Transcript Advancing a Collective Human Right to Public Health

The Highest Attainable Standard: Advancing a Collective
Human Right to Public Health
Benjamin Mason Meier, JD,
1
LLM
& Larisa M.
2
Mori
1 PhD Candidate, Sociomedical Sciences, Columbia University; 2 JD/MPH Candidate, University of California, Los Angeles
The States Parties to the present Covenant recognize the right of everyone to the
enjoyment of the highest attainable standard of physical and mental health…
-International Covenant on Economic, Social and Cultural Rights, Art. 12(1).
Objectives
The Globalization of Disease
An Evolving Right to Health
 To assess ways in which the human right to
health in article 12 of the International Covenant
on Economic, Social and Cultural Rights
(ICESCR) has evolved to meet global threats to
public health; and
 Contemporary processes of economic
globalization have resulted in the exacerbation
of endemic diseases and the rapid spread of
infectious diseases.
 The United Nations Committee on Economic,
Social and Cultural Rights (CESCR) viewed the
medicalized conception of health in article 12 as
anachronistic in light of a modern understanding of
health disparities.
Introduction
 Where once public health measures were
effective in safeguarding a state from
infectious disease, modern diseases (e.g.,
AIDS, SARS, BSE, and drug-resistant
tuberculosis) have spread as a result of
globalization.
 Social transformations through globalization
engage an evolving framework for health rights,
and formal human rights mechanisms must be
transformed to reflect these changing needs and
emerging threats.
 Growing poverty in the developing world is
responsible for injurious health
consequences, with structural adjustment
programs having undermined advancements
in individual medical care.
 The right to health in article 12 of the ICESCR
has been advanced as an individual right,
focusing on individual access to health care at
the expense of public health.
 Developing states now carry a majority of
the world’s disease burden but possess only
a fraction of the world’s health resources,
hampering national public health efforts.
 To develop a collective right to public health to
alleviate globalization’s impact on the underlying
determinants of health.
 This limited right to health has not been effective
in forcing states to address burgeoning
inequalities in the underlying determinants of
health, hampering efforts to operationalize the
right to health through public health programs.
Methods
Through formalistic legal analysis, this research
examines whether modern processes of
globalization necessitate a collective right to public
health to address changes in the underlying
determinants of health.
This research focuses on a collective right to
public health that complements the individual
human right to health promulgated in article 12 of
the ICESCR. This legal analysis is based upon the
jurisprudential discourse surrounding the right to
health and justified as a collective right independent
of the individual right to health.
International Law—The Globalization of
Public Health
 Although economic globalization has had
largely detrimental effects on health, the
globalization of public health systems offers
the prospect of reversing these insalubrious
trends by addressing the underlying
determinants of health.
 The World Health Organization’s Framework
Convention on Tobacco Control has shown
states the benefits of employing international
law to combat global disease.
 International treaty making allows states to
work cooperatively to uphold the human
right to health, challenging the globalization
of disease through the “globalization of
public health.”
 The CESCR acknowledged a correlation between
individual and public health, finding states to be
bound by both the individual and collective
dimensions of the right to health and holding that
there exist governmental responsibilities for
addressing the “underlying determinants of health.”
A Collective Human Right to Public Health
 The paradigm of individual health is no longer
applicable to a globalized world, compelling a
renewed focus on the collective social factors that
facilitate the spread of disease.
 Through an emphasis on the underlying
determinants of health, it becomes clear that the
human right sought to be protected is a collective
right.
 This collective human right—a right to public
health—obligates states to address the
fundamental social conditions that underlie
disease.
Conclusions
 Envisioning a public health component within the
right to health would explicitly acknowledge the
public health interventions necessary to fulfill
individual health needs, alleviating many of the
injurious inequities of globalization.
 By creating a framework for discussing public
health as a human right, international legal bodies
could derive concrete, measurable indicators for
governments in enacting public health programs
and assure that these governments can be held
accountable for realizing the highest attainable
standard of health.