The Human Right to Health

1. The Human Right to Health “everyone has the right to a standard of living adequate for the health of himself and of his family” [sic.] Universal Declaration of Human Rights, Article 25

2. Health as a Human Right • “Right to health and the Universal Declaration of Human Rights” Pillay, Navanethem. The Lancet 372 (2008): 2005-6. • What is the Human Right to Health and Health Care? National Economic and Social Rights Initiative • Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (August 2016, UN General Assembly) • Report of the Commission on the Social Determinants of Health (WHO, 2008) • Civil Society’s Report to the Commission on Social Determinants of HealthSocial Medicine 2(4):192-211 This report provides a critique from non-governmental actors to the Official Commission report, emphasizing its failure to address the structural sources of health inequities, which are based in the market-based model advanced by globalization.

3. What is the Human Right to Health and Health Care? National Economic and Social Rights Initiative • Universality: Everyone must have access to equal high-quality and comprehensive health care. • Equity: Resources and services must be distributed and accessed according to people's needs. We get what we need and give what we can. • Accountability: The health care system must be accountable to the people it serves. • Transparency: The health care system must be open with regard to information, decision-making, and management. • Participation: The health care system must enable meaningful public participation in all decisions affecting people's right to health care. Source: New Social Contract: Transformative Solutions Built by and for Communities

4. The Human Right to Health is protected in: • Article 25 of the Universal Declaration of Human Rights • Articel 12 of the International Covenant on Economic, Social and Cultural Rights • Article 24 of the Convention on the Rights of the Child • Article 5 of the Convention on the Elimination of All Forms of Racial Discrimination 1965 –U.S. Ratification 1994 • Articles 12 & 14 of the Convention on the Elimination of All Forms of Discrimination Against Women • Article XI (11) of the American Declaration on Rights and Duties of Man • Article 25 of the Convention on the Rights of Persons with Disabilities • UN ECOSOC--legally binding interpretation of the human right to health (General Comment 14). Source: NESRI https://www.nesri.org/programs/what-is-the-human-right-to-health-and-health-care

5. Collective vs. Individual Rights--Ensuring the social conditions necessary for individuals’ health and well-being ‘Collective rights’ can refer either to the right of a group to limit the liberties of its own members in the interest of group solidarity or purity (internal restrictions), or the right of a group to limit the powers of a majority to curtail the interests of minorities (external protections). It argues that the latter need not conflict with individual liberty. • The Significance of Collective Rights to Public HealthAmerican Journal of Public Health Research. 2018, 6(5), 203-214 • The essence of collective rights includes the social, economic, political, cultural and environmental rights; all of them are essential to the development of public health. • Violations of [social, economic, political, cultural ] rights act individually and synergistically and hinder the development of public health.

6. Institutionalizing the Human Right to Health Over time, we’ve seen a thickening and strengthening of international legal and institutional infrastructure supporting the human right to health as well as other dimensions of human rights. • Establishment in 2002 of the UN Special Rapporteur on the right to health under the Office of the High Commissioner for Human Rights; • Independent expert monitoring body overseeing the implementation of the Covenant, the Committee on Economic, Social and Cultural Rights, guidance on the right to health: • the availability, acceptability (culturally/gender sensitive) and accessibility of functioning public-health facilities, goods, services, and programmes; • States must ensure the so-called underlying determinants of health: safe drinking water, adequate sanitation facilities, availability of hospitals and clinics, training of medical and professional personnel, and access to sufficient essential medicines of good quality • UN ECOSOC--legally binding interpretation of the human right to health (General Comment 14) • United Nations Draft Conventionon Transnational Corporations and Human Rights • WHO Commission on the Social Determinants of Health

7. UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health • Established in 2002 • Monitors trends and developments in particular places, communicates with states and other key actors, promotes international cooperation around health concerns • Special Rapporteur presents annual reports to the Human Rights Council and to the General Assembly on the activities and studies undertaken in the view of the implementation of the mandate (See Annual Reports); • For more information on the history of the mandate, please refer to the following link: Overview of the mandate. • https://www.ohchr.org/EN/Issues/Health/Pages/SRRightHealthIndex.aspx

8. Civil Society Report on Commission on Social Determinants of Health Civil society plays a key role in helping define and defend human rights. This report critiques the Commission’s (predictable, due to its governmental status) failure to confront the power structures that reproduce poor health outcomes: • 30,000 children die every day, mainly from preventable and easily treatable diseases…they die, not because we do not have the knowledge and the technology to prevent such deaths. They die because of the conditions in which they live • [Declaration of] Alma Ata’s failure due to “ideological, globally orchestrated and globally co-coordinated” attack on Alma Ata agenda, which in 1978 called for governments to achieve universal primary health care by the year 2000.

9. Civil Society Report on Commission on Social Determinants of Health Key here is this document’s emphasis on the role of civil society movements and their transformative understanding of human rights in bringing about change (i.e., as opposed to government leadership and neoliberal ideology): • We view the human rightsframework, not as one that legitimizes and helps maintain the status-quo, but one that challenges the status-quo by pointing out how it structurally violates human rights. • Civil Society report emphasizes the importance of strengthening WHO and giving it priority over global financial institutions. • One of the principal reasons why the promise ofAlma Ata and the PHC approach did not wither away entirely is to be found in countless civilsociety initiatives across the globe that strove tokeep it alive • CS Report emerged from first People’s Health Assembly, (2000) which led to the People’s Health Movement & Charter • Social Medicine Portal: “Our goal in creating this site is to link together the diverse international community of people working in social medicine and health activism. We encourage visitors to e-mail us materials for inclusion.”– example of social movement education to counter predominant medical paradigm

10. What have been effects of the WHO Commission on Social Determinants of Health? • […T]here has not been widespread policy uptake of its recommendations to improve daily living conditions, tackle the inequitable distribution of power, money, and resources, and monitor both inequities and the impact of policies to address them. • The CSDH's report did not have the impact to which it aspired. It would be naive to ignore the reality of the global political economy, whereby powerful actors actively work against reducing health inequities when it threatens their political and economic interests. Source: 10 years after the Commission on Social Determinants of Health: social injustice is still killing on a grand scale The Lancet September 21, 2018

11. What have been effects of the WHO Commission on Social Determinants of Health? • Furthermore, recent electoral results in some countries suggest that the political appeal of increased social equality between population groups is not a given, especially in societies that are becoming more polarised. But weaknesses in the CSDH's report and the broader social determinants discourse have also hampered progress. These include the opaqueness of social determinants as a label, the absence of a prioritised, actionable agenda, dominance by public health academia, insufficient focus on policy and implementation, disengagement by sectors beyond health, and the absence of a broad and active social movement. • In the tenth anniversary year of the CSDH, health equity advocates should revisit its analyses and recommendations, and act together to overcome the challenges and interests stacked against action on social determinants (panel). The global health community cannot once again fail to adequately prioritise the actions in society most important to improving health and realising health equity. Source: 10 years after the Commission on Social Determinants of Health: social injustice is still killing on a grand scale The Lancet September 21, 2018