Values, Policies and Rights

Human rights and Health Equity

This bibliography pulls together recent articles that speak to the relationship between human rights and health, particularly focused on health equity, poverty and community agency. The bibliography was prepared for the EQUINET Health Rights theme and the articles described in the bibliography have informed much of the conceptual approaches developed in EQUINET to harnessing rights approaches to build health equity. The bibliography overlaps to some extent with other bibliographies held by EQUINET on health equity themes. It should prove useful for researchers exploring issues of human rights in relation to equity. The intention is to keep this bibliography updated in future, to support EQUINET’s activities in this area.

Human rights commitments relevant to heath made by states in Southern Africa: Implications for health equity

The audit aims to 1. conduct a review of the regional and international human rights instruments relevant to health; and 2. review the national commitments that have been made under these human rights instruments.

What is the Rights Based Approach all about?

In the last few years, there has been growing talk amongst development actors and agencies about a “rights-based approach” to development. Yet what exactly this consists of remains unclear. For some, its grounding in human rights legislation makes such an approach distinctive, lending it the promise of re-politicising areas of development work that have become domesticated as they have been “mainstreamed” by powerful institutions like the World Bank. Others complain that like other fashions it has become the latest designer item to be seen to be wearing and has been used to dress up the same old development. This paper from the Institute for Development Studies (IDS) seeks to unravel some of the tangled threads of contemporary rights talk.

The link between good governance and good health

HIV prevalence is significantly associated with poor governance. International public health programs need to address societal structures in order to create strong foundations upon which effective healthcare interventions can be implemented, according to a recent study in the journal International Health and Human Rights. Only governments sensitive to the demands of their citizens appropriately respond to needs of their nation. Based on Professor Amartya Sen's analysis of the link between famine and democracy, the study tested the null hypothesis: "Human Immunodeficiency Virus (HIV) prevalence is not associated with governance".

Health, human rights and mobilization of resources for health
BMC International Health and Human Rights 2004

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.

WHO submission to the United Nations Commission on Human Rights

"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."

A human rights analysis of health worker migration

"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

Human rights: does mental health care measure up?

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.

What can human rights do for health and health equity in South Africa

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.

Further details: /newsletter/id/30820
Access to Condoms and HIV/AIDS Information
Human Rights Watch: December 2004

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.

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