The World Health Constitution (“WHO”), which came into force on 7 April 1948, stated that “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”
Alma Ata Declaration
The principle that health is a human right has been the foundation of WHO’s programmes. The Alma Ata declaration of 6-12 September 1978 stated that “Governments have a responsibility for the health of their people which can be fulfilled only by the provision of adequate health and social measures.
A main social target of governments, international organizations and the whole world community in the coming decades should be the attainment by all peoples of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. Primary health care is the key to attaining this target as part of development in the spirit of social justice.”
Health is a human right
Amartya Sen, the 1998 Nobel Prize winner for contributions to welfare economics, addressed three basic questions in relation to the above in an article in the Lancet of 10 December 2008 (DOI:10.1016/S0140-6736(08)61784-5).
The response to the legal question of how health could be a right without legislation demanding that was it has been a tradition of thinking of rights from the social ethics perspective i.e. what a good society must have.
The response to the feasibility question of how could good health be a right when there is no way of ensuring that everyone has good health was “The acceptance of health as a right of all is a demand to take action to promote that goal, going beyond what is sometimes called the first-generation rights that involve personal liberties and political entitlements such as the right to vote.”
The response to the policy question of “why think of health, rather than health care, as a right, since health care is under the control of policy making, not the actual state of health of the people” was “good health depends on health care, and health care is something that we can legislate about.
But good health does not depend only on health care. It also depends on nutrition, lifestyle, education, women’s empowerment, and the extent of inequality and unfreedom in a society. A human right can serve as a parent not only of law, but also of many other ways of advancing the cause of that right. There are political, social, economic, scientific, and cultural actions that we can take for advancing the cause of good health for all.”
Universal health coverage
The concept of universal health coverage (“UHC”) has gained global acceptance since the WHO published its World Heart Report 2010 entitled Health systems financing; the path to universal coverage.
The WHO has explained UHC “means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
UHC enables everyone to access the services that address the most significant causes of disease and death, and ensures that the quality of those services is good enough to improve the health of the people who receive them.
Protecting people from the financial consequences of paying for health services out of their own pockets reduces the risk that people will be pushed into poverty because unexpected illness requires them to use up their life savings, sell assets, or borrow – destroying their futures and often those of their children.”
The United Nations (“UN”) General Assembly unanimously adopted a resolution on 12 December 2012 urging governments to provide all people with access to affordable, quality healthcare services.
It recognized the role of health in international development goals and called on all countries and organizations to include UHC in the international development agenda. The resolution also reaffirmed WHO’s leading role in supporting countries to the challenges of implementing UHC.
Health in Sustainable Development Goals
The UN General Assembly unanimously adopted the 2030 Agenda for sustainable development in September 2015. The Sustainable Development Goals (SDGs) were “a call for action by all countries to promote prosperity while protecting the planet.
They recognize that ending poverty must go hand-in-hand with strategies that build economic growth and address a range of social needs including education, health, social protection, and job opportunities, while tackling climate change and environmental protection.”
The SDG3 for health is to “Ensure healthy lives and promote wellbeing for all at all ages.” The rationale for SDG3 is “Access to good health and well-being is a human right, and that is why the Sustainable Development Agenda offers a new chance to ensure that everyone can access the highest standards of health and health care—not just the wealthiest.”
There are 13 targets and 26 indicators for SDG3. The WHO will be monitoring the progress of all countries towards SDG3.
The principle that health is a human right has pervaded through all UN and WHO resolutions, declarations and programmes for the past seven decades. As a subscriber to the UN and WHO resolutions and declarations, the government has an obligation to ensure that all the targets of SDG3 are attained by 2030, which is about a decade away.
Dr Milton Lum is a past President of the Federation of Private Medical Practitioners Associations, Malaysia and the Malaysian Medical Association.
This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organization the writer is associated with.
