Call for Compliance on Human, Reproductive Rights

To the States of the LAC Region:

We, the undersigned organizations, committed to the promotion and defense of human rights, sexual rights, and reproductive rights (SRHR):

Reaffirm that SRHR are fundamental rights protected by various international instruments such as the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), the International Covenant on Civil and Political Rights (ICCPR), the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT), the American Convention on Human Rights (ACHR), the Inter-American Convention on the Prevention, Punishment, and Eradication of Violence against Women (Belém do Pará), among others.

Despite the progress achieved in recent decades, structural and legal barriers persist, undermining the autonomy, dignity, and health of millions of people in our region, especially women, adolescents, girls, and people of diverse sexual and gender identities.

Express our deepest concern about the systematic non-compliance of various States in the region of their international obligations in this matter.

Among the most alarming issues, we highlight:

• The criminalization of abortion as an essential and time-sensitive sexual and reproductive health service, as well as the prosecution of those who exercise their right to decide and those who assist them, even when the pregnancy results from sexual violence or poses a risk to health and life.
• The lack of access to comprehensive and quality sexual and reproductive health services, including contraception, access to medications, obstetric care, and comprehensive sexuality education (CSE) in schools.
• Practices of institutional gynecological and obstetric violence, such as forced sterilizations, denial of access to reproductive health and legal abortion procedures, which violate the right to comprehensive health and represent discriminatory treatment of women and individuals capable of becoming pregnant.
• The misuse and lack of regulation of conscientious objection. International law does not require states to provide for conscientious objection in health care, and a state's primary duty of care is to the individual seeking health care. An assertion of conscientious objection should never result in the limitation or denial of access to health care -including abortion care- for others. If a state permits conscientious objection in health care, it must be exercisable only by individual healthcare providers, only if there are effective referral mechanisms so that it is not a barrier to accessing healthcare services. It should not be exercisable in emergency or urgent care situations and should not cause distress to those seeking medical care.
• The increase in stigmatizing discourses and attacks on SRHR defenders, as well as on feminist and human rights organizations.
• The lack of implementation of decisions and recommendations from international human rights bodies in this area, particularly decisions from UN treaty bodies.
• Structural challenges and contexts of intersectional discrimination that disproportionately affect women, girls, adolescents, people of diverse sexual and gender identities, people with disabilities, Afro-descendants, Indigenous peoples, rural populations, migrants, and those in poverty when accessing abortion through grounds-based systems.

In light of the above, we remind the States of the region of their obligation to:

• Fulfill their international obligations by implementing comprehensive policies to ensure universal access to safe, accessible, and quality sexual and reproductive health services, based on scientific evidence. Additionally, strengthen training and awareness processes for healthcare providers and regulate conscientious objection to prevent institutional barriers, in compliance with the provisions of international human rights bodies and the recommendations of the WHO Abortion Care Guidelines.
• Decriminalize abortion and ensure its legal, safe, and free access, in accordance with the recommendations of UN Treaty Bodies such as the Human Rights Committee (CCPR), the Committee for the Rights of the Child (CRC), and the Committee against Torture (CAT), with special attention to those facing significant barriers in accessing this service.
• Comply with rulings and decisions of international bodies: We emphasize the need for States to adopt measures and implement mechanisms to enforce recent decisions by international human rights bodies on SRHR, particularly regarding access to safe abortion in the region:
  • Committee for the Rights of the Child (CRC) - Camila v. Peru: This case addresses the international responsibility of Peru for the harm caused to a pregnant girl survivor of sexual violence, who was denied access to therapeutic abortion and was criminalized for an obstetric emergency. The CRC calls on States to implement recommendations to prevent similar cases, protect vulnerable girls, and eliminate the criminalization of abortion in all cases for girls and adolescents.
  • Inter-American Court of Human Rights (IACtHR) - Manuela v. El Salvador: In 2021, the Court determined the violation of the rights of Manuela, a woman convicted after suffering an obstetric emergency, recognizing the case within the context of absolute criminalization of abortion in El Salvador. The Court established that in obstetric emergencies, including abortion, the duty to maintain professional secrecy prevails over the duty to report. It also mandated States to provide non-discriminatory medical care, which implies that the alleged commission of a crime by a patient under no circumstances can condition their medical attention. Furthermore, the Court ordered the implementation of CSE.
  • IACtHR - Paola Guzmán Albarracín v. Ecuador: In 2020, the Court held Ecuador accountable for failing to investigate and sanction the sexual violence suffered by Paola, a teenager who died by suicide after years of harassment and violence by her school's vice-principal. The Court recognized for the first time that CSE is part of the human right to education. Additionally, it determined that this is a fundamental tool in enabling children and adolescents to understand the implications of sexual and affective relationships, particularly regarding consent and the exercise of freedoms concerning their SRHR.
  • IACtHR - Beatriz v. El Salvador: In 2024, the Court found El Salvador responsible for obstetric violence due to the lack of legal certainty and clear protocols for managing high-risk pregnancies, which led to the bureaucratization and judicialization of Beatriz's case, a woman with Systemic Lupus Erythematosus facing a high-risk pregnancy of a fetus with anencephaly, a condition incompatible with life outside the womb. The Court ordered the implementation of necessary health regulations and protocols to provide legal certainty to medical personnel on how to proceed in pregnancies endangering women's health and life.
• Monitor Cases in International Bodies: It is imperative to follow up on emblematic cases in sexual and reproductive rights;
  • Human Rights Committee - Cases of Norma, Lucía, Susana, and Fátima: These cases involve four Latin American girls survivors of sexual violence that were forced by their States to continue pregnancies resulting from these violations. While these cases are pending resolution, these decisions will set critical international obligations in protecting the rights of girls and adolescents requiring access to voluntary termination of pregnancy.
• Implement comprehensive sexuality education considering the Paola Guzmán Albarracín et al. v. Ecuador judgment, respecting cultural contexts and promoting gender equality as an essential tool to prevent unwanted pregnancies, sexually transmitted infections, and sexual and gender-based violence.
• Protect SRHR defenders by ensuring their freedom of expression, association, and participation in public life without risk of retaliation by anti-rights or fundamentalist groups, whose discourses aim to politicize SRHR, recognizing the importance of their work in the most vulnerable communities.
• Adopt an intersectional approach in public policies that recognizes and addresses the multiple forms of discrimination faced by historically excluded groups, especially when accessing quality sexual and reproductive health services.

We urge the international community, multilateral organizations, and international justice systems to strengthen their monitoring, oversight, and support to ensure States comply with international standards.

Sexual and reproductive rights are non-negotiable. Guaranteeing them is essential to eradicate inequalities and build a more just future for all people, regardless of their origin, identity, or condition.

Conclusion:

It is essential to act swiftly. As organizations defending human rights and the right to decide, we urge the States of the region to urgently fulfill their national and international obligations. It is imperative to prioritize the health, well-being, and rights of girls, adolescents, and women, ensuring their effective access to adequate health services, accessible justice, and comprehensive protection they need to live with dignity and free from violence.

Signatory Organizations:

1. Observatorio de Derechos y Justicia (Ecuador)
2. Planned Parenthood Global (LAC)
3. Niñas no Madres (LAC)
4. Ipas Latin America and the Caribbean (Ipas LAC)
5. PROMSEX (Peru)
6. Human Rights Watch (LAC)
7. Amnesty International (LAC)
8. Center for Reproductive Rights (LAC)
9. Colectiva Feminista El Salvador (El Salvador)
10. Agrupación Ciudadana por la Despenalización del Aborto (El Salvador)
11. Asociación Peruana de mujeres Juezas (Perú)
12. Proyecto JUSFEM (Perú)
13. Surkuna (Ecuador)
14. Fundación Desafío (Ecuador)
15. Coalición Nacional de Mujeres (Ecuador)
16. Akila Dignidad (Ecuador)
17. El Empute (Ecuador)
18. Red Ecuatoriana de Fe (Ecuador)
19. Fundación Legatum (Ecuador)
20. CEPAM Guayaquil (Ecuador)