The relationship between human rights and public health

Human rights and public health were once two distinct domains, the former belonging to the political and the latter to the medical. However, with the progress in the modem human rights movement and an expanded list of the determinants of public health, the two seemingly unrelated areas have become increasingly intertwined and mutually influencing (see Figure 5.1).

Tire structural links between health and human rights are emerging in ever wider areas. Changes in the discourse of "health and human rights” have revealed the unequivocal relationship between the two. Therefore, through conceptual, analytical, strategic and programmatic work, the two distinct areas can be linked

Table 5.1 Cunent Major International Declarations and Covenants on Human Rights (in chronological order)

No. Title Year

• 1 Convention Concerning Forced or Compulsory Labour 1930
• 2 UN Charter 1945
• 3 Convention on the Pr evention and Punishment of the Crime of Genocide 1948
• 4 Universal Declaration of Human Rights 1949
• 5 Convention for the Suppression of the Traffic in Persons and of the 1949

Exploitation of the Prostitution of Others

6 Geneva Convention (I) for the Amelioration of the Condition of the Wounded 1949

and Sick in Aimed Forces in the Field

7 Geneva Convention (II) on Wounded. Sick and Shipwrecked of Aimed 1949

Forces at Sea, 1949 and its commentary

• 8 Geneva Convention (III) on Prisoners of War 1949
• 9 Geneva Convention (FC) on Civilians 1949
• 10 Convention Relating to the Status of Refugees 1950
• 11 International Convention on the Elimination of All Fonns of Racial 1963

Discrimination

• 12 International Covenant on Civil and Political Rights 1966
• 13 International Covenant on Economic, Social and Cultural Rights 1966
• 14 Protocol Relating to the Status of Refugees 1967
• 15 Declaration on the Use of Scientific and Technological Progress in the 1975

Interests of Peace and for the Benefit of Mankind

• 16 Declaration on the Rights of Disabled Persons 1975
• 17 Convention on the Elimination of All Forms of Discrimination Against 1979

Women

18 Declaration on the Protection of All Persons from Being Subj ected to Toiture 1984

and Other Cruel. Inhuman or Degrading Treatment or Punishment

• 19 Declaration on the Right to Development 1986
• 20 Convention on the Rights of the Child 1989
• 21 Indigenous and Tribal Peoples Convention 1989
• 22 International Convention on the Protection of the Rights of All Migrant 1990

Workers and Members of Their Families

23 Principles for the Protection of Persons with Mental Illness and the 1991

Improvement of Mental Health Care

• 24 United Nations Principles for Older Persons 1991
• 25 Declaration on the Rights of Persons Belonging to National or Ethnic, 1992

Religious and Linguistic Minorities

26 Standard Rules on the Equalization of Opportunities for Persons with 1993

Disabilities

• 27 Declaration on the Elimination of Violence against Women 1993
• 28 The Universal Declaration on the Human Genome and Human Rights 1997
• 29 Declaration on the Right and Responsibility of Individuals, Groups and 1998

Organs of Society to Promote and Protect Universally Recognized Human Rights and Fundamental Freedoms

• 30 Guiding Principles on Internal Displacement 1998
• 31 Maternity Protection Convention 2000

RIGHT TO INFORMATION.

RIGHT TO < EDUCATION

RIGHT TO FOOD & NUTRITION

HARMFUL

TRAI

PRX

VIOLENCE AGAINST WOMEN

HUMAN RIGHTS VIOLATIONS RESULTING IN ILL HEALTH

REDUCING VULNERABILITY | TO ILL HEALTH THROUGH HUMAN RIGHTS

HEALTH & HUMAN RIGHTS

PROMOTION OR VIOLATION OF HUMAN RIGHTS THROUGH HEALTH DEVELOPMENT.

RIGHT TO PARTICIPATION

FREEDOM FROM DISCRIMINATION

FREEDOM OF MOVEMENT

RIGHT TO WATER

RIGHT TO PRIVACY

Figure 5.1 Linkages Between Human Rights and Public Health

and move forward together. In recent years, human rights have gradually become one of the focal points in studies regarding health and development issues. In fact, the level of explicit and institutional political commitment to health and human tights has never been stronger. This commitment manifests not only in the United Nations but also more importantly in governmental and non-governmental levels both domestically and internationally. Promoting and protecting health and respecting, protecting and fulfilling human rights are inextricably linked. The links between human rights and public health are best illustrated in the preamble to the Constitution of the World Health Organization, which states that “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” (WHO, 2020, p. 1). By implication, to violate civil rights on the bases of race, religion, political relief, gender and so forth is to render illusory the right to enjoy the highest attainable standard of health. Promotion and protection of human rights is “a prerequisite to health and wellbeing” (Gruskin et al., 2007, p. 452). Public health governance efforts which take human rights into account are more effective than those which ignore or violate such rights (Menon-Johansson, 2005).

The impact of human rights on public health can be construed positively and negatively. First, respecting and protecting human rights contribute to public health promotion. The protection of human rights is “the way to protect the public’s health. The protection of a full range of human rights is the key to protecting public health” (Jürgens & Cohen, 2007, p. 7). Governments have the responsibility to protect two groups of human rights: The first group comprises civil and political rights, including the right to life, freedom of information, freedom of movement, freedom of association, equality, freedom of speech and the right to participate. The second group consists of economic, social and cultural rights, including the right to education, development, the right to enjoy the benefits of scientific progress and its applications, the right to just and favourable conditions of work and the right to be free from hunger. Almost all these rights are closely related to public health. For example, rather than attempting to cover up the truth, a public health crisis can only be effectively managed if a government informs the public in a timely manner to ensure people’s right to information. Further, if people’s right to education is ensured and their general level of education is unproved, they will be better equipped with public health knowledge and thus collectively improve public health conditions. The close link between human rights and public health is also reflected in the fight against HIV/AIDS. At the UN High Level Meeting on HIV/AIDS in 2006, world leaders reaffirmed that “the frill realization of all human rights and fundamental freedoms for all is an essential element in the global response to the HIV/AIDS pandemic” (Jürgens & Cohen, 2007, p. 1). In short, human rights protection and public health governance share common goals. Human rights protection results in effective public health governance, and public health governance involves the protection of all types of human rights. Human rights “transcend almost every other right” (Gruskin et al., 2007, p. 450).

Second, human rights violations are not conducive to public health governance. Human rights violations “always have a negative impact on health” (Brandland G. H., 1998). Discrimination based on race, colour, gender, language, religion and so forth has exacerbated the situation in global health governance. Taking the global AIDS epidemic as an example, discrimination and human rights violations are not only the consequence of AIDS but also the cause of AIDS (Mann & Gruskin, 1999, p. 445). Violations of human rights have “exacerbated the AIDS epidemic” (Csete, 2004, p. 83). In the early 1990s, a UN special rapporteur on the prevention of discrimination against people with HIV/AIDS revealed that “discrimination against persons with HIV infection or AIDS remains widespread and occurs at all levels of society, including government, public and private institutions, and among individuals and communities” (Gostin & Lazzarini, 1997, p. 75). Despite other social roots of the human rights violations against people with HIV/AIDS, racial discrimination is the very reason behind the international community’s inaction on the scourge of AIDS in Africa. As Peter Piot, then executive director of UNAIDS, put it when he was asked to comment on the international community’s inaction on the AIDS epidemic in Africa, “if this would have happened in the Balkans, or in Eastern Europe, or in Mexico, with white people, the reaction would have been different” (Gelhnan, 2000. p. 5). Believing that health problems in Africa in the early 1990s were caused by overpopulation, the US government at the time insisted that AIDS-related deaths in Africa could lead to a decline in population, which in the end would be conducive to Africa’s economic development

(Gellman, 2000). That this view is no longer popular is too little, too late. AIDS inns rampant in Africa and has triggered a global health crisis. Take the right to enjoy the benefits of scientific progress and its applications as another example: Since 2001, one of the key contributors to public health problems in developing countries, including AIDS, tuberculosis and malaria, are the high prices of medications brought by the TRIPS Agreement, preventing those who need treatment from obtaining affordable and effective medications. In the end, people’s right to enjoy the benefits of scientific progress and its applications becomes a pipe dream, thereby further exacerbating global health crises.

If democracy is suppressed and human rights are ignored, it is impossible for citizens in any country to enjoy development and health. Respecting and protecting human rights will have a positive impact on public health promotion. The maimer in which international human rights nonns are implemented is bound to have a significant impact on global health governance (see Table 5.2). The integration of strategies on human rights in global health governance shows that establishing international human rights regimes has become the only viable approach for global health governance. Also described as a human rights-based approach, it has been increasingly used in global health governance. It has also been adopted by institutional actors in other international regimes. For example, the World Bank has incorporated health and human rights considerations in its regulations and rules pertaining to public health (World Bank, 1998). In 2006, the issue of health-related human rights was mentioned in the 11th Global Program of Work of the World Health Organization, demonstrating the importance WHO attaches to the relationship between health and Inunan rights (WHO, 2006). The IHR (2005), which entered into force in 2007, also incorporates principles of human rights into the nonns and standards used in health governance. For example. Article 32 of the IHR stipulates that “in implementing health measures under these Regulations, States Parties shall treat travellers with respect for their dignity, human rights and fundamental freedoms and minimize any discomfort or distress associated with such measures”. Simplicity of language aside, the Inunan rights provisions in the IHR bring into light the importance of human rights considerations in global health governance and further strengthen the link between health and human rights. The clarification and implementation of the Inunan rights-based approach enable the concept of international human rights regimes to be applied to the area of global health governance and play in it an important role (see Table 5.2). The lack of attention to human rights in global health governance “is an omission that, if ignored, may be too high a price to pay” (Gruskin et al., 2007, p. S18).