Understanding the history and development of the international right to health.

1. History and Development of the
Right to Health
Lyla Latif
Seminar 2
Cardiff University, Step-Up to University Programme

2. RecapfromLast
Session
 What are human rights and whether health is a
human right
 Case examples to justify the right to health
 The concept of the right to health: AAAQ and the legal
obligations on a government
 Health financing

3. Learning
Objectives
 The right to health: origin and development
 International human rights law (specific to the right to
health)
 Understand how history and society have shaped policy
and law
 Understand how international agreements are arrived at
 Understand the difference between national and
international law
 Knowledge of the human rights theorists who have
shaped discourse on human rights

4. TheRightto
Health
 How do you think the health system in Europe
developed (from an unregulated public health system
to a regulated healthcare sector)
 Was there a need for regulating public health? If so
why?

5. https://www.youtube.com/watch?v=KS76_gfmlNk

6. Origins and
Development of
theRight to
Health
1. 1944 Roosevelt’s State of Union Address
2. After WW2, the international community agreed on a
charter to respect and protect certain rights –UN
Charter – Article 55 and 56
3. Universal Declaration on Human Rights
4. World Health Organisation
5. International Covenant on Economic, Social and
Cultural Rights
6. Alma Ata Declaration
7. General Comment 14 on the Right to Health

7. Debate around
therecognition of
universal/human
rights
 John Locke: human beings have natural rights that the
sovereign must respect because sovereign power
granted through a social contract– Natural School of
Law
 Jeremy Bentham: natural rights is simple nonsense …
nonsense upon stilts– Positive School of Law
 John Rawls: Overlapping consensus. There are many
moral reasons for human rights. Each person can
endorse a political doctrine for his or her own moral
reasons –
 Donnelly argues against a universal concept of human
rights: says human rights are relative and takes into
consideration cultural values
 Marx and Hegel: It’s not about rights, but morals.

8. Roosevelt
 True individual freedom cannot exist without economic
security and independence
 Economic security identified as economic rights such as
right to food, clothing, housing, health, education and
employment
 Bill of rights to be drafted based on these economic
rights

9. UNCharter
 Article 55: The United Nations would promote ‘higher
standards of living, full employment, and conditions of
economic and social progress and development’ and
‘solutions of international economic, social, health and
related problems’.
 Article 56: all members pledged themselves to ‘take
joint and separate action’ for the achievement of the
goals set forth in Article 55.

10. UDHR
 Article 25 (1): UDHR recognizes the right to medical
care as a determinant of health and wellbeing

11. WHO
 Right to the highest attainable standard of health
 Health: a state of complete physical, mental and social
wellbeing and not merely the absence of disease or
infirmity
 World Health Assembly (May, 2018)

12. ICESCR
(20yearsaftertheadoptionof
theUDHRthisconventionwas
agreedupon)
 Article 12 (1) Right to the highest attainable standard
of health
 Legal obligations

13. AlmaAta
Declaration
 International Conference on Primary Health Care
 Accepted the WHO definition
 Illustrated the dangers of setting targets

14. GC14
 Right to the highest attainable standard of health
 Describes the features of a well functioning health
system: Core Principles and AAAQ
 Legal obligations
 Maximum Available Resources

15. Core Principles
 Minimum core content
 Progressive realisation
 Resource constraints
 International assistance
and cooperation
 Non discrimination
CONTENTIOUS

16. International
Legal Framework
oftheRight to
Health
UN
Charter
UDHR
WHO
ICESCR
GC 14

17. National Legal
Framework/
Strategies –
e.g.,Kenya
 Ratify international law
 Domestic policy and laws
 Health programs & plans
 Financing schemes

18. Arriving at
International
Consensus on
Implementing the
RighttoHealth
 Government cannot finance all health related problems
(need to focus on specific health problems that are of
global concern and within budget)
 Domestic resource mobilization is key
 International assistance and cooperation (0.7% of GNI
to ODA) – contentious
 MDGs
 SDGs and UHC

19. GroupTask
Imagine that you are Ministers representing different
countries at the United Nations General Assembly. Before
you is a resolution: “Free Health Care for All”. The USX is
moving this resolution.
It calls upon all member states to provide free healthcare for
all its citizens effective immediately upon the adoption of the
resolution. The resolution acknowledges that not everyone is
able to access healthcare because of:
 high user fees;
 high number of maternal and child deaths;
 high cost of essential medicines for the sick.
As a result, many sick persons are unable to receive
healthcare because they cannot afford it. Consequently, the
resolution calls upon member states to reverse this decline
in healthcare by taking action to provide healthcare for all.

20. Whatyouneed
to do
 Divide yourselves in 4 groups: (hypothetical countries)
 Group 1: USX – developed country, high GDP
 Group 2: Burunya – LDC, no infrastructure, no money,
dependent on aid
 Group 3: Indigo – developing country, moderate GDP but
also in need of donor aid
 Group 4: Germanistan – developed country, high GDP

21. Inyour groups
Discussyour
position onthe
resolution
 Accept; give reasons why
 Reject; give reasons why
 Accept with amendments? What amendments will you
propose

22. GuidanceTips:
 Remember the core principles
 Minimum core content: has it been defined in the
resolution? What would it be? Can there be a universal
agreement on this?
 Progressive realisation: Can free healthcare be achieved
immediately? What would it take to implement free
healthcare?
 Resource constraints: Each country is at a different stage
of development; Is there enough money?
 International assistance and cooperation: contentious, to
what extent are developed countries willing to help
developing countries?
 Recall the debates
 Recall the Alma Ata warning and reasons for the
MDGs not being entirely fulfilled