The right to health is the economic, social, and cultural right to a universal minimum standard of health to which all individuals are entitled. The concept of a right to health has been enumerated in international agreements which include the Universal Declaration of Human Rights, International Covenant on Economic, Social and Cultural Rights, and the Convention on the Rights of Persons with Disabilities. There is debate on the interpretation, application, and existence of the right to health due to considerations such as how health is defined, what minimum entitlements are encompassed in a right to health, and which institutions are responsible for ensuring a right to health.
The Human Rights Measurement Initiative measures the right to health for countries around the world, based on their level of income.
Definition
Constitution of the World Health Organization (1946) The preamble of the 1946 World Health Organization (WHO) Constitution defines health broadly as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." The Constitution defines the right to health as "the enjoyment of the highest attainable standard of health," and enumerates some principles of this right as healthy child development; equitable dissemination of medical knowledge and its benefits; and government-provided social measures to ensure adequate health.
Frank P. Grad credits the WHO Constitution as "claiming ... the full area of contemporary international public health," establishing the right to health as a "fundamental, inalienable human right" that governments cannot abridge, and are rather obligated to protect and uphold. The WHO Constitution, notably, marks the first formal demarcation of a right to health in international law.
Universal Declaration of Human Rights (1948)
Article 25 of the United Nations' 1948 Universal Declaration of Human Rights states that "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." The Universal Declaration makes additional accommodations for security in case of physical debilitation or disability, and makes special mention of care given to those in motherhood or childhood.
The Universal Declaration of Human Rights is noted as the first international declaration of fundamental human rights, both freedoms and entitlements alike. United Nations High Commissioner for Human Rights Navanethem Pillay writes that the Universal Declaration of Human Rights "enshrines a vision that requires taking all human rights—civil, political, economic, social, or cultural—as an indivisible and organic whole, inseparable and interdependent." Likewise, Gruskin et al. contend that the interrelated nature of the rights expressed in the Universal Declaration establishes a "responsibility [that] extends beyond the provision of essential health services to tackling the determinants of health such as, provision of adequate education, housing, food, and favourable working conditions," further stating that these provisions "are human rights themselves and are necessary for health."
International Convention on the Elimination of All Forms of Racial Discrimination (1965)
Health is briefly addressed in the United Nations' International Convention on the Elimination of All Forms of Racial Discrimination, which was adopted in 1965 and entered into effect in 1969. The Convention calls upon States to "Prohibit and to eliminate racial discrimination in all its forms and to guarantee the right of everyone, without distinction as to race, color, or national or ethnic origin, to equality before the law," and references under this provision "The right to public health, medical care, social security and social services."
International Covenant on Economic, Social and Cultural Rights (1966)
The United Nations further defines the right to health in Article 12 of the 1966 International Covenant on Economic, Social and Cultural Rights, which states:
General Comment No. 14 (2000) In 2000, the United Nations' Committee on Economic, Social and Cultural Rights issued General Comment No. 14, which addresses "substantive issues arising in the implementation of the International Covenant on Economic, Social and Cultural Rights" with respect to Article 12 and "the right to the highest attainable standard of health." The General Comment provides more explicit, operational language on the freedoms and entitlements included under a right to health,
The General Comment makes the direct clarification that "the right to health is not to be understood as a right to be healthy." Instead, the right to health is articulated as a set of both freedoms and entitlements which accommodate the individual's biological and social conditions as well as the State's available resources, both of which may preclude a right to be healthy for reasons beyond the influence or control of the State. Article 12 tasks the State with recognizing that each individual holds an inherent right to the best feasible standard of health, and itemizes (at least in part) the 'freedoms from' and 'entitlements to' that accompany such a right; however, it does not charge the State with ensuring that all individuals, in fact, are fully healthy, nor that all individuals have made full recognition of the rights and opportunities enumerated in the right to health.
Relation to other rights Like the Universal Declaration of Human Rights, the General Comment clarifies the interrelated nature of human rights, stating that, "the right to health is closely related to and dependent upon the realization of other human rights," and thereby underscoring the importance of advancements in other entitlements such as the rights to food, work, housing, life, non-discrimination, human dignity, and access to importance, among others, towards the recognition of the right to health. Similarly, the General Comment acknowledges that "the right to health embraces a wide range of socio-economic factors that promote conditions in which people can lead a healthy life, and extends to the underlying determinants of health." In this respect, the General Comment holds that the specific steps towards realizing the right to health enumerated in Article 12 are non-exhaustive and strictly illustrative in nature.
The inextricable link between Health and Human Rights
Jonathan Mann was a Francois-Xavier Bagnoud Professor of Health and Human Rights and Professor of Epidemiology and International Health at the Harvard T. H. Chan School of Public Health. He was known for being a powerful pioneer and advocate for the promotion of health, ethics, and human rights, championing the theory that Health and Human Rights were inextricably interlinked in a dynamic relationship.
According to Mann, Health and Human Rights are complementary approaches for defining and advancing human well-being. In 1994, Mann and his colleagues started the "Health and Human Rights" to underline the importance of this inextricable link between Health and Human Rights.
In the first volume of the "Health and Human Rights", Jonathan Mann and his colleagues published a transformative article to explore the potential collaboration in Health and Human Rights. In this article, Mann et al. describe a framework for connecting the two domains that are interlinked. This framework is broken into three broad relationships.
The first relationship between Health and Human Rights is a political one. Mann and colleagues state that health policies, programs, and practices have an impact on human rights, especially when state power is considered in the realm of public health.
Next, the article posits a reverse relationship: that human rights violations have health impacts. It also calls for health expertise to help understand how health and well-being can be impacted by human rights violations through measurement and assessment.
The third segment of the framework linking Health and Human Rights introduces the concept that the protection and promotion of human rights and health are linked fundamentally in a dynamic relationship. While literature has largely supported the first two relationships, this third hypothesis has not been explored as substantially.
The article supports this concept by stating that this link suggests there are dramatic practical consequences in the independent operations of, but also in the interaction in activities of, the practice of public health and the practice of human rights. There is what is deemed an interdependence that cannot be negated. Mann and his colleagues further posit that research, education, experience, and advocacy are all required to understand this intersection, in order to understand and advance human well-being globally.
Ultimately, Mann and his colleague's mission is to convey that, while individual health has been much of the focus for medical and other health provision services, especially concerning physical illness and disability, public health's focus has more so evolved around how people can be healthy. According to this surprisingly simple definition, public health's mission is to promote positive health and prevention of health problems – disease, disability, premature death. That is, the traditional sense of individual health as understood and processed by health care services is "one essential condition for health", but does is not the sole qualifier or an exchangeable term with "health". In other words, health care services are not sufficient for health, as public health practitioners understand it – there are external factors that have both nuanced as well as pronounced positive and negative impact on health and well-being of the global human population.
Health equity The General Comment also makes additional reference to the question of health equity, a concept not addressed in the initial International Covenant. The document notes, "The Covenant proscribes any discrimination in access to health care and underlying determinants of health, as well as to means and entitlements for their procurement." Moreover, responsibility for ameliorating discrimination and its effects with regards to health is delegated to the State: "States have a special obligation to provide those who do not have sufficient means with the necessary health insurance and health-care facilities, and to prevent any discrimination on internationally prohibited grounds in the provision of health care and health services." Additional emphasis is placed upon non-discrimination on the basis of gender, age, disability, or membership in indigenous communities.
Responsibilities of states and international organizations Subsequent sections of the General Comment detail the obligations of nations and international organizations towards a right to health. The obligations of nations are placed into three categories: obligations to respect, obligations to protect, and obligations to fulfill the right to health. Examples of these (in non-exhaustive fashion) include preventing discrimination in access or delivery of care; refraining from limitations to contraceptive access or family planning; restricting denial of access to health information; reducing environmental pollution; restricting coercive and/or harmful culturally-based medical practices; ensuring equitable access to social determinants of health; and providing proper guidelines for the accreditation of medical facilities, personnel, and equipment. International obligations include allowing for the enjoyment of health in other countries; preventing violations of health in other countries; cooperating in the provision of humanitarian aid for disasters and emergencies; and refraining from use of embargoes on medical goods or personnel as an act of political or economic influence.