A/HRC/29/33 23. The work of previous mandate holders has underlined the need to respect, protect and fulfil the enjoyment of right to health and other related rights of those groups who appear to be in vulnerable situations and face discrimination in general, including in accessing health-care services. 24. Previous work on the issue of sexual and reproductive health and rights, including on maternal mortality, has shown that human rights when applied to public health policies can save lives by ensuring that health policies are equitable, inclusive, non-discriminatory, participatory and evidence-based (A/61/338, para. 29). Most of pregnancy-related deaths and many of the causes of under-5 mortality are avoidable. Those most at risk are groups living in poverty, groups in rural areas and women from ethnic and religious minorities or indigenous communities. Women and children must be placed at the centre of an integrated approach to sexual and reproductive health and their rights must be fully recognized. 25. Moreover, the work of the mandate has focused on the serious detrimental impact that the criminalization of identities, behaviours and health status can have on the full enjoyment of the right to health. Criminalization and restrictive laws are ineffective as public health interventions and fuel underreporting of health indicators. For instance, the work done has shown that legal restrictions on access to abortion services, comprehensive sexual and reproductive education and information, and contraception and family planning methods can have a serious detrimental impact on the enjoyment of the right to health. Evidence shows that this includes a negative impact not only on access to goods, services and information, but also on the enjoyment of fundamental freedoms and entitlements, and on the dignity and autonomy of individuals, in particular women (see A/66/254). 26. Previous mandate holders have also looked into the negative impact of the criminalization of consensual same-sex conduct, of sexual orientation and gender identity, of sex work and of HIV transmission (see A/HRC/14/20). Such work has shown that punitive policies and criminalization are not effective and act as a barrier to access health services, fuel social stigma and exclusion and lead to poor health outcomes. 27. On the issue of drug policy, the work of the Special Rapporteur’s predecessors has shown that the current international system’s punitive regime, which focuses on creating a drug-free world, has failed mostly owing to ignorance of the realities surrounding drug use and dependence (see A/65/255). There is a need for a shift in the current drug control regime away from substance-oriented policies and an increased focus on human rights. Evidence has shown that the criminalization of certain behaviours leads to a reluctance to seek help, including health-related services, and this should be a concern to the authorities. Pursuing overly punitive approaches has resulted in more health-related harms than those the authorities seek to prevent. 28. The important issue of access to medicines has also been part of the work of the mandate. Medical care in the event of sickness and the prevention, treatment and control of diseases depend to a great extent on timely access to quality medicines. Despite progress made, an estimated 2 billion people still lack access to essential medicines. There remains an intrinsic link between poverty and the realization of the right to health, where developing nations have the greatest need and the least access to medicines. Previous mandate holders, including Anand Grover, have given details of the different dimensions of the issues, such as: the role and responsibilities of pharmaceutical companies; the impact of intellectual property laws and free-trade agreements; and the implications and elements of a right-tohealth approach to access to medicines (see A/63/263, A/HRC/17/43 and A/HRC/23/42). 29. During the past 12 years, the work of the mandate has also paid special attention to two other key elements of the analytical right-to-health framework: monitoring and accountability. Without monitoring and accountability, all human rights norms and obligations are likely to become empty promises. Accountability in respect of the right to 6