A/HRC/41/18 a result of the power outages in March 2019. 14 During the High Commissioner’s visit, health professionals and parents of sick children mentioned the effects of the economic sanctions on the health sector, in particular not having the possibility of receiving urgent medical treatment, including transplants, inside the country. 20. Violations of the right to health are the result of the Government’s failure to fulfil its core obligations, which are non-derogable even for economic reasons. Violations of core obligations were linked to the widespread lack of availability of, and access to, essential medicines and treatment, the deterioration of conditions in hospitals, clinics and maternity clinics, insufficient provision of underlying determinants of health, including water and adequate nutrition, deterioration in immunization and preventative health programmes, and restrictions on access to sexual and reproductive health. Moreover, the failure of the Government to publish comprehensive data on public health, which are essential for the development and implementation of an adequate response to the health crisis, is a violation of the right to health. C. Social programmes and policies 21. For two decades, the Government has promoted social policies through economic and social programmes aimed at fighting poverty and social exclusion and decreasing the gender equality gap (Misiones Bolivarianas). Today, Venezuelans are increasingly relying on social programmes to access minimum levels of income and food. 22. On 13 May 2016, the Government declared a “state of exception and economic emergency”,15 and created the Local Committees for Supply and Food Distribution as part of the local community councils structure. 16 The Local Committees, along with military and security forces, were mandated to distribute food assistance, the CLAP boxes which, according to the Government, reaches 6 million households. OHCHR received accounts of people who, despite not having adequate access to food, were not included in the distribution lists for the boxes because they were not government supporters. 23. In addition, at the end of 2016, the President announced the creation of a card system (the carnet de la patria) through which all social programmes would be delivered, including a new system of direct financial transfers to families. The list of beneficiaries of those programmes is managed by the local structures of the governing party, as opposed to government institutions. Interviewees reported that members of these local structures monitor the political activities of beneficiaries. 24. Most of the beneficiaries of social programmes related to health, food and housing are women, who carry the burden of household tasks and child-rearing. They also constitute 72 per cent of the membership of local community councils. 17 However, discrimination based on political grounds and social control through the Government’s social programmes has had a direct impact on their ability to exercise their rights. Between January 2018 and May 2019, women have led many local and peaceful protests demanding access to basic goods and services and they have also participated in anti-government protests. OHCHR received accounts of women, including local leaders, who have been targeted because of their activism, threatened by community leaders and pro-government civilian armed groups (known as armed colectivos) and excluded from social programmes. Women reported not exercising their rights, including their rights to peaceful assembly, freedom of opinion and expression and political participation, for fear of reprisals. 14 15 16 17 Interview with source on 10 May 2019; CONVITE X La Salud, “Monitoring of access to health in Venezuela”, newsletter of 20 March 2019. Presidential decree No. 2323 of 13 May 2016. The community councils were created in 2006 to manage public policies and social projects at a local level. Information provided by the Government. 5