Article Contents

Introduction

The purpose of this case note is to reflect on the process of monitoring the implementation of the decision in Camila v. Peru, issued by the Committee on the Rights of the Child (CRC Committee or the Committee). As one of Camila’s legal representatives, I have encountered several challenges in advancing the implementation of the Committee’s Views at the national level, including bureaucratic obstacles and other barriers, some of which are discussed in greater detail below.

Background

On 11 June 2023, the CRC Committee adopted its Views under the Optional Protocol to the Convention on the Rights of the Child on a Communications Procedure (OPIC) in respect of Communication No. 136/2021 Camila V Peru. This marked the first time that the Committee pronounced, in an Individual Communication, on the sexual and reproductive rights of a girl. The case concerned Camila, a 13-year-old victim of sexual violence who was criminally prosecuted for the offence of abortion. The Committee found that Peru had violated her rights under Articles 2, 6, 13(1), 16(1), 19, 24, 37(a), 39, and 12(1), read in conjunction with Articles 6 and 24 of the Convention on the Rights of the Child (CRC). 1

Scope and Content of the Reparations Ordered by the CRC Committee

The Committee recommended that Peru adopt reparation measures for Camila, including, among others, the following:

  • Compensation measures: Provision of adequate compensation and support to enable her to reconstruct her life, including access to continued formal education.
  • Rehabilitation measures: Provision of access to mental health services.
  • Satisfaction measures: Publication and translation of the present Views into Spanish and Quechua.
  • Guarantees of non-repetition:
    • Decriminalise abortion in all cases of child pregnancy;
    • Ensure access to safe abortion services and post-abortion care for pregnant girls, particularly in cases involving risks to life and health and in cases of rape or incest;
    • Amend the regulations on access to therapeutic abortion to make them specifically applicable to girls, taking into account the risks of mortality and morbidity in child pregnancies;
    • Establish clear and effective remedies and ensure accountability for non-compliance;
  • Public policy measures:
    • Provide all children with comprehensive and age-appropriate education on sexual and reproductive health;
    • Establish multisectoral action to prevent the revictimisation of child victims of sexual violence;
  • Training measures: Provide training to health professionals and judicial officials.

In the Case Note 2023/05 by Kangaude, a summary of the Committee's findings for further review can be found.

Commentary

The status of compliance with the reparations ordered by the CRC Committee

Despite marking a milestone in advancing sexual and reproductive rights, particularly with regard to access to abortion, Camila v. Peru continues to face significant challenges in the implementation of the standards it established.

On 19 July 2024, the State complied with the first reparation measure by publishing the decision translated into Quechua. The CRC Committee evaluated Peru at its 98th session, held from 13 to 31 January 2025. During this review, the Committee requested that the State report on the status of implementation of the reparations. The Peruvian delegation indicated that “the Committee’s decisions are being implemented and as demonstrated, the Supreme Court of Justice has incorporated Camila’s case into its case law compendium.” Furthermore, with regard to the provision of health services, government officials reported that Camila has obtained coverage under the Comprehensive Health Insurance System. 2

In the CRC Committee’s most recent follow-up progress report on Camila V Peru, the government stated that it has taken measures to fulfil the reparations, such as initiatives to promote the adoption of bills to decriminalise abortion. In reality, members of Congress have engaged in acts of harassment against the National Maternal Perinatal Institute.

Furthermore, the Government has approved legislation recognising the rights of the unborn child, which further restricts access to therapeutic abortion, as discussed below.

In addition, the application of Law No. 32301, which classifies certain conduct as a serious offence, has led to reprisals affecting the use of international cooperation funds for legal assistance in cases against the Peruvian State. This creates significant risks for NGOs providing legal representation, as they may be exposed to sanctions. Concerns regarding these risks have been raised in the context of the CRC follow-up process. The Committee has also expressed its “regrets that the government has not provided Camila with any compensation to date […]” (para. 64) and has decided to keep the follow-up dialogue open.

In total, more than two years and nine months have passed since the Views were issued. Nevertheless, Peru has not complied with most of the eleven remedies ordered by the CRC Committee, including the provision of adequate compensation at the individual level and the adoption of measures aimed at preventing similar violations at the systemic level in the future.

Challenges to Compliance with the Treaty Body Decision in Camila v. Peru at the National Level

National context setbacks

It is worth highlighting the institutional crisis and the broader setbacks in human rights in Peru, which have intensified in recent years. The legislative branch, the Congress of the Republic, has promoted and approved several harmful legislative initiatives. These include bills that restrict access to sexual and reproductive rights, impose heightened oversight and control over civil society organizations (CSOs), and challenge the recognition and authority of the Inter-American Human Rights System.

The Congress of the Republic, composed largely of conservative members, has promoted and adopted legislation that undermines the protection of sexual and reproductive rights. This includes Law No. 32000, which recognizes the conceived child as an “unborn child”, and Law No. 31935, which establishes that human life begins at conception. Through these initiatives, the congressional majority seeks to limit the rights of adolescents and women and to prioritise the protection of the unborn child, despite the potential impact on the rights of adolescents and women, including their rights to dignity, life, and bodily integrity. However, the Committee on the Elimination of Discrimination against Women (CEDAW Committee) has previously clarified, in L.C. v. Peru, that such approaches constitute discrimination against women (para. 8.15).

In addition, the State has been reluctant to engage in dialogue since the CRC Committee issued its Views. On 23 August 2023, a member of the Congress of the Republic convened a technical meeting with government authorities and human rights organizations to follow up on the remedies ordered by the Committee. The purpose of the meeting was to monitor the implementation of the decision and to ensure that governmental institutions fully comply with their responsibilities regarding reparations. Nevertheless, the State has not promoted any further follow-up meetings.

Peru has not established a follow-up mechanism, nor has it created a national-level method for determining the amount of compensation and how it will be paid. For this reason, the legal representatives have proposed conducting a pericial assessment to determine an amount that would fully compensate Camila, taking into account, in a reasonable and proportionate manner and based on evidence, the impact that the acts of violence committed by the State have had on her life plans.

Although the government has been found responsible in other cases, such as L.C. v. Peru, it has not taken adequate measures to establish a mechanism for payment, and victims are often required to wait many years to receive compensation. For example, in L.C. v. Peru, the government took approximately five years to compensate the victim. Therefore, it is a priority to establish an effective mechanism for monetory compensation for victims.

Persistent barriers to access to therapeutic abortion

Therapeutic abortion has been legal since 1924, as established in Article 119 of the Criminal Code, which permits it only to save the life of a pregnant person or to prevent serious and permanent damage to their health. Abortion remains criminalised in all other circumstances, including in cases of rape. Following the decisions in K.L. v. Peru (2005) and L.C. v. Peru (2011), the Government of Peru promulgated, in 2014, the “National Technical Guide for the Standardisation of the Procedure for Comprehensive Care of Pregnant Women in the Voluntary Termination of Pregnancies of less than 22 weeks by Therapeutic Indication” (Technical Guide).

The Technical Guide has been subject to judicial review for many years. In 2014, the NGO Acción de Lucha Anticorrupción Sin Componenda filed a constitutional appeal against the Ministry of Health (MINSA), seeking to prevent the implementation of the Technical Guide. In 2022, the Supreme Court declared the Guide lawful and recognised that “therapeutic abortion is constitutionally legal and that its regulation is necessary for its implementation.” The Court therefore ordered the State to update the Technical Guide with specific provisions that take into account the views of girls and adolescents and incorporate the principle of conscientious objection.

Despite judicial recognition of the validity of the Guide, there have been efforts in practice to restrict its interpretation. One example is the campaign against the National Maternal Perinatal Institute, known as “La Maternidad”, which is responsible for providing specialised reproductive health care nationwide and has adopted the Clinical Practice and Procedures Guide for Obstetrics and Perinatology in accordance with the Technical Guide. However, a conservative organisation, with the support of members of Congress, has promoted amendments to this Clinical Practice Guide, reducing the number of grounds for therapeutic abortion from 15 to 11.

These amendments have led to a restrictive interpretation of therapeutic abortion, which runs counter to the ruling in Camila’s case. In that decision, the Committee called for amendments to the Technical Guide to make it specifically applicable to girls, to establish a clear remedy for failures to comply with the procedures governing access to therapeutic abortion and to ensure that those responsible for such failures are held accountable (para. 9). Accordingly, the government must develop, adopt, and implement an administrative disciplinary procedure to penalise health care providers who fail to comply with the Therapeutic Abortion Guidelines, including by classifying the denial, delay, or obstruction of access to therapeutic abortion as a serious offence.

In its Concluding Observations to Peru issued in 2016 and 2025, the Committee has recommended that the State party should decriminalize abortion in all circumstances, ensure children’s access to safe abortion and post-abortion care services.

However, the lack of political will to implement the decision in Camila’s case has resulted in other girls who are victims of sexual violence being denied a therapeutic abortion, without due consideration of the significant adverse effects that forced pregnancy has on their physical and mental health. For example, Mila v Peru. Mila is an 11-year-old girl who was a victim of sexual abuse since she was 6 years old by her stepfather. As a result of the rape, she became pregnant. Just a few weeks after the Camila decision was published, on July 3 and then on July 20, 2023, Mila submitted a request for the application of the therapeutic abortion protocol, but her request was denied. Promsex and I filed a petition, including an urgent request for an interim measure before the CRC. On August 11, 2023, the CRC Committee registered the case and granted the interim measure, requesting the State to provide access to a therapeutic abortion. On August 12, the Minister of Health provided Mila with access to termination of pregnancy.

Although Mila, assisted by her lawyers and the CRC Committee, was able to access the service she needed, there are many other cases of girls and adolescents who cannot access abortion due to persistent barriers, particularly in rural and indigenous areas.

Binding nature of the pronouncement and decisions of treaty bodies

Peru's legal framework recognizes the binding nature of pronouncements and decisions adopted by supranational courts and treaty bodies. Indeed, the Constitution of Peru establishes that the international legal framework is integrated into national law pursuant to Articles 3 and 55, as well as the Fourth Final and Transitional Provision.

In addition, Article VIII of the New Peruvian Constitutional Procedural Code and Article V of the Preliminary Title of the Peruvian Constitutional Procedural Code stipulate that the content and scope of the rights protected by constitutional judicial proceedings must be interpreted in accordance with treaty bodies and judgments of supranational courts. Similarly, the Constitutional Court stated that the international legal framework must be binding on all public authorities (see Constitutional Court para 12).

Nevertheless, at the national level, domestic public authorities, judges, and prosecutors resist, fail to apply, or omit to recognize the international legal framework and the decisions of these supranational courts and bodies.

National mechanisms to follow up on decisions

Peru has not established a follow-up mechanism. It only has an Intersectoral Protocol for the Participation of the Peruvian State before the International Human Rights Protection System, which does not provide for programmatic actions to ensure the follow-up of decisions (see Supreme Decree 2020).

The creation of a national mechanism to follow up on decisions would facilitate not only the implementation of treaty bodies’ decisions but also improve the space for dialogue with victims and their legal representatives. In Camila’s case, the State has not defined a strategy for implementing the decision, nor has it specified which public institutions are responsible for implementing the remedies. In addition, the Government of Peru has not provided information on the status of each reparation, despite such information having been requested through public information procedures.

As a result, the government’s efforts remain largely nominal rather than practical. Finally, it is important to emphasise that the long path to justice, and the Views issued by treaty bodies, do not mark the end of victims’ suffering. This is evident in Camila’s case, where she had to pursue remedies at the domestic level and wait years for the CRC Committee’s decision and must now continue to wait for Peru to comply with the ordered remedies. I know her and deeply admire her resilience and patience; however, the question remains: how many more years will Camila have to wait to receive reparation?

Further References
  1. See further, Elida Guerra, Camila v. Peru: Standards Set by CRC on Sexual and Reproductive Rights, Hopkins Press. Human Rights Quarterly 46 (4), 2024.
  2. Comprehensive Health Insurance (Seguro Integral de Salud-SIS). SIS provides free and low-cost health insurance to Peruvians living in poverty and extreme poverty. However, SIS doesn’t provide effective mental health services.