Integrating individual rights with structural policy changes will expand human rights for all
The traditional liberal understanding whereby human rights, including the right to the highest attainable level of health, are individual rights has proven flawed. Restricting the right to health to the individual perspective in human rights theory and practice limits the advancement of planning, establishment of public policies, accountability, monitoring and assessment. In fact, a number of the UN human rights bodies that monitor the compliance of the relevant treaties (treaty-bodies) have requested States parties to the respective treaties to provide information on the planning, mapping access to health services for vulnerable populations and implementing respective policies for the realization of the right to health.
Increasing the collective perspective on the human right to health has also a potential of tackling non communicable diseases, by means of, for instance, awareness raising on healthier lifestyles, care of the ones in most need and formulating specific plans for these diseases. This goes in line with the States’ obligation under international law to prevent violations, including on the right to health.
Concurrently, global health debates and action would strengthen themselves if, within the actions in public policies, strengthening of health systems and other issues, take individual human rights into account. The human right to health, as both freedom and entitlement, can give greater priority and legitimacy to the goals of global health. It would also disclose the hidden faces of the ones on the ground in most need.
A clear example of how both individual and collective perspectives work together is seen in the fight against HIV/AIDS. It takes not only lipservice to declare that individuals living with HIV/AIDS have the right to information, prevention, testing and treatment, but it requires a whole range of structural policies on the present healthcare system, making ARVs affordable (including free provision and discussion on patents, where necessary), training of health personnel, among other actions. In fact, a growing number of international human rights jurisprudence and literature indicates that the States obligation towards persons living with HIV/AIDs include a number of structural measures. A better coordination of local, national and international level optimizes the avenues of improvement of the realization of the HIV patients’ rights.
As Einstein well said once, it is easier to break an atom than a prejudice. Thirty years after the appearance of AIDS, not a few people, including policy makes, consider this disease, even if unconsciously, as the ‘gay cancer’. Halting and reversing HIV/AIDS, as a Millennium Goal, requires more than provision of health care and goods. Persons living with HIV/AIDS face not only the biologic consequences of the disease, but also insurmountable stigma, which leads necessarily to a staggering inequality in the access to health goods and services, discrimination and lack of proper attention by health professionals and state agents dealing with them. HIV patients by times fear seek proper health care and treatment fearing sanctions including imprisonment. In countries where adult same sex behavior is criminalized, stigma is worsened. Therefore, global and structural discussions in global health governance, including diplomatic action, should necessarily take into account the individuals who sustain not only the disease, but all the political and social side effects of their conditions. A better look into the AIDS patients on the ground may provide better guidance for the global policy priorities.
Better policy for health rights, rights into policies. Both human rights and health sectors have a wealth of insights, methods and approaches to exchange. Bridging fragmented actions is key for achieving the goal of improving health worldwide.
Paulo Arantes writes from the Graduate Institute Geneva’s Global Health Programme.