The sub-Saharan African people experience the greatest burden of disease in the world although medicines exist that can treat the majority of the illnesses afflicting them. In fact, many essential medicines are not accessible for most of the people in the region. While the lack of resources is apparently a major impediment for access to medicines, man-made deliberations are also consequential, and can to some extent be influenced by regulation. The research question of this thesis therefore is: “can a human right to medicines be utilised to solve the problem of access to medicines in sub-Saharan Africa?”. In effect, in the last decade the notion of an international human right to medicines has started to develop in the human rights law and literature, prescribing that ultimately all individuals shall have access to medicines. This work contributes to the international human rights law doctrine by studying this area of the law, which is still largely uncharted.\ud
The thesis, furthermore, moves from a descriptive analysis of the law and undertakes a critical normative enquiry, underscoring the challenges of utilising human rights law to guide and redress access to medicines in sub-Saharan Africa. In effect, the contingencies of access to medicines within complex health systems make it practically difficult to identify the appropriate arrangement of access to medicines in a country. Moreover, policies and regulation for access to medicines can be morally questionable if conflicting with individuals’ legitimate rights, interests, needs and liberties. The relevance and merits of my arguments are grounded on different instances of critical-analytical research. I will use in particular interdisciplinary and empirical research on access to medicines, including a two-month field work in Tanzania, as well as the theoretical insights drawn from Luhmann’s social systems theory and Foucault’s theory of biopower. Therefore the thesis provides an ethical analysis of the potential operationalisation and implementation of the human right to medicines in sub-Saharan Africa. This analysis is also a case-study intervention to the debates concerning more generally health care, public health, development and human rights in the region. Moreover, the thesis contributes to socio-legal studies identifying the phenomena of autopoiesis, contingency, power and the limits of steering affecting human rights, law and politics