Text of the recommendation

52. The Committee recommends that the State party address the incidence of drug use by Children and/or adolescents by, inter alia, providing Children and/or adolescents with accurate and objective information and life skills education on preventing substance abuse, including tobacco and alcohol, and develop accessible and youth-friendly drug dependence treatment and harm reduction services.

Text of the recommendation

50. The Committee refers to its general recommendation No. 34 (2016) on the rights of rural women and recommends that the State party: (...) (b) Raise awareness of the low value ascribed to the work of rural women and how that is reflected in their low status in society, foster the equal sharing of family and household responsibilities between rural women and men and promote ending the prioritization of men in terms of access to food.

Text of the recommendation

34. The Committee recommends that the State party: (...) (f) Ensure adequate funding, logistics and provision of food to schools under the school feeding programme and ensure the sustainability of the programme.

Text of the recommendation

38. The Committee calls on the State party to take the necessary measures to increase and strengthen the participation of women in designing and implementing local development plans, and to pay special attention to the needs of rural women, in particular women heads of household, by ensuring that they participate in decision-making processes and have improved access to health, education, clean water and sanitation services, fertile land and income-generation projects. The Committee also urges the State party to eliminate all forms of discrimination with respect to ownership, co-sharing and inheritance of land. It further urges the introduction of measures to address negative customs and traditional practices, especially in rural areas, which affect full enjoyment of the right to property by women.

Text of the recommendation

53. The Committee welcomes the adoption of the Roadmap for Nutrition in South Africa 2013-2017, as well as the efforts made to facilitate breastfeeding. Nevertheless, the Committee is concerned at: (a) Child malnutrition, including undernutrition, micronutrient deficiencies and overnutrition, as key contributing factors for child mortality and child morbidity; (b) Child food insecurity caused by, among other things, poverty, food price increases, demographic changes, energy costs and climate change; (c) The persistently low rate of exclusive breastfeeding of infants aged up to 6 months; (d) The inadequate nutritiousness of food provided in the school meal programme; (e) The increase in the prevalence of obesity among children and the aggressive marketing of unhealthy food targeting children.

54. Taking note of target 2.2 of the Sustainable Development Goals on ending all forms of malnutrition, the Committee recommends that the State party: (a) Develop and implement a framework law on the right to food, as envisaged in the National Policy on Food and Nutrition Security for the Republic of South Africa, of 2014, paying due attention to the eradication of child food insecurity and malnutrition; (b) Take all measures necessary to promote exclusive breastfeeding for at least six months, with appropriate guidance and support for breastfeeding by HIV-infected mothers, and to regulate the promotion of breast milk substitutes; (c) Strengthen the monitoring of the National School Nutrition Programme, including of the frequency, quality and nutritional value of the food supplied through the programme; (d) Regulate the marketing of unhealthy foods to children in order to address the rise in child obesity, and introduce strategies that enable poor households to access healthy food; (e) Seek technical assistance from UNICEF and the Food and Agriculture Organization of the United Nations in this regard.

Text of the recommendation

56. The Committee is concerned at the high incidence of food insecurity and malnutrition in the State party, particularly among children. Given the fact that, in the State party, 12 per cent of children lived in hunger in 2017 and 27 per cent of children suffered from stunting in 2016, the Committee is particularly concerned that the child support grant (at 400 rand per month) has been set far below the food poverty line and that an estimated 18 per cent of eligible children do not benefit from the grant, owing to a lack of documentation. It is further concerned at the lack of a framework law to ensurethe right to food (arts. 9 and 11).

57. The Committee recommends that the State party: (a) Increase the child support grant at least up to the level of the food poverty line; (b) Ensure that all eligible children benefit from the grant; (c) Expedite the adoption of the Social Assistance Amendment Bill of 2018 to increase the level of child support grants for orphaned and abandoned children living with relatives, for which it has already earmarked funds; (d) Adopt framework legislation protecting the right to adequate food and nutrition, and develop a national food and nutrition security strategy, taking into account the Voluntary Guidelines to Support the Progressive Realization of the Right to Adequate Food in the Context of National Food Security of 2004 and the Committee ’ s general comment No. 12 (1999) on the right to adequate food.

Text of the recommendation

28. The Committee urges the State party to adopt emergency measures to combat the persistent problem of malnutrition in prisons, including by increasing the resources allocated to food for the prisoners and providing them with access to health care. It also recommends that the State party provide information on the results achieved by the programmes carried out to improve the food in prisons.

Text of the recommendation

22. The Committee recommends that the State party establish and implement regulations to ensure that the business sector complies with international and domestic standards on corporate social responsibility, in line with the United Nations Business and Human Rights Framework, which outlines the duty of States to protect against human rights abuses by businesses; corporate responsibility to respect human rights; and the need for more effective access to remedies when violations occur. In doing so, the Committee encourages the State party to focus on the protection of the rights of the child and to investigate and provide remedies in reported cases of abuse by corporations and their executives. The Committee encourages the State party to consider the Human Rights Council r esolution 8/7 welcoming the report identifying the ¨Protect, Respect and Remedy¨ framework and r esolution 14/7 requesting the new Working Group to follow-up on this matter , both of which note that the rights of the child be included when exploring the relationship between business and human rights.

Text of the recommendation

4. The Committee also welcomes the ratification of or accession to: (i)World Health Organization Framework Convention on Tobacco Control, in 2004.

Text of the recommendation

50. With reference to the Committee’s general comment No. 4 (2003) on adolescents health and development, the Committee recommends that the State party:(e) Implement education programmes and campaigns to promote healthy lifestyles and to prevent drug and substance abuse by children, monitor the use of drugs and other substances at schools with the participation of children, and develop accessible and youth-friendly drug and substance dependence treatment and harm reduction services as well as life skills education.

Text of the recommendation

20. With reference to the Committee’s general comment No. 16 (2013) on State obligations regarding the impact of the business sector on children’s rights, the Committee recommends that the State party: (a) Establish a clear regulatory framework for business enterprises operating in the State party to ensure that their activities do not negatively affect child rights or breach environmental, health or labor standards, especially those relating to children; (b) Monitor the compliance of business enterprises with such regulations, as well as with international and national environmental, health and labor standards, and sanction appropriately and provide remedies when violations occur; (c) Be guided by the United Nations Guiding Principles on Business and Human Rights (see A/HRC/17/31, annex).

Text of the recommendation

50. The Committee recommends that the State party: (b) Allocate more financial resources to child health, nutrition and access to safe drinking water and sanitation facilities.

Text of the recommendation

38. In line with general recommendation No. 34 (2016) on the rights of rural women, the Committee recommends that the State party, in view of the importance of the agricultural sector for its economic development and food and nutrition security: (a) Ensure implementation of the gender mainstreaming component of the agriculture and natural resources policy for the period 2017–2026 by conducting an evaluation of the progress achieved at its midpoint and at completion, including the responsiveness of agricultural policies, programmes and projects, such as national food security and nutritional investment programmes, to effectively address the needs of rural women;

Text of the recommendation

37. The Committee recommends that the State party: (c) Ensure that land lease contracts with foreign companies do not result in the forced eviction and internal displacement, or the increased food insecurity and poverty, of local populations, including women and/or girls, and that such contracts stipulate that the company concerned and/or the State party must provide the affected communities, including pastoralist communities, with adequate compensation and alternative land.

Text of the recommendation

22.The Committee notes with concern the prevalenceof chronic food insecurity and malnutrition, in particular amongst children (art.11). The Committee recommends that the State party take steps to address chronic food insecurity, chronic malnutrition and the critical nutritional needs of children. The Committee also urges the State party to ensure that the population of the Somali National Regional State of Ethiopia benefits from State-run food aid and rural development plans.

Text of the recommendation

56. The Committee recommends that the State party: (b) Ensure that women in detention have adequate access to health care, nutrition and hygiene and that women and men are separated in all detention facilities.

Text of the recommendation

30. The Committee urges the State party to continue and strengthen its efforts to address issues related to the right to life, survival and development, particularly through the application of its strategies, policies and programmes on this issue. The Committee further recommends that particular attention be given by the State party to addressing the problem of infant mortality, malnutrition and the related issue of household food insecurity, as well as sanitation coverage, in both urban and rural areas.

Text of the recommendation

37. Taking note of targets 1.1, 1.2, 1.3 and 2.2 of the Sustainable Development Goals, the Committee recommends that the State party: (a) Take urgent measures to prioritize children who suffer from severe acute malnutrition and provide them with the necessary treatment and nutrition; (b) Regularly monitor and assess the effectiveness of policies and programmes on security and nutrition among children; (c) Intensify efforts to prioritize access to clean drinking water, sanitation and shelter, as well as access to, and the availability and affordability of, food, in particular for rural populations, and consider asking UNICEF, WHO and the Food and Agriculture Organization of the United Nations, among others, for assistance to address those issues...

Text of the recommendation

38. The Committee urges the State party to continue and strengthen its efforts to address issues related to the right to life, survival and development, particularly through the application of its strategies, policies and plans on this issue. The Committee further recommends that particular attention be given by the State party to addressing the problem of malnutrition.

Text of the recommendation

25.The Committee recommends that the State party set up, and provide sufficient funding for, programmes designed to ensure for everyone, especially the most disadvantaged and marginalized persons and social groups, physical and economic access to the minimum of essential food that is sufficient, nutritionally adequate and safe to ensure freedom from hunger, in line with the Committee’s general comment No. 12 on the right to adequate food (1999) and its statement on the world food crisis.

Text of the recommendation

72. The Committee reiterates its previous recommendation and urges the State party , inter alia , to: (d) Ensure that children in street situations have access to education and are supported to stay in school, and provide them with adequate health services, shelter and food, bearing in mind the specific needs of girls.

Text of the recommendation

31. The Committee notes with concern the high rate of smoking in the State party, despite measures taken to cut the consumption of tobacco (art. 12).

The Committee recommends that the State party design effective policies to combat tobacco consumption, strengthen its prohibition on tobacco product advertising, enact legislation imposing a strict ban on smoking in all closed public areas, and intensify public awareness-raising campaigns. It also recommends that the State party allocate part of its revenue from taxes on cigarettes to discourage smoking.

Text of the recommendation

26. (...) The Committee urges the State party to take the necessary measures to protect the right to adequate food, including by setting up a public food distribution system for the most disadvantaged and marginalized regions and groups. It also calls on the State party to tackle structural problems related to food insecurity, such as security of land tenure for small-scale producers, the transport and distribution of foodstuffs, and the availability of agricultural credits. The Committee refers the State party to its general comment No. 12 (1999) on the right to adequate food and to the Voluntary Guidelines to support the progressive realization of the right to adequate food in the context of national food security, adopted by the Food and Agriculture Organization of the United Nations.

Text of the recommendation

34. (e) Address malnutrition by finalizing and implementing the food and nutrition policy, ensuring a dedicated budget line in the national budget for nutrition, intensifying awareness-raising campaigns, particularly in rural areas, promoting exclusive breastfeeding and knowledge of the national code on the marketing of breast milk substitutes and establishing hospitals certified as baby-friendly.

35. (d) Address the incidence of drug abuse by Children and/or adolescents, in particular Tramadol, by, inter alia, providing Children and/or adolescents with accurate and objective information and education on life skills for the prevention of substance abuse, including tobacco and alcohol, and develop accessible and youth-friendly drug dependency treatment and harm reduction services

Text of the recommendation

51. (a) Adopt a legislative and institutional framework and a comprehensive strategy for guaranteeing the right to adequate food and combating hunger and chronic malnutrition, particularly in rural areas and in the Far North Region, and seek technical support in that regard from the Right to Food Team of the Food and Agriculture Organization of the United Nations

Text of the recommendation

64. The Committee welcomes the integration of adolescents health in the National Health Policy, and the creation of sexual and reproductive health services for adolescents in 2008. The Committee is, however, concerned about the high number of pregnancies among girls and the discrepancy in access to sexual and reproductive health services between urban and rural areas. The Committee notes the training, education and awareness-raising activities to prevent the use of harmful drugs by children but remains concerned about their use by adolescents, with some starting to use drugs before the age of 15.

Text of the recommendation

82. Recalling its general comment No. 17 (2013) on the right of the child to rest, leisure, play, recreational activities, cultural life and the arts, the Committee recommends that the State party take measures to provide children with safe, accessible, inclusive and smoke-free spaces for play and socialization at the community level.

Text of the recommendation

55. (e) Ensuring that all segments of society are informed of and have access to education and support on the use of basic knowledge of child health and nutrition, including the advantages of exclusive breastfeeding for children up to six months;

Text of the recommendation

47. The Committee recommends that the State party implement the United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders (the Bangkok Rules), guarantee the separation of detained women from convicts, ensure their access to adequate nutrition, drinking water, sanitation and healthcare and strengthen support programmes for their integration upon release.

Text of the recommendation

40. Recalling its general comment No. 20 (2016) on the implementation of the rights of the child during adolescence, and targets 3.3, 3.7 and 5.6 of the Sustainable Development Goals, the Committee recommends that the State party: (d) Strengthen measures to address the incidence of tobacco, drug and alcohol abuse among children, and to provide children with accurate and objective information on preventing substance abuse, including tobacco and alcohol abuse.

38. The Committee recommends that the State party: (c) Strengthen coordination across relevant ministries to address child malnutrition, stunting and obesity, and raise public awareness on these issues; (d) Promote breastfeeding and monitor the implementation of the International Code of Marketing of Breast-milk Substitutes; (e) Strengthen measures to prevent mother-to-child transmission of HIV, combat the stigmatization of children with HIV/AIDS and enable children affected and infected by HIV/AIDS to remain in their family environments.

Text of the recommendation

80. The Committee recommends to the State party that it: Provide adolescents with information on the harmful consequences of alcohol, drug and tobacco use. The Committee recommends to the State party that it:(a) Effectively implement its domestic labour laws and the National Programme against Child Labour as well as its subprogrammes, for example the Elimination of Child Labour in the Tobacco Industry Project and ensure that child workers participate in discussions about the solution to this problem.

84. (c) Ensure that street children are reached through trained street educators and counsellors and provided with adequate nutrition, clothing and shelter as well as with social and health services and educational opportunities, including vocational and life skills training, in order to support their full development and provide them with adequate protection and assistance;

Text of the recommendation

56. The Committee recommends that the State party: (e) Effectively address the issue of under-nutrition by providing adequate nutritional food and supplements, as well as education on healthy early habits.

58. The Committee recommends that the State party further encourage exclusive breastfeeding for six months after birth with modifications for an appropriate infant diet thereafter and take measures to improve the nutritional status of children through education and promotion of healthy feeding practices.

Text of the recommendation

44. With reference to its general recommendation No. 34, the Committee recommends that the State party:

(a) Ensure that rural women have access to adequate food, nutrition, water and sanitation, taking into account international human rights standards on such rights.

Text of the recommendation

56. The Committee recommends that the State party take appropriate measures to address the issue of drug abuse among children including by, providing Children and/or adolescents with accurate and objective information and life skills education on preventing substance abuse — including tobacco and alcohol abuse — and by developing accessible and youth-friendly drug-dependence treatment and harm reduction services. It also recommends that the State party adopt standards applicable to rehabilitation centres, especially concerning the treatment of persons below the age of 18 years.

Text of the recommendation

23. The Committee urges the State party to take immediate measures to: (...)

(b) Prevent and combat malnutrition, especially among vulnerable and disadvantaged groups of children, such as those living in poverty, including Dalit children.

Text of the recommendation

70. The Committee recommends that the State party take all steps necessary to address persisting acute hunger and malnutrition and, in particular, the critical nutritional needs of infants and children. It also recommends that the State party allocate sufficient resources for the full implementation of the infant and young child feeding strategy and that it adopt a legislative framework protecting the right to adequate food and nutrition and a national action plan on food security and nutrition that is in line with the Committee’s general comment No. 12 (1999) on the right to adequate food and the Voluntary Guidelines to Support the Progressive Realization of the Right to Adequate Food in the Context of National Food Security.

Text of the recommendation

42. "In line with its general recommendation No. 24 (1999), on women and health, the Committee calls upon the State party to: (a) Ensure that adequate funding is allocated to health, and establish a system for monitoring the effective and transparent delivery of health-care services."

46. "The Committee urges the State party to: (a) Pay special attention to the needs of rural women to ensure that they have access to health, education, clean water, sanitation services and income-generating projects; and eliminate discrimination in women’s ownership and inheritance of land;"

Text of the recommendation

31. "The Committee recommends that the State party adopt a human rights-based approach to its food policy, including by: (a) Addressing critical issues to all aspects of the food system, including the production, processing, distribution and consumption of safe food, as well as parallel measures in the fields of health and education, especially in disadvantaged areas; and (b) Ensuring that activities of the private business sector are in conformity with the right to food. The Committee draws the attention of the State party to its general comment No. 12 (1999) on the right to adequate food."

35.(b) "The Committee recommends that the State party: Enact anti-tobacco legislation which prohibits indoor smoking in public buildings and in the workplace and enforces a comprehensive ban on tobacco advertising, promotion and sponsorship;"

35.(d) "Apply a human rights-based approach to the treatment of tobacco and drug addiction, and provide appropriate health care, culturally sensitive psychological support services and rehabilitation to such persons, including effective drug dependence treatment such as opioid substitution therapy. The Committee also encourages the State party to ratify the World Health Organization Framework Convention on Tobacco Control."

Text of the recommendation

54. The Committee recommends that the State party allocate all the necessary human, technical and financial resources to address drug use by Children and/or adolescents by, inter alia, providing Children and/or adolescents with accurate and objective information aimed at avoiding and preventing substance abuse, including tobacco and alcohol, and develop accessible and youth-friendly drug dependence treatment and harm reduction services as well as life skills education.

66.(d) Ensure that, in all circumstances, children are separated from unrelated adults, have access to sufficient food, clean drinking water and sanitation, as well as health care, education and recreation.

Text of the recommendation

64. In the light of its general comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health, the Committee recommends that the State party: (c) Ensure the effective implementation of the National Food Security Act, 2013, which contains provisions aimed at combating children’s undernourishment; (d) Enhance efforts to promote exclusive breastfeeding practices, including breastfeeding from birth, complementary feeding strategies, with or without provision of food supplements, as well as micronutrient interventions for mothers; ensure the effective implementation of, and compliance with, the International Code of Marketing of Breast-milk Substitutes (WHO, 1981); put in place a monitoring and reporting system to identify violations of the Code and take stringent measures in all situations of violations of the Code, which include the promotion and distribution of infant formula samples and promotional materials by private-sector companies involved in the marketing and distribution of infant formula.

Text of the recommendation

6. The Committee recommends that the State party increase the proportion of its budget allocated to sectors directly related to the Covenant rights, particularly health, education, housing and food.

Text of the recommendation

59.The Committee strongly recommends that the State party take immediate measures, inter alia by increasing allocations, for the protection of economic, social and cultural rights of persons living in disadvantaged areas, in particular with regard to adequate housing, food and water, health services and sanitation. The Committee calls upon the State party to develop a mechanism for measuring the poverty level and to monitor it closely, and refers the State party to the Committee’s statement on poverty adopted in May 2001.

Text of the recommendation

67. The Committee recommends that in all areas under its jurisdiction, the State party expand preventive and therapeutic mental health services for adolescents and develop programmes to decrease tobacco smoking, alcohol consumption and drug abuse among adolescents, in particular through the development of campaigns specifically designed for adolescents on health behavioural choices and life skills. It further recommends that in the Hong Kong SAR, the State party continue to strengthen its efforts to prevent suicide among the youth.

Text of the recommendation

66. The Committee strongly recommends that the State party: (a) Intensify its efforts to reform laws and strengthen implementation of regulations on food and health safety standards, including for the business sector, and ensure that any officials or companies violating international and national environment and health standards are appropriately sanctioned and remedies provided when violations occur.

Text of the recommendation

29. The Committee is concerned about the situation of food insecurity in some of the poor rural areas, particularly in the western mountainous areas, and about the persistence of child malnutrition, mainly in rural areas and in the Tibet Autonomous Region. Despite the efforts made by the State party to strengthen food safety supervision, including through the adoption of the Food Safety Law, the Committee remains concerned about the shortcomings in the implementation of that Law (art. 11).

The Committee urges the State party to strengthen its efforts to protect the right to adequate food. The Committee recommends that the State party step up its efforts to address effectively the situation of food insecurity and child malnutrition in poor rural areas, particularly in the western mountainous areas and in the Tibet Autonomous Region. The Committee recommends that the State party take all necessary measures to enforce the Food Safety Law effectively, to strengthen its efforts with regard to food safety supervision and to ensure the production, processing, distribution, marketing and consumption of safe food. The Committee draws the State party’s attention to its general comment No. 12 (1999) on the right to adequate food and to the recommendations of the Special Rapporteur on the right to food (A/HRC/19/59/Add.1, paras. 40–46).

Text of the recommendation

28. The Committee recommends to the State party to strengthen its strategic interventions in response to the alarming situation of increasing food insecurity. The Committee requests the State party in its next periodic report to provide detailed information on the results of these strategic interventions.

Text of the recommendation

39. The Committee recommends that the State party: (...) (c) Integrate the nutritional needs of women and/or girls into broader national strategies and policies on nutrition to ensure that their specific needs at various stages of life are met, especially among women of childbearing age in rural areas.

Text of the recommendation

38. The Committee is concerned about rising child pregnancy rates, the focus of education on abstinence to prevent child pregnancies and the prevalence of substance abuse among adolescents. Recalling its general comment No. 20 (2016) on the implementation of the rights of the child during adolescence, and taking note of targets 3.7 and 5.6 of the Sustainable Development Goals, the Committee reiterates its previous recommendations and urges the State party to: (...)

(c) Expeditiously adopt the draft law on alcohol in order to establish a minimum age for alcohol consumption, and adopt legislative measures to prohibit the sale of tobacco and drugs.

(d) Provide children with accurate and objective information on preventing substance abuse, including of tobacco and alcohol, and develop accessible and child-friendly drug dependence treatment and harm reduction services for adolescents.

Text of the recommendation

41. The Committee recommends that the State party redouble its efforts to protect the right to adequate food and make an assessment of the implementation of its Second National Strategy for Food Security and Nutrition 2019–2023, in order to tackle food insecurity and malnutrition in an effective and comprehensive manner, including by establishing programmes to increase the level of minimum income support, promote healthier diets, incorporate trade, land management, education and fiscal policy elements, set clear, time-bound targets and establish appropriate mechanisms for assessing the progress made.

Text of the recommendation

61. The Committee recommends that the State party provide Children and/or adolescents with accurate and objective information and life-skills education on preventing substance abuse, including the abuse of tobacco and alcohol but especially hard drugs, as well as glue and solvent sniffing, through public school programmes and media campaigns, and protect children from harmful misinformation and models. The Committee also recommends that the State party develop accessible and anonymous drug dependence treatments and harm reduction services for children and young people.

Text of the recommendation

57. The Committee recommends that the State party redouble its efforts to:

(a) Prevent food crises, including through the effective forecasting of food shortages and by securing food availability and distribution for areas in need;

(b) Fully implement the Food Safety Act, 2013 and the related rules of 2014;

(c) Develop a national strategy for food and nutrition security, taking into account the Voluntary Guidelines to Support the Progressive Realization of the Right to Adequate Food in the Context of National Food Security.

58. The Committee draws the attention of the State party to its general comment No. 12 (1999) on the right to adequate food.

Text of the recommendation

51. The Committee notes that some efforts are being undertaken to promote healthy lifestyles through the “Youth well-being” programme. However, the Committee remains concerned at the high incidence of drug abuse and the widespread alcoholism and tobacco use. (...)

52. The Committee recommends that the State party: (a) Take all necessary measures to fight substance abuse, and strengthen the programme of health education in schools.

Text of the recommendation

31. ...The Committee recommends that the State party address disparities between urban and rural areas and among regions with regard to adequate housing, sanitation systems and water connections. The Committee requests the State party in its next periodic report to provide detailed information relating to the housing situation, including the number of urban slum-dwellers and the percentage of dwellings in rural areas that do not have access to clean drinking water and proper sewage and sanitation systems. The Committee is concerned about the persistence of child labour in the State party, including by children of migrant workers in tobacco and cotton farms.

27. The Committee is also concerned that these children do not attend school during farming periods. The Committee calls on the State party to take urgent measures to ensure protection of all children against all forms of exploitation and undertake effective measures to enable them to fully enjoy their right to education.

Text of the recommendation

44. The Committee recommends that the State party: (a) Strengthen access for rural women to safe drinking water, health care, formal employment and entrepreneurship, and ensure that the specific needs of rural women are met and that they are aware of the opportunities and benefits available to them, including through the Internet.

Text of the recommendation

38. The Committee recommends that the State party combat poverty among rural women by ensuring access to education, adequate water and sanitation, formal employment, low-interest loans without collateral and other forms of financial credit for agribusinesses, and ownership and use of land. The Committee also recommends that the State party integrate a gender perspective into its agricultural policies and ensure the equal participation of rural women in decision-making on agricultural policies and in leadership positions.

Text of the recommendation

36. (a) Strengthen transformative policies and strategies to reduce the burden of unpaid care work on women, particularly rural women; facilitate access to good-quality and affordable gender-responsive public services, including in relation to health care, education, childcare, transportation, water, land use, housing and energy services; and generate data on and establish the monetization of unpaid care work as a baseline for its recognition and compensation

Text of the recommendation

28. The Committee recommends that the State party: (b) Continue efforts to address overweight and obesity in children and actions to promote a healthy lifestyle, including by regulating the marketing of unhealthy foods to children, raising public awareness of nutrition issues and ensuring that overweight and obese children receive the necessary support under the Young People at a Healthy Weight programme

Text of the recommendation

53. The Committee is deeply concerned at the increase in use of illicit drugs, in particular amphetamines, among adolescents in the State party. The Committee notes with concern that such drugs are often used to improve school performance and to fight depression. Further, the Committee is concerned at the high levels of alcohol consumption and tobacco use among children, and the negative influence of advertisements, through direct advertising or through the mass media in general.

54. The Committee, referring to its general comment No. 4, recommends that the State party take relevant measures to eliminate the use of illicit drugs by children, through communication programmes and campaigns, the provision of life-skills education to adolescents, and the training of teachers, social workers and other relevant officials. This must include programmes on promoting healthy lifestyles among adolescents to prevent the use of alcohol and tobacco and the enforcement of regulations on the advertising of such products to children. The Committee encourages the State party to present information on such efforts and data on the use of illicit drugs by children in its next periodic report to the Committee.

Text of the recommendation

49.The Committee is concerned at the low rate of exclusive breastfeeding for the first six months, and the practice of providing complementary foods to infants from the age of four months. The Committee is further concerned at the unregulated marketing of food for infants, young children and adolescents, and inadequacies in the monitoring of the marketing of breast-milk substitutes.

50. The Committee recommends that the State party take action to improve the practice of exclusive breastfeeding for the first six months, through awareness-raising measures including campaigns, information and training for relevant Government officials, particularly staff working in maternity units, and parents. The Committee further recommends that the State party strengthen the monitoring of existing marketing regulations relating to food for children and regulations relatingto the marketing of breast-milk substitutes, including bottles and teats, and ensure that such regulations are monitored on a regular basis and action is taken against those who violate the code.

Text of the recommendation

19. The Committee also recommends that the State party take measures to increase the number of reception centres, to improve the living conditions therein and to ensure that everyone in the centres has access to medical care, interpreters, adequate food, clothing and social support.

50. The Committee is concerned that one in ten adults is obese, with persons with lower levels of education being most at risk, and about the significant increase in child obesity in the State party (art. 12).

51. The Committee recommends that the State party redouble its efforts to combat obesity, particularly among children. It also recommends that the State party introduce higher taxes on junk foods and sweet beverages and consider adopting strict regulations on the marketing of such products, while ensuring improved access to healthy diets.

Text of the recommendation

56. The Committee reiterates its previous recommendation that the State party introduce higher taxes on junk foods and sweet beverages, and further recommends that it lower taxes on healthy food products, ensure mandatory physical exercise in the primary school system and increase earmarked funding for anti-obesity programmes for children in the southern regions.

Text of the recommendation

9. The Committee notes with deep concern the impact of the State party’s agriculture and trade policies, which promote the export of subsidized agricultural products to developing countries, on the enjoyment of the right to an adequate standard of living and particularly on the right to food in the receiving countries. The Committee urges the State party to fully apply a human rights-based approach to its international trade and agriculture policies, including by reviewing the impact of subsidies on the enjoyment of economic, social and cultural rights in importing countries. In this regard, the Committee draws the attention of the State party to the guidelines on international measures, actions and commitments as contained in the FAO Voluntary Guidelines on the Right to Food (2004).

Text of the recommendation

31. The Committee recommends that the State party... (d) Regulate the marketing of tobacco to children and continue to strengthen measures to provide adolescents with information on preventing substance abuse, including of tobacco and alcohol, and to ensure the early identification and adequate referral of adolescents requiring treatment for substance abuse;

Text of the recommendation

22. The Committee recommends that the State party:...(b) Ensure that companies effectively implement international standards, including on human rights, the environment and health.

68. The Committee recommends that the State party address the incidence of drug use by children and adolescents by, inter alia, providing children and adolescents with accurate and objective information as well as life skills education on preventing substance abuse, including of tobacco and alcohol, and develop accessible and youth-friendly drug dependence treatment and harm reduction services for children and young people.

Text of the recommendation

47. The Committee urges the State party to... (e) Further the development of public water supply and sanitation systems and provide access to those systems at an affordable price in order to reduce the prevalence of parasitic and infectious diseases.

Text of the recommendation

58. (c) Systematically collect information on the consumption of alcohol and tobacco products amongst children.

58. (d) Undertake measures necessary for the effective enforcement of the prohibition of the sale of such products to children; the Committee also recommends that the State party consider prohibiting the promotion of alcohol and tobacco products in media and/or information commonly accessed by children.

Text of the recommendation

41. The Committee recommends that the State party, taking into account the Committee’s general comment No. 4 (2003) on adolescents health and development in the context of the Convention on the Rights of the Child, systematically collect comprehensive information on the consumption of alcohol and tobacco among children, and take the necessary measures for the effective enforcement of the prohibition of the sale of such products to children. The Committee also recommends that the State party consider prohibiting the advertising of alcohol and tobacco products through television, radio, publications, the Internet and other media commonly accessed by Children and/or adolescents.

Text of the recommendation

28. The Committee urges the State party to take the necessary measures to address the deteriorating mental health situation of young girls, to prevent and combat the abuse of alcohol and use of drugs, and to prevent girls’ suicide. It also recommends awareness-raising and educational campaigns, in particular through the media, targeted at adolescents girls.

Text of the recommendation

12. The Committee recommends that the State party intensify its efforts to prevent and combat the persistent discrimination against persons with immigrant backgrounds and against persons belonging to national or ethnic, religious and linguistic minorities, including by adopting specific and targeted measures to address the problems faced by all minorities in having access to employment, housing, education and health care and by undertaking awareness-raising campaigns.

Text of the recommendation

41. The Committee recommends that the State party continue and strengthen its efforts to manage overweight and obesity among children and pay close attention to child and adolescents health, taking into account the Committee’s general comment No. 4 (2003) on adolescents health and development in the context of the Convention. In particular, the State party is urged to strengthen its efforts to prevent and combat obesity and to reduce and prevent malnutrition in Greenland. The Committee recommends that the State party continue to refine its policies on prenatal care in remote and rural areas to address the issue of high infant mortality.

Text of the recommendation

50. The Committee recommends that the State party strengthen its efforts to combat obesity among Children and/or adolescents, including by ensuring access to health advice and care, including in schools, to healthy foods, and to adequate opportunities for engaging in physical activity. In this respect, the Committee recommends that the State party engage the mass media and the food industry to ensure their contribution to healthy lifestyles and consumption patterns by Children and/or adolescents. The Committee also recommends that the authorities in the territories of Greenland and the Faroe Islands expeditiously prepare and implement appropriate programmes and strategies for preventing and addressing unwanted pregnancies.

Text of the recommendation

32. In view of the reports according to which the inhabitants of certain smaller settlements and towns in Greenland suffer from significant food shortages between January and May, which have a particularly negative impact on children from low-income families, the Committee recommends that the State party allocate adequate resources to ensure that all areas of Greenland have sufficient and healthy food reserves and to provide adequate benefits to low-income families to ensure that they can provide their children with sufficient and healthy food. In this regard, the Committee also recommends that the State party develop policies to ensure that healthy food choices are available and affordable in Greenland, and strengthen awareness-raising campaigns to promote the benefits of healthy eating for children. 33. While noting with appreciation that alcohol consumption among children in mainland Denmark has decreased, the Committee recommends that the State party continue addressing the incidence of drug use by Children and/or adolescents, with a particular emphasis on the situation in Greenland, by, inter alia, providing Children and/or adolescents with accurate and objective information, as well as life skills education, on preventing substance abuse (including tobacco and alcohol), and develop accessible and youth-friendly drug dependence treatment and harm reduction services.

Text of the recommendation

47. State party strengthen measures to address alcohol and drug consumption and abuse, in general, as well as alcohol use by Children and/or adolescents, through education programmes and campaigns to promote healthy lifestyles, and ensure enforcement of regulations on the sale and advertising of alcohol and tobacco products to children. The Committee also recommends that the State party strengthen measures to raise awareness on sexual and reproductive health, with special attention to sexually transmitted infections, and ensure systematic health education.

Text of the recommendation

35. (d) Address the incidence of drug use by Children and/or adolescents by, inter alia, providing Children and/or adolescents with accurate and objective information and life skills education on preventing substance abuse – including of tobacco and alcohol – and develop accessible and youth-friendly addiction treatment;

Text of the recommendation

25. The Committee recommends that the State party effectively implement and enforce the existing legal and policy frameworks with regard to combating tobacco smoking, alcohol abuse and drug use and enhance its preventive measures, including but not limited to the promotion of healthy lifestyles and awareness-raising programmes about the serious health risks associated with such substance abuse. It also recommends that the State party apply a human rights-based approach to the treatment of persons abusing alcohol and drug users, and provide appropriate health care, psychological support services and rehabilitation to such persons, including effective drug dependence treatment such as opioid substitution therapy.

Text of the recommendation

32. (d) Identify and effectively address the causes of child malnutrition, including obesity, underweight, diabetes and vitamin and iodine deficiency; develop and monitor policies and programmes on child food security and nutrition, including school meal programmes and programmes addressing infants and young children; and regulate the marketing of unhealthy foods to children.

34. (a) Strengthen its efforts to prevent and address the incidence of alcohol and tobacco addiction, including by providing Children and/or adolescents with accurate and objective information and life skills education on preventing substance abuse, and develop specialized accessible and youth-friendly drug-dependence treatment and harm-reduction services;

Text of the recommendation

17. The Committee further recommends that the State party guarantee the right to adequate food for people living in poverty, as set out in its general comment No. 12 (1999) on the right to adequate food and the Voluntary Guidelines to Support the Progressive Realization of the Right to Adequate Food in the Context of National Food Security adopted by the Food and Agriculture Organization.

Text of the recommendation

30. The Committee recommends that the State party educate young people about the risks of drug abuse and of tobacco and alcohol consumption, to intensify its campaigns against such abuse and excessive consumption, as well as its information campaigns for children, parents, teachers and the general public, and to ensure that adequate counselling services are available to all persons affected by drug, tobacco or alcohol addiction.

Text of the recommendation

51. The Committee recommends that the State party increase its efforts to address the needs of children from dysfunctional families and take measures to minimize the psychological effect of such family situations, and strengthen care and rehabilitation programmes for children suffering from alcohol, tobacco, cannabis and other illicit substance addiction, depression and obesity. With reference to its general comment No. 4 (2003), the Committee recommends that the State party develop specialized and youth-friendly drug-dependence treatment and harm reduction services for children.

Text of the recommendation

32. (a) Strengthen measures to address obesity in children and actions to promote a healthy lifestyle, including physical activity.

Text of the recommendation

22. The Committee recommends that the State party establish and implement regulations to ensure that the business sector complies with international and domestic standards on corporate social responsibility, in line with the United Nations Business and Human Rights Framework , which outlines the duty of States to protect against human rights abuses by businesses; corporate responsibility to respect human rights; and the need for more effective access to remedies when violations occur. In doing so, the Committee encourages the State party to focus on the protection of the rights of the child and to investigate and provide remedies in reported cases of abuse by corporations and their executives. The Committee encourages the State party to consider the Human Rights Council r esolution 8/7 welcoming the report identifying the ¨Protect, Respect and Remedy¨ framework and r esolution 14/7 requesting the new Working Group to follow-up on this matter , both of which note that the rights of the child be included when exploring the relationship between business and human rights.

Text of the recommendation

4. (i)The Committee also welcomes the ratification of or accession to: (i)World Health Organization Framework Convention on Tobacco Control, in 2004.

Text of the recommendation

50. With reference to the Committee’s general comment No. 4 (2003) on adolescents health and development , the Committee recommends that the State party: (e) Implement education programmes and campaigns to promote healthy lifestyles and to prevent drug and substance abuse by children, monitor the use of drugs and other substance s at schools with the participation of children , and develop accessible and youth-friendly drug and substance dependence treatment and harm reduction services as well as life skills education.

Text of the recommendation

20. With reference to the Committee’s general comment No. 16 (2013) on State obligations regarding the impact of the business sector on children’s rights, the Committee recommends that the State party: (a) Establish a clear regulatory framework for business enterprises operating in the State party to ensure that their activities do not negatively affect child rights or breach environmental, health or labor standards, especially those relating to children; (b) Monitor the compliance of business enterprises with such regulations, as well as with international and national environmental, health and labor standards, and sanction appropriately and provide remedies when violations occur; (c) Be guided by the United Nations Guiding Principles on Business and Human Rights (see A/HRC/17/31, annex).

Text of the recommendation

64. The Committee welcomes the integration of adolescents health in the National Health Policy, and the creation of sexual and reproductive health services for adolescents in 2008. The Committee is, however, concerned about the high number of pregnancies among girls and the discrepancy in access to sexual and reproductive health services between urban and rural areas. The Committee notes the training, education and awareness-raising activities to prevent the use of harmful drugs by children but remains concerned about their use by adolescents, with some starting to use drugs before the age of 15.

Text of the recommendation

82. Recalling its general comment No. 17 (2013) on the right of the child to rest, leisure, play, recreational activities, cultural life and the arts, the Committee recommends that the State party take measures to provide children with safe, accessible, inclusive and smoke-free spaces for play and socialization at the community level.

Text of the recommendation

38. The Committee calls on the State party to take the necessary measures to increase and strengthen the participation of women in designing and implementing local development plans, and to pay special attention to the needs of rural women, in particular women heads of household, by ensuring that they participate in decision-making processes and have improved access to health, education, clean water and sanitation services, fertile land and income-generation projects. The Committee also urges the State party to eliminate all forms of discrimination with respect to ownership, co-sharing and inheritance of land. It further urges the introduction of measures to address negative customs and traditional practices, especially in rural areas, which affect full enjoyment of the right to property by women.

Text of the recommendation

53. The Committee welcomes the adoption of the Roadmap for Nutrition in South Africa 2013-2017, as well as the efforts made to facilitate breastfeeding. Nevertheless, the Committee is concerned at: (a)Child malnutrition, including undernutrition, micronutrient deficiencies and overnutrition, as key contributing factors for child mortality and child morbidity; (b)Child food insecurity caused by, among other things, poverty, food price increases, demographic changes, energy costs and climate change; (c)The persistently low rate of exclusive breastfeeding of infants aged up to 6 months; (d)The inadequate nutritiousness of food provided in the school meal programme; (e)The increase in the prevalence of obesity among children and the aggressive marketing of unhealthy food targeting children. 54. Taking note of target 2.2 of the Sustainable Development Goals on ending all forms of malnutrition, the Committee recommends that the State party: (a) Develop and implement a framework law on the right to food, as envisaged in the National Policy on Food and Nutrition Security for the Republic of South Africa, of 2014, paying due attention to the eradication of child food insecurity and malnutrition; (b) Take all measures necessary to promote exclusive breastfeeding for at least six months, with appropriate guidance and support for breastfeeding by HIV-infected mothers, and to regulate the promotion of breast milk substitutes; (c) Strengthen the monitoring of the National School Nutrition Programme, including of the frequency, quality and nutritional value of the food supplied through the programme; (d) Regulate the marketing of unhealthy foods to children in order to address the rise in child obesity, and introduce strategies that enable poor households to access healthy food; (e) Seek technical assistance from UNICEF and the Food and Agriculture Organization of the United Nations in this regard.

Text of the recommendation

56. The Committee is concerned at the high incidence of food insecurity and malnutrition in the State party, particularly among children. Given the fact that, in the State party, 12 per cent of children lived in hunger in 2017 and 27 per cent of children suffered from stunting in 2016, the Committee is particularly concerned that the child support grant (at 400 rand per month) has been set far below the food poverty line and that an estimated 18 per cent of eligible children do not benefit from the grant, owing to a lack of documentation. It is further concerned at the lack of a framework law to ensurethe right to food (arts. 9 and 11).

57. The Committee recommends that the State party: (a) Increase the child support grant at least up to the level of the food poverty line; (b) Ensure that all eligible children benefit from the grant; (c) Expedite the adoption of the Social Assistance Amendment Bill of 2018 to increase the level of child support grants for orphaned and abandoned children living with relatives, for which it has already earmarked funds; (d) Adopt framework legislation protecting the right to adequate food and nutrition, and develop a national food and nutrition security strategy, taking into account the Voluntary Guidelines to Support the Progressive Realization of the Right to Adequate Food in the Context of National Food Security of 2004 and the Committee ’ s general comment No. 12 (1999) on the right to adequate food.

Text of the recommendation

51. The Committee is concerned that, while tobacco, alcohol and drug consumption are widespread among adolescents, programmes and services for those affected by substance abuse remain limited.

52. The Committee recommends that the State party address the prevalence of substance abuse, including tobacco and alcohol abuse, provide children and adolescents with objective information in this respect, and develop accessible and youth-friendly drug dependence treatment and harm reduction services.

Text of the recommendation

40. The Committee is concerned about the high rates of obesity in the State party and the lack of comprehensive, effective measures for addressing this problem (arts. 11 and 12).

41. The Committee recommends that the State party redouble its efforts to design a comprehensive national strategy for upholding the right to adequate food, along with programmes for promoting healthier diets. It also recommends that this strategy cover matters relating to marketing, land use planning, education and fiscal policy and that all stakeholders take part in its development. The Committee refers the State party to its general comment No. 12 (1999) on the right to adequate food and to the Voluntary Guidelines to Support the Progressive Realization of the Right to Adequate Food in the Context of National Food Security adopted by the Council of the Food and Agriculture Organization of the United Nations (FAO).

Text of the recommendation

64. The Committee recommends that the State party: (b) Provide children living or working on the street with adequate nutrition, housing, necessary health-care and educational opportunities, as well as recovery and social reintegration services, while taking into account gender aspects and the views of the children in accordance with article 12.

Text of the recommendation

45. The Committee welcomes the State party’s efforts to improve the coverage of the National System of Health and welcomes the adoption of the National Programme on Rural Health. However, the Committee is concerned about the large number of children suffering from nutritional disorders, such as chronic malnutrition, anaemia and obesity.

46. In the light of its general comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health, the Committee recommends that the State party strengthen its efforts to ensure access to high- quality health services by all children, particularly children living in the most disadvantaged and remote areas of the country, and encourages the State party to develop policies and programmes to address chronic malnutrition and anaemia.

Text of the recommendation

55. The Committee recommends that the State party provide adequate access to mental health services to all children and take all necessary measures to fight drug, alcohol and tobacco addictions including, inter alia, by providing specific rehabilitation services.

Text of the recommendation

18. The Committee is concerned that a significant number of children still suffer from malnutrition, in particular those living in rural and remote areas (art.11).

The Committee recommends that the State party intensify its efforts to combat and prevent malnutrition amongst children, in particular those living in rural and remote areas.

Text of the recommendation

16. The Committee is concerned about the situation of street children in the State party, as well as their high numbers (art.10).

The Committee recommends that the State party address the situation and the high number of street children, with the aim of protecting these children and preventing and reducing this phenomenon. The Committee also recommends that these efforts focus on recovery and social reintegration services, as well as on ensuring adequate nutrition, housing, health care and educational opportunities.

Text of the recommendation

66. The Committee recommends that the State party: (a) Provide street children, in consultation with them, with recovery and social reintegration services as well as with adequate nutrition, housing, necessary health care and educational opportunities;

Text of the recommendation

47. The Committee recommends that the State party: (a) Ensure basic health care and services to all children throughout the country and continue to address the problem of malnutrition, with special emphasis on rural and remote areas;

Text of the recommendation

24. In the light of its general comment s No. 16 (2013) on State obligations regarding the impact of the business sector on children’s rights and No. 11 (2009) on indigenous children and their rights under the Convention , the Committee recommends that the State party: (b) Require all companies to undertake assessments, consultations, and full public disclosure of the environmental, health-related and human rights impacts of their business activities and their plans to address such impacts;

Text of the recommendation

70. In the light of its general comment No. 10 (2007) on children’s rights in juvenile justice, the Committee urges the State party to bring its juvenile justice system fully into line with the Convention and other relevant standards. In particular, the State party should: (d) In cases where detention is unavoidable, ensure that detention conditions are compliant with international standards, including with regard to protection from violence, with adequate accommodation and access to food, education, health services and independent, child-sensitive complaints mechanisms;

Text of the recommendation

68. The Committee recommends that the State party: (b) Adopt a comprehensive child-protection-based approach to dealing with children in street situations , focusing on ensuring adequate assistance for recovery and reintegration, nutrition, housing, health care and educational opportunities;

Text of the recommendation

54. The Committee draws the State party’s attention to its general comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health, and recommends that the State party: (a) Continue to strengthen its efforts to address child mortality and malnutrition, focusing primarily on children living in poverty, children living in rural and remote areas and indigenous children. In this context, the State party should consider the t echnical guidance on the application of a human rights-based approach to the implementation of policies and programmes to reduce and eliminate preventable mortality and morbidity of children under 5 years of age (A/HRC/27/31);

Text of the recommendation

50. Referring to its general comments No. 4 (2003) on adolescents health and No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health, the Committee recommends that the State party: (d) Evaluate the consumption patterns of drugs by adolescents and strengthen the existing programmes aimed at preventing drug use and assisting children who use drugs. Those programmes should provide children, in particular in schools, with accurate and objective information as well as life skills education on preventing substance abuse — including tobacco and alcohol — and develop accessible and youth-friendly drug dependence treatment and harm reduction services;

Text of the recommendation

11. The Committee recommends that the State party step up its efforts to ensure the prompt adoption of the National Action Plan on Business and Human Rights and to see to it that all relevant stakeholders participate in the processes of developing and implementing the Plan. In addition, it encourages the State party to adopt appropriate legislative and administrative measures to ensure that companies operating in the State party exercise due diligence in human rights matters in order to prevent their activities from having a negative impact on the exercise of economic, social and cultural rights. The Committee encourages the State party to consider implementing the recommendations made by the Working Group on the issue of human rights and transnational corporations and other business enterprises in its report (A/HRC/35/32/Add.2) and refers it to the Committee’s general comment No. 24 (2017) on State obligations under the International Covenant on Economic, Social and Cultural Rights in the context of business activities.

Text of the recommendation

48. The Committee is concerned that there continute to be high levels of malnutrition and food insecurity, on the one hand, and rising levels of excess weight and obesity, on the other, which interferes with the effective enjoyment of the right to adequate food (art 11). 49. The Committee recommends that the State party develop a comprehensive national strategy for the protection and promotion of the right to adequate food in order to address food insecuirty in the different regions of the State party and to promote a healtheir diet, which, among other things, can reduce problems of excess weight and obesity.

Text of the recommendation

15. (a) The Committee recommends that the State party redouble its efforts to prevent teenage pregnancy by, inter alia, ensuring that school programmes on sexual and reproductive health are age-appropriate and properly implemented and conducting campaigns to raise awareness among the general public of the negative impact of teenage pregnancy.

Text of the recommendation

58.The Committee is concerned about the lack of recreational activities, in particular sports facilities and playgrounds, and about the insufficiency of resources and infrastructure to guarantee the right to sport and leisure. The Committee notes with concern the relation between the lack of implementation of this right and the increase of child obesity.

59. The Committee recommends that the State party ensure that all children have access to sport and recreational activities by:

(a) Increasing the hours and quality of sports programmes in schools;

(b) Developing specific sports and leisure programmes for children and adolescents;

(c) Increasing allocation of resources for the development of infrastructure and of recreational and cultural activities.

Text of the recommendation

48.The Committee welcomes the emphasis on children’s health of the National Development Plan for 2001-2006 and the National Health Programme for 2001-2006.The Committee also welcomes the decrease of malnutrition rates in urban areas, the decrease of the mortality rates for children under 1 year and for children under 5 years of age related to infection diseases, as well as the high vaccination coverage.The Committee remains concerned at the high rates of maternal mortality, the emergence of obesity and the low percentage of the GDP allocated to health.The Committee remains deeply concerned that post‑natal health care is still inadequate and that mortality and malnutrition rates, as well as other health indicators, are significantly worse in rural and remote areas and for indigenous mothers and children.

49. The Committee reiterates its previous recommendations (see document CRC/C/15/Add.112, paras. 26 and 27), in particular, its recommendation that the State party implement all necessary measures to reduce the persistence of regional disparities in access to health care, the high rates of malnutrition among children under 5 years of age and those of school age, especially in rural and remote areas and among children belonging CRC/C/MEX/CO/3 page 12 to indigenous groups. It also recommends developing interventions programmes for the new challenges that emerge from the globalization and the urbanization process: child obesity as well as environmental health.

Text of the recommendation

53. The Committee recommends that the State party, taking into account the Committee’s general comment No. 3 (2003) on HIV/AIDS and the rights of the child and

the International Guidelines on HIV/AIDS and Human Rights: (a) Strengthen its efforts to combat HIV/AIDS, including through awareness-raising campaigns.

Text of the recommendation

48. The Committee draws the State party’s attention to its general comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health, and recommends that the State party: (d) Increase efforts to promote breastfeeding through educational campaigns and training to professionals, adequately implement the International Code of Marketing of Breast-milk Substitutes and the Child-friendly Hospital Initiative; (e) Continue raising awareness at the national, federal and local levels on the negative health impacts of processed food and strengthen regulations to restrict advertising and marketing of junk, salty, sugary and fatty foods and their availability to children.

Text of the recommendation

47. The Committee notes the measures taken by the State party to reduce child and maternal mortality. However, it is concerned that: (c)Child chronic malnutrition is persistent, especially among indigenous and rural children; (d) Exclusive breastfeeding is decreasing; (e) The number of children who are overweight or obese is increasing.

Text of the recommendation

52. The Committee recommends that the State party: (c) Further examine and adapt its legislative framework to ensure the legal accountability of business enterprises involved in activities having a negative impact on the environment, in the light of its general comment No. 16 (2013) on State obligations regarding the impact of the business sector on children’s rights.

Text of the recommendation

26. The Committee takes note of the difficulties faced by the State party to guarantee the right to adequate food by way of local production due to the frequency of natural hazards, inefficient farming practices, lack of suitable land, and increases in commodity prices. While noting the importance of food importation to meet the dietary needs of the population, the Committee is concerned at the information provided by the State party that exposure to cheaper imports based on new trading agreements has led to the displacement of local farmers (art. 11).

The Committee recommends that the State party adopt effective long-term strategies aimed at improving domestic productivity in a sustainable manner and building the capacity of local farmers, taking into account the Committee’s general comment N o. 12 (1999) on the right to adequate food. It also reminds the State party to assess the adverse impact of any trade agreements on the enjoyment of economic, social and cultural rights of the population, and provide detailed information in its next State party report concerning trade agreements entered by the State party and their impact on the enjoyment of economic, social and cultural rights, particularly among local farmers.

Text of the recommendation

44. The Committee is concerned, however, about perinatal mortality levels, the increase in maternal mortality, persistent levels of undernourishment among the poorest children, the general shortage of health-care providers and the lack of access by children to quality health care, the low levels of breastfeeding and the high proportion of children classified as overweight or obese.

45. The Committee, in the light of its general comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health ( art. 24), recommends that the State party: (f) Combat obesity among children , intensify measures to raise awareness of healthy nutrition among parents, children and the public in general , and promote healthy eating habits , particularly among young Children and/or adolescents.

Text of the recommendation

18. The Committee recommends that the State party: (a) Address the issue of budget allocations for children not simply as a matter of expenditures in the areas of child protection, but in a more holistic approach which covers health, education, food and food security, water, basic sanitation, recreation, prevention of violence, etc.;

Text of the recommendation

20.The Committee recommends that Parliament complete ratification of the constitutional amendments guaranteeing the right to food and access to water in the Constitution. It also urges the State party to step up its efforts to prevent and combat child malnutrition, in particular among children in rural and remote areas.

Text of the recommendation

37. The Committee is concerned about the unavailability of specialized health facilities for children aged older than 12 years and the number of children consuming alcohol, tobacco and drugs, and recommends that the State party:

(a) Make specialized health facilities available for children aged older than 12 years;

(b) Continue taking measures to address alcohol, drug and tobacco use among adolescents, including through awareness-raising programmes and campaigns, strengthen the regulation of alcohol and tobacco sales, and develop accessible and youth-friendly drug dependence treatment and harm-reduction services.

39. The Committee remains concerned about the incidence of child malnutrition, mostly among children in situations of poverty and, taking note of target 2.2 of the Sustainable Development Goals on ending all forms of malnutrition, recommends that the State party:

(a) Address the underlying causes of child malnutrition, including economic deprivation;

(b) Continue to invest in measures to promote exclusive breastfeeding for the first six months;

(c) Strengthen measures to address the issue of overweight children and childhood obesity in both urban and rural areas;

(d) Systematically collect data on children ’ s food security and nutrition.

Text of the recommendation

27. (c)Ensure that lesbian, gay, bisexual, transgender and intersex persons are able to enjoy their economic, social and cultural rights and have access to health, education, employment, housing, poverty reduction and food security programmes.

Text of the recommendation

43. The Committee is also concerned at the rates of malnutrition in the State party, a problem which disproportionately affects children and adolescents. Lastly, the Committee is also concerned about barriers faced by campesino and Montubio people in enjoying access to seeds (art. 11).

44. The Committee recommends that the State party: (d) Recognize the situation of malnutrition as a national priority and adopt a comprehensive policy to address malnutrition, with sufficient human and financial resources.

Text of the recommendation

24. The Committee recommends that the State party work with civil society to draw up municipal maps showing the location of population sectors subject to food and nutritional insecurity and that it compile disaggregated information for use in setting priorities for the development of measures to combat malnutrition and mechanisms for monitoring progress towards the achievement of proposed targets. The Committee recommends that the State party expand upon the existing legal framework for the protection of the right to food and that it supplement the Food Sovereignty Organization Act with provisions designed to safeguard food sovereignty.

Text of the recommendation

33. With reference to its general comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health and taking note of target 3.2 of the Sustainable Development Goals to end preventable deaths of newborns and children under 5 years of age. 19. the Committee recommends that the State party: (c) Ensure sufficient budget allocation and accountability mechanisms for universal coverage of vaccination s and the provision of nutrients and minerals , as well as programmes to combat child and maternal mortality and malnutrition;

Text of the recommendation

11. the Committee recommends that the State party: (b) Set up a data-collection system on chronic malnutrition, in particular in rural areas, and on different forms of violence against children;

Text of the recommendation

10. While noting the information concerning the increase in social investment as a proportion of the general State budget, with reference to its general comment No. 19 (2016) on public budgeting for the realization of children' s rights , the Committee recommends that the State party: (...) (b) Allocate resources for the rights of all children, including for the eradication of multidimensional poverty in early childhood, eradication of child malnutrition, comprehensive protection of children, and actions to tackle violence against children.

Text of the recommendation

58. The Committee recommends that the State party increase its effort to provide vulnerable and marginalized children, including indigenous and Afro-Ecuadorian children, with material assistance and support programmes, particularly with regard to nutrition, clothing and housing in accordance with article 27 of the Convention.

Text of the recommendation

52. The Committee recommends that the State party strengthen its efforts to improve the health situation of children in the State party and improve access to quality health services and address the issue of malnutrition, particularly in rural and remote areas. The Committee also recommends that the State party strengthen the “Mother-and-child friendly hospitals” Initiative and update training manuals for health professionals on the promotion and protection of breastfeeding.

Text of the recommendation

39. The Committee recommends that the State party continue and strengthen policies and programmes to address issues related to the right to life, survival and development of children, and continue to pay particular attention to addressing the problems of child mortality and chronic malnutrition.

Text of the recommendation

45. The Committee recommends that the State party adopt the measures needed to promote exclusive breastfeeding in accordance with World Health Assembly resolutions, including by introducing breastfeeding breaks and ensuring support for breastfeeding in the workplace. It also encourages the State party to take the necessary steps to ensure that women of childbearing age have access to adequate food.

Text of the recommendation

21. The Committee is concerned about the high malnutrition rate which affects a considerable number of children and women, in particular among internally displaced groups, as well as persons living in rural areas. The Committee firmly recommends that the State party adopt an effective national food policy to combat hunger and malnutrition, in particular among children, women, internally displaced persons and persons living in rural areas.

Text of the recommendation

17. The Committee is concerned about the negative impact on children's rights of some of the activities conducted by business enterprises, in particular in the mining and tourism sectors.

18. In light of its general comment No. 16 (2013) on State obligations regarding the impact of the business sector on children's rights, the Committee recommends that the State party...(a) Examine and adapt its legislative framework to ensure the legal accountability of business enterprises and their subsidiaries operating in or managed from the State party´s territory, especially in the mining and tourism sectors, regarding violations of children’s rights; (b) Require companies to undertake assessments, consultations and full public disclosure of the environmental, health-related and human rights impacts of their business activities and their plans to address such impacts; (c) Establish monitoring mechanisms for the investigation and redress of such abuses, with a view to improving accountability, transparency and the prevention of violations.

Text of the recommendation

12. While the Committee welcomes the efforts made by the State party in adopting a National Plan on Business and Human Rights, it is concerned that the Plan does not incorporate appropriate measures clearly establishing the principle of human rights due diligence in order to identify, prevent and mitigate the risk of violation of Covenant rights.

13. The Committee recommends that, in revising the National Plan on Business and Human Rights, the State party: (a) Take appropriate legislative and administrative measures, including the incorporation of human rights due diligence, to ensure that business enterprises operating in the State party do not adversely affect the enjoyment of economic, social and cultural rights in the course of their work; (b) Establish effective mechanisms to guarantee the conducting of human rights due diligence by companies; (c) Strengthen existing mechanisms to investigate complaints against companies, and take effective measures to ensure victims’ access to effective remedies and to reparation or compensation.

Text of the recommendation

57. The Committee is concerned at the prevailing disparities in relation to the right to adequate food, specifically between the critical rates of malnutrition and food insecurity and the rising number of overweight or obese persons in some regions. The Committee is also concerned at the lack of adequate measures to support peasant and smallholder farmers, which has a negative impact on the enjoyment of the right to food (art. 11).

58. The Committee recommends that the State party develop, pursuant to the National Food Security and Nutrition Policy, a comprehensive national strategy for the protection and promotion of the right to adequate food in order to address food insecurity throughout its national territory and to promote healthier diets.

Text of the recommendation

63. The Committee recommends that the State party address the incidence of alcohol abuse and drug abuse by children by, inter alia, providing them with accurate and objective information and life skills education on preventing substance abuse, including tobacco and alcohol abuse, and develop accessible and youth-friendly drug - dependence treatment and harm-reduction services.

Text of the recommendation

25. The Committee is concerned at the rising rate of obesity due to the nutritional changes occurring in the State party and the lack of comprehensive measures currently addressing this problem (art. 11).

The Committee recommends that the State party should intensify its efforts to devise a comprehensive national strategy for the protection and promotion of the right to adequate food, which promotes healthier diets and incorporates aspects related to trade, territorial planning, education and fiscal policy, and is developed with the participation of all the stakeholders involved. The Committee refers the State party to its general comment No. 12 (1999) on the right to adequate food and the Voluntary Guidelines to support the progressive realization of the right to adequate food in the context of national food security, adopted by the United Nations Food and Agriculture Organization.

Text of the recommendation

68. The Committee recommends that the State party: (...)

(b) Provide street children with recovery and social reintegration services, taking into account their views in accordance with article 12 of the Convention, taking due account of gender and ethnic aspects, and provide them with adequate nutrition, housing, and necessary health-care and educational opportunities;

Text of the recommendation

53. The Committee welcomes the substantially increased budget allocations in the public expenditure for health through the AUGE system and the attempts that have been made to improve access for low-income families by providing guaranteed medical treatment for several conditions relating specifically to the health of children. The Committee also notes the advances made in reducing infant mortality and the high vaccination rates among children. The Committee however notes that further efforts need to be undertaken in order to ensure access to health services in practice among indigenous peoples, low-income and rural population. Finally, the Committee is concerned about nutritional problems leading to obesity.

54. The Committee recommends that the State party continue and provide further resources for the AUGE health system and enhance the access to medical services in rural areas, among low-income families and indigenous peoples. The Committee recommends that the State party increase and strengthen strategies to promote the use of indigenous traditional medicine. Finally the Committee recommends the State party to take necessary measures to reduce and prevent the incidence of obesity among children.

Text of the recommendation

58. The Committee is still concerned about the lack of an integral system of health care for all children up to age 18, the difference in quality between public and private health-care services, the increased medication of children diagnosed with attention deficit hyperactivity disorder (ADHD) and both the undernourishment and obesity levels among children.

59. The Committee reiterates some of its previous recommendations (see CRC/C/CHL/CO/3) and draws the State party’s attention to its general comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health, and recommends that the State party: (...) (c) Strengthen measures to address underweight and overweight among children, promote a healthy lifestyle that includes physical activity and take the necessary measures to reduce the pressure of food marketing on children , in particular with regard to food high in fat, sugar and salt;

Text of the recommendation

30. The Committee notes with concern that it is still permissible to promote the use of tobacco through advertising in the State party and that, while the use of tobacco-derived products is banned in publicly accessible areas, smoking is permitted in areas specially designed for the purpose. The Committee notes, however, that the State party has taken important steps to reduce the threat tobacco poses for life, health, the environment and the general population by ratifying the WHO Framework Convention on Tobacco Control and developing public policies to reduce tobacco use. (art. 12, par. 1)

The Committee recommends that the State party take measures to ban the promotion of tobacco products and enact legislation to ensure that all enclosed public environments are completely free of tobacco.

Text of the recommendation

59. While noting more recent information by the State party that infant mortality has decreased and that poverty maps are helping the distribution of food through the school system, the Committee urges the State party to continue expanding maternal and child health services and nutritional surveillance and support including to more remote areas, in a gender and culturally sensitive manner and with an emphasis on prevention and promotion. The Committee further recommends that the International Code of Marketing Breast-milk Substitutes be disseminated. It further recommends that coordination with other actors of the Integral Protection System and teamwork be improved. The Committee also urges the State party to continue to increase public allocations to health, as required in the Constitution.

Text of the recommendation