The right to health as the basis for universal access to essential medicines Perehudoff, Sammi-Jo Katrina

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1 University of Groningen The right to health as the basis for universal access to essential medicines Perehudoff, Sammi-Jo Katrina IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2018 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Perehudoff, S-J. K. (2018). The right to health as the basis for universal access to essential medicines: A normative framework and practical examples for national law and policy [Groningen]: Rijksuniversiteit Groningen Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date:

2 The right to health as the basis for universal access to essential medicines A normative framework and practical examples for national law and policy S. Katrina Perehudoff

3 Publisher: Layout by: Cover: University of Groningen, the Netherlands Bloom - Creating Imagination Bloom - Creating Imagination ISBN: (printed version) (electronic version) S. Katrina Perehudoff The right to health as the basis for universal access to essential medicines: A normative framework and practical examples for national law and policy Doctoral Dissertation, University of Groningen, the Netherlands 2018 by S. Katrina Perehudoff - Oostende. All rights reserved. no part of the material protected by this copyright notice may be reproduced or utilised in any form by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without the prior permission of the author.

4 The right to health as the basis for universal access to essential medicines A normative framework and practical examples for national law and policy PhD Thesis to obtain the degree of PhD at the University of Groningen on the authority of the Rector Magnificus Prof. E Sterken and in accordance with the decision by the College of Deans. This thesis will be defended in public on Wednesday September 5th, 2018 at 9:00 hours by Sammi-Jo Katrina Perehudoff born on 7 September 1986 in Medicine Hat, Canada

5 Supervisors Prof. H. V. Hogerzeil Prof. B. C. A. Toebes Assessment Committee Prof. A. Chapman Prof. A. L. B. Colombi Ciacchi Prof. A. K. Mantel-Teeuwisse

6 To my first role models: To the outstanding teachers at my primary and secondary school, the Centre for Academic and Personal Excellence (CAPE) in Medicine Hat, Canada, and in particular, its founder, former principal and superintendent Dr. Teresa DiNinno. Dr. DiNinno, you wove scientific inquiry into the fabric of our school, creating a place where young people are equal parts student and scientist. My interest in research is a testament to CAPE s training and your inspiration all those years ago. Beyond that, you were a role model in every way: the first and for a long time, the only woman I knew with a PhD. A dedicated firstgeneration Canadian who overcame a host of challenges to build your life in a new country. A person who put everything on the line to realise your vision of a more holistic and equitable education policy. To my mom, Linda Ferguson, for her willingness to trial a little prairie school with big ideas, her unseen sacrifices to make my attendance possible and her unconditional love.

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8 Table of Contents Chapter 1 Introduction Chapter 2 The normative framework for access to medicines 2.1 What constitutes 'reasonable' state action on core obligations? Considering a right to health framework to provide essential medicines 2.2 A human rights-based approach to the reimbursement of expensive medicines 2.3 Realising the right to sexual and reproductive health: Access to essential medicines for medical abortion as a core obligation 2.4 Normative framework Chapter 3 Human rights in domestic law and policy for access to medicines 3.1 Essential medicines in national constitutions: progress since The right to health as the basis for universal health coverage: A cross-national analysis of national medicines policies of 71 countries 3.3 Legislating for universal access to medicines: A rights-based cross-national comparison of UHC laws in 16 countries Chapter 4 Towards access to medicines through policy and practice 4.1 Access to medicines in 195 countries: A human rights approach to sustainable development

9 Chapter 5 Human rights for access to medicines in domestic courts 5.1 How the Uruguayan judiciary shapes access to high-priced medicines: A critique through the right to health lens 223 Chapter 6 Discussion and conclusions 249 Summary Samenvatting Acknowledgements Annexes Annex 1 - Innovative text for access to medicines in national medicines policies Annex 2 - Innovative text for access to medicines in national UHC legislation Annex 3 - Access to medicines indicators in 195 countries Annex 4 - CV of the Author Research Institute SHARE

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