(São Paulo) – Brazil should treat access to sexual and reproductive health services, including access to abortion as provided by law, as essential services that need to be continued without interruptions during the Covid-19 pandemic, Human Rights Watch said today.
On June 1, 2020, the Health Ministry published a technical note highlighting the difficulties women and girls may encounter in getting sexual and reproductive health services during the pandemic and suggested measures to improve access. Two days later, President Jair Bolsonaro distorted the note’s content in a tweet, saying that the ministry was trying to identify its authors and did not support “any proposal to legalize abortion.” The ministry then removed two of the three public servants who signed the note from leadership positions.
“The Brazilian health system is under strain because of Covid-19, but women and girls who need abortions can’t wait until the end of the pandemic,” said Tamara Taraciuk Broner, Americas acting deputy director at Human Rights Watch. “Instead of ensuring that women and girls have access to essential health care and support during this crisis, President Bolsonaro ignored expert guidelines, lied about a Health Ministry document that recommended improving services, and punished the officials who signed it.”
Several news reports in Brazil have suggested that some local authorities have suspended sexual and reproductive services considered “not urgent,” including providing contraception, during the Covid-19 pandemic. In addition, only 42 hospitals, in a country of about 210 million people, are currently performing legal abortions, according to a study conducted by the nonprofit Article 19 and news sites AzMina and Género e Número. In 2019, it was 76 hospitals.
On June 1, three offices within the Health Ministry, including the Office of Coordination of Women’s Health, jointly published Technical Note 16/2020, with support from the Pan American Health Organization (PAHO), which serves as Regional Office for the Americas of the World Health Organization (WHO). The note was posted on a Health Ministry website.
The five-page note underscored the impact of the Covid-19 pandemic on access to health services for vulnerable populations, particularly poor women and girls. It warned that women and girls may not have access to contraceptives and also may suffer increased gender-based violence during the pandemic, leading to unwanted pregnancies.
It said that the authorities should make “all possible efforts” to maintain sexual and reproductive health services to prevent causing “important and irreparable harm to women’s comprehensive health.” Among those “essential” services it listed services for victims of sexual violence; access to contraception, particularly emergency contraception; prevention and treatment of sexually transmitted diseases; and access to “safe abortion in the cases contemplated by Brazilian law.”
Abortion is legal in Brazil in cases of rape, when necessary to save a woman’s life, or when the fetus has anencephaly, a fatal congenital brain disorder. Human Rights Watch has urged Brazilian authorities to decriminalize abortion and ensure access to safe abortion and post-abortion care, in line with its obligations under international human rights law.
On June 4, the Health Ministry acknowledged in a statement that its Office of Coordination of Women’s Health had written the note. But it claimed that “the note was not discussed within the Ministry of Health” and said that the ministry had initiated disciplinary proceedings to identify those responsible for writing and publishing it.
The next day, the acting health minister removed two of the people who signed the note from their positions as coordinators for women’s health and for life cycles, respectively. Both are public servants, who can only be fired if they commit a crime or a serious infraction. They continue to work for the ministry in lower-level positions.
In a joint letter released on June 6, 98 civil society organizations, including Human Rights Watch, rejected the government’s distortion of the note’s content and expressed their solidarity with the two public servants who suffered reprisals and all other employees of the Health Ministry who are trying to ensure high quality public health.
The WHO has warned that reductions in the availability of essential sexual and reproductive health care, including maternal and newborn health services, around the world during the Covid-19 pandemic will result in many thousands of maternal and newborn deaths due to millions of additional unintended pregnancies, unsafe abortions, and complicated deliveries without access to essential and emergency care. The WHO has recommended that governments prioritize ensuring access to contraception, abortion to the full extent allowed by law, and prevention and treatment of sexually transmitted infections.
Even before the Covid-19 pandemic, many pregnant women and girls in Brazil had to choose between continuing dangerous or unwanted pregnancies or seeking unsafe methods to end them.
A case challenging the criminalization of abortion in the first 12 weeks of pregnancy is pending before the Supreme Court. In a different case, in April, the court rejected on a technicality a petition to allow pregnant women infected with the Zika virus, which can cause microcephaly and other harm when a fetus is exposed in utero, to choose whether to continue their pregnancy.
In both cases, Human Rights Watch submitted amicus briefs arguing that Brazil’s abortion laws are incompatible with its human rights obligations under international law.