Health and Human Rights

Given the discussion about the issue of health today, whether it is related to health care coverage in the United States of America, the health of Syrian refugees (or many other non-Syrian refugees) as they either try to escape conflict (now living in refugee camps, or in other parts of the Middle East), or are migrating to European states , or the Ebola Virus, health and human rights are a very important topic. Health rights are often related to many other rights and issues (OHCHR & WHO), and when guaranteed, offer many positive benefits to the individual, and to society as a whole.

In this article, we will discuss the relationship between health and human rights in international relations. We will begin by talking about health and human rights from the perspective of international human rights law. We will examine the various types of legal support for health rights in the international system. Then, we shall address some of the ways in which activists are working to ensure the human right to health. We will also discuss state actions related to the health and human rights, as well as legal responses towards those that may try to deflect responsibility for ensuring the health of their citizens.

The Right to Health

The right to health is an important question in the field of human rights. The idea that the rights to health care matters is the foundation of the reason why we have an international human rights system in place to begin with: human beings have the right to safety and security, and these ideas of human security are not limited to notions of conflict or state violations of these rights. While that has been the argument for many, it is not the only way that people can lose their security. Namely, “human life is also threatened when human beings do not have access to adequate food or nutrition, housing, or medical care. Indeed, more human lives are threatened by poverty and lack of access to food or health care on a daily basis than by intentional state killings” (DeLaet, 2006: 102).

The World Health Organization, an UN related international organization, states the connection between health and human rights, when they say that a ” state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity” and “the highest attainable level of health is the fundamental right of every human being” (in Gruskin, Mills, & Tarantola, 2007: 450).

History of Health and Human Rights

There is a great deal of support for health as a human rights in international human rights law. In fact, the idea of health, or the protection of health of the individual, has been advocated internationally, and by international organizations for roughly a century.

While there has been a great deal of reference to, and the importance of health in secular and religious texts for centuries, from an international relations perspective, one of the first organizations to allude to the idea of health and human rights was the International Labour Organization. This organization, founded in 1919, set out to protect the labour rights of workers around the world. The ILO was clearly concerned about the health conditions that many workers were dealing with, alongside other issues such as low pay, unfair treatment at the workplace, etc… For example, beginning early in its creation, and throughout the decades, the ILO has continued to advocate for the health (among other issues) of workers. For example,

The ILO… has endeavoured to set international standards for workers’ protection and to provide practical information about the world’s labour problems. Many of the ILO Conventions and Recommendations thus concern safety, health and conditions of work. For example, Convention No. 1 (1919), which provided working hours should not exceed eight hours a day and 48 hours a week, has had an enormous influence on national law and practice. Recommendation No. 5 (1919) advocated the establishment of government services to safeguard the health of workers. Other examples include Convention No. 14 (1921) on weekly rest in industry, Recommendation No. 102 (1956) on welfare facilities, the Minimum Age Convention No. 138 (1973) and a series of Conventions and Recommendations on safety, health and working conditions. Recent examples are Convention No. 155 and Recommendation No. 164 (1981) on occupational safety and health (ILO, 1987).

In the mid 1940s we saw the formation of the United Nations, an international organization formed out of World War II, in order to ensure international peace and security. Human rights, while arguably not the primary motivation for the formation of the organization by original architects such as the United States, Russia, and Great Britain, the idea of human rights was a central principle for many of the Global South States.

In 1949, the United Nations General Assembly passed the Universal Declaration of Human Rights, by a vote of 48-0-9. There are a couple of articles in the UDHR has have connections to health and human rights. For example, Article 3 states that “Everyone has the right to life, liberty and security of person.” Article 5 says that “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.” And Article 25 makes specific references to health and human rights. Article 25 reads: (1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. (2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.”

Shortly after the passing of the UDHR, states began working on additional human rights documents. Two additional human rights documents were formalized in 1966 (and put into force in 1976) were the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social, and Cultural Rights. In the ICCPR, there are a handful of references to protecting the public health.

The ICESCR in particular has many more direct references to health and human rights. For example, in Article 7 (b) of the ICESCR, speaking on work conditions, calls for “Safe and healthy working conditions,” and 7(d) calls for “Rest, leisure and reasonable limitation of working hours…”. Article 10, speaking on behalf of children, says that “Special measures of protection and assistance should be taken on behalf of all children and young persons without any discrimination for reasons of parentage or other conditions. Children and young persons should be protected from economic and social exploitation. Their employment in work harmful to their morals or health or dangerous to life or likely to hamper their normal development should be punishable by law. States should also set age limits below which the paid employment of child labour should be prohibited and punishable by law.” And as a positive development from previous documents (that did not mention health), Article 12 not only talks about health as a human rights, but also speaks about mental health and human rights.

Article 12 (1) states that “The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.” It goes on to also say that:

Convention on the Rights of Persons with Disabilities

One of the other advancements on the issue of health and human rights in the context of international law is the formation and passing of the Convention on the Rights of Persons with Disabilities. This convention was passed in 2006, and calls for a variety of rights for persons who are disabled. Article 1 of the Convention states that “The purpose of the present Convention is to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity. Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.” The convention also calls for “Recognizing the importance of accessibility to the physical, social, economic and cultural environment, to health and education and to information and communication, in enabling persons with disabilities to fully enjoy all human rights and fundamental freedoms” (v).

There are many other recerenes to health and human rights in the document. Some of the other references are:Article 16 (4), which states that States Parties shall take all appropriate measures to promote the physical, cognitive and psychological recovery, rehabilitation and social reintegration of persons with disabilities who become victims of any form of exploitation, violence or abuse, including through the provision of protection services. Such recovery and reintegration shall take place in an environment that fosters the health, welfare, self-respect, dignity and autonomy of the person and takes into account gender- and age-specific needs. The Convention also has an article article (25) dedicated to health. Article 25 reads:

States Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability. States Parties shall take all appropriate measures to ensure access for persons with disabilities to health services that are gender-sensitive, including health-related rehabilitation. In particular, States Parties shall:

(a) Provide persons with disabilities with the same range, quality and standard of free or affordable health care and programmes as provided to other persons, including in the area of sexual and reproductive health and population-based public health programmes;

(b) Provide those health services needed by persons with disabilities specifically because of their disabilities, including early identification and intervention as appropriate, and services designed to minimize and prevent further disabilities, including among children and older persons;

(c) Provide these health services as close as possible to people’s own communities, including in rural areas;

(d) Require health professionals to provide care of the same quality to persons with disabilities as to others, including on the basis of free and informed consent by, inter alia, raising awareness of the human rights, dignity, autonomy and needs of persons with disabilities through training and the promulgation of ethical standards for public and private health care;

(e) Prohibit discrimination against persons with disabilities in the provision of health insurance, and life insurance where such insurance is permitted by national law, which shall be provided in a fair and reasonable manner;

(f) Prevent discriminatory denial of health care or health services or food and fluids on the basis of disability.

Health and Human Rights Advocacy

Given the legal protections for health as a human rights, it is important to examine how these sorts of rights are being protected.

One of the most continued points of emphasis on health and human rights is through advocacy. Health and human rights activists are fighting to not only offer their own resources to ensure health human rights are provided, but are also working with government and other organizations to ensure that these actors are doing all that they can do to for health human rights (Gruskin, Mills, & Tarantola, 2007).

Health advocacy can take a number of forms. Health and human rights can mean that an individual has access to necessary medicines, health professionals, and clean water and food. In addition, an individual has health services for their children, and education on health issues (OHCHR & WHO).

Health and Human Rights as it pertains to the State

As mentioned above, international human rights law calls for states to guarantee health as a fundamental human right. However, one of the greatest challenges that activists and citizens face is that the state can (and sadly, often does) attempt to frame the issue of health care either outside of the rights discourse, or they discuss health and human rights separate from one another, thus trying to minimize the responsibility that a government has to ensure their citizens have access to various health rights. Or, at other times, they may recognize the idea of health care as a human rights, but argue that they do not have the sufficient resources to provide this right.

Activists challenge this idea, arguing that just because a state makes the claim that they cannot afford to offer health services, this does not excuse their actions of not protecting this right. As the OHCHR & WHO argue, “…no State can justify a failure to respect its obligations because of a lack of resources. States must guarantee the right to health to the maximum of their available resources, even if these are tight. While steps may depend on the specific context, all States must move towards meeting their obligations to respect, protect and [fulfill]”.

Conclusion

Health and human rights is an important topic. International law guarantees the right to health. And yet, so many people continue to go without health rights. Therefore, it is important that activists continue to work with the state and other non-state actors to advocate and establish programs that help ensure the health rights of all in society.

 

References

Gruskin, S., Mills, E.J. & Tarantola, D. (2007). Health and Human Rights 1: History, principles, and practices. The Lancet, 370, pages 449-55. Available Online: http://ac.els-cdn.com.ezproxy.butler.edu/S0140673607612008/1-s2.0-S0140673607612008-main.pdf?_tid=86e9b390-a370-11e5-96ac-00000aab0f6b&acdnat=1450214120_56bf4d31b4e7992398030a57dded92bf

International Labor Organization (1987). Safety-Health and Work Conditions. Training Manual. Joint Industrial Safety Council Available Online: http://www.ilo.org/wcmsp5/groups/public/@ed_protect/@protrav/@safework/documents/instructionalmaterial/wcms_175900.pdf

OHCHR & WHO (2008). The Right to Health. Fact Sheet No. 31. June 2008. Available Online: http://www.ohchr.org/Documents/Publications/Factsheet31.pdf