<br>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:14.0pt"></span></b><b><span style="font-size:14.0pt"></span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:14.0pt"> </span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:14.0pt">Interim report of the Special Rapporteur on the right
of</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:14.0pt">everyone to the enjoyment of the highest attainable</span></b></p>
<p class="MsoNormal"><b><span style="font-size:14.0pt">standard of physical and
mental health.</span></b></p>
<p class="MsoNormal"><b><span style="font-size:14.0pt"> </span></b></p>
<p class="MsoNormal"><b><span style="font-size:14.0pt">Conclusions and
recommendations:</span></b></p>
<p class="MsoNormal"> </p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">55. <b>The right to health approach to health
financing provides a framework</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">with which to ensure adequate, equitable and
sustainable health financing. The</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">approach addresses three critical areas in health
financing: how States ensure</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">adequate funds are available for health and the
sources from which they raise</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">these funds; how these funds are pooled; and how funds
and resources are</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">allocated within health systems towards ensuring
universal access to good</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">quality health facilities, goods and services.</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">56. <b>The Special Rapporteur urges States to take the
following steps in order to</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">ensure adequate funds are available for health:</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(a) <b>Implement a progressively structured system of
general taxation to</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">fund health or improve upon the progressivity of such
systems where they</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">already exist;</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(b) <b>Ensure that consumption taxes, such as excise
taxes and VAT, are not</b></span><b><span style="font-size:8.0pt"></span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">regressive. This may include setting appropriate
thresholds below which small</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">enterprises are not subject to taxation and reducing
or removing consumption</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">taxes on necessity goods;</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(c) <b>Consider earmarking portions of revenue from
specific taxes, such as</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">sin taxes and VAT, for spending on health;</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(d) <b>Ensure tax liberalization policies resulting
from international tax</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">competition, including tax abatements for foreign
investors and low or non-existent</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">trade and capital gains taxes, do not result in
reduced public funding for</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">health;</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(e) <b>Find ways to collect taxes from businesses in
the informal sector,</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">contingent upon the provision of State services and
other benefits associated</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">with being a taxable entity to such businesses.</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">57. <b>The Special Rapporteur urges States to take the
following steps in order to</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">cooperate internationally towards ensuring the
availability of sustainable</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">international funding for health:</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(a) <b>Coordinate all donor activities in recipient
States, incorporating the</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">participation of civil society and affected
communities, towards meeting domestic</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">health needs and promoting the development of
self-sustaining health systems;</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(b) <b>Develop a treaty-based global pooling
mechanism, comprising</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">compulsory progressive contributions from States
allocated based upon need</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">and driven by transparent, participatory processes, in
order to shift from a</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">donor-based system towards an obligatory system of
international funding.</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">58. <b>The Special Rapporteur urges States to
prioritize funding for national and</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">sub-national health budgets in order to reduce
over-dependence on international</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">funding and ensure domestic resource self-sufficiency
for health.</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">59. <b>The Special Rapporteur urges States to take the
following steps in order to</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">pool funds for health:</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(a) <b>Implement a pooling system comprising
compulsory, progressive</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">prepayments, such as taxes and insurance
contributions, in order to reduce or</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">eliminate out-of-pocket payments for health and ensure
access to good quality</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">health facilities, goods and services for the poor;</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(b) <b>Develop social health insurance programmes
funded through</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">compulsory, progressive contributions, supplemented by
general tax revenue,</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">comprising a pool of contributors large enough to
promote effective cross-subsidization,</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">with absolute exemptions for the poor;</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(c) <b>Ensure that enrollment in social health
insurance programmes</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">captures all necessary parts of the populations,
particularly vulnerable or</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">marginalized populations, with special attention to
informal workers;</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(d) <b>Ensure that benefits under social health
insurance programmes</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">include a minimum set of health goods and services and
are available and</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">universally accessible based on need. Benefits
packages must:</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(i) <b>Be responsive to the disease burden and health
needs of the population;</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(ii) <b>Include effective and community-centred
primary health-care services;</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(iii) <b>Include essential medicines and generic drugs
in order to ensure</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">access to safe, effective and affordable medicines.</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">60. <b>The Special Rapporteur urges States to take the
following steps in order to</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">equitably allocate funds for health:</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(a) <b>Ensure equitable and efficient allocation of
health funds and</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">resources between primary, secondary and tertiary
health care, with particular</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">emphasis on primary care;</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(b) <b>Ensure that good quality health facilities,
goods and services are</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">available and accessible on a non-discriminatory basis
for rural and remote</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">populations. This will require:</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(i) <b>Increased investment in physical health
infrastructure in rural and</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">remote communities;</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><span style="font-size:10.0pt">(ii) <b>Creation of incentives for health workers,
such as competitive</b></span></p>
<p class="MsoNormal" style="text-autospace:none"><b><span style="font-size:10.0pt">salaries, tax abatements, rotational postings and
accelerated career</span></b></p>
<p class="MsoNormal"><b><span style="font-size:10.0pt">advancements to work in
rural and remote areas.</span></b></p>
<p class="MsoNormal"> </p>
<br>