Right to the highest attainable standard of health

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Right to the highest attainable standard of
health

• By Rajat Khosla

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Introduction

• The health and human rights communities have much
  in common
• The last few years have seen some remarkable
  developments in the field of international human
  rights

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What is the right to the highest attainable
standard of health?

• The right to the highest attainable standard of
  health is codified in numerous legally binding
  international and regional human rights treaties.
• The right is also enshrined in numerous national
  constitutions

4
Contd.

• While the right to health includes the right to
  health care, it goes beyond health care to
  encompass the underlying determinants of health
• The right includes freedoms
• It also includes entitlements
• The right requires an effective, inclusive health
  system of good quality
• One of the techniques devised to unpack this
  right is with the help of what is called as the
  AAAQ analysis

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Contd.

• Another way to unpack this right is by
  considering the right in the light of trilogy of
  obligations namely respect, protect and fulfil
• International human rights law is realistic and
  recognises that the right to the highest
  attainable standard of health for all cannot be
  realised overnight
• Although qualified in this way, nonetheless the
  right to health imposes some obligations of
  immediate effect
• The right demands indicators and benchmarks to
  monitor the progressive realization of the right

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Contd.

• It also encompasses the active and informed
  participation of individuals and communities in
  health decision-making
• Under international human rights law, developed
  States have some responsibilities towards
  realisation of right to health in poor countries
• Right to health demands effective mechanisms of
  accountability

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Health professionals and human rights

• As providers of health services, health
  professionals play an indispensable role in the
  promotion and protection of right to health
• They have played an important role in helping
  document and redress violations of human rights,
  such as violence and torture
• In many countries, health professionals are
  poorly paid and work long hours with shortages
  equipment in obsolete facilities

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Contd.

• Poor terms and conditions of employment are a
  major cause of brain drain
• While some benefits may accrue due to the
  exporting countries, the potential adverse
  outcomes, including shortages of health
  professionals and a decline in the quality of
  health care outweigh these
• In some countries, on account of their
  professional activities, health workers have been
  victims of discrimination, arbitrary killings and
  torture

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Contd.

• Some health professionals have participated,
  often under duress, in human rights abuses
  including torture
• Inadequate compliance by health professionals
  with human rights standards is often the result
  of complex and interrelated circumstances
  including political pressure and social
  influences
• However, it is often attributable to inadequate
  or non-existent training in human rights

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Contd.

• Human rights education is an essential starting
  point for equipping health professionals with the
  knowledge and tools to empower them to protect
  and promote human rights
• The value of educating health professionals in
  human rights has been widely endorsed by states
  and the health and human rights communities
  worldwide
• What the health professionals need to know, to
  some extent will depend upon the country they
  work in and also their area of specialisation
• At a minimum all health professionals should
  receive education on human rights of patients
  including their right to health, health related
  human rights of vulnerable groups and their own
  human rights

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The UN Special Rapporteur on the right to the
highest attainable standard of health

• A UN Special Rapporteur is an independent expert
  appointed to promote and protect human rights.
• For many years, the UN appointed Special
  Rapporteurs to focus on the classic civil and
  political rights, like freedom of religion and
  the prohibition against torture

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Contd.

• Recently the UN has appointed experts to focus on
  economic, social and cultural rights, the first
  being the Special Rapporteur on the right to
  education who was appointed in 1998
• In 2002, the UN decided to appoint a Special
  Rapporteur on the right to the highest attainable
  standard of health

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Contd.

• The Rapporteur is asked to help States, and
  others, better promote and protect the right to
  the highest attainable standard of health
• The first report of the SR identified three key
  objectives to promote and encourage others to
  promote the right to health as a fundamental
  human right to clarify the scope of the right to
  health and to identify good practices for the
  operationalisation of the right to health at the
  community, national and international levels

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Contd.

• These three objectives are pursued by the SR by
  focussing on two inter-related themes poverty
  and discrimination
• Each year the SR submits written and oral annual
  reports to the UN General Assembly and another to
  the UN Human Rights Council

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Contd.

• In each report he then selects one or more issues
  that is then examined through the prism of the
  right to health
• To date, these annual reports have looked at a
  range of issues, including the health-related
  Millennium Development Goals, the skills drain of
  health professionals, access to medicines,
  maternal mortality, sexual and reproductive
  health rights, indigenous peoples, mental
  disability, and others

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Contd.

• The SR also undertake two country missions each
  year
• Hitherto, country missions have been undertaken
  to - and reports completed on Lebanon/Israel,
  Mozambique, Peru, Romania, Uganda, and Sweden.
  One mission was not to a country but to the World
  Trade Organisation to examine important global
  issues trade liberalisation, patents that
  impact on the right to health in all States

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Contd.

• Special Rapporteurs frequently receive
  information alleging human rights abuses falling
  within their mandate.
• The information comes from victims, their
  families, and civil society organizations.
• These complaints have included the persecution of
  health workers on account of their professional
  activities discrimination on the basis of health
  status, including HIV/AIDS the abusive treatment
  of mental health patients etc.

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Conclusion

• A right to health approach - whether to poverty
  reduction, neglected diseases (Uganda) or trade
  (Peru) - does not imply a radically new
  departure.
• Nonetheless, an examination of the problem
  through the right to health lens can provide
  insights, and signal measures, that sharpen and
  deepen existing initiatives.

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Conclusion

• Increasingly, the right to the highest attainable
  standard of health presents health and human
  rights professionals with new opportunities and
  challenges.
• While human rights do not provide magic
  solutions, they have a constructive contribution
  to make. The failure to use them is a missed
  opportunity of major proportions.