A/HRC/37/57 of such care, financial constraints and limited accessibility, notably regarding transportation due to the uneven spatial distribution of services. 9 18. In addition to the socioeconomic and environmental factors, a range of other exogenous determinants greatly, and often negatively, affect the enjoyment of the right to health by persons with albinism. Those factors include myths, discrimination and stigmatization, which are often conveyed and reinforced through popular culture, such as folklore, media and film, and exacerbated by a widespread lack of awareness about albinism, including among health professionals. Any consideration of such exogenous determinants requires “a reorientation in dealing with albinism — away from just medical intervention to treating it as a social construct requiring a holistic approach”.10 19. In sub-Saharan Africa, it has been widely documented that myths and misbeliefs surrounding persons with albinism have led to witchcraft-related harmful practices, involving the use of their body parts obtained through brutal attacks and mutilations. 11 In that region, the psychological impact of stigmatization and fear of being attacked greatly affect the health of persons with albinism. For instance, in the United Republic of Tanzania, persons with albinism — victims or not — often exhibit a high level of anxiety, including hypervigilance scanning, which is often a response to a ubiquitous fear in all environments. 20. Moreover, it is reported that persons with albinism — particularly when there is a strong visible contrast between their appearance and that of the general population — are rejected, shunned and excluded from their community, owing to the myths surrounding the condition and related stigmatization. 21. Climate is also a significant risk factor. Regions of high sun exposure represent a particular threat to persons with albinism, such as in the Sahel, equatorial countries, the South Pacific and South America. D. International normative framework 22. Article 12 of the International Covenant on Economic, Social and Cultural Rights provides the most comprehensive normative framework on the right to the highest attainable standard of health. It is buttressed by specific provisions in other international 12 and regional13 human rights instruments. The right to health 23. Pursuant to that article, States parties should take all appropriate measures to ensure access for persons with albinism to gender-sensitive health services, including healthrelated rehabilitation. In particular, States parties shall provide tailored health services for the condition of albinism, and ensure that such health services are made available as close 9 10 11 12 13 6 N.N. Udeh and others, “Oculocutaneous albinism: identifying and overcoming barriers to vision care in a Nigerian population”, Journal of Community Health, vol. 39, No. 3 (2014), pp. 508–513. R.J. Gaigher, P.M. Lund and E. Makuya, “A sociological study of children with albinism at a special school in the Limpopo province”, Curationis (2002). A/HRC/34/59. The right to health is also recognized in the following international legal instruments: International Convention on the Elimination of All Forms of Racial Discrimination, art. 5 (e) (iv); Convention on the Elimination of All Forms of Discrimination against Women, arts. 11 (1) (f), 12 and 14 (2) (b); Convention on the Rights of the Child, art. 24; International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families, arts. 28, 43 (e) and 45 (c); and Convention on the Rights of Persons with Disabilities, art. 25. The right to health is also recognized in several regional instruments, such as the African Charter on Human and Peoples’ Rights, the Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights, known as the Protocol of San Salvador (1988) and the European Social Charter (1961, revised in 1996). The American Convention on Human Rights (1969) and the Convention for the Protection of Human Rights and Fundamental Freedoms (1950) contain provisions related to health, such as the right to life, the prohibition on torture and other cruel, inhuman or degrading treatment or punishment, and the right to family and private life.