Uganda still grappling with many health challenges



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Uganda still grappling with many health challenges

  • Uganda still grappling with many health challenges

  • Despite comprehensive HSSIP & NHP, no universal and equitable health care system, health services continue to be functionally weak

  • 2013 Human Development Report indicates Uganda has low human development in Health. only 48% of Ugandans satisfied with quality of healthcare

  • Gaps in access to health care between rural and urban areas, and between social groups

  • Limited budge support for health, drug stock-outs

  • Maternal mortality at 438/100000 , IMR at 54/1000, HIV/AIDs prevalence at 4030/100000.



Potential to catalyze legal and policy reform

  • Potential to catalyze legal and policy reform

  • Can reduce inequity through causing resource redistribution

  • Enhance government accountability and improve priority –setting for health sector financing

  • Raises public awareness that can trigger social movements and citizen advocacy

  • Enhances access to justice and remedies for victims of health rights violations



PIL still under utilised in area of health

  • PIL still under utilised in area of health

  • Complex legal framework

  • Activists still reluctant to bring cases – limited knowledge and experience, political environment

  • Weaknesses with judiciary & quasi judicial bodies– judgments very inconsistent , limited training, no activism

  • No awareness among rights holders

  • No reliable statistics and limited research

  • International litigation – no ratification (op.protocol, African court)



Locus standi – Art. 50 (1 &2)

  • Locus standi – Art. 50 (1 &2)

  • Uganda ratified several regional International Human Right Instruments providing for right to Health (ICESCR, ACHPR etc)

  • No substantive right to health under BOR

  • NODPSP (objective xiv-health services, clean and safe water, decent shelter, food security etc, XX- basic medical services to the population, XXI –clean and safe water, XXII- food security and nutrition.



Art. 8A – makes preamble justiciable

  • Art. 8A – makes preamble justiciable

  • Art. 45 – BOR does not exclude other rights

  • Art. 287 – international instruments

  • Art. 39 – Right to clean and healthy environment

  • Art.33(3)- Protection of women’s maternal functions

  • Art.40 (1) – work under safe & healthy conditions

  • Arts. 40(3), 34(3&4), 35(1), 26(2), 23(1)d,22(1&2)



Courts of Judicature –High court, constitutional court (arts. 50 , 137)

  • Courts of Judicature –High court, constitutional court (arts. 50 , 137)

  • Quasi-Judicial bodies

    • UHRC
    • EOC
  • The Uganda Medical and Dental Practitioners Council



Salvatori Abuki & Anor V AG- EgondaNtende J

  • Salvatori Abuki & Anor V AG- EgondaNtende J

  • [T]he right to life is inviolable. I take this view guided by the National Objectives and Directive Principles of State Policy which we are enjoined to apply in interpreting this Constitution in part thereof. I take comfort in part (xiv) General Social and Economic objectives…An exclusion order under section 7 of the witchcraft Act seems to me to be set in the opposite direction from assuring access of the person banished to any shelter, food, security, clean and safe water, and health services.



Vincent Oribi V BAT

  • Vincent Oribi V BAT

  • Thomas Okumu V BAT & Mastermind Tobacco ltd. (court sought to determine whether case was representative/class action suit or a PIL case. Case dismissed because court found it was a class action and plaintiff did not notify and seek the consent of the people he sought to represent.



UETCL V De Samaline Incorporation Ltd.

  • UETCL V De Samaline Incorporation Ltd.

  • [T]he right to a clean and healthy environment must not only be regarded as a purely medical matter. It should be regarded as a holistic socio-cultural phenomenon because it is concerned with physical and mental well-being of human beings... a clean and healthy environment is measured in both ethical and medical context. It is about linkages in human well-being. These may include social injustice, poverty, diminishing self -esteem, and poor access to health services. That right is not restricted to a clinical model

  • Discharge of unpleasant, noxious and chocking dust constituted violation of employees’ right to a clean and healthy environment under Art. 39 .



Byabazaire Grace Thaddeus v. Mukwano Industries

  • Byabazaire Grace Thaddeus v. Mukwano Industries

  • Court indicated that applicant had no locus standi . Only NEMA has power to sue under NEA



TEAN ltd V BAT ltd

  • TEAN ltd V BAT ltd

  • court held that a petition concerning unregulated smoking in public places disclosed no cause of action. Judgment disregarded the flexible locus standi allowed under article 50 of the Constitution that allows anybody to bring a case in public interest regardless of whether they are affected by the violation.

  • BAT V TEAN ltd - where the court held that spirited persons or groups of persons who may feel obliged to represent those persons or groups of persons may, acting in the public interest do so under article 50(2) of the Constitution



In The Environmental Action Network Ltd v Attorney General & NEMA (2001)- smoking in public places

  • In The Environmental Action Network Ltd v Attorney General & NEMA (2001)- smoking in public places

  • &

  • ACODE V AG & NEMA (2004)

  • where the court held that the right to a healthy environment entitles Ugandans to a right to an environment adequate for their health and wellbeing.



CEHURD & Others V AG

  • CEHURD & Others V AG

  • First attempt to bring case on substantive health issues – Maternal mortality, EmOC, stock outs

  • Political Question

  • (learn from other jurisdictions, but also inadequate research preparation)

  • Enforcement of rights before the High Court (disregard of article 137(3)- court may make order of redress or refer to High Court)



Capacity building (judges and civil society)- training, attachments to judges, research for cases

  • Capacity building (judges and civil society)- training, attachments to judges, research for cases

  • Judiciary to develop framework within which to adjudicate right to health

  • Activists to develop creative strategies for litigation

  • Exploit existing constitutional provisions to argue for justiciability

  • Use Equality and non-discrimination as cross-cutting issues.

  • Coalition building

  • Use of Amicus curiae (Law clinics have a role)

  • Use of other strategies to supplement litigation (awareness raising, research & monitoring, advocacy and social mobilisation)





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