E/C.12/GC/22
reproductive health. It extends beyond sexual and reproductive health care to the underlying
determinants of sexual and reproductive health, including access to safe and potable water,
adequate sanitation, adequate food and nutrition, adequate housing, safe and healthy
working conditions and environment, health-related education and information, and
effective protection from all forms of violence, torture and discrimination and other human
rights violations that have a negative impact on the right to sexual and reproductive health.
8.
Further, the right to sexual and reproductive health is also deeply affected by “social
determinants of health”, as defined by WHO. 8 In all countries, patterns of sexual and
reproductive health generally reflect social inequalities in society and unequal distribution
of power based on gender, ethnic origin, age, disability and other factors. Poverty, income
inequality, systemic discrimination and marginalization based on grounds identified by the
Committee are all social determinants of sexual and reproductive health, which also have
an impact on the enjoyment of an array of other rights as well. 9 The nature of these social
determinants, which are often expressed in laws and policies, limits the choices that
individuals can exercise with respect to their sexual and reproductive health. Therefore, to
realize the right to sexual and reproductive health, States parties must address the social
determinants as manifested in laws, institutional arrangements and social practices that
prevent individuals from effectively enjoying in practice their sexual and reproductive
health.
Interdependence with other human rights
9.
The realization of the right to sexual and reproductive health requires that States
parties also meet their obligations under other provisions of the Covenant. For example, the
right to sexual and reproductive health, combined with the right to education (articles 13
and 14) and the right to non-discrimination and equality between men and women
(articles 2 (2) and 3), entails a right to education on sexuality and reproduction that is
comprehensive, non-discriminatory, evidence-based, scientifically accurate and age
appropriate.10 The right to sexual and reproductive health, combined with the right to work
(article 6) and just and favourable working conditions (article 7), as well as the right to
non-discrimination and equality between men and women, also requires States to ensure
employment with maternity protection and parental leave for workers, including workers in
vulnerable situations, such as migrant workers or women with disabilities, as well as
protection from sexual harassment in the workplace and prohibition of discrimination based
on pregnancy, childbirth, parenthood,11 sexual orientation, gender identity or intersex status.
10.
The right to sexual and reproductive health is also indivisible from and
interdependent with other human rights. It is intimately linked to civil and political rights
underpinning the physical and mental integrity of individuals and their autonomy, such as
the rights to life; liberty and security of person; freedom from torture and other cruel,
inhuman or degrading treatment; privacy and respect for family life; and non-discrimination
and equality. For example, lack of emergency obstetric care services or denial of abortion
often leads to maternal mortality and morbidity, which in turn constitutes a violation of the
8
WHO Commission on Social Determinants of Health, Closing the Gap in a Generation: Health
Equity through Action on the Social Determinants of Health – Final Report of the Commission
on Social Determinants of Health (2008).
9
See Committee on Economic, Social and Cultural Rights general comment No. 20 (2009) on
non-discrimination in economic, social and cultural rights.
10
A/65/162.
11
See Convention on the Elimination of All Forms of Discrimination against Women,
art. 11 (1) (f) and 11 (2).
3