United Nations

联 合 国

E/C.12/GC/22

E/C.12/GC/22

Economic and Social Council

经济及社会理事会

Committee on Economic, Social and Cultural Rights

经济、社会及文化权利委员会

General comment No. 22 (2016) on the right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social and Cultural Rights)

关于性健康和生殖健康权利(《经济、社会及文化权利国际公约》第十二条)的第22号一般性意见(2016年)

I.

一.

Introduction

导言

1.

1.

The right to sexual and reproductive health is an integral part of the right to health enshrined in article 12 of the International Covenant on Economic, Social and Cultural Rights.

性健康和生殖健康权利是《经济、社会及文化权利国际公约》第十二条所载健康权不可或缺的一部分。

It is also reflected in other international human rights instruments.

其它国际人权文书也承认这一权利。

The adoption of the Programme of Action of the International Conference on Population and Development in 1994 further highlighted reproductive and sexual health issues within the human rights framework.

1994年通过《国际人口与发展会议行动纲领》，进一步强调生殖健康和性健康问题在人权框架中的重要性。

Since then, international and regional human rights standards and jurisprudence related to the right to sexual and reproductive health have considerably evolved.

自此以后，涉及性健康和生殖健康权的国际和区域人权标准和判例有了很大发展。

Most recently, the 2030 Agenda for Sustainable Development includes goals and targets to be achieved in the area of sexual and reproductive health.

最近，《2030年可持续发展议程》包含了在性健康和生殖健康领域需要实现的目标和具体目标。

2.

2.

Due to numerous legal, procedural, practical and social barriers, access to the full range of sexual and reproductive health facilities, services, goods and information is seriously restricted.

由于诸多法律、程序、实践和社会障碍，获得全面性健康和生殖健康医疗设施、服务、物资和信息的机会严重受限。

In fact, the full enjoyment of the right to sexual and reproductive health remains a distant goal for millions of people, especially for women and girls, throughout the world.

事实上，对全世界数百万人而言，特别是对妇女和女童而言，充分享有性健康和生殖健康权的目标远未实现。

Certain individuals and population groups that experience multiple and intersecting forms of discrimination that exacerbate exclusion in both law and practice, such as lesbian, gay, bisexual, transgender and intersex persons and persons with disabilities, the full enjoyment of the right to sexual and reproductive health is further restricted.

某些个人和群体，如男女同性恋、双性恋、变性人和两性人 以及残疾人等，遭受多重和交叉歧视，加剧了法律上和实践中对他们的排斥，因此他们在充分享有性健康和生殖健康权方面进一步受限。

3.

3.

The present general comment is aimed at assisting State parties in their implementation of the Covenant and fulfilling their reporting obligations thereunder.

本一般性意见的目的是协助国家缔约方执行《公约》并履行相关的报告义务。

It concerns primarily the obligation of States parties to ensure every individual’s enjoyment of the right to sexual and reproductive health, as required under article 12, but is also related to other provisions of the Covenant.

该文件主要涉及缔约国根据第十二条的要求有义务确保每个人享有性健康和生殖健康的权利，也与《公约》其他条款相关。

4.

4.

In its general comment No. 14 (2000) on the right to the highest attainable standard of health (article 12 of the International Covenant on Economic, Social and Cultural Rights), the Committee has already addressed in part the issue of sexual and reproductive health.

委员会在其关于享有能达到的最高健康标准权利的第14号一般性意见(2000年)(《经济、社会及文化权利国际公约》第十二条)中已部分涉及性健康和生殖健康问题。

Considering the continuing grave violations of this right, however, the Committee is of the view that the issue deserves a separate general comment.

但是，考虑到这一权利持续遭到严重侵犯，委员会认为应就该问题达成单独的一般性意见。

II.

二.

Context

背景

5.

5.

The right to sexual and reproductive health entails a set of freedoms and entitlements.

性健康和生殖健康权包含一系列自由和权利。

The freedoms include the right to make free and responsible decisions and choices, free of violence, coercion and discrimination, regarding matters concerning one’s body and sexual and reproductive health.

这些自由包括在不遭受暴力、胁迫和歧视的情况下，在涉及个人身体、性健康和生殖健康的事项上，有权做出自由和负责任的决定和选择。

The entitlements include unhindered access to a whole range of health facilities, goods, services and information, which ensure all people full enjoyment of the right to sexual and reproductive health under article 12 of the Covenant.

这些权利则包括不受阻碍地获得各种医疗设施、物资、服务和信息，确保所有人依据《公约》第十二条充分享有性健康和生殖健康权。

6.

6.

Sexual health and reproductive health are distinct from, but closely linked, to each other.

性健康和生殖健康是不同的，但彼此密切相关。

Sexual health, as defined by the World Health Organization (WHO), is “a state of physical, emotional, mental and social well-being in relation to sexuality”.

根据世界卫生组织(世卫组织)的定义，性健康是指“身体、情感、心理和社会方面与性有关的福祉”。

Reproductive health, as described in the Programme of Action of the International Conference on Population and Development, concerns the capability to reproduce and the freedom to make informed, free and responsible decisions.

如《国际人口与发展会议行动纲领》所述，生殖健康是指生殖的能力以及作出知情、自由和负责任决定的自由权。

It also includes access to a range of reproductive health information, goods, facilities and services to enable individuals to make informed, free and responsible decisions about their reproductive behaviour.

还包括获得各种生殖健康信息、物资、设施和服务的机会，使个人能够对自己的生殖行为作出知情、自由和负责任的决定 。

Underlying and social determinants

基础因素和社会决定因素

7.

7.

In its general comment No. 14, the Committee stated that the right to the highest attainable standard of health not only included the absence of disease and infirmity and the right to the provision of preventive, curative and palliative health care, but also extended to the underlying determinants of health.

委员会在其第14号一般性意见中指出，享有能达到的最高健康标准的权利，不仅包括没有疾病和不虚弱以及获得预防、治疗和缓和医疗的权利，而且还延伸到健康的基本决定因素。

The same is applicable to the right to sexual and reproductive health.

这同样适用于性健康和生殖健康权。

It extends beyond sexual and reproductive health care to the underlying determinants of sexual and reproductive health, including access to safe and potable water, adequate sanitation, adequate food and nutrition, adequate housing, safe and healthy working conditions and environment, health-related education and information, and effective protection from all forms of violence, torture and discrimination and other human rights violations that have a negative impact on the right to sexual and reproductive health.

该 权利超越了性健康和生殖健康，延伸至性健康和生殖健康的基本决定因素，包括获得安全饮用水、适足的卫生设施、足够的食物和营养、适当的住房、安全和健康的 工作条件和环境、与健康相关的教育和信息，并获得有效保护免受一切形式暴力、酷刑和歧视以及对性健康和生殖健康权产生不利影响的其他侵犯人权行为。

8.

8.

Further, the right to sexual and reproductive health is also deeply affected by “social determinants of health”, as defined by WHO.

此外，根据世卫组织的定义，“健康的社会决定因素”也对性健康和生殖健康权产生很深的影响。

In all countries, patterns of sexual and reproductive health generally reflect social inequalities in society and unequal distribution of power based on gender, ethnic origin, age, disability and other factors.

在所有国家中，性健康和生殖健康的模式通常反映社会不平等现象以及基于性别、族裔、年龄、残疾等因素的权利不平等分配。

Poverty, income inequality, systemic discrimination and marginalization based on grounds identified by the Committee are all social determinants of sexual and reproductive health, which also have an impact on the enjoyment of an array of other rights as well.

贫困、收入不平等、基于委员会所确定理由的系统性歧视和边缘化都是性健康和生殖健康的社会决定因素，也对一系列其他权利的享有产生影响。

The nature of these social determinants, which are often expressed in laws and policies, limits the choices that individuals can exercise with respect to their sexual and reproductive health.

这些社会决定因素的性质往往通过法律和政策得以体现，限制了个人在其性健康和生殖健康方面可作出的选择。

Therefore, to realize the right to sexual and reproductive health, States parties must address the social determinants as manifested in laws, institutional arrangements and social practices that prevent individuals from effectively enjoying in practice their sexual and reproductive health.

因此，为了实现性健康和生殖健康权，缔约国必须解决法律、体制安排和社会做法中阻碍个人在实践中有效享有其性健康和生殖健康的社会决定因素。

Interdependence with other human rights

与其他人权的相互依存关系

9.

9.

The realization of the right to sexual and reproductive health requires that States parties also meet their obligations under other provisions of the Covenant.

实现性健康和生殖健康权要求缔约国也履行其依据《公约》其它条款的义务。

For example, the right to sexual and reproductive health, combined with the right to education (articles 13 and 14) and the right to non-discrimination and equality between men and women (articles 2 (2) and 3), entails a right to education on sexuality and reproduction that is comprehensive, non-discriminatory, evidence-based, scientifically accurate and age appropriate.

例如，性健康和生殖健康权，与受教育权(第十三条和第十四条)以及不受歧视和男女平等的权利(第二条第二款和第三条)相结合，需要确保全面、非歧视性、基于证据、科学上准确和适合年龄的关于性健康和生殖健康的受教育权。

The right to sexual and reproductive health, combined with the right to work (article 6) and just and favourable working conditions (article 7), as well as the right to non‑discrimination and equality between men and women, also requires States to ensure employment with maternity protection and parental leave for workers, including workers in vulnerable situations, such as migrant workers or women with disabilities, as well as protection from sexual harassment in the workplace and prohibition of discrimination based on pregnancy, childbirth, parenthood, sexual orientation, gender identity or intersex status.

性健康和生殖健康权，与工作权(第六条)、公正和良好的工作条件(第七条)以及不受歧视和男 女平等的权利相结合，也要求国家确保就业中工人有生育保护和育儿假，包括处于弱势的工人，如移徙工人或残疾妇女，以及保护工人在工作场所免受性骚扰，禁止 基于怀孕、分娩、生育、 性取向、性别认同或双性人身份的歧视。

10.

10.

The right to sexual and reproductive health is also indivisible from and interdependent with other human rights.

性健康和生殖健康权与其他人权不可分割，相互依存。

It is intimately linked to civil and political rights underpinning the physical and mental integrity of individuals and their autonomy, such as the rights to life; liberty and security of person; freedom from torture and other cruel, inhuman or degrading treatment; privacy and respect for family life; and non-discrimination and equality.

它与支撑个人的身心完整及其自主性的公民权利和政治权利密切相关，如生命权、人身自由和安全权、免受酷刑和其他残忍、不人道或有辱人格的待遇或处罚的权利、隐私和家庭生活得到尊重的权利以及不受歧视和平等权。

For example, lack of emergency obstetric care services or denial of abortion often leads to maternal mortality and morbidity, which in turn constitutes a violation of the right to life or security, and in certain circumstances can amount to torture or cruel, inhuman or degrading treatment.

例如，缺乏紧急产科护理服务或拒绝提供流产服务往往导致孕产妇死亡和发病，这又构成了侵犯生命权或安全权，在某些情况下相当于酷刑和其他残忍、不人道或有辱人格的待遇。

III.

三.

Normative content of the right to sexual and reproductive health

关于性健康和生殖健康权的规范性内容

A.

A.

Elements of the right to sexual and reproductive health

性健康和生殖健康权的要素

11.

11.

The right to sexual and reproductive health is an integral part of the right of everyone to the highest attainable physical and mental health.

性健康和生殖健康是人人享有能达到的最高标准的身心健康权利的组成部分。

Following the elaboration in the Committee’s general comment No. 14, comprehensive sexual and reproductive health care contains the four interrelated and essential elements described below.

继委员会拟订第14号一般性意见后，全面的性健康和生殖健康包含下述四个相互关联的基本要素。

Availability

可用性

12.

12.

An adequate number of functioning health‑care facilities, services, goods and programmes should be available to provide the population with the fullest possible range of sexual and reproductive health care.

应有足够数量运转良好的医疗保健设施、服务、物资和方案，向人们提供尽可能充分的性健康和生殖健康保健。

This includes ensuring the availability of facilities, goods and services for the guarantee of the underlying determinants of the realization of the right to sexual and reproductive health, such as safe and potable drinking water and adequate sanitation facilities, hospitals and clinics.

这包括确保提供设施、物资和服务，以保障实现性健康和生殖健康权的基本决定因素，如安全饮用水和充分的卫生设施、医院和诊所。

13.

13.

Ensuring the availability of trained medical and professional personnel and skilled providers who are trained to perform the full range of sexual and reproductive health‑care services is a critical component of ensuring availability.

确保提供训练有素的医疗和专业人员以及技能熟练的提供者，他们已接受培训，可提供全面的性健康和生殖健康保健服务，这是确保可用性的一个关键组成部分。

Essential medicines should also be available, including a wide range of contraceptive methods, such as condoms and emergency contraception, medicines for abortion and for post-abortion care, and medicines, including generic medicines, for the prevention and treatment of sexually transmitted infections and HIV.

还应当提供基本药物，包括一系列广泛的避孕方法，如避孕套和紧急避孕，用于流产和流产后护理的药物，以及用于预防和治疗性传播感染和艾滋病毒的药物，包括非专利药。

14.

14.

Unavailability of goods and services due to ideologically based policies or practices, such as the refusal to provide services based on conscience, must not be a barrier to accessing services.

因基于意识形态的政策或做法(例如基于良心拒绝提供服务)而导致无法获得物资和服务，这不应成为获得服务的障碍。

An adequate number of health‑care providers willing and able to provide such services should be available at all times in both public and private facilities and within reasonable geographical reach.

应有足够数量的医疗保健提供者愿意并且有能力在公共和私人设施中、在合理的地理范围内随时提供这样的服务。

Accessibility

可获取性

15.

15.

Health facilities, goods, information and services related to sexual and reproductive health care should be accessible to all individuals and groups without discrimination and free from barriers.

有关性健康和生殖健康保健的医疗设施、物资、信息和服务 应便于所有个人和群体不受歧视和无障碍地获取。

As elaborated in the Committee’s general comment No. 14, accessibility includes physical accessibility, affordability and information accessibility.

如委员会第14号一般性意见所述，可获取性包括实际可获取性、可负担性和信息可获取性。

Physical accessibility

实际可获取性

16.

16.

Health facilities, goods, information and services related to sexual and reproductive health care must be available within safe physical and geographical reach for all, so that persons in need can receive timely services and information.

必须在安全的环境中及合理的距离内为所有人提供与性健康和生殖健康服务有关的医疗设施、物资、信息和服务，以便让有需要的人都能及时获得服务和信息。

Physical accessibility should be ensured for all, especially persons belonging to disadvantaged and marginalized groups, including, but not limited to, persons living in rural and remote areas, persons with disabilities, refugees and internally displaced persons, stateless persons and persons in detention.

应对所有人确保实际可获取性，特别是处于弱势和被边缘化的人，包括但不限于居住在农村和偏远地区的人、残疾人、难民和境内流离失所者、无国籍人员和被拘留者。

When dispensing sexual and reproductive services to remote areas is impracticable, substantive equality calls for positive measures to ensure that persons in need have communication and transportation to such services.

在偏远地区提供性健康和生殖健康服务不可行时，实质平等要求采取积极措施，确保为有需要的人提供通讯和交通，以便他们获得这类服务。

Affordability

可负担性

17.

17.

Publicly or privately provided sexual and reproductive health services must be affordable for all.

公共或私人提供的性健康和生殖健康服务必须让所有人负担得起。

Essential goods and services, including those related to the underlying determinants of sexual and reproductive health, must be provided at no cost or based on the principle of equality to ensure that individuals and families are not disproportionately burdened with health expenses.

必须免费提供或基于平等原则提供基本物资和服务，包括与性健康和生殖健康基本决定因素相关的基本物资和服务，以确保个人和家庭不会因医疗支出而负担过重。

People without sufficient means should be provided with the support necessary to cover the costs of health insurance and access to health facilities providing sexual and reproductive health information, goods and services.

应为没有足够财力的人提供必要的支助以支付医疗保险费用，并让他们能够享有提供性健康和生殖健康信息、物资和服务的医疗设施。

Information accessibility

信息可获取性

18.

18.

Information accessibility includes the right to seek, receive and disseminate information and ideas concerning sexual and reproductive health issues generally, and also for individuals to receive specific information on their particular health status.

信息可获取性包括寻求、接收和传播关于性健康和生殖健康问题的信息和观点的权利，以及个人获得关于其特定健康状况的具体信息的权利。

All individuals and groups, including adolescents and youth, have the right to evidence-based information on all aspects of sexual and reproductive health, including maternal health, contraceptives, family planning, sexually transmitted infections, HIV prevention, safe abortion and post‑abortion care, infertility and fertility options, and reproductive cancer.

所有个人和群体，包括青少年和青年，都有权获得关于性健康和生殖健康各方面的基于证据的信息，包括孕产妇健康、避孕药具、计划生育、性传播感染、艾滋病毒预防、安全流产和流产后护理、不育和生育选择以及生殖系统癌症。

19.

19.

Such information must be provided in a manner consistent with the needs of the individual and the community, taking into consideration, for example, age, gender, language ability, educational level, disability, sexual orientation, gender identity and intersex status.

提供此类信息必须符合个人和社区的需求，同时考虑到例如年龄、性别、语言能力、教育水平、残疾、性取向、性别认同和双性人身份。

Information accessibility should not impair the right to have personal health data and information treated with privacy and confidentiality.

信息可获取性不应损害个人健康数据和信息得到保密的权利。

Acceptability

可接受性

20.

20.

All facilities, goods, information and services related to sexual and reproductive health must be respectful of the culture of individuals, minorities, peoples and communities and sensitive to gender, age, disability, sexual diversity and life-cycle requirements.

与性健康和生殖健康有关的所有设施、物资、信息和服务必须尊重个人、少数群体、人民和社区的文化，并考虑到性别、年龄、残疾、性多样性和生命周期的需求。

However, this cannot be used to justify the refusal to provide tailored facilities, goods, information and services to specific groups.

然而，这不能作为拒绝对特定群体提供针对性设施、物资、信息和服务的理由。

Quality

质量

21.

21.

Facilities, goods, information and services related to sexual and reproductive health must be of good quality, meaning that they are evidence-based and scientifically and medically appropriate and up-to-date.

与性健康和生殖健康有关的设施、物资、信息和服务必须具有良好的质量，意味着它们基于证据、在科学上和医学上适当且是最新的。

This requires trained and skilled health‑care personnel and scientifically approved and unexpired drugs and equipment.

这需要训练有素的熟练的医疗保健专业人员、经科学验证且未过期的药品以及设备。

The failure or refusal to incorporate technological advances and innovations in the provision of sexual and reproductive health services, such as medication for abortion, assisted reproductive technologies and advances in the treatment of HIV and AIDS, jeopardizes the quality of care.

未能或拒绝将技术进步和创新纳入提供的性健康和生殖健康服务中，例如用于流产的药物、 辅助生殖技术和治疗艾滋病毒和艾滋病方面的进展，会有损医疗保健的质量。

B.

B.

Special topics of broad application

广泛适用的专项议题

Non-discrimination and equality

不歧视和平等

22.

22.

Article 2 (2) of the Covenant provides that all individuals and groups shall not be discriminated against and shall enjoy equal rights.

《公约》第二条第二款规定，任何个人和群体都不得受歧视，都应享有平等权利。

All individuals and groups should be able to enjoy equal access to the same range, quality and standard of sexual and reproductive health facilities, information, goods and services, and to exercise their rights to sexual and reproductive health without experiencing any discrimination.

所有个人和群体应能够平等地享有在范围、质量和标准方面相同的性健康和生殖健康医疗设施、信息、物资和服务，并不受任何歧视地行使性健康和生殖健康权。

23.

23.

Non-discrimination, in the context of the right to sexual and reproductive health, also encompasses the right of all persons, including lesbian, gay, bisexual, transgender and intersex persons, to be fully respected for their sexual orientation, gender identity and intersex status. Criminalization of sex between consenting adults of the same gender or the expression of one’s gender identity is a clear violation of human rights.

在性健康和生殖健康权方面，不歧视也包括所有人(包括男女同性恋、双性恋、变性人和双性人)的性取向、性别认同和双性人身份受到充分尊重的权利。 将同性成年人自愿发生性关系或表达性别认同的行为定为刑事罪，明显侵犯了人权。

Likewise, regulations requiring that lesbian, gay, bisexual transgender and intersex persons be treated as mental or psychiatric patients, or requiring that they be “cured” by so-called “treatment”, are a clear violation of their right to sexual and reproductive health.

同样，要求将男女同性恋、双性恋、变性人和双性人视为心理或精神病患者，或要求通过所谓的“治疗”对他们进行“治愈”的规章条例，都明显侵犯了他们的性健康和生殖健康权。

State parties also have an obligation to combat homophobia and transphobia, which lead to discrimination, including violation of the right to sexual and reproductive health.

缔约国也有义务打击对同性恋和变性者的恐惧，这种恐惧导致歧视，包括侵犯性健康和生殖健康权的行为。

24.

24.

Non-discrimination and equality require not only legal and formal equality but also substantive equality.

不歧视和平等不仅需要法律上和形式上的平等，而且需要实质平等。

Substantive equality requires that the distinct sexual and reproductive health needs of particular groups, as well as any barriers that particular groups may face, be addressed.

实质平等要求对特定群体特殊的性健康和生殖健康需求，以及该特定群体可能面临的任何障碍，予以解决。

The sexual and reproductive health needs of particular groups should be given tailored attention.

特定群体的性健康和生殖健康需求应得到特别关注。

For example, persons with disabilities should be able to enjoy not only the same range and quality of sexual and reproductive health services but also those services which they would need specifically because of their disabilities.

例如，残疾人应能够不仅享有在范围和质量方面相同的性健康和生殖健康服务，而且还能享有针对残疾的特别服务。

Further, reasonable accommodation must be made to enable persons with disabilities to fully access sexual and reproductive health services on an equal basis, such as physically accessible facilities, information in accessible formats and decision-making support, and States should ensure that care is provided in a respectful and dignified manner that does not exacerbate marginalization.

此外，必须作出合理的安排，使残疾人在平等基础上充分获得性健康和生殖健康服务，如无障碍设施，以无障碍形式提供的信息和决策支助，国家应确保以尊重和有尊严且不加剧边缘化的方式提供医疗。

Equality between women and men, and gender perspective

男女平等和性别观点

25.

25.

Due to women’s reproductive capacities, the realization of the right of women to sexual and reproductive health is essential to the realization of the full range of their human rights.

由于妇女具有生殖能力，所以实现妇女的性健康和生殖健康权对实现她们的全面人权而言至关重要。

The right of women to sexual and reproductive health is indispensable to their autonomy and their right to make meaningful decisions about their lives and health.

在妇女的自主权以及对自己的生活和健康作出有意义的决定的权利中，性健康和生殖健康权是必不可少的部分。

Gender equality requires that the health needs of women, different from those of men, be taken into account and appropriate services provided for women in accordance with their life cycles.

性别平等要求考虑到妇女的保健需求(不同于男子的保健需求)，并根据妇女的生命周期为她们提供适当的服务。

26.

26.

The experiences of women of systemic discrimination and violence throughout their lives require comprehensive understanding of the concept of gender equality in the right to sexual and reproductive health.

妇女在一生中遭受系统性歧视和暴力，解决该问题需要全面了解在性健康和生殖健康权方面的性别平等概念。

Non-discrimination on the basis of sex, as guaranteed in article 2 (2) of the Covenant, and the equality of women, as guaranteed in article 3, require the removal of not only direct discrimination but also indirect discrimination, and the ensuring of formal as well as substantive equality.

《公约》第二条第二款保障不得性别歧视以及第三条保障男女平等，这不仅要求消除直接歧视，还要消除间接歧视，以及确保形式平等和实质平等。

27.

27.

Seemingly neutral laws, policies and practices can perpetuate already existing gender inequalities and discrimination against women.

看似中立的法律、政策和做法可延长现有的性别不平等和对妇女的歧视。

Substantive equality requires that laws, policies and practices do not maintain, but rather alleviate, the inherent disadvantage that women experience in exercising their right to sexual and reproductive health.

实质平等要求法律、政策和做法去改善(而不是维持)妇女在行使其性健康和生殖健康权过程中的固有弱势。

Gender‑based stereotypes, assumptions and expectations related to women being the subordinates of men and their role being solely as caregivers and mothers, in particular, are obstacles to substantive gender equality, including the equal right to sexual and reproductive health, and need to be modified or eliminated, as does the role of men solely as heads of household and breadwinners.

尤 其是，关于妇女附属于男子以及妇女的作用仅仅是照料者和母亲这样基于性别的陈规定型观念、假设和预期，是实质性别平等(包括平等的性健康和生殖健康权)的 障碍，需要予以改变或消除，认为男子的作用仅仅是一家之主和经济支柱的陈规定型观念、假设和预期也需要予以改变或消除。

At the same time, special measures, both temporary and permanent, are necessary to accelerate the de facto equality of women and to protect maternity.

与此同时，需要采取暂行和永久性的特别措施，以加快实现妇女事实上的平等并保护母性。

28.

28.

The realization of the rights of women and gender equality, both in law and in practice, requires repealing or reforming discriminatory laws, policies and practices in the area of sexual and reproductive health.

在法律上和实践中实现妇女权利和性别平等，需要废除或改革在性健康和生殖健康领域的歧视性法律、政策和做法。

Removal of all barriers interfering with access by women to comprehensive sexual and reproductive health services, goods, education and information is required.

要求消除所有妨碍妇女获得全面的性保健和生殖保健服务、物资、教育和信息的障碍。

To lower rates of maternal mortality and morbidity requires emergency obstetric care and skilled birth attendance, including in rural and remote areas, and prevention of unsafe abortions.

为了降低产妇死亡率和发病率，需要提供紧急产科护理和熟练的助产护理，包括在农村和偏远地区，并预防不安全流产。

Preventing unintended pregnancies and unsafe abortions requires States to adopt legal and policy measures to guarantee all individuals access to affordable, safe and effective contraceptives and comprehensive sexuality education, including for adolescents; to liberalize restrictive abortion laws; to guarantee women and girls access to safe abortion services and quality post-abortion care, including by training health‑care providers; and to respect the right of women to make autonomous decisions about their sexual and reproductive health.

预防意外怀孕和不安全流产，要求国家制定 法律和政策措施，以保障所有人能获得负担得起的、安全有效的避孕药具和全面的性教育，包括对青少年；放宽限制流产的法律；保障妇女和女童能够获得安全的流 产服务和优质的流产后护理，包括通过培训医疗保健提供者；以及尊重妇女就其性健康和生殖健康作出自主决定的权利。

29.

29.

It is also important to undertake preventive, promotional and remedial action to shield all individuals from the harmful practices and norms and gender-based violence that deny them their full sexual and reproductive health, such as female genital mutilation, child and forced marriage and domestic and sexual violence, including marital rape, among other things.

还必须采取预防、促进和补救行动，保护所有个人免遭使其不能充分享有性健康和生殖健康的有害做法和习俗以及基于性别的暴力，例如切割女性生殖器官、童婚和强迫婚姻、家庭暴力和性暴力，包括婚内强奸，等等。

States parties must put in place laws, policies and programmes to prevent, address and remediate violations of the right of all individuals to autonomous decision-making on matters regarding their sexual and reproductive health, free from violence, coercion and discrimination.

所有人都有权在不受暴力、胁迫和歧视的情况下就其性健康和生殖健康问题进行自主决策，缔约国必须制定法律、政策和方案，以防止、处理和纠正侵犯该权利的行为。

Intersectionality and multiple discrimination

歧视的交叉性和多种形式

30.

30.

Individuals belonging to particular groups may be disproportionately affected by intersectional discrimination in the context of sexual and reproductive health.

属于特定群体的个人可能在性健康和生殖健康方面过多地受到交叉歧视的影响。

As identified by the Committee, groups such as, but not limited to, poor women, persons with disabilities, migrants, indigenous or other ethnic minorities, adolescents, lesbian, gay, bisexual, transgender and intersex persons, and people living with HIV/AIDS are more likely to experience multiple discrimination.

如委员会所确定的， 诸如(但不限于)贫穷妇女、残疾人、移徙者、土著或其他少数族裔、青少年、男女同性恋、双性恋、变性人和双性人以及艾滋病毒/艾滋病患者这样的群体更可能遭受多重歧视。

Trafficked and sexually exploited women, girls and boys are subject to violence, coercion and discrimination in their everyday lives, with their sexual and reproductive health at great risk.

被贩运和遭受性剥削的妇女、女童和男童在日常生活中容易遭受暴力、胁迫和歧视，他们的性健康和生殖健康面临很大风险。

Also, women and girls living in conflict situations are disproportionately exposed to a high risk of violation of their rights, including through systematic rape, sexual slavery, forced pregnancy and forced sterilization.

此外，生活在冲突局势中的妇女和女童尤其面临侵权行为的高风险，包括蓄意强奸、性奴役、强迫怀孕和强迫绝育。

Measures to guarantee non-discrimination and substantive equality should be cognizant of and seek to overcome the often exacerbated impact that intersectional discrimination has on the realization of the right to sexual and reproductive health.

旨在保证不歧视和实质平等的措施应认识到并努力克服交叉歧视对实现性健康和生殖健康权的恶化影响。

31.

31.

Laws, policies and programmes, including temporary special measures, are required to prevent and eliminate discrimination, stigmatization and negative stereotyping that hinder access to sexual and reproductive health.

需要法律、政策和计划，包括暂行特别措施，以防止和消除阻碍获得性健康和生殖健康的歧视、污名化或负面成见。

Prisoners, refugees, stateless persons, asylum seekers and undocumented migrants, given their additional vulnerability by condition of their detention or legal status, are also groups with specific needs that require the State to take particular steps to ensure their access to sexual and reproductive information, goods and health care.

囚犯、难民、无国籍者、寻求庇护者和无证移徙者的脆弱性因拘留条件或其法律地位而加剧，他们也是具有特殊需求的群体，需要国家采取具体步骤，确保他们获得性健康和生殖健康方面的信息、物资和医疗保健。

States must ensure that individuals are not subject to harassment for exercising their right to sexual and reproductive health.

国家必须确保个人不受骚扰地行使其性健康和生殖健康权。

Eliminating systemic discrimination will also frequently require devoting greater resources to traditionally neglected groups and ensuring that anti-discrimination laws and policies are implemented in practice by officials and others.

消除系统性歧视通常需要对历来被忽视的群体投入更多资源， 并确保官员和其他人员在实践中执行反歧视法律和政策。

32.

32.

States parties should take measures to fully protect persons working in the sex industry against all forms of violence, coercion and discrimination.

缔约国应采取措施，充分保护在性行业工作的人免遭一切形式暴力、胁迫和歧视。

They should ensure that such persons have access to the full range of sexual and reproductive health‑care services.

应确保这类人员有机会获得全面的性健康和生殖健康保健服务。

IV.

四.

Obligations of States parties

缔约国的义务

A.

A.

General legal obligations

一般法律义务

33.

33.

As prescribed by article 2 (1) of the Covenant, States parties must take steps, to the maximum of their available resources, with a view to achieving progressively the full realization of the right to sexual and reproductive health.

《公约》第二条第一款规定，缔约国必须采取措施，最大限度地利用现有资源，以期逐步充分实现性健康和生殖健康权。

States parties must move as expeditiously and effectively as possible towards the full realization of the highest attainable standard of sexual and reproductive health.

缔约国必须尽可能迅速和有效地充分实现能达到的最高标准的性健康和生殖健康。

This means that, while full realization of the goal may be achieved progressively, steps towards it must be taken immediately or within a reasonably short period of time.

这意味着，在逐步充分实现该目标的同时，必须立即或在适当短的期限内采取步骤。

Such steps should be deliberate, concrete and targeted, using all appropriate means, particularly including, but not limited to, the adoption of legislative and budgetary measures.

此类步骤应当周密、具体且具有针对性，利用一切适当方法，尤其包括但不限于通过立法和预算措施。

34.

34.

States parties are under immediate obligation to eliminate discrimination against individuals and groups and to guarantee their equal right to sexual and reproductive health.

缔约国负有紧要义务消除对个人和群体的歧视，并保障他们平等享有性健康和生殖健康权。

This requires States to repeal or reform laws and policies that nullify or impair the ability of certain individuals and groups to realize their right to sexual and reproductive health.

这要求国家废除或改革那些使特定个人和群体实现性健康和生殖健康权的能力丧失或减损的法律和政策。

There exists a wide range of laws, policies and practices that undermine autonomy and right to equality and non-discrimination in the full enjoyment of the right to sexual and reproductive health, for example criminalization of abortion or restrictive abortion laws.

存在一系列广泛的法律、政策和做法，会削弱在充分享有性健康和生殖健康权方面的自主性以及平等和不受歧视的权利，例如将流产定为犯罪或限制流产的法律。

States parties should also ensure that all individuals and groups have equal access to the full range of sexual and reproductive health information, goods and services, including by removing all barriers that particular groups may face.

缔约国还应确保所有个人和群体能平等地获得全面的性健康和生殖健康信息、物资和服务，包括通过消除特定群体可能面临的一切障碍。

35.

35.

States must adopt the measures necessary to eliminate conditions and combat attitudes that perpetuate inequality and discrimination, particularly on the basis of gender, in order to enable all individuals and groups to enjoy sexual and reproductive health on the basis of equality.

国家必须采取必要措施，消除使不平等和歧视长期存在的条件并打击这样的态度，特别是基于性别的不平等和歧视，以使所有个人和群体平等享有性健康和生殖健康。

States must recognize, and take measures to rectify, entrenched social norms and power structures that impair the equal exercise of that right, such as gender roles, which have an impact on the social determinants of health.

国家必须承认并采取措施纠正有损平等行使这一权利的根深蒂固的社会规范和权力结构，如性别角色，这些对健康的社会决定因素产生影响。

Such measures must address and eliminate discriminatory stereotypes, assumptions and norms concerning sexuality and reproduction that underlie restrictive laws and undermine the realization of sexual and reproductive health.

这些措施必须解决和消除有关性和生殖的歧视性陈规定型观念、假设和规范，这些是限制性法律的基础并有损性健康和生殖健康的实现。

36.

36.

As needed, States should implement temporary special measures to overcome long‑standing discrimination and entrenched stereotypes against certain groups and to eradicate conditions that perpetuate discrimination.

必要时国家应采取暂行特别措施，以克服对某些群体的长期歧视和根深蒂固的陈规定型观念，并根除使歧视长期存在的条件。

States should focus on ensuring that all individuals and groups effectively enjoy their right to sexual and reproductive health on a substantively equal basis.

国家应侧重于确保所有个人和群体在实质平等的基础上切实享有性健康和生殖健康权。

37.

37.

A State party has the duty to establish that it has obtained the maximum available resources, including those made available through international assistance and cooperation, with a view to complying with its obligations under the Covenant.

缔约国有责任证明其已获得最大程度的可用资源，包括通过国际援助和合作获得的资源，以履行其《公约》义务。

38.

38.

Retrogressive measures should be avoided and, if such measures are applied, the State party has the burden of proving their necessity.

应避免倒退措施，如果适用这种措施，缔约国有义务证明其必要性。

This applies equally in the context of sexual and reproductive health.

这同样适用于性健康和生殖健康方面。

Examples of retrogressive measures include the removal of sexual and reproductive health medications from national drug registries; laws or policies revoking public health funding for sexual and reproductive health services; imposition of barriers to information, goods and services relating to sexual and reproductive health; enacting laws criminalizing certain sexual and reproductive health conduct and decisions; and legal and policy changes that reduce oversight by States of the obligation of private actors to respect the right of individuals to access sexual and reproductive health services.

倒 退措施的例子包括在国家药物登记目录中撤销性健康和生殖健康药物；通过法律或政策撤销对性健康和生殖健康服务的公共卫生经费；对有关性健康和生殖健康的信 息、物资和服务施加障碍；颁布法律将某些性健康和生殖健康行为和决定定为刑事罪；通过法律和政策改革，减少国家对私营行为体尊重个人获得性健康和生殖健康 服务权利的监督义务。

In the extreme circumstances under which retrogressive measures may be inevitable, States must ensure that such measures are only temporary, do not disproportionately affect disadvantaged and marginalized individuals and groups, and are not applied in an otherwise discriminatory manner.

在不可避免使用倒退措施的极端情况下，国家必须确保这些措施只是暂时的，不会过度影响处于弱势和被边缘化的个人和群体，并且其适用方式在其他方面不具有歧视性。

B.

B.

Specific legal obligations

具体法律义务

39.

39.

States parties have an obligation to respect, protect and fulfil the right of everyone to sexual and reproductive health.

缔约国有义务尊重、保护和实现所有人的性健康和生殖健康权。

Obligation to respect

尊重的义务

40.

40.

The obligation to respect requires States to refrain from directly or indirectly interfering with the exercise by individuals of the right to sexual and reproductive health.

尊重的义务要求缔约国不直接或间接干涉个人行使性健康和生殖健康权。

States must not limit or deny anyone access to sexual and reproductive health, including through laws criminalizing sexual and reproductive health services and information, while confidentiality of health data should be maintained.

国家不得限制或剥夺任何人享有性健康和生殖健康权，包括通过法律将提供性健康和生殖健康服务和信息的行为定为刑事罪，同时应对健康数据保密。

States must reform laws that impede the exercise of the right to sexual and reproductive health.

国家必须对阻碍行使性健康和生殖健康权的法律进行改革。

Examples include laws criminalizing abortion, non-disclosure of HIV status, exposure to and transmission of HIV, consensual sexual activities between adults, and transgender identity or expression.

这方面的例子包括将流产、不披露艾滋病毒状况、接触和感染艾滋病毒、成年人之间的自愿性活动、变性身份或表达定为刑事罪的法律。

41.

41.

The obligation to respect also requires States to repeal, and refrain from enacting, laws and policies that create barriers in access to sexual and reproductive health services.

尊重的义务还要求国家废止和避免颁布对获得性健康和生殖健康服务造成障碍的法律和政策。

This includes third-party authorization requirements, such as parental, spousal and judicial authorization requirements for access to sexual and reproductive health services and information, including for abortion and contraception; biased counselling and mandatory waiting periods for divorce, remarriage or access to abortion services; mandatory HIV testing; and the exclusion of particular sexual and reproductive health services from public funding or foreign assistance funds.

这包括第三方授权的要求，例如要求有父母、配偶和司法授权才能享有性健康和生殖健康服务和信息，包括流产和避孕药具；在离婚、再婚或获得流产服务方面带有偏见的咨询和强制等待期；强制性艾滋病毒检测；以及在公共资金或外国援助资金中排除特定的性健康和生殖健康服务。

The dissemination of misinformation and the imposition of restrictions on the right of individuals to access information about sexual and reproductive health also violates the duty to respect human rights.

传播错误信息和限制个人获取性健康和生殖健康信息的权利也违反了尊重人权的义务。

National and donor States must refrain from censoring, withholding, misrepresenting or criminalizing the provision of information on sexual and reproductive health, both to the public and to individuals.

国家和捐助国在向公众和个人提供关于性健康和生殖健康的信息时必须避免审查、隐瞒、歪曲或将提供信息的行为定为刑事罪。

Such restrictions impede access to information and services, and can fuel stigma and discrimination.

这些限制阻碍人们获得信息和服务的机会，并可能助长污名化和歧视。

Obligation to protect

保护的义务

42.

42.

The obligation to protect requires States to take measures to prevent third parties from directly or indirectly interfering with the enjoyment of the right to sexual and reproductive health.

保护义务要求国家采取措施，防止第三方直接或间接干涉享有性健康和生殖健康权。

The duty to protect requires States to put in place and implement laws and policies prohibiting conduct by third parties that causes harm to physical and mental integrity or undermines the full enjoyment of the right to sexual and reproductive health, including the conduct of private health‑care facilities, insurance and pharmaceutical companies, and manufacturers of health-related goods and equipment.

保护的义务要求国家制定和执行法律和政策，禁止第三方的行为造成身心伤害或有损充分享有性健康和生殖健康权，包括私人医疗保健设施、保险和制药公司以及健康相关物资和设备制造商的行为。

This includes the prohibition of violence and discriminatory practices, such as the exclusion of particular individuals or groups from the provision of sexual and reproductive health services.

这包括禁止暴力和歧视性做法，例如在提供性健康和生殖健康服务时将某些个人或群体排除在外。

43.

43.

States must prohibit and prevent private actors from imposing practical or procedural barriers to health services, such as physical obstruction of facilities, dissemination of misinformation, informal fees and third-party authorization requirements.

国家必须禁止和防止私人行为者在实践上或程序上对保健服务施加障碍，例如设施的实质障碍、传播错误信息、非正式收费和第三方授权的要求。

Where health‑care providers are allowed to invoke conscientious objection, States must appropriately regulate this practice to ensure that it does not inhibit anyone’s access to sexual and reproductive health care, including by requiring referrals to an accessible provider capable of and willing to provide the services being sought, and that it does not inhibit the performance of services in urgent or emergency situations.

如果允许医疗保健提供者出于良心拒绝提供服务，国家必须适当地规范这种做法，以确保这不阻碍任何人获得性健康和生殖健康保健，包括要求转介给有能力并愿意提供所寻求服务的提供者而且容易达到，并且不会阻碍紧急情况下提供服务。

44.

44.

States are obliged to ensure that adolescents have full access to appropriate information on sexual and reproductive health, including family planning and contraceptives, the dangers of early pregnancy and the prevention and treatment of sexually transmitted diseases, including HIV/AIDS, regardless of their marital status and whether their parents or guardians consent, with respect for their privacy and confidentiality.

国家有义务确保青少年能够充分获得适当的性健康和生殖健康的信息，包括计划生育和避孕药具、早孕的危险以及预防和治疗性传播疾病，包括艾滋病毒/艾滋病，无论青少年的婚姻状况如何，及其父母或监护人是否同意，尊重其隐私并保密。

Obligation to fulfil

实现的义务

45.

45.

The obligation to fulfil requires States to adopt appropriate legislative, administrative, budgetary, judicial, promotional and other measures to ensure the full realization of the right to sexual and reproductive health.

实现的义务要求国家采取适当的立法、行政、预算、司法、宣传和其他措施，以确保充分实现性健康和生殖健康权。

States should aim to ensure universal access without discrimination for all individuals, including those from disadvantaged and marginalized groups, to a full range of quality sexual and reproductive health care, including maternal health care; contraceptive information and services; safe abortion care; and prevention, diagnosis and treatment of infertility, reproductive cancers, sexually transmitted infections and HIV/AIDS, including with generic medicines.

国家的目标应是确保所有个人(包括处于弱势和被边缘化群体的个人)不受歧视地普遍获得全面的优质性健康和生殖健康保健服务，包括产妇保健；避孕信息和服务；安全流产保健；以及预防、诊断和治疗不孕症、生殖系统癌症、性传播感染和艾滋病毒/艾滋病，包括使用非专利药品。

States must guarantee physical and mental health care for survivors of sexual and domestic violence in all situations, including access to post-exposure prevention, emergency contraception and safe abortion services.

国家必须保证在所有情况下对性暴力和家庭暴力幸存者提供身体和精神保健，包括事后预防、紧急避孕和安全流产服务。

46.

46.

The obligation to fulfil also requires States to take measures to eradicate practical barriers to the full realization of the right to sexual and reproductive health, such as disproportionate costs and lack of physical or geographical access to sexual and reproductive health care.

实现的义务还要求国家采取措施，消除充分实现性健康和生殖健康权的实际障碍，诸如费用过高、性和生殖保健方面缺乏有形的无障碍设施，或设施的地理距离太远。

States must ensure that health‑care providers are adequately trained on the provision of quality and respectful sexual and reproductive health services and ensure that such providers are equitably distributed throughout the State.

国家必须确保医疗保健提供者获得关于提供优质和有尊严的性健康和生殖健康服务的充分培训，并确保在整个国家均衡分配这类提供者。

47.

47.

States must develop and enforce evidence-based standards and guidelines for the provision and delivery of sexual and reproductive health services, and such guidance must be routinely updated to incorporate medical advancements.

国家必须为提供和交付性健康和生殖健康服务制定和执行循证标准和准则，这种准则必须定期更新，以包含医疗的进步。

At the same time, States are required to provide age-appropriate, evidence-based, scientifically accurate comprehensive education for all on sexual and reproductive health.

同时，国家必须提供适合年龄、基于证据、科学上准确的性健康和生殖健康全面教育。

48.

48.

States must also take affirmative measures to eradicate social barriers in terms of norms or beliefs that inhibit individuals of different ages and genders, women, girls and adolescents from autonomously exercising their right to sexual and reproductive health.

国家还必须采取积极措施，在妨碍不同年龄和性别的人、妇女、女童和青少年自主行使他们的性健康和生殖健康权的规范或信仰方面消除社会障碍。

Social misconceptions, prejudices and taboos about menstruation, pregnancy, delivery, masturbation, wet dreams, vasectomy and fertility should be modified so that these do not obstruct an individual’s enjoyment of the right to sexual and reproductive health.

应改变对月经、怀孕、分娩、手淫、梦遗、输精管结扎术和生育的社会误解、偏见和禁忌，以使这些不妨碍个人享有性健康和生殖健康权。

C.

C.

Core obligations

核心义务

49.

49.

States parties have a core obligation to ensure, at the very least, minimum essential levels of satisfaction of the right to sexual and reproductive health.

缔约国负有核心义务确保性健康和生殖健康权的满足至少达到最低的必要水平。

In this regard, States parties should be guided by contemporary human rights instruments and jurisprudence, as well as the most current international guidelines and protocols established by United Nations agencies, in particular WHO and the United Nations Population Fund (UNFPA).

在这方面，缔约国应遵循当代人权文书和判例以及联合国机构制定的最新的国际准则和协议，特别是世卫组织和联合国人口基金(人口基金)制定的国际准则和协议。

The core obligations include at least the following:

核心义务至少包括以下方面：

(a)

(a)

To repeal or eliminate laws, policies and practices that criminalize, obstruct or undermine access by individuals or a particular group to sexual and reproductive health facilities, services, goods and information;

废除或消除将个人或特定群体获得性健康和生殖健康医疗设施、服务、物资和信息的行为定为刑事罪、加以阻碍或破坏的法律、政策和做法；

(b)

(b)

To adopt and implement a national strategy and action plan, with adequate budget allocation, on sexual and reproductive health, which is devised, periodically reviewed and monitored through a participatory and transparent process, disaggregated by prohibited ground of discrimination;

通过并执行一项关于性健康和生殖健康的国家战略和行动计划，给予充足的预算拨款，通过参与性和透明的程序予以制定、定期审查和监测，并按被禁止的歧视理由分类；

(c)

(c)

To guarantee universal and equitable access to affordable, acceptable and quality sexual and reproductive health services, goods and facilities, in particular for women and disadvantaged and marginalized groups;

保障普遍和公平地获得负担得起的、可接受的和高质量的性健康和生殖健康服务、物资和设施，特别是对妇女以及处于弱势和被边缘化的群体；

(d)

(d)

To enact and enforce the legal prohibition of harmful practices and gender‑based violence, including female genital mutilation, child and forced marriage and domestic and sexual violence, including marital rape, while ensuring privacy, confidentiality and free, informed and responsible decision-making, without coercion, discrimination or fear of violence, in relation to the sexual and reproductive needs and behaviours of individuals;

颁布和执行法律禁令，禁止有害习俗和基于性别的暴力，包括切割女性生殖器官、童婚和强迫婚姻、家庭暴力和性暴力，包括婚内强奸，同时在个人性健康和生殖健康的需求和行为方面确保隐私、保密以及自由、知情和负责任的决策，不受胁迫、歧视或暴力恐惧；

(e)

(e)

To take measures to prevent unsafe abortions and to provide post-abortion care and counselling for those in need;

采取措施防止不安全流产并为有需求的人提供流产后保健和咨询；

(f)

(f)

To ensure all individuals and groups have access to comprehensive education and information on sexual and reproductive health that are non-discriminatory, non-biased, evidence-based, and that take into account the evolving capacities of children and adolescents;

确保所有个人和群体都能获得关于性健康和生殖健康的全面的教育和信息，而且这种教育和信息是非歧视性、不带偏见、基于证据的并考虑到儿童和青少年不断发展的能力；

(g)

(g)

To provide medicines, equipment and technologies essential to sexual and reproductive health, including based on the WHO Model List of Essential Medicines;

提供性健康和生殖健康方面的基本药品、设备和技术，包括根据世卫组织基本药物标准清单来提供；

(h)

(h)

To ensure access to effective and transparent remedies and redress, including administrative and judicial ones, for violations of the right to sexual and reproductive health.

确保就侵犯性健康和生殖健康权的行为提供有效和透明的补救和赔偿，包括行政和司法补救和赔偿。

D.

D.

International obligations

国际义务

50.

50.

International cooperation and assistance are key elements of article 2 (1) of the Covenant and are crucial for the realization of the right to sexual and reproductive health.

国际合作与援助是《公约》第二条第一款的关键内容，对实现性健康和生殖健康权而言至关重要。

In compliance with article 2 (1), States that are not able to comply with their obligations and that cannot realize the right to sexual and reproductive health due to a lack of resources must seek international cooperation and assistance.

根据第二条第一款，由于缺乏资源而无法履行其义务而且不能实现性健康和生殖健康权的国家必须寻求国际合作和援助。

States that are in a position to do so must respond to such requests in good faith and in accordance with the international commitment of contributing at a minimum 0.7 per cent of their gross national income for international cooperation and assistance.

有能力这样做的缔约国必须依照至少将国民总收入的0.7%用于国际合作和援助的国际承诺并本着诚意来回应此类请求。

51.

51.

States parties should ensure, in compliance with their Covenant obligations, that their bilateral, regional and international agreements dealing with intellectual property or trade and economic exchange do not impede access to medicines, diagnostics or related technologies required for prevention or treatment of HIV/AIDS or other diseases related to sexual and reproductive health.

缔约国应依据其《公约》义务，确保涉及知识产权或经贸往来的双边、区域和国际协议不妨碍获得用于预防或治疗艾滋病毒/艾滋病以及其他与性健康和生殖健康有关的疾病的药品、诊断或相关技术。

States should ensure that international agreements and domestic legislation incorporate to the fullest extent any safeguards and flexibilities therein that may be used to promote and ensure access to medicines and health care for all.

国家应确保国际协定和国内法在最大程度上纳入保障和灵活性，可用于促进和确保所有人获得药品和医疗保健。

States parties should review their international agreements, including on trade and investment, to ensure that they are consistent with the protection of the right to sexual and reproductive health, and should amend them as necessary.

各缔约国应审查其国际协定，包括关于贸易和投资的国际协定，以确保它们与性健康和生殖健康权的保护协调一致，并在必要时进行修订。

52.

52.

Donor States and international actors have an obligation to comply with human rights standards, which are also applicable to sexual and reproductive health.

捐助国和国际行为方有义务遵循人权标准，这些标准也适用于性健康和生殖健康。

To this end, international assistance should not impose restrictions on information or services existing in donor States, draw trained reproductive health‑care workers away from recipient countries or push recipient countries to adopt models of privatization.

为此，国际援助不应对捐助国现有的信息或服务加以限制，从受援国撤回训练有素的生殖健康医疗保健工作者，或推动受援国采取私有化模式。

Also, donor States should not reinforce or condone legal, procedural, practical or social barriers to the full enjoyment of sexual and reproductive health that exist in the recipient countries.

此外，捐助国不应加剧或纵容受援国在充分享有性健康和生殖健康方面已存在的法律、程序、实践或社会方面的障碍。

53.

53.

Intergovernmental organizations, and in particular the United Nations and its specialized agencies, programmes and bodies, have a crucial role to play and contribution to make with regard to the universal realization of the right to sexual and reproductive health.

政府间组织，特别是联合国及其专门机构、方案和机关，在普遍实现性健康和生殖健康权方面可以发挥关键作用并作出贡献。

The World Health Organization, UNFPA, the United Nations Entity for Gender Equality and the Empowerment of Women (UN–Women), the Office of the United Nations High Commissioner for Human Rights and other United Nations entities provide technical guidance and information, as well as capacity‑building and strengthening.

世界卫生组织、人口基金、联合国促进两性平等和增强妇女权能署(妇女署)、联合国人权事务高级专员办事处和联合国其他实体可提供技术指导和信息，以及能力建设和加强。

They should cooperate effectively with States parties, building on their respective expertise in relation to the implementation of the right to sexual and reproductive health at the national level, with due respect to their individual mandates, in collaboration with civil society.

它们应该与缔约国开展有效合作，利用各自在国家一级落实性健康和生殖健康权方面的专门知识，遵循各自的任务授权，与民间社会合作。

V.

五.

Violations

违反行为

54.

54.

Violations of the right to sexual and reproductive health can occur through the direct action of States or other entities that are insufficiently regulated by States.

发生侵犯性健康和生殖健康权的情况，可以是国家直接所为，也可能是国家管理不严的其他实体所为。

Violations through acts of commission include the adoption of legislation, regulations, policies or programmes that create barriers to the realization of the right to sexual and reproductive health in the State party or in third countries, or the formal repeal or suspension of legislation, regulations, policies or programmes that are necessary for the continued enjoyment of the right to sexual and reproductive health.

因作为而造成的侵权，包括通过立法、规章、政策或方案，阻碍在缔约国或第三国实现性健康和生殖健康权，或正式废除或中止执行继续享有性健康和生殖健康权所必须的立法、规章、政策或方案。

55.

55.

Violations through acts of omission include the failure to take appropriate steps towards the full realization of everyone's right to sexual and reproductive health and the failure to enact and enforce relevant laws.

因不作为而造成的侵权，包括未能采取适当措施充分实现每个人的性健康和生殖健康权，以及未能颁布和执行相关法律。

Failure to ensure formal and substantive equality in the enjoyment of the right to sexual and reproductive health constitutes a violation of this right.

未能确保享受性健康和生殖健康权方面的形式平等和实质平等，就构成侵犯这项权利。

The elimination of de jure as well as de facto discrimination is required for the equal enjoyment of the right to sexual and reproductive health.

要实现平等享有性健康和生殖健康权，就需要消除法律上和实际上的歧视。

56.

56.

Violations of the obligation to respect occur when the State, through laws, policies or actions, undermines the right to sexual and reproductive health.

国家通过法律、政策或行动破坏性健康和生殖健康权，即违反了尊重义务。

Such violations include State interference with an individual’s freedom to control his or her own body and ability to make free, informed and responsible decisions in this regard.

这些违反行为包括国家干涉个人控制自己身体的自由和在这方面作出自由、知情和负责任决定的能力。

They also occur when the State removes or suspends laws and policies that are necessary for the enjoyment of the right to sexual and reproductive health. 57.

国家废除或暂停享有性健康和生殖健康权所必须的法律和政策，也是违反行为。

57.

Examples of violations of the obligation to respect include the establishment of legal barriers impeding access by individuals to sexual and reproductive health services, such as the criminalization of women undergoing abortions and the criminalization of consensual sexual activity between adults.

违反尊重义务的例子包括设立阻碍个人获得性健康和生殖健康服务的法律障碍，例如将妇女流产以及成年人之间的自愿性活动定为刑事罪。

Banning or denying access in practice to sexual and reproductive health services and medicines, such as emergency contraception, also violates the obligation to respect.

禁止或拒绝在实践中获得性健康和生殖健康服务和药物，如紧急避孕，也违反了尊重义务。

Laws and policies that prescribe involuntary, coercive or forced medical interventions, including forced sterilization or mandatory HIV/AIDS, virginity or pregnancy testing, also violate the obligation to respect.

规定非自愿、强迫或强制医疗措施的法律和政策，包括强制绝育或强制的艾滋病毒/艾滋病、贞操或怀孕测试，也违反了尊重义务。

58.

58.

Laws and policies that indirectly perpetuate coercive medical practices, including incentive- or quota-based contraceptive policies and hormonal therapy, as well as surgery or sterilization requirements for legal recognition of one’s gender identity, constitute additional violations of the obligation to respect.

间接延续强制性医疗做法的法律和政策，包括基于激励或配额的避孕政策和激素疗法，以及性别认同要得到法律承认需要进行手术或绝育的要求，构成新的违反尊重义务的行为。

Further violations include state practices and policies that censor or withhold information, or present inaccurate, misrepresentative or discriminatory information, related to sexual and reproductive health.

更多的违反行为包括通过国家做法和政策审查或隐瞒有关性健康和生殖健康的信息，或提供不准确、虚假或歧视性信息。

59.

59.

Violations of the obligation to protect occur when a State fails to take effective steps to prevent third parties from undermining the enjoyment of the right to sexual and reproductive health.

如果一个国家未能采取有效步骤，防止第三方破坏享有性健康和生殖健康权，即违反了保护义务。

This includes the failure to prohibit and take measures to prevent all forms of violence and coercion committed by private individuals and entities, including domestic violence, rape (including marital rape), sexual assault, abuse and harassment, including during conflict, post-conflict and transition situations; violence targeting lesbian, gay, bisexual, transgender and intersex persons or women seeking abortion or post-abortion care; harmful practices such as female genital mutilation, child and forced marriage, forced sterilization, forced abortion and forced pregnancy; and medically unnecessary, irreversible and involuntary surgery and treatment performed on intersex infants or children.

这 包括未能禁止并采取措施防止个人和实体在冲突期间、冲突后和过渡情况下实施的一切形式暴力和胁迫，包括家庭暴力、强奸(包括婚内强奸)、性侵犯、虐待和骚 扰；针对男女同性恋、双性恋、变性人和双性人或寻求流产或流产后保健的妇女的暴力行为；有害习俗，如切割女性生殖器官、童婚和强迫婚姻、强迫绝育、强迫流 产和强迫怀孕；以及对双性婴儿或儿童进行的医学上不必要、不可逆转和非自愿的手术和治疗。

60.

60.

States must effectively monitor and regulate specific sectors, such as private health‑care providers, health insurance companies, educational and child-care institutions, institutional care facilities, refugee camps, prisons and other detention centres, to ensure that they do not undermine or violate enjoyment by individuals of the right to sexual and reproductive health.

国家必须有效地监督和规范特定部门，如私人医疗保健提供者、医疗保险公司、教育和儿童保育机构、机构照料设施、难民营、监狱和其他拘留中心，以确保它们不会破坏或侵犯个人享有性健康和生殖健康权。

States have an obligation to ensure that private health insurance companies do not refuse to cover sexual and reproductive health services.

国家有义务确保私营医疗保险公司不拒绝将性健康和生殖健康服务纳入赔保范围。

Furthermore, States also have an extraterritorial obligation to ensure that transnational corporations, such as pharmaceutical companies operating globally, do not violate the right to sexual and reproductive health of people in other countries, for example through non-consensual testing of contraceptives or medical experiments.

此外，国家还有域外义务 确保跨国公司(如在全球运营的制药公司)不侵犯其他国家人民的性健康和生殖健康权，例如在未经同意的情况下进行避孕药具测试或医学试验。

61.

61.

Violations of the obligation to fulfil occur when States do not take all necessary steps to facilitate, promote and provide for the right to sexual and reproductive health within maximum available resources.

国家不采取一切必要步骤，在最大可用资源范围内便利和促进性健康和生殖健康权并提供资助，即违反实现义务。

Such violations arise when States fail to adopt and implement a holistic and inclusive national health policy that adequately and comprehensively includes sexual and reproductive health or when a policy fails to appropriately address the needs of disadvantaged and marginalized groups.

如果国家未能通过并执行一项全面和包容性的国家卫生政策，充分并全面地包含性健康和生殖健康，或一项政策未能妥善解决处于弱势和被边缘化群体的需求，也属于违反实现义务的行为。

62.

62.

Violations of the obligation to fulfil also occur when States fail to progressively ensure that sexual and reproductive health facilities, goods and services are available, accessible, acceptable and of good quality.

如果国家未能逐步确保性健康和生殖健康医疗设施、物资和服务可用、可获得、可接受且具有高质量，即违反了实现义务。

Examples of such violations include the failure to guarantee access to the full range of contraceptive options so that all individuals are able to utilize an appropriate method that suits their particular situation and needs.

此类违反行为的例子包括未能保障人们获得全面的避孕选择，使所有人都能使用适合自己具体情况和需求的适当方法。

63.

63.

In addition, violations of the obligation to fulfil occur when States fail to take affirmative measures to eradicate legal, procedural, practical and social barriers to the enjoyment of the right to sexual and reproductive health and to ensure that health‑care providers treat all individuals seeking sexual and reproductive health care in a respectful and non-discriminatory manner.

此外，如果国家未能采取积极措施，消除享有性健康和生殖健康权的法律、程序、实际和社会障碍，以及确保医疗保健提供者以尊重和非歧视的方式对待所有寻求性健康和生殖健康保健服务的个人，则构成违反实现义务的行为。

Violation of the obligation to fulfil also occur when States fail to take measures to ensure that up-to-date, accurate information on sexual and reproductive health is publicly available and accessible to all individuals, in appropriate languages and formats, and to ensure that all educational institutions incorporate unbiased, scientifically accurate, evidence-based, age-appropriate and comprehensive sexuality education into their required curricula.

如果国家未能采取措施，确保最新、准确的性健康和生殖健康的信息以适当语文和形式公开，使所有人可得，并确保所有教育机构将公正、科学上准确、基于证据、适合年龄和全面的性教育纳入其课程，也构成违反实现义务的行为。

VI.

六.

Remedies

补救措施

64.

64.

States must ensure that all individuals have access to justice and to meaningful and effective remedy in instances in which the right to sexual and reproductive health is violated.

国家必须确保所有人都能诉诸司法，并在性健康和生殖健康权受到侵犯的情况下获得有意义和有效的补救。

Remedies include, but are not limited to, adequate, effective and prompt reparation in the form of restitution, compensation, rehabilitation, satisfaction and guarantees of non-repetition, as appropriate.

补救措施包括但不限于充分、有效和迅速的赔偿、恢复原状、补偿、康复、抵偿和保证不再发生，具体视情况而定。

The effective exercise of the right to remedy requires funding access to justice and information about the existence of these remedies.

有效行使获得补救的权利要求资助诉诸司法的机会，并提供资料说明是否存在这些补救办法。

It is also important that the right to sexual and reproductive health be enshrined in laws and policies and be fully justiciable at the national level, and that judges, prosecutors and lawyers be made aware of that such a right can be enforced.

同样重要的是，性健康和生殖健康权在法律和政策中得以体现，并可在国家一级予以充分审理，并确保法官、检察官和律师了解这一权利可执行。

When third parties contravene the right to sexual and reproductive health, States must ensure that such violations are investigated and prosecuted, and that the perpetrators are held accountable, while the victims of such violations are provided with remedies.

如果第三方侵犯性健康和生殖健康权，国家必须确保对这种侵权行为进行调查和起诉，追究犯罪者的责任，并对侵权行为的受害者提供补救。

2

2

See Committee on Economic, Social and Cultural Rights general comment No. 14 (2000) on the right to the highest attainable standard of health, paras. 2, 8, 11, 16, 21, 23, 34 and 36.

见经济、社会及文化权利委员会关于享有能达到的最高健康标准权利的第14号一般性意见(2000年)第2段、第8段、第11段、第16段、第21段、第23段、第34段和第36段。

3

3 See Convention on the Elimination of All Forms of Discrimination against Women, art. 12; Convention on the Rights of the Child, arts. 17, 23-25 and 27; and Convention on the Rights of Persons with Disabilities, arts. 23 and 25.

见《消除对妇女一切形式歧视公约》第十二条；《儿童权利公约》第17条、第23-25条和第27条；以及《残疾人权利公约》第二十三条和第二十五条。

See also Committee on the Elimination of Discrimination against Women general recommendation No. 24 (1999) on women and health, paras 11, 14, 18, 23, 26, 29, 31 (b); and Committee on the Rights of the Child general comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health.

另见消除对妇女歧视委员会关于妇女与健康的第24号一般性建议(1999年)第11段、第14段、第18段、第23段、第26段、第29段和第31段(b)项；儿童权利委员会关于儿童享有可达到的最高标准健康的权利问题的第15号一般性意见(2013年)。

4

4

Report of the International Conference on Population and Development, Cairo 5-13 September 1994 (United Nations publication, Sales No. E.95.XIII.18), chap. I, resolution 1, annex.

国际人口与发展会议报告，开罗，1994年9月5日至13日(联合国出版物，出售编号：E.95.XIII.18)，第一章，决议1,附件。

The Programme of Action is based on 15 principles.

《行动纲领》基于15项原则。

Principle 1 states that “All human beings are born free and equal in dignity and rights”.

原则1规定“人人生而自由，在尊严和权利上一律平等”。

5

5

United Nations, Transforming our World: the 2030 Agenda for Sustainable Development, adopted by the General Assembly in September 2015.

联合国，《改变我们的世界：2030年可持续发展议程》，大会于2015年9月通过。

Goal 3 of the 2030 Agenda is “Ensure healthy lives and promote well-being for all at all ages”, and Goal 5 is “Achieve gender equality and empower all women and girls”.

《2030年议程》目标3是“确保健康的生活方式，促进各年龄段人群的福祉”，目标5是“实现性别平等，为所有妇女、女童赋权”。

6

6

For the purpose of the present general comment, references to lesbian, gay, bisexual, transgender and intersex persons include other persons who face violations of their rights on the basis of their actual or perceived sexual orientation, gender identity and sex characteristics, including those who may identify with other terms.

出于本一般性意见的目的，提及的男女同性恋、双性恋、变性人和双性人包括因实际或被认为的性取向、性别认同和性特征而面临侵权的其他人，其中包括可能认同其他指称的人。

For intersex persons, see fact sheet available from https://unfe.org/system/unfe-65-Intersex_Factsheet_ENGLISH.pdf.

就双性人而言，见概况介绍，可查阅https://unfe.org/system/unfe-65-Intersex_Factsheet_ENGLISH.pdf。

7

7

See WHO, Sexual Health, Human Rights and the Law (2015), working definition on sexual health, sect. 1.1.

见世卫组织，性健康、人权和法律(2015年)，关于性健康的可行定义，第1.1节。

8

8

See Programme of Action of the International Conference on Population and Development, chap. 7.

见《国际人口与发展会议行动纲领》，第七章。

9

9

WHO Commission on Social Determinants of Health, Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health – Final Report of the Commission on Social Determinants of Health (2008).

世卫组织健康问题社会决定因素委员会，《用一代人时间弥合差距：通过健康问题社会决定因素方面的行动实现健康公平》――健康问题社会决定因素委员会的最终报告(2008年)。

10

10

See Committee on Economic, Social and Cultural Rights general comment No. 20 (2009) on non-discrimination in economic, social and cultural rights.

见经济、社会及文化权利委员会关于经济、社会及文化权利方面不歧视的第20号一般性意见(2009年)。

11

11

A/65/162.

A/65/162。

12

12

See Convention on the Elimination of All Forms of Discrimination against Women, art. 11 (1) (f) and 11 (2).

见《消除对妇女一切形式歧视公约》第十一条第1款(f)项和第十一条第2款。

13

13

See Human Rights Committee Communication No. 1153/2003, Karen Noelia Llantoy Huamán v. Peru, views adopted on 24 October 2005; Committee on the Elimination of Discrimination against Women communication No. 17/2008, Alyne da Silva Pimentel v. Brazil, views adopted on 25 July 2011; CAT/C/SLV/CO/2, para. 23; and CAT/C/NIC/CO/1, para. 16.

见人权事务委员会第1153/2003号来 文，Karen Noelia Llantoy Huamán诉秘鲁案，2005年10月通过的意见；消除对妇女歧视委员会第17/2008号来文，Alyne da Silva Pimentel诉匈牙利案，2011年7月25日通过的意见；CAT/C/SLV/CO/2,第23段；以及CAT/C/NIC/CO/1, 第16段。

14

14

In paragraph 12 of general comment No. 14, the Committee defined normative elements of state obligations to guarantee the right to health.

在第14号一般性意见的第12段中，委员会界定了国家保障健康权义务的规范性内容。

These standards also apply to the underlying determinants, or the preconditions of health, including access to sexuality education and sexual and reproductive health information.

这些标准也适用于基本决定因素，即健康的先决条件，包括获得性教育以及性健康和生殖健康的信息。

See also Committee on the Rights of the Child general comment No. 15, which applied those norms to adolescents.

另见儿童权利委员会15号一般性意见，该意见规定这些规范适用于青少年。

States parties should provide health services that are sensitive to the particular needs and human rights of all adolescents.

缔约国提供的医疗保健服务应照顾到所有青少年的特殊需要和人权。

15

15

See Committee on Economic, Social and Cultural Rights general comment No. 14, para. 12 (a); and A/HRC/21/22 and Corr.1 and 2, para. 20.

见经济、社会及文化权利委员会第14号一般性意见，第12段(a)项；A/HRC/21/22及Corr.1和2,第20段。

16

16

Essential medicines are defined by WHO as “those that satisfy the priority health care needs of the population” and that “are intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and community can afford”.

世卫组织将基本药物定义为“那些满足大部分群众的优先的卫生保健需要”，“在任何时候均有足够的数量和适宜的剂型，其价格是个人和社区能够承受得起的药品”。

See Committee on Economic, Social and Cultural Rights general comment No. 14; and WHO, Model List of Essential Medicines, 19th ed. (2015).

见经济、社会及文化权利委员会第14号一般性意见；和世卫组织基本药物标准清单，第19版(2015年)。

17

17

International Planned Parenthood Federation – European Network v. Italy, complaint No. 87/2012 (2014), resolution adopted by the Committee of Ministers of the Council of Europe on 30 April 2014.

国际计划生育联合会――欧洲网络诉意大利案，申诉号87/2012(2014年)，欧洲理事会的部长委员会于2014年4月30日通过。

18

18

Reference in the present document to health facilities, goods and services includes the underlying determinants.

本文件中提到的医疗设施、物资和服务包括基本决定因素。

19

19

See, generally, Committee on Economic, Social and Cultural Rights general comment No. 14, para. 19.

见经济、社会及文化权利委员会第14号一般性建议，第19段。

20

20

Council of Europe Commissioner for Human Rights, “Human rights and intersex people”, issue paper (2015).

欧洲委员会人权专员，“人权和双性人”，议题文件(2015年)。

21

21

WHO, Safe Abortion: Technical and Policy Guidance for Health Systems, 2nd ed. (2012).

世卫组织，安全流产：健康体系的技术和政策指南，第二版(2012年)。

22

22

See Convention on the Rights of Persons with Disabilities, art. 25.

见《残疾人权利公约》第二十五条。

23

23

Committee on Economic, Social and Cultural Rights general comment No. 16 (2005) on the equal right of men and women to the enjoyment of all economic, social and cultural rights.

见经济、社会及文化权利委员会关于男女在享受一切经济、社会及文化权利方面的平等权利的第16号一般性意见(2005年)。

24

24

See Convention on the Elimination of All Forms of Discrimination against Women, art. 5.

见《消除对妇女一切形式歧视公约》第五条。

25

25

Article 4 (1) of the Convention on the Elimination of All Forms of Discrimination against Women is concerned with “temporary special measures aimed at accelerating de facto equality between men and women”, while article 4 (2) focuses on “special measures… aimed at protecting maternity”.

《消除对妇女一切形式歧视公约》第四条第1款提到“为加速实现男女事实上的平等而采取的暂行特别措施”，而第四条第2款重点关注“为保护母性而采取的特别措施”。

See also Committee on Economic, Social and Cultural Rights general comment No. 16, para. 15.

见经济、社会及文化权利委员会第16号一般性意见，第15段。

26

26

A/69/62; see also WHO, Safe Abortion: Technical and Policy Guidance for Health Systems, 2nd ed. (2012).

A/69/62；另见世卫组织，安全流产：健康体系的技术和政策指南，第二版(2012年)。

27

27

Including groups that are discriminated against on the grounds of race and colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status, including ethnicity, age, nationality, marital and family status, disability, sexual orientation and gender identity, intersex status, health status, place of residence, economic and social situation or other status, and those facing multiple forms of discrimination.

包 括基于种族和肤色、性别、语言、宗教、政治或其他见解、民族或社会出身、财产、出生或其他身份，包括族裔、年龄、国籍、婚姻和家庭状况、残疾、性取向和性 别认同、双性人身份、健康状况、居住地点、经济和社会状况或其他状况而受歧视的群体，以及那些面临多种形式歧视的群体。

See Committee on Economic, Social and Cultural Rights general comment No. 20.

见经济、社会及文化权利委员会第20号一般性意见。

28

28

See Vienna Declaration and Programme of Action of 1993 (A/CONF.157/23), para. 38; and Beijing Declaration and Platform for Action of 1995 (A/CONF.177/20), para. 135.

见1993年《维也纳宣言和行动纲领》(A/CONF.157/23)，第38段；见1995年《北京宣言和行动纲领》(A/CONF.177/20)，第135段。

29

29

See Committee on Economic, Social and Cultural Rights general comment No. 20, para. 39.

见经济、社会及文化权利委员会第20号一般性意见，第39段。

30

30

See Committee on Economic, Social and Cultural Rights general comment No. 16, paras. 6-9.

见经济、社会及文化权利委员会第16号一般性意见，第6-9段。

31

31

See Committee on Economic, Social and Cultural Rights general comment No. 14, para. 32.

见经济、社会及文化权利委员会第14号一般性意见，第32段。

32

32

See e.g. E/C.12/1/Add.105 and Corr.1, para. 53; Committee on the Elimination of Discrimination against Women general recommendation No. 24, paras. 24 and 31 (c);

例如，见E/C.12/1/Add.105和Corr.1,第53段；消除对妇女歧视委员会，第24号一般性意见，第24段和第31段(c)项。

A/66/254; and A/HRC/14/20.

A/66/254；以及A/HRC/14/20。

33

33

Committee on Economic, Social and Cultural Rights general comment No. 14; and Committee on the Rights of the Child general comment No. 4 (2003) on adolescent health and development in the context of the Convention on the Rights of the Child.

经济、社会及文化权利委员会，第14号一般性意见；以及儿童权利委员会关于在《儿童权利公约》框架内青少年的健康和发展的第4号一般性意见(2003年)。

34

34

Amnesty International, Left Without a Choice: Barriers to Reproductive Health in Indonesia (2010).

大赦国际，没有选择：印度尼西亚生殖健康的障碍(2010年)。

35

35

See E/C.12/POL/CO/5, para. 28; A/66/254, paras. 24 and 65 (m); and Committee on the Elimination of Discrimination against Women general recommendation No. 24, para. 11.

见E/C.12/POL/CO/5, 第28段；A/66/254,第24段和第65段(m)项；消除对妇女歧视委员会第24号一般性建议，第11段。

36

36

See Committee on the Rights of the Child general comment No. 4, paras. 28 and 33.

见儿童权利委员会第4号一般性意见，第28段和第33段。

37

37

See Committee on Economic, Social and Cultural Rights general comment No. 14, paras. 33 and 36-37.

见经济、社会及文化权利委员会第14号一般性意见，第33段以及第36-37段。

38

38

See Committee on Economic, Social and Cultural Rights general comment No. 14; Committee on the Elimination of Discrimination against Women general recommendation No. 30 on women in conflict prevention, conflict and post-conflict situations, para. 52 (c); and Committee on the Rights of the Child general comment No. 15, para. 60.

见经济、社会及文化权利委员会第14号一般性意见；消除对妇女歧视委员会关于妇女在预防冲突、冲突中及冲突后局势中的作用的第30号一般性建议，第52段(c)项；以及儿童权利委员会第15号一般性评论，第60段。

39

39

See, for example, www.icpdbeyond2014.org; Committee on the Elimination of Discrimination against Women communications No. 17/2008, and No. 22/2009, L.C. v. Peru, views adopted on 17 October 2011; and general comments and recommendations of Committee on the Rights of the Child and Committee on the Elimination of Discrimination against Women.

例如，见 www.icpdbeyond2014.org；消除对妇女歧视委员会第17/2008号来文，以及第22/2009号来文，L.C.诉秘鲁案，2011年10月17日通过的意见；以及儿童权利委员会和消除对妇女歧视委员会的一般性意见和建议。

40

40

See e.g. Inter-agency Field Manual on Reproductive Health in Humanitarian Settings (Inter‑agency Working Group on Reproductive Health in Crises, 2010), available from www.who.int/reproductivehealth/publications/emergencies/ field_manual_rh_humanitarian_settings.pdf; and publications by UNFPA on sexual and reproductive health, available from www.unfpa.org/sexual-reproductive-health.

例如，见人道危机中 生殖健康机构间实地手册(危机中生殖健康机构间工作组，2010年)，可查阅www.who.int/reproductivehealth /publications/emergencies/ field_manual_rh_humanitarian_ settings.pdf；以及人口基金关于性健康和生殖健康的出版物，可查阅www.unfpa.org/sexual-reproductive- health。

41

41

See WHO Model List of Essential Medicines, sect. 18.3.

见世卫组织基本药物标准清单，第18.3条。

42

42

See Committee on Economic, Social and Cultural Rights general comment No. 14, paras. 63‑65.

见经济、社会及文化权利委员会第14号一般性意见，第63-65段。

43

43

See Committee on Economic, Social and Cultural Rights general comment No. 16, para. 41.

见经济、社会及文化权利委员会第16号一般性意见，第41段。

44

44

Maastricht Principles on Extraterritorial Obligations of States in the Area of Economic, Social and Cultural Rights.

《关于国家在经济、社会和文化权利领域的域外义务的马斯特里赫特原则》。