Guinea-Bissau

The Constitution does not refer explicitly to the right to health. The sole direct reference to health is included in article 15 under Part I (Fundamental Principles) of the Constitution. This article provides that public health's main goal is to promote the physical and mental well-being of the population and the balanced insertion in the social-ecological environment where they live. It must orient itself towards prevention, and must aim for the progressive socialization of medicine and medical-pharmaceutical sectors.

The National Popular Assembly has the exclusive competence to legislate on rights, freedoms, and guarantees (articles 85 and 86); these are enumerated under Part II of the Constitution. While the Right to Health has not been explicitly enumerated under Part II, Article 58 provides that the State will create conditions to establish economic and social rights provided for under Part II. Moreover, Article 29(2) provides that constitutional and legal principles relating to fundamental rights have to be interpreted in accordance with the UDHR. The only mention of health is made in article 15, addressing public health and its goals for society.

The main goal of the "Política Nacional de Saúde: Orientações Estratégicas para Mais Saúde para a Guiné-Bissau" (National Health Policy: Strategic Guidelines for Better Health for Guinea-Bissau) (2017) is to improve the health status of the population by providing accessible, safe, and progressively free healthcare services (pages 13).

The document identifies several priorities and objectives, including improvement of the population's health, reducing maternal, adolescent and child mortality, combating infectious diseases, improving healthcare quality, improving sexual and reproductive health, and ensuring equitable access to health services (pages 13-16).

In the General considerations and introductory sections, the policy references the Constitution of Guinea Bissau which establishes that public health should promote the physical and mental well-being of the population (page 11). It also discusses the need for a Basic Health Law to clearly define the roles and responsibilities within the health sector (page 22).

The policy highlights, under the governance section, that the current legislation does not differentiate between the role of the Ministry of Health and of the National Health System. Highlighting the lack of relevant or up-to-date legislation, the policy further provides that legislation (Basic Health Law) needs to be adopted to provide for a comprehensive legal framework for health and that capacity for law-making within the Ministry of Health must be reinforced (sections 6.1 and 6.2, pages 21 and 22). Furthermore, the policy provides that the provision of free services, cost recovery and co-payments must be clarified and regulated (page 25).

The main goal of the "Plano Nacional de Desenvolvimento Sanitário (PNDS III) 2023-2028" (National Health Development Plan 2023-2028) is to contribute to universal health coverage and ensure preparedness and response to public health emergencies (page 56).

The PNDS III identifies several priorities and objectives, including increasing access to and use of health services, improving the quality of services, ensuring equity in health service delivery, improving the distribution, skills and training of human resources, improving efficiency in the provision and use of services and resources (medicines), strengthening partnerships, increasing transparency and accountability for the use of public goods, aligning programs with the health system strengthening (page 57).

The plan references several legislative and regulatory documents in its sections dedicated to "PNDS 2023-2028: Contextualization and planning process", "General context, epidemiological profile and characteristics of the health system" and "Health system". These are, for example, regulatory order No 37/GMS/2016 approving the legal regime applicable to the licensing and inspection of private clinics and medical offices (page 42), Decree No 11/2010 establishing legal framework for pharmaceutical activity (page 44), National List of Essential Medicines of 2016 (page 44), Statute of ARFAME (page 44), the Order No 30/2009, which creates the National Civil Registration Committee (page 52), Civil Protection Framework Law No 9/2011 (page 54).

The PNDS III outlines specific actions to enhance the legal and regulatory framework of the health sector. As highlighted in the section 3.1.1. on the "Updates to the legal framework", the plan emphasizes the need to strengthen and redefine the terms of reference of the Legal Office for the health sector which will report to the Secretary-General of MINSAP. It also outlines the requirement of the draft legal instrument to be validated by the Health Sector Coordinating Committee for expeditious adoption (by the MoH, Council of Ministers, or Assembly of the Republic). Finally, it outlines the need for training/updating/acquiring skills in health/sanitary laws, and relying on international technical assistance on the matter when necessary. In terms of the expected products to be delivered, these include the Health Framework Law which will serve as a structuring legal framework for the health system in line with the National Health Policy 2017; the Statute of the National Health Service of Guinea-Bissau (page 59).