Health systems and the right to the highest attainable standard of health

Health and Human Rights

Volumn 10, Issue 1, 2008, Pages 81-92

  Hunt, Paul ^a,b   Backman, Gunilla ^a  

^a UNIVERSITY OF ESSEX   (United Kingdom)

^b UNIVERSITY OF WAIKATO   (New Zealand)

Author keywords

[No Author keywords available]

Indexed keywords

HEALTH POLICY; HEALTH SERVICES; HUMAN RIGHTS; PRIMARY HEALTH CARE; PUBLIC HEALTH; STRATEGIC APPROACH;

CONSUMER; CULTURAL COMPETENCE; ETHICS; HEALTH; HEALTH CARE DISPARITY; HEALTH CARE QUALITY; HEALTH DISPARITY; HUMAN; HUMAN RIGHTS; MEDICAL SOCIOLOGY; ORGANIZATION AND MANAGEMENT; POVERTY; PROCEDURES; PUBLIC HEALTH SERVICE;

CONSUMER PARTICIPATION; CULTURAL COMPETENCY; GLOBAL HEALTH; HEALTH STATUS DISPARITIES; HEALTHCARE DISPARITIES; HUMAN RIGHTS; HUMANS; POVERTY; PUBLIC HEALTH ADMINISTRATION; QUALITY OF HEALTH CARE; SOCIOLOGY, MEDICAL;

EID: 57049138911     PISSN: 10790969     EISSN: None     Source Type: Journal    
DOI: 10.2307/20460089     Document Type: Article

References (35)

1. This article is a shortened and revised version of the Report of the UN Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, UN Doc. No. A/ HRC/7/11 (2008). In this article, "the right to the highest attainable standard of health," or "the right to health," is used as shorthand for the full formulation of the right.
2. See for example, J. Mann, S. Gruskin, M. Grodin, and G. Annas (eds), Health and Human Rights: A Reader (New York and London: Routledge, 1999)
3. S. Gruskin, M. Grodin, G. Annas, and S. Marks (eds), Perspectives on Health and Human Rights (New York and London: Routledge, 2005)
4. A. Yamin, "Journeys towards the Splendid City," Human Rights Quarterly 26 (2004): p. 519
5. Report of the UN Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, UN Doc. No. A/HRC/4/28 (2007)
6. and P. Hunt, "The Health and Human Rights Movement: Progress and Obstacles," Journal of Law and Medicine 15/5 (2008) (forthcoming).
7. L. Freedman, "Achieving the MDGs: Health Systems as Core Social Institutions," Development 48 (2005): p. 1.
8. World Health Organization, Everybody's Business: Strengthening Health Systems to Improve Health Outcomes (Geneva: 2007): p. 1.
9. The literature reveals many definitions of a health system, each with carefully nuanced differences. In 2007, for example, WHO defined a health system as "all organizations, people and actions whose primary intent is to promote, restore or maintain health" (Ibid.): p. 2 (italics in original). For present purposes, there is no need to favor one definition over another because all the features and measures identified in this article should be part of any health system, however defined.
10. For surveys of the key international instruments and a selection of the case law, see the reports of the UN Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, UN Doc. No. E/CN.4/2003/58 (2003) and UN Doc. No. A/ HRC/4/28 (2007).
11. Health workers include all those developing, managing, delivering, monitoring, and evaluating preventive, curative, and rehabilitative health in the private and public health sectors, including traditional healers.
12. World Health Organization, People at the Centre of Health Care (Geneva: 2007): p. v.
13. Ibid., p. vii.
14. See H. Potts, Human Rights in Public Health: Rhetoric, Reality and Reconciliation, PhD thesis (2006). Also, participation in the context of the right to health has been explored in several reports of the UN Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, including UN Doc. No. E/CN.4/2006/48/Add.2 (2006) (on Uganda) and UN Doc. No. E/CN.4/ 2005/51 (2005) (on mental disability).
15. A. Green, "An Introduction to Health Planning for Developing Health Systems," (Oxford: Oxford University Press, 2007): p. 64.
16. For more on indigenous peoples and the right to the highest attainable standard of health, see, for example, the reports of the UN Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, UN Doc. No. A/59/422 (2004) and UN Doc. No. E/CN.4/2005/51/Add.3 (2005).
17. United Nations Population Fund, Culture Matters (Geneva: 2000): p. v.
18. See, for example, Convention on the Rights of the Child (CRC), G.A. Res. 44/25, annex, UN GAOR, 44th Sess., Supp. No. 49, at 166, UN Doc. No. A/ 44/25 (1989), Article 24. Medical care includes dental care.
19. Declaration of Alma-Ata, adopted by the International Conference on Primary Health Care, Alma-Ata, USSR, September 6-12, 1978, para. VII (6).
20. For more on planning, see the next section.
21. For a human rights-based approach to health indicators, see the Report of the UN Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, UN Doc. No. E/CN.4/2006/48 (2006).
22. Committee on Economic, Social and Cultural Rights, General Comment No. 14. The Right to the Highest Attainable Standard of Health, UN Doc. No. E/C.12/2000/4 (2000), para. 32.
23. Ibid., paras. 43-45.
24. This section draws extensively from the UK Department of Health, Health Is Global: Proposals for a UK Government-Wide Strategy (A Report from the UK's Chief Medical Adviser, Sir Liam Donaldson) (2007), especially at p. 46.
25. See S. Skogly, Beyond National Borders: States' Human Rights Obligations in International Cooperation (Antwerp: Intersentia, 2006).
26. On prioritization, see the report of the UN Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health, UN Doc. No. A/62/214 (2007).
27. Everybody's Business (see note 4): p. 3.
28. Such as ex-ante impact assessments (see paragraphs below on planning).
29. Everybody's Business (see note 4): p. 23.
30. Green (see note 11): p. 18.
31. See previous section on progressive realization and resource availability.
32. General Comment No. 14 (see note 18): paras. 43-45.
33. Declaration of Alma-Ata (see note 15): para. VIII.
34. See P. Hunt and G. MacNaughton, Impact Assessments, Poverty and Human Rights: A Case Study Using the Right to the Highest Attainable Standard of Health, (2006). Available at http://www2.essex.ac.uk/ human_rights_centre/rth/projects.shtm.
35. P. Hunt, Reclaiming Social Rights: International and Comparative Perspectives, (Aldershot, UK: Dartmouth, 1996): p. 186 and Yamin (see note 2): p. 528.