"In recent years, WHO has strengthened its work on health and human rights. In 2005-2006, WHO is focusing on the process of developing an organization-wide health and human rights strategy, which will serve as a policy platform for WHO and ensure that human rights become further "institutionalized" in our everyday work. WHO is actively working to increase awareness and understanding of the scope, content and application of the right to health (shorthand for "the right to the highest attainable standard of physical and mental health"). Training for WHO staff on health and human rights was initiated in 2002 and has continued in 2003 and 2004. Recently, consultations on health and human rights took place between WHO headquarters, regional and country offices."
Values, Policies and Rights
"The international migration of health workers away from underserved areas in low income countries is increasingly recognised as one of the most profound problems facing health systems, and the safeguarding of health, in these countries. The problem is particularly acute in sub-Saharan Africa where the burdens of poverty and underresourcing, infectious disease and, worthy of distinct mention, HIV/AIDS which has infected up to a quarter of the population in some countries, are causing public health systems to break down...The language of human rights is commonly used when describing the motivations of health workers to migrate to seek a better life and to further their careers. But human rights are less commonly invoked to articulate the consequences of their migration, which may include most notably the impact on the right to health of health system users in the country of origin," says the abstract of this paper commissioned by health charity Medact as part of its programme of work on health, poverty and development.
* Read the related paper 'The ‘Skills Drain’ of Health Professionals from the Developing World'
http://www.medact.org/content/Skills%20drain/Mensah%20et%20al.%202005.pdf
Are people living with mental illness guaranteed the best available mental health care? Evidence suggests that they do not enjoy the same rights, in terms of self-determination and protection from exploitation and discrimination, as do people who do not suffer from mental illness. Some ethical codes do relate specifically to mental health - yet the transition from rhetoric to reality has so far been limited.
As South Africa enters its second decade of democracy, we find that health gains anticipated in 1994 remain unrealized for the majority of our people, particularly the poorest in society. Why is it that, despite a Constitution hailed as the most progressive in the world, a victorious liberation movement and a set of governmental and non-governmental institutions designed to promote human rights in our society, we have failed to translate the provisions of our Bill of Rights into reality? To understand this contradiction, we need to understand, firstly, what are human rights; secondly, the relationship between health and human rights; and, thirdly, how human rights commitments can be translated into health-generating conditions and material gains in health for those who need it most. There are potential contradictions between a human rights approach and broad strategies for Primary Health Care, but these arise because of an incomplete or selective understanding of human rights, sometimes deliberately so, intended to further neo-liberal or imperialist political agendas.
What are human rights?
Human rights can be described as claims (material or social) that individuals make on society that are essential for their dignity and well-being. Rights are usually incorporated in national and international law (although Apartheid South Africa flouted this). The impetus for developing a human rights infrastructure was the revelation of the atrocities committed by the Nazis in World War II. As a result, the United Nations adopted the Universal Declaration of Human Rights (UDHR) based on the idea that "all human beings are born free and equal in dignity and rights." Unlike principles of medical ethics, once a treaty is ratified by a state, it becomes law and binds its conduct.
A human rights approach implies the use of rights as a set of standards to develop policy; or to monitor and analyse policy to hold governments accountable; or as a lobbying and advocacy tool to mobilise civil society.
However, human rights are not a uniformly understood set of concepts and principles and there is much dispute about rights. Two broad categories of rights emerged following the UDHR, civil and political rights (like traditional freedoms of speech, movement, the vote etc) and socio-economic rights (to housing, water, health, education etc). Driven primarily by Cold War political agendas this is a false dichotomy, since rights are indivisible. One cannot enjoy civil and political rights unless socio-economic conditions are such that you are adequately clothed, educated, fed and healthy enough to exercise civil and political rights.
Another criticism is that rights are generally framed as belonging to individuals, who are seen to exist in isolation, a typical Western philosophical tradition. In contrast, traditional societies are constructed on a web of relations - social, economic, cultural and political - in which humans exist as social beings and where social interactions, clashes and conflicts, form the basis of social relations. This has given rise to some suspicion of rights as a culturally imposed practice.
HIV/AIDS is a preventable disease, yet approximately 5 million people were newly infected with HIV in 2003, the majority of them through sex. Many of these cases could have been avoided, but for state-imposed restrictions on proven and effective HIV prevention strategies, such as latex condoms. Condoms provide an essentially impermeable barrier to HIV pathogens. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), scientific data "overwhelmingly confirm that male latex condoms are highly effective in preventing sexual HIV transmission." However, many governments around the world either fail to guarantee access to condoms or impose needless restrictions on access to condoms and related HIV/AIDS information. Such restrictions interfere with public health as well as set back internationally recognized human rights - the right to the highest attainable standard of health, the right to information, and the right to life.
Enthusiasm for “rights-based approaches” to development has grown during the past decade. Rights now have diverse meanings within the policies and actions of development agencies, governments and civil society organisations. This “rise of rights” has sparked critical reflection about the origins of rights-based approaches to development and what they mean in policy and practice. One of the key concerns, as with all development fashions, is “what is really different this time?” Can this emerging focus on rights help to bring about real changes in favour of poor and marginalised people? How do we know that “rights-based development” is not just putting new labels on old wine? This is the issue explored by the 'IDS Bulletin' from the Institute of Development Studies.
As part of basic building-blocks to develop a solid foundation for WHO's emerging work on health and human rights, a Global Database on Health and Human Rights Actors has just been launched on WHO Health and Human Rights website. This database contains information gathered from a survey of organizations concerning their structures and programs. It is searchable by country (where the organization is located) or by specific health issue.
The HIV/AIDS pandemic presents a stark example of the nexus between human rights and health. This first became evident when government responses to HIV/AIDS subjected people living with the disease to violations of their rights to liberty, privacy, freedom of association, nondiscrimination, and equality before the law. As the pandemic has progressed, it has become apparent that human rights law is relevant not only to the treatment of infected individuals but also to wider policies that influence vulnerability to HIV/AIDS, as populations that are discriminated against, marginalized, and stigmatized are at a greater risk of contracting the disease.
This paper argues that the human rights framework does provide us with an appropriate understanding of what values should guide a nation's health policy, and a potentially powerful means of moving the health agenda forward. It also, however, argues that appeals to human rights may not necessarily be effective at mobilizing resources for specific health problems one might want to do something about. Specifically, it is not possible to argue that a particular allocation of scarce health care resources should be changed to a different allocation, benefiting other groups. Lack of access to health care services by some people only shows that something has to be done, but not what should be done.
The Cairo Agenda – a set of international agreements – which came out of the International Conference on Population and Development in 1994, shifted policy focus away from population control. Access to good quality reproductive health care for both women and men was promoted as a right. The more recently agreed Millennium Development Goals (MDGs) however, narrowed the focus down to maternal mortality. While it is crucial to address maternal mortality, it is important to bring reproductive health back into the picture as without this the MDGs will not be met.