Other Publications, Articles and Projects on the Right to Health

Publications

International Assistance and Cooperation in Sexual and Reproductive Health: A Human Rights Responsibility for Donors

Judith Bueno de Mesquita and Paul Hunt

States' obligations under some international treaties extend beyond their national borders to international assistance and cooperation for human rights, including the rights to sexual and reproductive health, in other countries. This publication focuses on what is expected of donors in the context of this responsibility. It shows how many donors are taking important steps towards fulfilling this duty through measures they are taking to integrate the rights to sexual and reproductive health into their policies and programmes, but also argues that many donors can also do more. The publication concludes with a set of recommendations addressed to donors and their developing country partner governments.

Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines: the Sexual and Reproductive Health Context

Rajat Khosla and Paul Hunt

When Paul Hunt was UN Special Rapporteur (2002-2008), a recurrent theme in his work was access to medicines. For the most part, he - and colleagues in the Right to Health Unit - looked at the duties of States in relation to access to medicines e.g. his report to the UN General Assembly A/61/338, dated 13 September 2006. However, States reported that when endeavouring to enhance access to medicines the policies and practices of some pharmaceutical companies were a very considerable obstacle. Thus, he was urged to prepare access-to-medicines guidelines for pharmaceutical companies. After extensive research and wide-ranging consultations over some years, Paul Hunt and Rajat Khosla wrote 'Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines'. These Guidelines were published by the UN General Assembly in A/63/263, dated 11 August 2008. The present publication briefly discusses medicines and sexual and reproductive health, in particular medicines, HIV/AIDS and the human papillomavirus (HPV) - HPV being responsible for over 99% of cervical cancers. In this context, the publication then introduces, and reproduces, the 'Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines' that were published by the General Assembly in 2008.

Participation and the right to the highest attainable standard of health

Dr Helen Potts

Active and informed participation is an integral component of health systems, as well as the right to the highest attainable standard of health. Despite its critical importance, health and human rights have not given participation the attention it deserves. While some health researchers have made more headway than those working in human rights, neither community has a widely accepted understanding of what the process of participation means in practice. The monograph is an accessible, practical, timely and original introduction to the process of participation; the need for a variety of participatory mechanisms; the relationship between fairness and transparency of the process; the relationship between participation and accountability and participation in accountability. The publication of the monograph was supported by the Ford Foundation.

Conscientious Objection: Protecting Sexual and Reproductive Health Rights

Judith Bueno de Mesquita and Louise Finer

Healthcare providers' conscientious objection to involvement in certain procedures is grounded in the right to freedom of religion, conscience and thought. However, such conscientious objection can have serious implications for the human rights of healthcare users, including their sexual and reproductive health rights. This briefing paper examines the implications of conscientious objection, by healthcare providers, for the protection of sexual and reproductive health rights, and concludes with a set of recommendations for States' policies and laws.

Health Systems and the Right to the Highest Attainable Standard of Health

Paul Hunt and Gunilla Backman

Today, there is growing recognition that a strong health system is an essential element of a healthy and equitable society. However, health systems in many countries are failing and collapsing. It is vital to find ways of strengthening health systems. This briefing looks at health systems from the perspective of the right to the highest attainable standard of health. It outlines how this fundamental human right underpins and reinforces an effective, integrated, accessible health system - and why this is important. In other words, the briefing signals a right-to-health approach to health systems strengthening.

Accountability and the Right to the Highest Attainable Standard of Health

Dr. Helen Potts

Accountability is a central feature of human rights. Despite its critical role, little work has been done to explore its meaning and content. Even less work has been done in the context of the right to health. As a result, accountability is cloaked in misunderstandings. The monograph is an accessible, practical and timely study, addressing these misunderstandings by clarifying the process of accountability; the relationship between monitoring, mechanisms and redress; and the pre-conditions for effective accountability. The publication of the monograph was supported by OSI's Public Health Program and Law and Health Initiative.

The Rights to Sexual and Reproductive Health

Paul Hunt and Judith Bueno de Mesquita

Sexual and reproductive health are among the most sensitive and controversial issues in international human rights law, but they are also among the most important. This publication examines the outcomes of the International Conference on Population and Development held in Cairo in 1994 and the Fourth World Conference on Women held in Beijing held in Beijing in 1995 that can be applied alongside international human rights law standards in the context of sexual and reproductive health rights.

Reducing Maternal Mortality: The contribution of the right to the highest attainable standard of health

Paul Hunt and Judith Bueno de Mesquita

Over half a million women die each year due to complications during pregnancy and birth. The vast majority of these deaths are preventable. Despite longstanding international commitments to reducing maternal mortality, progress to date has been disappointing. This publication introduces the contribution of the right to the highest attainable standard of health to reducing maternal mortality.

Neglected Diseases: A human rights analysis

Paul Hunt, Rebecca Steward, Judith Bueno de Mesquita and Lisa Oldring

Paul Hunt, Rebecca Steward, Judith Bueno de Mesquita and Lisa Oldring researched on the human rights implications of neglected diseases. The report, entitled "Neglected diseases: A human rights analysis" was published as an issues paper in 2007. This project was funded by the WHO-World Bank-UNDP Special Programme for Research and Training in Tropical Diseases.

In 2004, Paul Hunt participated in the International Workshop on Intensified Control of Neglected Diseases, held in Berlin. Paul Hunt prepared for this conference, on the topic of Neglected Diseases, Social Justice and Human Rights: Some Preliminary Observations (PDF).

In March 2005, Paul Hunt undertook an official mission to Uganda, where he focused on the issue of neglected diseases. This mission was carried out in coordination with the World Health Organization.

Our Right to the Highest Attainable Standard of Health

This briefing, entitled "Our Right to the Highest Attainable Standard of Health" aims to provide a very short, concise and accessible introduction to the right to the highest attainable standard of health. This project was a joint initiative of the Human Rights Centre and the International Federation for Health and Human Rights Organisations (IFHHRO). The briefing is available in English, French and Spanish.

Articles

Health systems and the right to health: an assessment of 194 countries

Gunilla Backman, Paul Hunt, Rajat Khosla, Anna Protano-Briggs, Camila Jaramillo- Strouss, Belachew Mekuria Fikre, Caroline Rumble, David Pevalin, David Acurio Páez, Mónica Armijos Pineda, Ariel Frisancho, Duniska Tarco, Mitra Motlagh, Dana Farcasanu, Cristian Vladescu

Published in The Lancet (13-19 December 2008), this report identifies some of the right-to-health features of health systems and proposes 72 indicators that reflect some of these features. Globally processed data on these indicators for 194 countries and national data for five countries (Ecuador, Mozambique, Peru, Romania and Sweden) were collected. Globally processed data were unavailable for 18 indicators for any country, suggesting that organisations that obtain such data give insufficient attention to the right-to-health features of health systems. Where they are available, the indicators show where health systems need to be improved to better realise the right to health. The report provides recommendations for governments, international bodies, civil society organisations, and other institutions and suggests that these indicators and data, although not perfect, provide a basis for evaluating health systems and monitoring the progressive realisation of the right to health. Right-to-health features are not just good management, justice, or humanitarianism, they are obligations under human rights law. Many of the features are reflected in the Alma-Ata Declaration (1978) and the recent World Health Report on primary health care (2008). In the same issue, The Lancet carries an editorial calling this "a landmark report", as well as short articles by Navanethem Pillay (UN High Commissioner for Human Rights), Amartya Sen (Harvard University), Hedia Belhadj and Aminata Toure (UNFPA), and Ariel Frisancho and Jay Goulden (CARE Peru).

Right to the Highest Attainable Standard of Health (Comment, Vol. 370, Lancet, pp.369-371)

The right to the highest attainable standard of health lies at the heart of the health and human rights movement. Of course, this right does not provide magic solutions to complex health issues, any more than do ethics or economics. Nonetheless, the right to health has a crucial constructive role to play.

The Human Right to the Highest Attainable Standard of Health: New Opportunities and Challenges (Transactions of the Royal Society of Tropical Medicine and Hygiene (2006) 100, 603-607)

The health and human rights communities have much in common. Recently, the international community has begun to devote more attention to the right to the highest attainable standard of health (‘the right to health’). Today, this human right presents health and human rights professionals with a range of new opportunities and challenges. The right to health is enshrined in binding international treaties and constitutions. It has numerous elements, including the right to health care and the underlying determinants of health, such as adequate sanitation and safe water. It empowers disadvantaged individuals and communities. If integrated into national and international policies, it can help to establish policies that are meaningful to those living in poverty.

Using All the Tools at Our Disposal: Poverty Reduction and the Right to the Highest Attainable Standard of Health (Special Report, Development Outreach, October 2006, pp.21-23)

For the most part, development practitioners fail to use the human rights tools at their disposal in the struggle against poverty. Of course, neither human rights nor anything else provide a magic solution to the immensely complex problem of global poverty. Nonetheless, human rights have a constructive contribution to make and a failure to use them is a missed opportunity of major proportions. There has been some progress at the policy level, much less progress at the operational level.

Projects

Draft human rights guidelines for pharmaceutical companies

Paul Hunt, UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, has launched for public consultation draft Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines.

Consisting of some 50 provisions, the draft Guidelines were launched on 19 September 2007 at the University of Toronto, Canada. They are available for comment until 15 May 2008. It is important that the consultative process is as transparent as possible. Accordingly, we are approaching the authors of all comments received on or before 25 February 2008 and asking permission to place their comments in the public domain. All comments received after 25 February will automatically be placed in the public domain.

Impact Assessments and the Right to Health (Completed Project)

UNESCO provided a grant for a short-term project to develop a methodology on human rights and impact assessments, using the right to health as a case study. Prof Paul Hunt and Gillian MacNaughton co-authored a report, entitled Impact Assessment, Poverty and Human Rights: A Case Study Using the Right to the Highest Attainable Standard of Health. This report was submitted to UNESCO on 31 May 2006.

Medical Associations and the Right to Health (Completed Project)

The British Medical Association, in collaboration with MedAct, provided a grant for a short-term project to research national medical association projects supporting the right to health and health-related Millennium Development Goals. The research focused particularly on support provided to national medical associations in developing countries by their counterparts in developed countries. The research findings are written up in a report by Dr Octavio Ferraz.

International Assistance and Cooperation for the Right to Health (Completed Project)

The British Medical Association, in collaboration with Medact, provided a grant to support research on the duty of international assistance and cooperation, enshrined in the International Covenant on Economic, Social and Cultural Rights, and its relationship to the right to health. The research examined this legal duty, its relationship with the Millennium Goals, jurisprudence, and examples of its practical application by States. The research culminated in a report by Dr Octavio Ferraz and Judith Mesquita, "The Right to Health and the Millennium Development Goals in developing countries: A Right to International Assistance and Cooperation?"

Guidelines for the Medical Investigation of Victims of Torture (Completed Project)

This project of the Human Rights Centre is carried out in close cooperation with the Medical Foundation for the Care of Victims of Torture, and is funded by the UK Foreign and Commonwealth Office. Paul Hunt is on the advisory board of this project.

International Health Worker Migration and Human Rights (Completed Project)

Commissioned by MedAct, a UK-based charity taking action on key global health issues, Judith Bueno de Mesquita wrote a paper on the human rights implications of international health worker migration, co-authoring with Matthew Gordon (London School of Hygiene and Tropical Medicine). This project was funded by the British Medical Association and Save the Children UK.

EU-China Human Rights Network Seminar: The rights to health and social security (Completed Project)

In April 2004, the Human Rights Centre hosted a meeting of the EU-China Human Rights Network on the topics of the right to health and social security. The Right to Health Project coordinated the event and contributed three background papers and working papers for the meeting.

Judith Bueno de Mesquita also participated as Seminar Co-Rapporteur in a follow-up EU-China Human Rights Dialogue Seminar on the right to health and HIV/AIDS, held in the Hague, Netherlands, on 8-9 November 2004.

This project is coordinated by the Irish Centre for Human Rights and the Chinese Academy of Social Sciences. The Human Rights Centre, University of Essex, is a member of the Steering Group. The project is funded by the European Commission.

A Human Rights Approach to Health in the Context of Poverty Reduction Strategies

Building on recent conceptual advances focusing on the operationalisation of a human rights-based approach to health in the context of poverty reduction strategy papers and current experiences in developing and implementing poverty reduction strategies, this project will identify and analyze good practices for the delivery of pro-poor health policies through the prism of a human rights-based approach to health.

WHO is the lead institution in this project, and the Special Rapporteur is a member of the core project steering group. The project will culminate in the publication of a handbook on a human rights approach to health in the context of poverty reduction strategies, which will be published by WHO.