Q&A with Dr Tlaleng Mofokeng, UN Special Rapporteur on the Right to Health

In this interview, Dr Tlaleng Mofokeng, the United Nations’ Special Rapporteur on the right to health, shares insights on why protecting people's rights, especially the right to health, is key for societal progress and economic gains. She highlights the key role of communities and civil society in shaping inclusive healthcare policies and discusses strategies for making global healthcare systems more accessible and equitable, particularly for LGBTQ+ people.?

This interview was edited for clarity.?

1. Why do you think it is crucial to protect people's rights, including the right to health??

Human rights are at the core of the Sustainable Development Goals, with the human right to health specifically mentioned in the 2030 Development Agenda. Protecting people's rights, specifically the right to health, is fundamental as it has significant consequences for the realization of other human rights, and on social and economic development. These include basic needs like safe drinking water, electricity, a healthy environment, as well as access to sexual and reproductive health information and nutritious food. To protect people’s rights, we need to protect people’s health.??

2. How do you see communities and civil society playing a role in policy making to ensure that healthcare is inclusive and accessible for everyone??

The human right to health requires meaningful participation and engagement in decision-making in the development and improvement of health services, particularly by those who have faced barriers to access. Civil society’s role therefore is indispensable, being closest to the community, and thus aware first-hand of urgent issues affecting people in the immediate term. Their participation is crucial for a human rights-based approach to healthcare, exemplified in the HIV response.??

As a doctor, I witness the positive impact of civil society involvement in healthcare every day.

Generic medicines, for instance, are available because of the hard work and activism of feminists in the Global South. Furthermore, the efforts of community healthcare workers directly influence patient outcomes. It is imperative that we recognize these workers as valued professionals within the healthcare system. Despite their commendable contributions, they often face inequitable employment conditions and remuneration, highlighting the need for fair recognition worldwide.?

3. How can healthcare systems globally become inclusive for everyone, including LGBTQ+ individuals???

Achieving health for all requires the prioritization and fast-tracking of actions for the most marginalized people.

This requires prioritizing listening to their lived experience and concerns. In global health, we often think that because we have a master's degree or we are doctors and world leaders, that we know everything. The reality is: we don't know everything.??

Communities face daily challenges coupled by societal biases, including racism, sexism, and/or homophobia. As an advocate, I emphasize the importance of understanding community needs before designing, monitoring, and evaluating programmes. This approach ensures that community voices drive inclusive agendas.?

4. What collaboration and innovation opportunities exist in healthcare policies to advance inclusivity and dignity and uphold human rights??

Dignity is the cornerstone of my approach as the Special Rapporteur on the right to health. Throughout my tenure, I've been committed to the philosophical idea of restoring dignity to all people, because when your rights are violated, it strips away your dignity.?

Much of our efforts include reparative work. We must reflect on what this entails from a right to health perspective for LGBTQ+ people. For gay communities, it may mean advocating for the banning of conversion therapy for gay people by states. For intersex communities, it could mean speaking out against unnecessary medical interventions and surgeries on intersex children. For sex workers, supporting the decriminalization of sex work, given the known harm of criminalization. It is important to acknowledge that the restoration of dignity varies for each person and should be respected as such.?

It is important to listen what dignity looks like for each constituency. If leaders prioritize this approach, significant progress can be made, as it ensures that dignity is not imposed but rather recognized according to people’s experiences and needs.?

5. What are your hopes and aspirations for realizing the right to health beyond your mandate??

My goal is to promote sustainable communities and societies that equip people with the means and tools to autonomously make informed decisions about their lives. Through my tenure as Special Rapporteur, I hope to contribute to creating a world that humanizes all of us. A world where the most marginalized people are central and fully integrated into the broader community.?

While my aspirations may sound very unreasonable and unrealistic, it is crucial to keep the fires of justice burning and to be unmoveable in our belief that achieving justice for all, everywhere, is attainable.?

?