Laws and Policies in Colombia, Equador, Guatamala, Mexico and Venezuela

ISSUE 70 - 21 March 2007

This issue of the UNFPA Global Population Policy Update chronicles important laws and policies relating to HIV/AIDS, family planning, sexual and reproductive health services, abortion, and sexual crimes that were adopted in Latin America in the past few years.

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Colombia Adopts Law to Improve Access to HIV Treatment
In July 2005, Colombia adopted Law 972 of 2005, which makes combating HIV/AIDS a national priority. Under the law, the fundamental task of the health authorities is to provide treatment and rehabilitation for patients living with HIV and to reduce the spread of the virus. The law makes Colombia's General System for Social and Health Security responsible for the care of persons living with HIV and other serious illnesses and for the supply of the appropriate medications and treatments. The law also calls for programmes by the Ministry of Social Protection to promote prevention messages and to encourage HIV testing.

The law states that its content and the measures taken to implement it must be interpreted and executed with respect and guarantees for the right to life of persons living with HIV and should not affect the dignity of the person, produce any effect of marginalization or segregation, or violate the patient's fundamental rights to intimacy and privacy, work and study.

Health facilities that are aligned with the General System for Social and Health Security cannot deny appropriate services and treatment to people living with HIV or others who suffer from a serious illness. Insurance companies are also obligated to continue providing treatment to formerly insured patients who lost their insurance as a result of prolonged incapacity, with the costs recouped from a central fund. Uninsured patients must be cared for by the local health facilities. Health facilities and insurance companies that violate the law will be subject to fines. 
Within six months of the promulgation of the law, the Ministry of Social Protection must develop a clear and precise strategy to reduce the costs of medications for HIV and other serious illnesses such as cancer.  This would include creating a centralized system for negotiating the cost and controlling the quality of medications.

Guatemala Adopts Law on Universal Access to Family Planning Services
In April 2006, Guatemala adopted the Law on Universal and Equal Access to Family Planning Services.  The law aims at ensuring that all persons receive access to family planning services, which it defines as including information, counseling, sexual and reproductive health education and the provision of family planning methods. Furthermore, the law establishes mechanisms for funding family planning services at the national level in order to reduce Guatemala's dependency on foreign donors for these services.  The law is to be implemented nationally, in primary and secondary schools, public health facilities, and in facilities run by private and non-governmental organizations (NGOs) offering basic health care services. The law is intended to primarily benefit rural populations who do not have access to basic health care services.

The law requires measures to ensure that public health facilities can provide universal access to all modern contraceptive methods.  It calls for national surveys to identify unmet needs for family planning in order to determine the best means of ensuring access for underserved populations.  It also calls for the Ministry of Health to work with NGOs to ensure that geographically isolated populations have access to family planning measures. The government must ensure that family planning services are offered by skilled providers and that these services are integrated into other reproductive health services, including prenatal, delivery, and postnatal care; uterine and breast cancer detection; testing for sexually transmissible infections; and prevention of osteoperosis.  A special strategy is to be developed for adolescent access to family planning.

Educational curricula are to be developed containing information in the areas of health and sexuality and addressing the effects of early and unwanted pregnancy on maternal and infant mortality. There are also provisions ensuring free and informed decision-making, provider training, adequate counseling, information campaigns, and monitoring of the provision of services and removal of barriers to access.

Ecuador Approves Policy on Sexual Health and Reproductive Rights  
On 6 April 2005, Ecuador approved Decree No. 2717, which establishes a Sexual Health and Reproductive Rights Policy within the country's national health system law. The decree also establishes a national committee, which will act as an advisory group aimed at evaluating and supervising the implementation of the policy and its Plan of Action within the framework of the law.
http://www.dlh.lahora.com.ec/paginas/judicial/PAGINAS/R.O.Abril.15.2005.htm#anchor727511

Mexico Issues Guidelines on Abortion Access  
On 4 April 2006, the Mexican Ministry of Health's National Center of Gender Equity and Reproductive Health issued a circular to all State Secretaries of Health, asking them to "establish and follow the necessary guidelines and procedures to guarantee that every woman can exercise her right to prompt and legal abortions that meet the conditions stipulated in state legislation..." The circular was issued in response to an 8 March 2006 settlement reached by the Mexican government in a case before the Inter-American Commission for Human Rights, involving a 13-year-old who became pregnant as the result of rape and was then denied access to a legal abortion. In the settlement, the Mexican government agreed to issue a decree setting guidelines for access to abortion for rape victims.  

Noting that abortion laws in Mexico vary state by state, the circular affirms that "public health institutions are obligated to provide timely pregnancy terminations that meet the conditions, terms and time frames" as specified by applicable state law. The circular underscores the Mexican government's "commitment to the Inter-American Commission on Human Rights to implement measures to prevent further violations of women's rights to legal abortions."It recognizes that denying access to legal abortions violates women's right to health and reproductive freedom and "worsens a serious public health problem" by forcing women to undergo unsafe abortion, which increases the risk of maternal mortality and morbidity.  

To ensure the establishment of appropriate procedures for abortion services, the circular laid out seven criteria for care. It: a) calls for all State Secretaries of Health and federal-level medical institutions to issue specific guidelines on legal abortion for each state; b) directs healthcare institutions to provide women with a sufficient amount of objective, timely and clearly understandable information about legal abortion; c) requires that healthcare institutions be staffed with competent personnel who are trained to perform abortion procedures and who will respect patients' dignity, confidentiality and safety; d) directs medical personnel to provide women with the safest and most scientifically advanced method of abortion; e) calls upon authorities to ensure that there are no unnecessary delays in providing legal abortion services; f) specifies that legal abortions should be provided at no cost to women as a healthcare service to prevent maternal mortality, and g) requires that healthcare institutions establish formal mechanisms to coordinate the activities of public and private sector social organizations that promote women's health and redress rights violations. The circular concludes by cautioning that "impeding access to legal abortion qualifies as a violation of the responsibility of civil servants and therefore merits sanction."

Guatemala Revises Penal Code to Address Sexual Exploitation
On 3 February 2005, Guatemala approved Decree No. 14-2005, which extensively revises Article 194 of the Penal Code. This article had previously criminalized promotion, facilitation or supporting of the entry into or exit from the country of women for the purpose of prostitution. The article now imposes penalties on persons who in any way promote, induce, facilitate, collaborate in, or participate in the procuring, transport, transfer, or reception of persons for the purposes of exploitation, prostitution, pornography or other forms of sexual exploitation, by means of threats, force or other means of coercion, kidnapping, fraud, deceit, abuse of power, confinement, a situation of vulnerability, or the exchange of money or benefits to obtain the consent of a person who has authority over the victim. A person convicted of this crime is subject to 6 to 12 years imprisonment. The same penalty is imposed on persons who, under the above circumstances, subject another person to begging, forced labour or services, subservient marriage, irregular adoption, slavery or similar practices. The penalties are increased if the victim is a minor, disabled, elderly or is injured.

Venezuela Amends Penal Code to Address Sex Crimes
On 3 March 2005, Venezuela amended its Penal Code. The amendments contain provisions to: a) broaden the definition of rape to encompass a wider range of sexual acts and increase the penalties imposed on persons who commit rape; b) increase the penalties further if rape is committed against a child or adolescent; c) broaden the definition of statutory rape (having sex with a minor with his/her consent) to include situations where a sexual act is committed against a victim who is especially vulnerable because of his or her "situation;" d) prohibit persons convicted of the crimes of rape or statutory rape from being sentenced to means of punishment other than imprisonment, and e) repeal provisions that reduced the penalties when the above crimes were committed against a sex worker. The amendments also increase the penalties imposed when homicide is committed against an ascendant, descendant, or spouse and prohibit the application of means of punishment other than imprisonment.
http://www.asambleanacional.gov.ve/ns2/PaginasPlanas/informecodigopenal.asp

All previous issues of the UNFPA Global Population Policy Update can now be found on UNFPA's website at: http://www.unfpa.org/parliamentarians/news/newsletters.htm .

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This newsletter is issued by the United Nations Population Fund (UNFPA) in its capacity as secretariat for the biennial International Parliamentarians' Conference on the Implementation of the ICPD Programme of Action (IPCI/ICPD). The first IPCI/ICPD  was held in November 2002 in Ottawa, Canada, the second in October 2004 in Strasbourg, France and the third in November 2006 in Bangkok, Thailand. These dispatches are intended to highlight important developments taking place around the world so that parliamentarians can be kept informed of and learn from the successes, setbacks and challenges encountered by their fellow parliamentarians in other countries and regions in their efforts to promote the implementation of the Programme of Action of the International Conference on Population and Development (September 1994, Cairo, Egypt). It should be noted that UNFPA does not necessarily endorse all of the policies described in this newsletter.

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