Law reform

Review and reform laws to reduce health inequalities and strengthen access to universal health coverage.

Where laws, regulations and policies fail to protect human rights and promote universal health coverage for all, including adolescent girls and young women and other vulnerable and key populations, law review and reform is critical.

Enabling legal and policy environments to reduce inequalities and promote effective and inclusive governance for health require the review and reform of all laws, regulations and policies that discriminate against and deny the rights of vulnerable and key populations and/or limit their access to health care services.

Laws that may need review or reform may include, for example:

  • Laws that criminalize consensual same-sex sex
  • Laws that criminalize adult sex work
  • Laws that provide for punitive approaches to drug use
  • Laws that provide for unreasonably punitive approaches to people with tuberculosis
  • Laws that criminalize HIV transmission, exposure and non-disclosure
  • Laws that criminalize consensual sexual activity amongst older adolescents
  • Health laws and policies that allow for breaches of the confidentiality and privacy rights of adolescent girls and young women, vulnerable and key populations
  • Intellectual property laws that block access to affordable medicines
  • Laws that provides inadequate protection against harmful gender norms and gender-based violence
  • Laws that deny entry or access to health care services to migrants
  • Age of consent laws that make it difficult for young people to access sexual and reproductive health services independently of a parent or guardian
  • Laws and school policies that require pregnant girls to drop out of schools
  • Laws that allow for child marriage, placing young girls at risk of HIV and sexual and reproductive health risks

UNDP supports countries to undertake law review and reform, through the concerted efforts of all national stakeholders and with the technical support of other development partners. This includes initiatives to understand the political commitment from government executives and parliamentarians, support informed decision-making by an active judiciary, and promote advocacy by civil society organizations.

Case Study: Removing legal barriers for people who use drugs in Myanmar

In 2015, Myanmar’s Parliament removed the legal prohibition on possession of needles and syringes in the Excise Act in order to support people who use drugs and to enable health workers to implement needle and syringe exchange programmes. This law reform measure was a priority recommendation endorsed by the joint Parliamentarian and Community Network Consortium Committee on Human Rights and HIV, as part of a legal review conducted in the country.

Read more: Review of Country Progress in Addressing Legal and Policy Barriers to Universal Access to HIV services in Asia and the Pacific

Case Study: Tax law reform for better health in Philippines

Non communicable diseases (NCDs), such as cardiovascular disease, cancers, diabetes and chronic respiratory disease, are the single greatest cause of preventable illness, disability and mortaility worldwide. Nearly three quarters of deaths occur in low- and middle-income countries.

Risk behaviours, such as tobacco use, harmful use of alcohol, physical inactivity and unhealthy diet, place all people at risk of NCDs. However, people living in vulnerable situations may face particular human rights and gender-related barriers to access health information and services to prevent and control NCDs.

In 2012, the President Benigno Aquino III of the Philippines passed the Sin Tax Reform Law, which taxes tobacco and alcohol. The law reform initiative not only intends to discourage people from tobacco and alcohol consumption – important risk factors for non-communicable diseases – but also serves to increase resources for health, since the tax revenues are used to finance universal health coverage and better health care.

Read more: WHO and UNDP (2016) Non-Communicable Diseases: What Heads of State and Government Need to Know

COVID-19 laws and human rights

The COVID-19 pandemic has resulted in countries enacting a wide range of restrictive laws, regulations and policies, many of which severely limit human rights including through legitimizing broad travel restrictions, criminalizing people suspected to have acquired COVID-19, permitting wide-reaching surveillance of residents and authorising sharing of sensitive health data across agencies. Initial research suggests that these laws and their enforcement have disproportionately impacted on key and vulnerable populations.

UNDP, UNAIDS Secretariat and the O’Neill Institute for National and Global Health Law at Georgetown University developed an online database of COVID-19 laws, providing an opportunity for analysis, identification of best practice and advocacy for law reform.