initiatives, and new guidance resources can all support governments in progressing along this continuum.
For example, countries may be respecting women’s right to an informed choice of contraceptive methods simply by making family planning information and services available. A document like the WHO guidance provides recommendations for ensuring women have access to a range of contraceptive options (short-acting, long-acting, permanent and emergency contraception). When a country is able to ensure that women always have a range of options they are closer to realizing informed choice as a reproductive right. However, tangible and sustainable change must be country-led and country-owned. Reproductive rights will not be meaningfully fulfilled unless leaders and key decision-makers believe this is a duty for which government is responsible.
What if a government is falling down on the job? Who has the capacity to assess whether countries across the world are violating reproductive rights, simply respecting these rights, actively protecting them, or taking real, positive action?
The most sustainable answer is local civil society. Civil society organizations (CSOs) have the potential to fill a variety of roles – from dynamic partners who can work with government to effective watchdogs and agitators who shed light on abuses and shortcomings. In some countries, CSOs are already playing this pivotal role, but in others they are poised but lack the necessary capacity and support. Serious gaps remain.
Who is going to support local civil society to pursue monitoring and accountability around reproductive rights? This is not a place for governments, as that would detract from CSO credibility and complicate the relationship between civil society and government. We can’t continue to ignore this question.
We keep reaffirming women’s rights to access contraceptive information and services. However, we need to get past the empty words and get into how we are going to achieve these rights for women and men around the world. If this is an absolute priority, donors need to be having these discussions with recipient country governments and there needs to be greater investment in building the capacity of civil society.