The document discusses the international legal framework protecting the right to health for refugees and migrants. It explains that refugee law and international human rights law both establish rights to health. Refugee law requires countries to provide lawfully staying refugees access to social services like health care equivalent to nationals. The International Covenant on Economic, Social and Cultural Rights and International Covenant on Civil and Political Rights establish rights to health and non-discriminatory access to health services. However, migrants still face barriers to realizing these rights in practice due to discrimination, social attitudes, and legal status restrictions.

1. Human Rights and Health
FOCUS ON REFUGEES AND
MIGRANTS

2. International Legal Framework of the Right to
Health for Refugees
• Several interrelated fields of international law are involved
in discussions of the rights to health of refugees and internally
displaced populations. The 2 most important are
 Refugee law
 General international human rights law
• In each field, the body of law is made up of treaties, which
create binding obligations for the countries that have ratified
them.

3. REFUGEE LAW
• The Geneva Refugee Convention requires countries to treat
refugees lawfully staying in their territory the same as
their nationals are treated with respect to social security
schemes, including those covering maternity and sickness
(Article 24(1) b).
• For refugees who do not meet the criterion of "lawful stay"
and for non-Convention refugees, UNHCR works to
guarantee that they will be treated no worse than
foreigners are usually treated by that state (Article 7(1)).
• With respect to health, this can often mean little if any
access to national health services.

4. Everyone has the
Right to Seek and
Enjoy in Other
Countries, Asylum
from Persecution.
 Article 14, UDHR
 http://www.un.org/en/documents/udhr/index.shtml#a14
General international Human Rights Law

5. What are Human Rights?
 Human rights are legally guaranteed by human rights
law, to protect individuals and groups against actions of
the state that interfere with fundamental freedoms and
dignity
 Enshrined in the 1948 Universal Declaration of Human Rights (UDHR)
 Human Rights encompass what are known as civil,
political, cultural, economic and social rights that were
codified in the following legally binding treaties (1966):
 The International Covenant on Economic, Social and Cultural Rights (
ICESCR)
 The International Covenant on Civil and Political Rights (ICCPR).

6. What does the ICESCR say?
•Part 1 (Article 1) recognises the right of all peoples to self-determination,
•Part 2: Principle of "progressive realisation“ (Article 2-5). It acknowledges
that some of the rights (for example, the right to health) may be difficult in
practice to achieve in a short period of time, and that states may be subject to
resource constraints, but requires them to act as best they can within their means
•Part 3 (Articles 6 – 15) lists the rights themselves. These include rights to:
•Work, social security, including social insurance,family life, adequate standard of
living
•Right to highest attainable standard to health
•http://en.wikipedia.org/wiki/Right_to_health
•Right to free education, participation in cultural life

7. What does the ICCPR say?
These include rights to
•physical integrity, in the form of the right to life and freedom from torture and
slavery
•liberty and security of the person, in the form of freedom from arbitrary arrest
and detention
•Procedural fairness in law, rights to due process, fair trail, presumotion of
innocence
•Individual liberty, in the form of the freedoms of movent, thought, conscience,
religion, speech, association, family rights, right to a nationality, the right to
privacy
•Prohibition of any propaganda for war, of national or religious hatred,
incitement to discrimination, hostility or violence by law
•Right to political participation, including the right to join a political party, right
to vote
•Non-discrimination, minority rights and equality before the law

8. Health as a Human Right
 The “enjoyment of the highest
attainable standard of health” has
been recognised as a “fundamental
right” since the adoption of the World
Health Organisation (WHO) Constitution
in 1946 and since then it has been
recognised by various international
human rights treaties.
http://www.who.int/governance/eb/who_constitution_en.pdf

9. Health as a Human Right
Since then it has been recognised by various
international human rights treaties e.g. ICESCR
The right to the highest attainable standard of health is a
claim to a set of social arrangements - norms,
institutions, laws, an enabling environment - that can
best secure the enjoyment of this right

11. Other HR Instruments guaranteeing the
Right to Health
• The International Convention on the Elimination of all Forms of
Discrimination December 21st
, 1965 (entry into force January 4th
, 1969)
• The Convention on the Elimination of All Forms of Discrimination
Against Women,December 18th
, 1979 (entry into force September 3rd
, 1981)
•The Convention on the Rights of the Child November 20th
, 1989 (entry into
force September 2nd
, 1990)
• The International Convention on the Protection of the Rights of All
Migrant Workers and Members of Their Families (entry into force July
1st
, 2003)

12. What does the Right to Health Mean?
 * The two main components are:
1. Elements related to “healthcare”
2. Elements concerning the underlying
determinants of health which may
include a healthy environment, safe
drinking water and adequate sanitation,
occupational health and access to
health related education and
information.
 * Consensus among scholars that the
meaning and scope of the right to health
lacks conceptual clarity. This in turn
hinders its implementation and the
subsequent monitoring of states’
practices by international treaty
monitoring bodies.

13. Question: Why is migrants‘ health an issue
and why is it a human rights issue?
• Migrants as a “vulnerable group” due to:
• Bias against foreigners – stereotypes, racism, xenophobia
• Under-representation in power structures
• Perceived or de-jure distinctions between citizens and non-
citizens can lead to the belief than only citizens have rights
• Impact of the economic crisis and terrorist violence on
social attitudes towards migrants and realisation of their
rights

14. Migrants‘ vulnerability related to a number of barriers
and problems which affect their enjoyment of the right to
the highest attainable standard of health
• Migrants may be disadvantaged and discriminated
against in relation to health determinants and to
accessibility to adequate health care services
– Evidence of migrants‘ poorer health outcomes
• Migrant workers frequently concentrated in 3-D jobs
– Occupational health risks and injuries high in this context
• Migratory or legal status may constrain or obstruct
health service use
– Undocumented migrants fear arrest or deportation

15. Migrants as “ rights holders” and States as
“duty bearers”
 Human rights are principally concerned with the
relationship between the individual and the state
 Governmental obligations with regard to human rights
broadly fall under the principles of respect, protect
and fulfill
 International human rights instruments explicitly
recognize that human rights, including specific health-
related rights, apply to all persons including migrants,
refugees and other non nationals.
 Many provisions are recognized as applicable to all
migrants, regardless of legal status.

16. General Comment No. 14 (May, 2000): Clarification
of the scope and content of the right to health

17. General Comment No. 14
Issued May, 2000
 Provides direction for the practical application of Article
12 of the CESCR and outlines a monitoring framework.

http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4.En
 It distinguishes between four essential features of health
services:
 * Availability
 * Accessibility
 * Acceptability
 * Quality of health services

19. States’ Obligations to Respect the Right to Health
 Particular attention should be paid to
vulnerable and marginalized groups.
General Comment 14 paragraph 34
specifies inter alia that states must:
“refrain from denying or limiting equal
access for all persons including prisoners
or detainees, minorities, asylum seekers
and illegal immigrants (emphasis added),
to preventative, curative and palliative
health services; abstaining from imposing
discriminatory practices as a State policy;
and abstaining from imposing
discriminatory practices relating to
women’s health status and needs.”