A/HRC/14/20/Add.2 mind. Adopting human rights and public health approaches are ways of ensuring that the interests of the rural and urban poor are given full and proper attention. 59. In 2006, the international community recognized the seriousness of the worldwide health workforce crisis and established the Global Health Workforce Alliance. Two years later, the Alliance published an important report that strongly recommends all countries prepare a 10-year health workforce plan.34 Today, India has no such overarching plan. India’s health workforce issues are complex and grave and they are not going to be resolved without a nationwide health workforce strategy and plan of action. Within an agreed national framework, Rajasthan, Maharashtra and other states will have to prepare their own health workforce strategies. While the National Rural Health Mission anticipates that each state will prepare a health workforce plan, neither Rajasthan nor Maharashtra had one at the time of the Special Rapporteur’s visit. The absence of health workforce strategies and plans of action places India in breach of its right-to-health obligations. 60. As a first step, the Government should establish, as a matter of urgency, a highlevel, high-profile independent task force to prepare a report on human resources in health, both the public and private sectors, with a particular focus on the needs of rural and underserved areas. The report should be wide-ranging and include the issues of training, posting, transfers, incentives and delegation or task-sharing. The report’s findings and recommendations should inform the health workforce strategies and plans of action of national and state governments. B. Monitoring, accountability and redress 61. As signalled in chapter III above, Governments have a responsibility to put in place arrangements that make monitoring, accountability and redress a practical reality. Although part of a World Health Organization (WHO) building-block for a health system (under “leadership, governance and stewardship”), in practice monitoring, accountability and redress are neglected in many countries. 62. In India, there is a growing recognition that monitoring, accountability and redress in relation to maternal mortality are exceptionally important and very weak. In the last two years, UNICEF, Human Rights Watch, the Center for Reproductive Rights and others have published important studies dedicated to different aspects of these issues in the Indian context.35 63. The National Rural Health Mission’s commitment to monitoring and accountability, including community-based monitoring, is one of the Mission’s most striking features. When visiting Rajasthan and Maharashtra, the Special Rapporteur was impressed by monitoring and accountability initiatives, including public meetings organized by the Women’s Commission of Rajasthan that addressed maternal health issues, such as those arising from the JSY scheme. The National Human Rights Commission has devoted significant attention to women’s right to health and the courts are presently considering public interest litigation on maternal health.36 The People’s Health Movement, Sahayog, the Centre for Enquiry into Health and Allied Themes (CEHAT), Sewa Ashram, Action Research and Training for Health and other national and local civil society groups have 34 35 36 GE.10-12866 Global Health Workforce Alliance, Scaling up, Saving Lives (2008), p. 1. UNICEF, Maternal and Perinatal Death Inquiry and Response (New Delhi, n.d.); Human Rights Watch, No Tally of the Anguish: Accountability in Maternal Health Care in India (New York, 2009); Center for Reproductive Rights, Maternal Mortality in India (New York, 2008). See, for example, N.B. Sarojini and others, Women’s Right to Health (New Delhi, National Human Rights Commission, 2006). 15