Health As A Basic Human Right

Health as a Basic Human Right

been to constrain the individual in order to protect the group. 

––––––––––––––––––––––––––––––––––––––––––––––– In exploring the connection between health and human rights, we propose three relationships, each of which focuses on an important aspect of this critical linkage.

Certain public health measures, proposed on the basis of excellent scientific data )e.g., adding iodine to table salt to prevent iodine efficiency and cretinism), may limit or eliminate individual choice and also have some side effects and costs.

The first relationship, which can be diagrammed simply as H  HR concerns the potential impacts of health policies, programs, and practices on human rights.

Human rights and public health have increasingly recognized the vital role of the societal environment to both health and the realization of human rights.

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Even while many individuals do what they can to be healthy (for example, eating well and avoiding tobacco smoking), their health will be strongly influenced by a polluted environment, dangerous work conditions or lack of safe drinking water. Similarly, the freedom to make one’s own decisions depends on conditions such as having sufficient income, a place to live, and good health. In turn, these factors are heavily influenced by whether or not an individual belongs to a group that suffers discrimination. Thus, the relationship between the individual and the society is more complex than it may initially appear.

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Recognition of the complementarily of public health goals and human rights norms can lead to more effective health policies and programs. The challenge is to negotiate the optimal balance between promoting and protecting public health and promoting and protecting human rights.

The second relationship, which can be diagrammed, equally simply as H  HR, expresses the idea that violations or lack of fulfillment of any and all human rights have negative effects on physical, mental, and social well-being (health). •

This is true in peacetime and of course in times of conflict and extreme political repression.

The third relationship, which can be diagrammed as H  HR, conveys the idea of inextricable connection. • •

The central idea of the health and human rights movement is that health and human rights act in synergy. Promoting and protecting health requires explicit and concrete efforts to promote and protect human rights and dignity, and greater fulfillment of human rights necessitates sound attention to health and to its societal determinants.

The Public Health ––– Human Rights Dialogue Public health and human rights can be considered as two different, often complementary and occasionally conflicting ways of looking at the world. Even when they address similar or even identical problems, their language and underlying assumptions may differ. Public health is concerned with promoting and protecting health –– in other words, physical, mental, and social well-being –– and with preventing or reducing morbidity (illness, disability, or suffering) and premature mortality. A fundamental yet often unstated assumption is that public health seeks the greatest good for the greatest number. Human rights are concerned with promoting and protecting the well-being of individuals by ensuring respect for individual rights and dignity. A central concern in human rights is the ethical principle of autonomy. It is therefore inevitable that some tension will emerge between public health and human rights perspectives and approaches to promoting human well-being For example:

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At times, an individual may be considered dangerous for the health of the larger group. (e.g. a person with tuberculosis can infect contacts; the intoxicated driver may cause automobile crashes that endanger others.) The public health response to these situations has often

Human rights and public health are two complementary approaches, and languages, to address and advance human well – being. •

The human rights approach to seek to describe –– and then promote and protect –– the societal prerequisites for human well – being in which an individual can achieve his or her full potential.

Health concerns are the physical, mental, and social wellbeing of individuals. Public health can be defined as “ensuring the conditions in which people can be healthy.” The core of public health knowledge, based on research and experience, is that blends of individual and societal – level factors are involved in determining health status. For many, if not most people, the societal context is the major determinant of vulnerability to preventable disease, disability, and premature death. The Universal Declaration of Human Rights –– the cornerstone document of modern human rights –– through its focus on the societal-level determinants of well-being addresses a panoply of public health issues and concerns, even though the word health itself appears only once in the document. •

The focus of the universal Declaration on these societal-level health determinants provides public health with a framework, vocabulary, and guidance for analysis and direct response that may ultimately prove more useful to promote public health than frameworks inherited from biochemical and public health traditions.

From a human rights perspective, interest in health has primarily focused on governmental actions taken in the name of public health and their impact on the rights enshrined in international human rights law. Most actions taken in the name of public health care are carried out under the aegis of governmental authority and responsibility. Most are actually performed by governmental agencies, and others are indirectly supported and organized by governmental funding and regulation. Recognition of the dependency of fulfillment of human rights provides a new

approach to monitoring governmental accountability for rights affecting health.

responsibility

and

What is the Human Right to Health? Every woman, man, youth and child has the human right to the highest attainable standard of physical and mental health, without discrimination of any kind. Enjoyment of the human right to health is vital to all aspects of a person's life and well-being, and is crucial to the realization of many other fundamental human rights and freedoms.

The Human Rights to Health Human Rights relating to health are set out in basic human rights treaties and include:       

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The human right to the highest attainable standard of physical and mental health, including reproductive and sexual health. The human right to equal access to adequate health care and health-related services, regardless of sex, race, or other status. The human right to equitable distribution of food. The human right to access to safe drinking water and sanitation. The human right to an adequate standard of living and adequate housing. The human right to a safe and healthy environment. The human right to a safe and healthy workplace and to adequate protection for pregnant women in work proven to be harmful to them. The human right to freedom from discrimination and discriminatory social practices, including female genital mutilation, prenatal gender selection, and female infanticide. The human right to education and access to information relating to health, including reproductive health and family planning to enable couples and individuals to decide freely and responsibly all matters of reproduction and sexuality. The human right of the child to an environment appropriate for physical and mental development.

Governments' Obligations to Ensuring the Human Right to Health "Everyone has the right to a standard of living adequate for ... health and well-being of himself and his family, including food, clothing, housing, medical care and the right to security in the event of ... sickness, disability.... Motherhood and childhood are entitled to special care and assistance...." --Universal Declaration of Human Rights, Article 25 "States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health...." --Convention on the Rights of the Child, Article 24

Governments' Commitments to Ensuring the Human Right to Health "Health and development are intimately interconnected. Both insufficient development leading to poverty and inappropriate development ... can result in severe environmental health problems.... The primary health needs of the world's population ... are integral to the achievement of the goals of sustainable development and primary environmental care.... Major goals ... By the year 2000 ... eliminate guinea worm disease...; eradicate polio; By 1995 ... reduce measles deaths by 95 per cent...; ensure universal access to safe drinking water and ... sanitary measures

of excreta disposal...; By the year 2000 [reduce] the number of deaths from childhood diarrhea ... by 50 to 70 per cent..." -- Agenda 21,Chapter 6, paras. 1 and 12

"Everyone has the right to the enjoyment of the highest attainable standard of physical and mental health. States should take all appropriate measures to ensure, on a basis of equality of men and women, universal access to health-care services, including those related to reproductive health care.... The role of women as primary custodians of family health should be recognized and supported. Access to basic health care, expanded health education, the availability of simple cost-effective remedies ... should be provided...." --Cairo Programme of Action, Principle 8 and para. 8.6 "Human health and quality of life are at the centre of the effort to develop sustainable human settlements. We ... commit ourselves to ... the goals of universal and equal access to ... the highest attainable standard of physical, mental and environmental health, and the equal access of all to primary health care, making particular efforts to rectify inequalities relating to social and economic conditions ..., without distinction as to race, national origin, gender, age, or disability. Good health throughout the lifespan of every man and woman, good health for every child ... are fundamental to ensuring that people of all ages are able to ... participate fully in the social, economic and political processes of human settlements .... Sustainable human settlements depend on ... policies ... to provide access to food and nutrition, safe drinking water, sanitation, and universal access to the widest range of primary health-care services...; to eradicate major diseases that take a heavy toll of human lives, particularly childhood diseases; to create safe places to work and live; and to protect the environment.... Measures to prevent ill health and disease are as important as the availability of appropriate medical treatment and care. It is therefore essential to take a holistic approach to health, whereby both prevention and care are placed within the context of environmental policy...." --Habitat Agenda,