104 Afulukwe-Eruchalu and Durojaye/Maternal mortality in Africa Charter.130 This approach provides an opportunity for the Commission in future to address maternal mortality as not only a violation of women’s rights to health and reproductive well-being, but also the rights to life, dignity and non-discrimination.131 Although the Commission is yet to clearly outline the nature of states’ obligations in relation to the right to health under the Charter or the African Women’s Rights Protocol, it has, however, noted as follows: Enjoyment of the human right to health as it is widely known is vital to all aspects of a person’s life and well-being, and is crucial to the realisation of all the other fundamental human rights and freedoms. This right includes the right to health facilities, access to goods and services to be guaranteed to all without discrimination of any kind … The African Commission would however like to state that it is aware that millions of people in Africa are not enjoying the right to health maximally because African countries are generally faced with the problem of poverty which renders them incapable to provide the necessary amenities, infrastructure and resources that facilitate the full enjoyment of this right. Therefore, having due regard to this depressing but real state of affairs, the African Commission would like to read into article 16 the obligation on part of states party to the African Charter to take concrete and targeted steps, while taking full advantage of its available resources, to ensure that the right to health is fully realised in all its aspects without discrimination of any kind.132 This statement would seem to suggest that the realisation of the right to health under the Charter must be interpreted broadly to cover not only physical access but also health facilities and goods. Implicit in this is that states must ensure access to comprehensive maternal health care including availability of skilled health care providers, emergency medical care and access to transportation services for women in rural areas. In addition, it would require African governments to ensure access to quality, affordable maternal health medicines such as oxytocin and misoprostol to prevent post-partum haemorrhage and magnesium sulphate for the treatment of pre-eclampsia and eclampsia. A report has noted that more than 80 million out of 136 million women (majority of whom are in developing countries, including Africa) that give birth annually suffer from excessive bleeding (known medically as postpartum haemorrhage (PPH)) after childbirth.133 It further notes that pre-eclampsia and eclampsia claim the lives of an estimated 63,000 women (majority in developing countries) each year.134 It is noted that the odds of a woman dying as a result of these conditions in developing countries are about 300 times higher than that of developed countries.135 This unacceptable and tragic waste of human lives requires the urgent attention of African governments. 130 International Pen and Others (on behalf of Ken SaroWiwa) v Nigeria (2000) AHLR 212 (ACHPR 1998). 131 For a detailed discussion of this approach see E Durojaye ‘The approaches of the African Commission to the right to health under the African Charter’ (2013) 17 Law Democracy and Development 393. 132 See Purohit and Another v The Gambia (2003) AHRLR 96 (ACHPR 2003) paras 80-84. 133 R Wilson et al Key data and findings: medicines for maternal health (2012). 134 As above. 135 As above.

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