PHM-Exch> Health and Human Rights

[Claudio Schuftan]

Health and Human Rights  (simple training materials adapted from PHM South
Africa that can be used in your training) 1. What are Human Rights? *Human
rights are: *

   - Something we can claim from society


   - Claims that are legitimate (not just anything)


   - Claims for social needs as well as material resources


   - Needs that are fundamental to being human


   - Limit what the state CAN and CAN'T do to individuals, groups


   - Also, prescribes what the state SHOULD do for us


   - General or universal


   - Codified in law - national / international

2. Can rights ever be limited?

   - Rights can be restricted *only* if one right interferes with another
   person or person's right/s


   - Certain rights can NEVER be restricted


   - Right to a fair trial


   - Right to be free of torture


   - Etc


   - Civil/political rights (freedoms) are indivisible from socio-economic
   entitlements

3. What does it mean to have a right?

   - Rights imply a claim; it is more than charity - the state has an
   OBLIGATION to enable you to realize your rights


   - With rights go responsibilities


   - You cannot enjoy right of access to health care if (e.g.) clinic is too
   far


   - For every right ® there is a corresponding duty
   Usually, it is government that has the duty, but increasingly, private
   corporations are regarded as having rights responsibilities

4. How is government a bona-fide duty bearer?

Government has four kinds of human rights obligations:

   - To RESPECT your rights by NOT passing laws or having programs that
   violate your rights


   - To PROTECT your rights from other people who might violate your rights
   (e.g., an exploitative employer)


   - To take ACTIVE measures to FULFILL your rights - by budgeting
   implementing programs and passing laws


   - To PROMOTE rights by enabling people to know about how to realize their
   rights

5. Government obligations in line with international human rights law

   - If governments sign an international treaty, they indicate they agrees
   with the principle and aim of the treaty, but they are not bound by that
   treaty


   - If governments ratify an international treaty, they are bound by that
   treaty and must:


   - Pass laws


   - Budget for implementation


   - Put in place programs

                                              that put the treaty into
effect.
6. Are human rights just for use by lawyers?

   - No


   - Human rights can be used:


   - To hold governments accountable


   - To shape government policies


   - Get redress and compensation for people suffering violations


   - Create space for Civil Society Mobilization

7. What can constitutions say about health as a right? *Broadly speaking, it
can talk about 2 kinds of things:* *1. Health care*

   - Access to health services


   - Emergency care, etc

*2. Conditions we need to be healthy.* 8. Health Rights Provisions in a
Typical Bill of Rights *It should make reference to different ways in which
the right to health should be realized:*

   - Access to health care services…(progressively realized)


   - No-one can be refused emergency treatment


   - Right to Life


   - An Environment not harmful to health


   - Access to sufficient food and water


   - Access to adequate housing


   - Bodily integrity; freedom and security of persons


   - Children - basic nutrition & health care services, shelter


   - Dignity, equality, non-discrimination


   - Access to information


   - Freedom from Torture

9. Health as a Human Right – National level

   - Progressive realization: The State does *not* have to put in place
   expensive services it cannot afford, or provide all forms of health care to
   those who need it, but it must say how it is going to increase its provision
   of health care over time.


   - Right to Participation and Rights to Information are instrumental for
   achieving other rights.

10. Health as Human Right – International level

The United Nations defines the right to health as follows:

   - The ICESCR speaks of “… the right of everyone to the enjoyment of the
   highest attainable standard of physical and mental health…”


   - Health is closely related and dependent on other rights (food, water,
   housing, work…) illustrating the recognition of the social determinants of
   health.


   - Not only “timely and appropriate health care” is required for meeting
   the right to health but also the underlying determinants of health: i.e.,
   all relevant services, facilities and resources, not just health care

*11. How do we know if right to health is met?*

The United Nations defines the right to health as being measurable in terms
of:

   - Availability: functioning public facilities, programs, in sufficient
   quantity


   - Access:


   - No discrimination


   - Geographical/physically accessible


   - Affordable


   - Information available


   - Acceptability: respect culture, ethics


   - Quality: medically appropriate, scientific quality

 xxxxxx
The People’s Health Movement and the
“Right to Health Campaign”

 *Who is the People’s Health Movement?*

The People’s Health Movement is a global network of civil society groups,
researchers, trade unions, activists and workers involved in health.  PHM
believes that “*The true indicator of the state of a nation is the health of
its people*”, in that the health of a nation is a reflection of enlightened
and equitable social policies, compassionate communities, a caring
leadership and a social system based on the indisputable value of human
life.  In short, we are committed to health as a right.

*“Health is a social, economic and political issue and above all a
fundamental human right. Inequality, poverty, exploitation, violence and
injustice are at the root of ill-health and the deaths of poor and
marginalized people.”** People’s Charter for Health*

We are concerned about the single-minded focus on ‘growing the economy’ as
the “cure” for all our ills. The time frame for that to benefit our people
is too slow. People need food now, clean water now, a place to sleep now and
access to health care now. We believe that the economy does not come before
the people, rather, economic development should be a tool to benefit the
people.

PHM has proposed the launch of a *Global Campaign on the Right to Health *and
local circles are launching this campaign in already 16 countries.  For
further information on PHM global please go to www.phmovement.org

*Why Do We Need a Right to Health Campaign?*

The health of people worldwide and in this country is getting worse. They
are burdened with four epidemics of disease including (1) diseases of so
called ‘developing’ countries, like childhood diarrhea, pneumonia,
tuberculosis, and measles (2) emerging chronic diseases like diabetes,
hypertension, obesity, and heart disease, (3) a high burden of injuries and
violence, and, not least, (4) the HIV/AIDS epidemic, which is a huge problem
worldwide.

*Who Should Be Involved in the Right to Health Campaign?*

Health and illness are not just the result of healthcare services. They
result from policies, both local and global, that affect people’s access to
healthy food, clean water, decent sanitation, adequate housing/shelter,
steady employment and proper health information. In short, our poor health
status is a reflection of a ‘diseased society’, one in which insufficient
priority is given to human well-being.

Because health is determined by so many factors outside the health services,
we need a campaign led by civil society, including many sectors required for
the health of communities such as health, water, land, housing, education,
labor, etc.  In fact, PHM has long been working with NGOs and social
movements in other sectors that seek to secure healthier environments,
workplaces, and communities.

*What is the Purpose of the Right to Health Campaign?*

   1. To raise awareness worldwide of what constitutes health: not only
   health services but also the range of basic services and relationships that
   are the determinants of good health
   2. To strengthen civil society organizations and build strong
   partnerships with trade unions
   3. To create a platform for health workers to discuss working conditions
   and other challenges
   4. To enable communities and ordinary people to have a meaningful say in
   the development, implementation and monitoring of policies.
   5. To enable local organizations to link with international networks of
   like-minded health groups, building international solidarity and capacity to
   advance the right to health.
   6. To give meaning to the right to participation by giving people a
   voice.
   7. To urge government to create a sustainable health system that gives
   substance to recent charters and declarations.

*What is the “Right to Health”?*

As part of many countries’ constitutional commitment to realizing rights,
the promotion of the right to health is a key obligation for the state.
Health is one of a number of socio-economic rights, all dependent on each
other and essential for human well-being and development. Unfortunately, the
world over, there is a large gap between the human rights provisions in the
constitution and what is happening on the ground.

A campaign that focuses on the right to health will help to identify system
failures, secure redress for those unfairly treated, prevent future abuses
from taking place and show case positive experiences. We believe a Right to
Health campaign can build a health system that helps all people realize
their human potential.

*What can the Right to Health Campaign Do?*

The Right to Health Campaign can draw from the extremely successful campaign
in India where public hearings, often in very simple community settings,
gave community members the chance to give testimony of their experiences of
the health services and of the violation of their right to health.  It can
also embark in doing a right to healthcare assessment using the PHM
Assessment Guide found in the PHM website (www.phmovement.org following the
link to ‘campaigns’).

The campaign will be driven by NGOs, with key leaders as patrons, and
supplemented with media coverage (radio, print, TV). We will solicit
testimony from ordinary beneficiaries who experienced violations of their
right to health as well as positive experiences that advance the right to
health. Activities can include:

   - Hearings & testimonies, both of violations and of positive experiences
   in realizing the right to health from users of health care, community
   members, health workers and others.
   - Carrying out a RTH assessment as per the PHM Guidelines followed by a
   national workshop to present the findings and.
   - Surveys of working conditions, staff morale, motivation and human
   resource migration.
   - Materials development on the ‘Right to Health’ in the form of
   pamphlets, manuals, etc.
   - Education regarding the right to health and the broader determinants of
   health;
   - Discussing progress on the Right to Health campaign in each country.
   - Research and Analysis – to monitor accountability and significant
   improvements or lack thereof.

 We are especially interested in working in the following areas to promote
the right to health:

   - Children, the elderly, the disabled and other vulnerable groups
   - Domestic violence
   - HIV/AIDS
   - Transport and obstacles for access
   - Housing, land rights activism
   - Social security
   - Environmental issues: garbage collection; safe water and sanitation
   - Impact of alcohol on children and communities
   - The situation faced by Health Workers themselves and human resources in
   health
   - Right to information.

 More information from cschuftan at phmovement.org
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