Table 5: Minority Health and the Right to Participate in Public Life

Examples of Human Rights Violations 

  • Ethnic minority members are unable to obtain citizenship papers and a health card, leaving them without access to social and health services.
  • Labelled “child-like,” ethnic minority members have little say in policy decisions affecting their health and well-being.
  • Ethnic minorities, particularly women, are unable to participate in public life and access needed social services.
Human Rights Standards Treaty Body Interpretation
ICCPR 25: Every citizen shall have the right and the opportunity, without . . . distinctions . . . (a) To take part in the conduct of public affairs, directly or through freely chosen representatives. HRC: Recommending that France “[f]acilitate the participation of persons who are members of minority groups in publicly elected bodies, including the national assembly and local government. In particular, seek ways to increase the number of candidates belonging to minorities included in the list of political parties running for elections. The appointment of persons from minority backgrounds as members of the police, public administration and the judiciary, is also important to assure the representation of the needs of varied communities in the planning, design, implementation and evaluation of policies and programmes affecting them.” CCPR/C/FRA/CO/4 (HRC, 2008).
ICCPR 26: All persons are equal before the law and are entitled without any discrimination to the equal protection of the law. HRC: Calling for the removal of all administrative obstacles and fees to enable the Roma in Bosnia to obtain personal documents necessary for them to access health insurance and other basic rights. CCPR/C/BIH/CO/1 (HRC, 2006), para. 22.
ICERD 5(c): States will guarantee political rights, in particular the right to take part in the Government as well as in the conduct of public affairs at any level and to have equal access to public services. CERD: Recommending that Paraguay take the necessary steps to register all children in its territory, particularly those residing in areas inhabited by indigenous peoples, while safeguarding and respecting their culture, and ensure that they receive the services required to promote their intellectual and physical development. CERD/C/PRY/CO/1-3 (CERD, 2011).

CERD: Indicating that the Roma Council in Bosnia does not have sufficient funding or resources to fulfill its mandate and is rarely consulted by the Council of Ministers. [CERD/C/BIH/CO/6 (CERD, 2006), para. 14.

CERD: Noting the cultural, social, economic, and political exclusion of San peoples in Botswana. CERD/A/57/Supp.18 (CERD, 2001), para. 301.

ICERD 5: In compliance with the fundamental obligations laid down in article 2 of this Convention, States Parties undertake to prohibit and to eliminate racial discrimination in all its forms and to guarantee the right of everyone, without distinction as to race, colour, or national or ethnic origin, to equality before the law, notably in the enjoyment of the following rights: (a) the right to equal treatment before the tribunals … (d)(iii) The right to housing; (d)(iv) The right to public health, medical care, social security and social services; (d)(v) The right to education and training. CERD: Expressing concern that a lack of identification documents effectively deprives the Roma in the Ukraine of their right to equal access to health care, housing, social security, education, and the legal system. CERD/C/UKR/CO,
August 2006, para. 11.
ICESCR 12(1): The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. CESCR, General Comment 14: Explaining the importance of “participation in political decisions relating to the right to health taken at both the community and national levels.” [para. 17].
CEDAW 7: State Parties shall take all appropriate measures to eliminate discrimination against women in the political and public life of the country and, in particular, shall ensure to women, on equal terms with men, the right: . . . (b) [t]o participate in the formulation of government policy and the implementation thereof. CEDAW Committee: Calling for the immediate issuance of identity documents to Roma women in Romania. CEDAW/C/ROM/CO/6 (CEDAW 2006) para. 27.
FCNM 15: The Parties shall create the conditions necessary for the effective participation of persons belonging to national minorities in cultural, social and economic life and in public affairs, in particular those affecting them. AC: Noting the “weak and ineffective participation by the Roma community” in design and implementation of health strategies in Romania. ACFC/OP/II(2005)007, Nov 2005, para. 540.
Human Rights Standards Case Law
African Children’s Charter 14 (1); Every child shall have the right to enjoy the best attainable state of physical, mental and spiritual health.(2) State Parties to the present Charter shall undertake to pursue the full implementation of this right:(b) to ensure the provision of necessary medical assistance and health care to all children with emphasis on the development of primary health care;

(c) to ensure the provision of adequate nutrition and safe drinking water;

(g) to integrate basic health service programmes in national development plans.

ACHPR (Committee): The Committee held that Kenya violated the right to health of children of Nubian descent under the African Children’s Charter, stating that “[t]here is de facto inequality in their access to available health care resources, and this can be attributed in practice to their lack of confirmed status as nationals of the Republic of Kenya. Their communities have been provided with fewer facilities and a disproportionately lower share of available resources as their claims to permanence in the country have resulted in health care services in the communities in which they live being systematically overlooked over an extended period of time.” 002/09: IHRDA and Open Society Justice Initiative (OSJI) (on behalf of children of Nubian descent in Kenya) v. Kenya.
ESC 12 Part I: Everyone has the right to benefit from any measures enabling him to enjoy the highest possible standard of health attainable.

Part II: With a view to ensuring the effective exercise of the right to protection of health, the Parties undertake, either directly or in cooperation with public or private organisations, to take appropriate measures designed inter alia:

1. to remove as far as possible the causes of ill-health;

2. to provide advisory and educational facilities for the promotion of health and the encouragement of individual responsibility in matters of health;

3. to prevent as far as possible epidemic, endemic and other
diseases, as well as accidents.

ECSR: The Commission held that Bulgaria violated the right to health by not granting about 46% of the Roma population state-subsidized health insurance. Under the current law, many Roma cannot access health insurance because it is made conditional on being eligible for the right to social assistance or being registered as unemployed. European Roma Rights Centre (ERRC) v. Bulgaria, Complaint No. 46/2007(2008).

Other Interpretations

SR on the rights of Indigenous People: Stating to the Congo that “[i]t is essential, as part of this process, to include indigenous peoples themselves in the design and delivery of culturally appropriate projects, especially in areas of poverty reduction, health and education.” A/HRC/18/35/Add.5 (SR Indigenous, 2011)

SR on the rights of Indigenous People: Highlighting that the San are not sufficiently empowered to impact government decisions regarding allocation of limited resources in South Africa.  E/CN.4/2006/78/Add.2 (SR Indigenous, 2005), para. 75.

Independent Expert on Minority Issues: Recommending to Bulgaria, “The small, inconsistent pilot-project-based approach that has characterized government activities to date will never reach the transformative tipping point necessary to confront the vast socio-economic challenges faced by the Roma. A new, holistic and incisive approach to Roma integration, designed and implemented in full consultation with Roma organizations, is required to break the vicious circle of social exclusion and poverty. Furthermore, Roma themselves must make efforts to engage fully with government initiatives, not as passive recipients, but as pro-active stakeholders in immediate and longer-term Roma integration strategies. It is essential that Roma have a role in decision – making and are fully consulted in decisions that affect them.” A/HRC/19/56/Add.2 (IE Minorities, 2012)

Independent Expert on Minority Issues: Noting of Kazakhstan that “groups, including Roma and Luli (or Lyuli), were generally described as nomadic or itinerant and with livelihoods solely in the informal sector [and that]such groups are not represented in the assembly of the people or other state institutions [and] they often lack identification documents required to secure services and may be vulnerable with regard to access to healthcare, education, housing and the effects of extreme poverty.” A/HRC/13/23/Add.1 (IE Minorities, 2010)

Special Rapporteur on the highest attainable level of health: recommending that Guatemala “[i]ncorporate and ensure the consultation and participation of indigenous community members in the development of policies and programmes related to the delivery of health services and goods into indigenous communities.” A/HRC/17/25/ADD.2 (SR Health, 2011)

European Race Equality Directive Preamble (12): To ensure the development of democratic and tolerant societies which allow the participation of all persons irrespective of racial or ethnic origin, specific action in the field of discrimination based on racial or ethnic origin should go beyond access to employed and self-employed activities and cover areas such as education, social protection including social security and healthcare, social advantages and access to and supply of goods and services.