World Health Day, 7 April 2011, is not only as day to remember how important health is to every one of us, but it is also a day in which we should recall that the highest attainable level of mental and physical health is a human right for every single person on earth.
While this doesn’t mean that every person has to be healthy, it does mean that governments everywhere must cooperate to ensure adequate access to healthcare for everyone —no exceptions. This “idea” is not merely idealistic language, but it is “rights” language that evidences the legal obligations of every government that has ratified a treaty that includes the human right to health.
This includes almost every government in the world.
The Convention on the Rights of the Child has been ratified by 190 governments that have undertaken to ensure the right to health for every child under their jurisdiction. The Convention on the Elimination of All Forms of Discrimination against Women has been ratified by 186 governments that have undertaken legal obligations to ensure women’s equal access to healthcare. And the International Covenant of Economic, Social and Cultural Rights has been ratified by more than 160 governments that have undertaken to ensure the right to health for every individual under their jurisdiction.
The list of treaties and other international instruments containing the right to health is much longer, but these three treaties alone show that virtually every government in the world has undertaken a solemn legal obligation to protect the right to health. They have done this publicly, attesting to their commitment not only to their own people, but also to the public at large.
With such strong commitment to the human right to health, one would expect that the World Health Organisation (WHO), the United Nations specialised agency for health, would also be driven by the human right to health. Indeed, the WHO’s Constitution recognises this right to health and the WHO was a leading force behind the inclusion of the right to health in the influential and aspirational Universal Declaration of Human Rights more than 50 years ago. Unfortunately, however, it is not the case.
The states that make up WHO’s top plenary body, the World Health Assembly (WHA) have failed to adopt a single resolution calling for the right to health to be operationalised through a human rights-based approach. The WHA’s resolutions establish the priorities of the 193 member states of the United Nations family’s primary health agency. WHA resolutions also set the priorities for the WHO. In 60 years of existence, the WHO has never made the rights-based approach to health one of its top priorities.
This has happened despite the WHO’s leading role in fashioning the first expression of this right in international instruments, despite the fact that its constitution recognises this right, and despite the fact that every one of its member states have unambiguously undertaken legal commitments to ensure the human right to health.
For the past few years, several member states have been suggesting that the WHO mend its misguided ways. There have been several proposals from states, most recently the Lusophone countries of Timor Leste, Brazil, Angola and Portugal, which have interested themselves in trying to correct this odd situation. Some proposals have been for a resolution on the right to health, while other efforts have been incremental attempts to make governments feel comfortable with “rights” language.
These proposals usually surface in the WHO Executive Board meetings held in January of each year. Four years ago, rights language was proposed in a resolution on the Health of Migrant Workers, but the WHO opposed it and contributed to it being edited out. At the last Executive Board meeting in January 2011, a proposal for a resolution on the human right to health was circulated. While no government opposed it, none were willing to put it forward. Brazil, however, did propose “rights” language taken verbatim from paragraph 1 of Article 25 of the Universal Declaration of Human Rights for inclusion in a resolution on Sustainable Health Financing Structure and Universal Coverage. After watching the single government delegation that might object, huddle and then remain silent, sighs of relief and surprise murmured through the Executive Board room as the language was adopted. The draft resolution will now be considered by the WHA in May 2011.
Still, however, there is no resolution on the human right to health on the WHA agenda. This is even more surprising when one notes that the WHO has several staff working on the right to health. By some counts, there may be almost two-dozen WHO staff that have mandates to focus their work on the right to health. As a consequence a resolution operationalising the human right to health would add no additional burden to the WHO’s budget, but could provide important guidance for the use of resources already committed to the human right to health.
Most importantly, however, is what the rights-based approach means for the WHO and government action on health. It means the most to those individuals and groups of individuals who are the most vulnerable among us. It focuses our attention on vulnerable individuals and groups, especially women and children, and on our most important global problems, such as climate change and disease and their impacts on human beings.
The rights-based approach to health or the human right to health is about human beings. It requires reflection on how the actions of governments affect the wellbeing of the people who are most vulnerable. It also requires that we include the voices and concerns of the most vulnerable in our international action to ensure the greatest attainable health for all. And it requires accountability by these actors to the people who are the beneficiaries of the human right to health.
For the WHO, these requirements oblige it to encourage cooperation between governments to encourage resources sharing, to achieve the highest attainable standards of health for all. It also requires that the WHO open its ears to civil society whose access to its international health policy forums it has severely restricted in recent years. Civil society actors who work within states, but not with the WHO Secretariat, cannot be accredited to the WHO, according to the WHO’s civil society liaison office. And it requires that the WHO be evaluated on what it delivers to the people who need their health improved the most, and whose health can be measured in terms of basic indicators like maternal, infant and child mortality.
For governments, a WHA resolution on the human right to health reiterates their already existing commitments in their primary international forum dealing with health. Rather than creating any new obligations, governments would merely be saying that health is a human right, and not merely a negotiable good for them as they undertake international action under the auspices of the principle international health agency that they have created. Such a resolution could also reiterate an all-important message about the cooperation that is needed to achieve the right to health for all. Such cooperation includes resource sharing and optimisation between governments and between other international bodies like the International Labour Organisation and the UN’s Human Rights Council, which themselves have already adopted resolutions on the human right to health.
On World Health Day 2011, governments can take an important collective step to secure health for all by reiterating their commitment to the human right to health. The member states of the WHO can do this by committing to adopt a meaningful resolution on the right to health at the next World Health Assembly, just over one month away. This would be a fitting way to celebrate the 63rdWorld Health Day and to redress a delinquency that has continued unaddressed for far too long.
The writer is an international human rights lawyer based in Geneva, Switzerland, who represents Nord-Sud XXI at the United Nations.