AN ANALYSIS OF THE LEGAL AND INSTITUTIONAL FRAMEWORK FOR THE REALIZATION OF THE RIGHT TO HEALTH IN NIGERIA

TABLE OF CONTENTS
Title Page
Table of Cases
Legal Instruments
List of Tables
Abstract
Table of Contents

CHAPTER ONE
GENERAL INTRODUCTION
1.1       Background of the study
1.2       Statement of Problem
1.3       Objectives of the Research
1.4       Scope of the Study
1.5       Research Methodology
1.6       Justification of the Study
1.7       Literature Review
1.8       Structure of the Study

CHAPTER TWO
CONCEPTUAL CLARIFICATION OF RELEVANT TERMS AND THEIR HISTORICAL DEVELOPMENT
2.1       Introduction
2.2       Human Right
2.2.1    Historical and Philosophical Evolution of Human Rights
2.2.2    Definition and Characteristics of Human Rights
2.2.3   Origin of Health as an International Human Right
2.3       Concept and Definition of the Right to Health
2.3.1    Nature of the Right to Health
2.4       Maternal Mortality
2.5       Maternal mortality Ratio
2.6       Childhood Mortality
2.7       Linkages between Health and Human Rights

CHAPTER THREE
THE RIGHT TO HEALTH IN NIGERIA
3.1       Legal Framework on the Right to Health In Nigeria
3.2       Health as a Justiciable Right
3.3       Judicial Application of the Right to Health in Selected National Jurisdictions
3.3.1    South Africa
3.3.2    India
3.4       Application of International Human Right to Health in Nigeria
3.5       Nigeria’s Obligations under International and Regional Instruments Protecting the Right to Health
3.5.1    Obligation to Respect
3.5.2    Obligation to Protect
3.5.3    Obligation to Fulfill
3.6       Effective Remedies for the Violation of the Right to Health
3.6.1    Declaratory Order
3.6.2    Mandatory Order
3.6.3    Structural Interdicts
3.7       International Monitoring Mechanisms for the Protection of the Right to Health
3.7.1    Reporting System under Art. 16 and 17 of the ICESCR
3.7.2    Optional Protocol to the ICESCR

CHAPTER FOUR
DOMESTIC IMPLEMENTATION OF THE RIGHT TO HEALTH IN NIGERIA
4.1       Introduction
4.2       Legal Protection of the Right to Health in Nigeria
4.2.1    Constitutional Protection
4.2.2    Child Right Act 2003
4.2.3    The African Charter on Human and Peoples‟ Rights
4.3       Review of the Implementation of the Right to Health Policies in Nigeria
4.3.1   National Health Policy
4.4       Health Institutions and their Regulatory Bodies Protecting Health in Nigeria
4.4.1   Federal Ministry of Health
4.4.2   Courts
4.4.3   National Human Rights Commission
4.4.4   National Agency for Food and Drug Administration and Control
4.4.5   National Health Insurance Scheme
4.4.6   Nigerian Medical and Dental Practitioners Act
4.5       Legislations Dealing with Access to Qualitative Drugs
4.5.1    National Drugs ForSmulatory and Essential Drugs List Act
4.5.2    Dangerous Drugs Act
4.5.3    Food and Drug Act
4.6       Proposed Law
4.6.1    National Health Bill
4.7       Substantive Elements of the Right to Health in Nigeria
4.7.1    Availability
4.7.2    Accessibility
4.7.3    Acceptability
4.7.4    Quality

CHAPTER FIVE
AN ANALYSIS OF MILLENNIUM DEVELOPMENT GOALS AND THE RIGHT TO HEALTH IN NIGERIA
5.1       Introduction
5.2       Millennium Development Goals and the Right to Health in Nigeria
5.3       Millennium Development Goals in Nigeria
5.4       An Overview of MDG 4 (Reduction of Childhood Mortality), 5 (Improving Maternal Health) and 6 (Combating HIV/AIDS, Tuberculosis, Malaria)
5.4.1   Eradicating Poverty and Extreme Hunger
5.4.2   Achieving Universal Primary Education
5.4.3   Achieving Gender Equality and Women‟s Empowerment
5.4.4    Childhood Mortality
5.4.5    Maternal Mortality
5.4.6   HIV/AIDS, Tuberculosis and Malaria
5.5       Key Challenges to Attaining the MDGs in Nigeria
5.5.1    Inequities in the Distribution of Human Health Resources and Facilities
5.5.2    Poverty and Cost of Healthcare
5.5.3    Availability of Health care facilities and Poor Utilization of Reproductive health services
5.5.4   Women’s Low Socio-Economic Status and Lack of Empowerment

CHAPTER SIX
FACTORS IMPEDING THE REALIZATION OF THE RIGHT TO HEALTH IN NIGERIA
6.1       Introduction
6.2       Constitutional Impediment
6.3       The Attitude of Courts/Judges
6.4       Socio-Economic and Cultural Factors
6.5       Corruption and Mismanagement of states resources
6.6       Poverty
6.7       Debts, Debt Servicing and Structural Adjustments Programmes
6.8       Lack of Political Will to Address the Health Sector Crisis

CHAPTER SEVEN
CONCLUSION
7.1       Summary
7.2       Findings
7.3       Recommendations
7.4       Contribution to Knowledge
7.5       Suggestions for Further Research

BIBLIOGRAGHY
1.         Books
2.         Journals
3.         Conference Papers
4.         Other Sources

ABSTRACT
Health is an important element of an individual life and also to the individual’s country.

A country cannot develop with its citizens sick and dying. A healthy state is a wealthy state. As such, states must provide adequately for the health of its citizens. The research analysed international law and national legal framework that regulate the health system under international law and in Nigeria. It also examined health policies, institutions and other regulatory bodies established for the protection of the right to health in Nigeria.

The research was informed by the dismal performance of Nigeria’s health care system when the World Health Organization assessed its 191 member states in terms of responsiveness, fairness, overall goal attainment, level of health expenditure per capita, impact on health and overall performance. Nigeria was ranked 187 out of 191 despite its human and natural resources compared with many other African countries which is indeed a cause for concern. This is evidenced from the high level of maternal and childhood mortality, HIV/AIDS related deaths which continue to ravage families and communities, the slow pace of attaining international goals for health and survival and negative progress towards attaining the Millennium Development Goals (MDGs).The research adopted as methodology the doctrinal approach which entailed the use of relevant literature including international instruments, reports and general comments/recommendations. Nigeria is a party to the major regional and international human rights instruments recognizing and protecting the right to health and has assumed tripartite obligations- obligations to respect protect and fulfill the right to health of the Nigerians. Right to health under the Nigerian Constitution is non -justiciable. However, non justiciability of the right to health is a challenge but not a bar to the protection of the said right. It does not also absolve Nigeria from its obligation to protect health of its citizens. The research finds that according health the status of non-justiciable right is not infact related to any inability to deal with socio-economic rights including the right to health as was exemplified with the experience of South Africa which has justiciable socio-economic rights including the right to health. It also finds that the debate whether or not the right to health exist or is non-justiciable is irrelevant as the Indian experience revealed. The research therefore, recommends the court to adopt judicial activism in adjudicating socio-economic rights including the right to health as is done in India. The research finds that Nigeria had put in place and established laws, policies and institutions for the protection of health of her citizens. The research also finds that several factors impede the realization of the right to health in Nigeria including legal impediments, socio-economic impediment and lack of political will on the part of the government. It is also a finding of the research that Nigeria is moving at a slow pace towards attaining the MDGs with less than a year to the target date. Although the research finds that some progress had been achieved especially in reducing childhood mortality and halting HIV/AIDS, the progress is not sufficient to meet the MDGs target date of 2015. The research finds that several key challenges exist which exercabates the slow pace at which Nigeria is moving towards achieving the MDGs notably among them are lack of reproductive health care services, poverty, low socio-economic status of women, inequities in the distribution of human health resources which if addressed will come a long way in helping Nigeria to move faster towards achieving the MDGs and subsequently in fulfilling its obligations under the right to health.

CHAPTER ONE

GENERAL INTRODUCTION

1.1              Background of the Study

Health is important for every human being in the world. It is an important matter for individuals and states. It is a fundamental human right indispensable for the exercise of other human rights. This can be seen in the impact the denial or enjoyment of other rights can have on a person‟s ability to achieve the highest attainable standard of physical and mental health and, conversely, the role health plays in our enjoyment of other rights.1A person in bad health cannot live life to the fullest. Enjoying good health therefore, is a prerequisite to the enjoyment of other human rights. For instance, a sick person can work to earn a living, go to school and be educated therefore leading life to the fullest and ultimately contribute to the development of his country. Denying people good health care is to deny them the right to life as good health is an indispensable element of life.

Also, social and economic development is closely tied to good health. A country cannot achieve economic growth and development with sick and dying population. As such, for any country to achieve development, it must take care of its citizen‟s health. The World Health Organization (WHO) recognizes the international human right to health in its Constitution by stating that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”2

This has led to global debate to focus on the human right to health which now occupies a prominent place on the agenda of the international community. Given the importance of......

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