Guinea

The right to health and physical and mental well-being is specifically provided under article 21 of the Constitution which also refers to the State's duty to promote health and fight epidemics and social disorders. Article 22 refers to the right to a clean environment and also addresses the role of the State in ensuring environmental protection and improved access to decent housing. Both these articles are included under the constitutional title dedicated to rights, freedoms and duties with no apparent limitation regarding justiciability.

Areas to be addressed by laws are specified in article 80 and include, among other things, rules regarding freedoms, fundamental rights, citizenships, civil rights, criminal rules, taxation, electoral rules, and the establishment of local collectivities (non-exhaustive list). The law further sets fundamental principles for national defence, teaching and scientific research, labour law, environmental protection (non exhaustive list). The issues not falling under the scope of legislative action are of regulatory nature (i.e. to be addressed via regulations) (article 81).

The main goal of the "Politique Nationale de Santé" (National Health Policy) (2015) is to improve the health status of the Guinean population (pages 7, 20).

The policy identifies a general objective which is to improve the state of health of the population of Guinea. It also outlines several strategic objectives such as the reduction of mortality and morbidity from communicable and non-communicable diseases and emergency situations; improving health at all stages of life; and enhancing the performance of the national health system (page 20).

The document references various legislative and regulatory documents in the introductory and background sections such as the Constitution of Guinea (pages 6, 17), Decree No D/2011/061/PRG/SGG on the organization and responsibilities of the Ministry of Health (page 11), Public Health Code (page 18), the Local Government Code (page 18), and the Environmental Code (page 18).

The National Health Policy includes a strategic priority on health systems strengthening (strategic orientation 3). Under this strategic priority, a sub priority is to strengthen leadership and health systems governance (section 4.3.6). In this regard, references are made to the need to reinforce decentralization and deconcentration , to revise and adjust existing legal instruments (including the pharmaceutical law, organic laws providing the status for specific structures and the public health code), the need to adopt new laws to implement the reforms provided for by the National Health Policy (including to create structures to regulate, manage, oversee the implementation of the Universal Health Coverage) as well as the need to specify these laws using appropriate regulatory tools (e.g. to restructure the Ministry, incentivize human resource for health etc. ) (pages 25 and 26).

The main goal of the Plan National de Développement Sanitaire (PNDS) 2015-2024 is to contribute to the improvement of the well-being of the population of Guinea (pages 12, 50).

The PNDS 2015-2024 identifies several priorities and objectives, including the improvement of the health of the Guinean population. Its strategic goals include reducing mortality and morbidity related to communicable and non-communicable diseases, as well as emergencies; improving health at all stages of life; and enhancing the performance of the national health system (page 50).

The introductory, background and situation analysis parts of the plan reference several key legislative and regulatory frameworks. For example, they include the Constitution of Guinea which establishes the right to health and physical and mental well-being (pages 2, 19, 28). Sections 2.5 and 2.6 provide an overview of the general legislative framework and the one specific for health and list laws such as Law L010/AN/2000 that gives the right to access reproductive health services; law and texts prohibiting female genital mutilation; the Family Code prohibiting all forms of violence; the bill on the age of marriage aiming to reduce early marriages; the Law L/2005/025/AN of 2011 adopting and promulgating the law relating to the prevention, care and control of HIV/AIDS. Furthermore, Law L/2008/028/AN of 31 December 2009 relating to the General Status of Civil Servants defines and classifies civil service employment. Additionally, Ordonnance N° 003/PRG/SGG/88 and Ordonnance N° 91/002/PRG/SGG regulate general and specific labour conditions, respectively (pages 17-18).

Some priority actions identified under Chapter IV ("strategic health priorities") specifically refer to legal reform or enhanced implementation. This includes, among other things, the implementation of the International Health Regulations (page 54), the development and implementation of legislative and regulatory texts for patients and personnel safety (page 55), the enhanced implementation of legislation banning female genital mutilation (page 58), the development of a bill to progressively increase the percentage of the budget allocated to health to 15% in line with the Abuja declaration (page 59) (non-exhaustive list). Several other actions, while not specifically referring to legislative and regulatory reforms, are assumed to have a strong legal dimension (e.g. setting up structures, defining norms and standards, developing accreditation systems, tax exemptions etc.) and require an assessment of the laws and regulations in place to inform implementation efforts.