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Hunt has recently turned his attention to social rights in the UK. In —15, he sat on the statutory human rights inquiry into emergency health care established by the Northern Ireland Human Rights Commission. He has been appointed a Patron of Just Fair , a London-based think-tank on economic and social rights. The Advisory Group is due to report in December From Wikipedia, the free encyclopedia. For other uses, see Paul Hunt.

The Lancet. The School of Law. University of Essex. Retrieved 1 October While the domestic health systems in the affected countries failed to address the crisis appropriately, a major international response was not put into place. For international health law, it is also important to assess the interplay between the Regulations and human rights norms, in particular those pertaining to individual patients and others who may potentially carry on the disease.

During health emergencies, the rights of individual patients and others are easily overlooked. While the Regulations seem to incorporate human rights law, the precise implications of this interface at a practical level demand further study. Furthermore, as mentioned, there is a need to address the connections between health and armed conflict under international health law. It has been stressed on various occasions that war and health influence each other mutually: while health is seen as a preventer of war, war and violent conflict can have a devastating effect on the lives and health of both combatants and civilians.

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By preventing armed conflicts, health and well-being could be spared. This protection includes a prohibition of the use of methods or means of warfare which are intended or may be expected to cause such damage to the natural environment and thereby to prejudice the health or survival of the population. Based on the international human right to health, States are required to realise the right to healthcare domestically. While the health problems and needs in developed and developing countries differ to a great extent, at a more abstract level very similar questions arise, for example, on how to allocate the limited budgets in a fair and efficient manner, taking into account the needs of the various population groups, as well as individual needs.

Some of these questions have transnational dimensions, for example, when it comes to the affordability of medicines in the developing world and the increasing expansion of cross-border healthcare delivery and financing. While the State bears the primary responsibility for realising the right to health, developed States and international organisations may carry responsibilities to realise the right to health in developing nations.

This abuse is especially prevalent in the care of socially marginalized groups—people living with HIV, ethnic minorities, sexual and gender minorities, people who use drugs, and people with intellectual disabilities or mental health problems.


In addition to healthcare, international health law should also engage with securing the underlying determinants to health, including such issues as access to safe drinking water and sanitation, health-related information, environmental and occupational health. It is widely acknowledged that the causes of ill-health and health inequalities go far beyond the possibility to access healthcare services.

Reducing health inequities is … an ethical imperative. Social injustice is killing people on a grand scale. Important challenges lie in exploring how the social determinants of health can be addressed from the perspective of human rights and international law more generally. Part of the solution may lie in connecting the different human rights together. Knowing that the ways we are raised, educated and work are decisive to our health implies looking into how the right to health is connected to other health-related rights, including the rights to education, housing and work, which reflect values like good quality education and adequate labour standards.

A related challenge for international health law concerns the dramatic global increase of chronic or non-communicable diseases the NCDs such as cancer, diabetes, respiratory diseases and cardiovascular conditions. The NCDs accounted for 65 per cent of global death in and are set to rise by 17 per cent over the next decade. At the domestic level, governments increasingly attempt to regulate certain aspects of food and beverages, such as the advertisement, packaging, size, and salt, sugar and trans fat content.

In addition, the food and beverage producers themselves, although strictly speaking not legally bound by the human rights treaties, potentially have indirect responsibilities under human rights law to ensure the healthiness of their products. As was already pointed out above, there are many connections between the international trade law framework and the international health-related standards, often leading to a tension between the urge to foster international trade and the need to protect the health of the public.

Firstly, the WTO law gives Members the possibility to adopt measures for the protection of public health. This provision, which creates a tension with the principle of non-discrimination mentioned above, recognises that Members may wish to give priority to public health concerns. The relationship between this framework and the human rights framework is still under-explored. While members invoking these public health clauses could potentially invoke the right to health, Members barred from trading their goods based on such measures could possibly stress the right to development of their people.

It is important to strike a balance between allowing Members to protect public health or other social interests and preventing them from using these policies in such a way that they have a negative effect on trade and on the interests of the other Members. Secondly, there is potentially a tension between the realisation of the right to healthcare at the domestic level, and the liberalisation and marketization of healthcare services.

While privatisation and liberalisation can make the provision of healthcare more efficient, it may also place the affordability and accessibility of healthcare under threat. This potentially threatens the ability of State to realise the right to healthcare at the domestic level.

According to Hilary in a study for Save the Children, the specific provisions of GATS undermine the ability of countries to implement their own public health priorities. Such rulings can have a considerable impact on the health-related instruments and norms in international law. After all, judicial decisions are seen sources of international law. After this identification of the relevant standard-setting instruments and their potential application in practice, I will now analyse the way in which these instruments are implemented, monitored and enforced by the responsible actors.

These questions are closely connected to the notion of governance which could, in this context, be defined as the totality of ways in which a society organises and manages its health-related concerns. To some extent this distinction is artificial, as global and national health laws are very much intertwined; however, it may help us gain a clearer picture of the nature and adequacy of the existing efforts at various levels of governance and accountability.

States, the primary duty holders under public international law, have certain legal obligations to enhance the health of their population. Based on the right to health, they have the duty to realise the highest attainable standard of health of all individuals residing on their territory and potentially beyond. They should also realise the other health-related rights as well as the rights of patients. Among other things, this means that the State is under a duty to establish a national public health strategy and plan of action.

Violations of the obligation to protect follow from the failure of a State to take all necessary measures to safeguard persons within their jurisdiction from infringements of the right to health by third parties. This category includes such omissions as the failure to regulate the activities of individuals, groups or corporations so as to prevent them from violating the right to health of others; the failure to protect consumers and workers from practices detrimental to health, e.

While only States are parties to the Covenant and thus ultimately accountable for compliance with it, all members of society — individuals, including health professionals, families, local communities, intergovernmental and non-governmental organizations, civil society organizations, as well as the private business sector — have responsibilities regarding the realization of the right to health […]. This statement recognises that many different actors have responsibilities under the right to health — setting aside the question of whether such responsibilities are legal or moral in character.

Based on the Regulations, States are under an obligation to maintain core surveillance and response capacities Articles 5 1 and 13 1 , while the WHO shall assist States in this task Articles 5 3 and 13 3. These international bodies increasingly recognise that a multi-stakeholder approach should be taken to achieve health at the national level.

When it comes to enforcing the health-related instruments, States should ensure that accountability mechanisms are in place to hold responsible actors accountable for their failure to respect and to realise the instruments. It is increasingly recognised that creating accountability for violations of international human rights standards is a multi-faceted process which should not rely on quasi judicial accountability mechanisms only, but also on a wide range of non-judicial tools, including political, professional, social, financial and administrative accountability mechanisms.

An example of a case where there was considerable cross-fertilization between civil society and the court system is the well-known Treatment Action Campaign case, which addressed access to an anti-retroviral drug in South Africa. After a broad campaign by the Treatment Action Campaign, the matter was put before the South African Constitutional Court which decided that the unavailability of the drug to the population at large violated the right to health in the Constitution of South Africa.

The case was based on Article 5 3 of the FCTC and the ensuing guidelines, which require States Parties to protect their anti-tobacco policies from commercial and other vested interests of the tobacco industry. This case creates an interesting precedent for similar cases in which the interests of public health are balanced against the interests of international trade.

Such cases set important examples on domestic judicial enforcement of the right to health and other health-related international instruments and norms. The primary intergovernmental body in the global health field is the WHO.

John Harrington

However, due to increasing globalisation, the WHO has now been joined by many players. While these new organisations bring in important new experiences and resources, the existence of so many organisations together also creates a considerable level of miscommunication and a lack of adequate leadership and accountability. To address the global health governance deficit, several scholars and civil society organisations have called for a strengthening of the WHO, for more standard-setting in global health and for more resources to address global health problems.

This article has attempted to bring coherence to the international standard-setting instruments and norms relevant to health. It has been done to outline the content and the scope of international health law as an emerging branch of international law. The article has shown that international health law consists of a set of disjointed health-related instruments that have been adopted within the framework of various international organisations, including the WHO, human rights treaty-monitoring bodies and the ICRC.

The implementation and enforcement of international health law remain a huge challenge. A major difficulty will be in bringing coherence to a field that is very broad and relies on instruments and norms from various branches of international law. Universal Human Rights in a World of Diverse Beliefs and Practices , worldwide moral unanimity about human rights does not exist. Human rights declarations and treaties are intended to change existing norms, not just describe the existing moral consensus.

Global Health and Human Rights

Yet another way of explaining the existence of human rights is to say that they exist most basically in true or justified ethical outlooks. On this account, to say that there is a human right against torture is mainly to assert that there are strong reasons for believing that it is always morally wrong to engage in torture and that protections should be provided against it. This approach would view the Universal Declaration as attempting to formulate a justified political morality for the whole planet.

It was not merely trying to identify a preexisting moral consensus; it was rather trying to create a consensus that could be supported by very plausible moral and practical reasons. This approach requires commitment to the objectivity of such reasons. It holds that just as there are reliable ways of finding out how the physical world works, or what makes buildings sturdy and durable, there are ways of finding out what individuals may justifiably demand of each other and of governments.

Even if unanimity about human rights is currently lacking, rational agreement is available to humans if they will commit themselves to open-minded and serious moral and political inquiry. If moral reasons exist independently of human construction, they can—when combined with true premises about current institutions, problems, and resources—generate moral norms different from those currently accepted or enacted.

The Universal Declaration seems to proceed on exactly this assumption see Morsink One problem with this view is that existence as good reasons seems a rather thin form of existence for human rights.

How is Children’s Health a Human Rights Issue? | Health and Human Rights

But perhaps we can view this thinness as a practical rather than a theoretical problem, as something to be remedied by the formulation and enactment of legal norms. The best form of existence for human rights would combine robust legal existence with the sort of moral existence that comes from widespread acceptance based on strong moral and practical reasons.

Justifications for human rights should defend their main features including their character as rights, their universality, and their high priority. Such justifications should also be capable of providing starting points for justifying a plausible list of specific rights on starting points and making the transition to specific rights see Nickel ; see also Section 3 Which Rights are Human Rights? Further, justifying international human rights is likely to require additional steps Buchanan These requirements make the construction of a good justification for human rights a daunting task.

Approaches to justification include grounding human rights in prudential reasons, practical reasons, moral rights Thomson , human well-being Sumner , Talbott , fundamental interests Beitz , human needs Miller , agency and autonomy Gewirth , Griffin dignity Gilabert , Kateb , Tasioulas , fairness Nickel , equality, and positive freedom Gould , Nussbaum , Sen Justifications can be based on just one of these types of reasons or they can be eclectic and appeal to several Tasioulas.

Grounding human rights in human agency and autonomy has had strong advocates in recent decades. For example, in Human Rights: Essays on Justification and Application Alan Gewirth offered an agency-based justification for human rights. He argued that denying the value of successful agency and action is not an option for a human being; having a life requires regarding the indispensable conditions of agency and action as necessary goods.

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Abstractly described, these conditions of successful agency are freedom and well-being. Having demanded that others respect her freedom and well-being, consistency requires her to recognize and respect the freedom and well-being of other persons. Since all other agents are in exactly the same position as she is of needing freedom and well-being, consistency requires her to recognize and respect their claims to freedom and well-being. These two abstract rights work alone and together to generate equal specific human rights of familiar sorts Gewirth , , From a few hard-to-dispute facts and a principle of consistency he thinks we can derive two generic human rights—and from them, a list of more determinate rights.

Accordingly, the justifying generic function that Griffin assigns to human rights is protecting normative agency while taking account of practicalities. He thinks that tying all human rights to the single value of normative agency while taking account of practicalities is the best way to remedy this malady.

Beyond this, Griffin takes human rights to include many rights in interpersonal morality. Unfortunately, accepting and following this proposal is unlikely to yield effective barriers to proliferation or a sharp line between human rights and other moral norms. Views that explain human rights in terms of the practical political roles that they play have had prominent advocates in recent decades. Two philosophers who have developed political conceptions are discussed in this section, namely, John Rawls and Charles Beitz for helpful discussions of political conceptions and their alternatives see the collections of essays in Etinson and Maliks and Schaffer Advocates of political conceptions of human rights are often agnostic or skeptical about universal moral rights while rejecting wholesale moral skepticism and thinking possible the provision of sound normative justifications for the content, normativity, and roles of human rights for challenges to purely political views see Gilabert , Liao and Etinson , Sangiovanni , and Waldron John Rawls introduced the idea of a political conception of human rights in his book, The Law of Peoples Rawls The basic idea is that we can understand what human rights are and what their justification requires by identifying the main roles they play in some political sphere.

In The Law of Peoples this sphere is international relations and, secondarily, national politics. Rawls says that human rights are a special class of urgent rights. He seems to accept the definition of human rights given in Section 1 above. But Rawls was working on a narrower project than Gewirth and Griffin. The international human rights he was concerned with are also defined by their roles in helping define in various ways the normative structure of the global system. They provide content to other normative concepts such as legitimacy, sovereignty, permissible intervention, and membership in good standing in the international community.

According to Rawls the justificatory process for human rights is analogous to the one for principles of justice at the national level that he described in A Theory of Justice Rawls Instead of asking about the terms of cooperation that free and equal citizens would agree to under fair conditions, we ask about the terms of cooperation that free and equal peoples or countries would agree to under fair conditions.

These representatives are imagined to see the countries they represent as free rightfully independent and equal equally worthy of respect and fair treatment. Rawls holds that under these conditions these representatives will unanimously choose principles for the global order that include some basic human rights for further explanation of the global original position see the entries on John Rawls and original position. Rawls advocated a limited list of human rights, one that leaves out many fundamental freedoms, rights of political participation, and equality rights.

He did this for two reasons. One is that he wanted a list that is plausible for all reasonable countries, not just liberal democracies. The second reason is that he viewed serious violations of human rights as triggering permissible intervention by other countries, and only the most important rights can play this role. Leaving out protections for equality and democracy is a high price to pay for assigning human rights the role of making international intervention permissible when they are seriously violated.

To accept the idea that countries engaging in massive violations of the most important human rights are not to be tolerated we do not need to follow Rawls in equating international human rights with a heavily-pruned list. Instead we can work up a view—which is needed for other purposes anyway—of which human rights are the weightiest and then assign the intervention-permitting role to this subset. Like Rawls, Beitz deals with human rights only as they have developed in contemporary international human rights practice.

The focus is not on what human rights are at some deep philosophical level; it is rather on how they work by guiding actions within a recently emerged and still evolving discursive practice. The norms of the practice guide the interpretation and application of human rights, the appropriateness of criticism in terms of human rights, adjudication in human rights courts, and—perhaps most importantly—responding to serious violations of human rights. He accepts that the requirements of human rights are weaker than the requirements of social justice at the national level, but denies that human rights are minimal or highly modest in other respects.

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Beitz rightly suggests that a reasonable person can accept and use the idea of human rights without accepting any particular view about their foundations. It is less clear that he is right in suggesting that good justifications of human rights should avoid as far as possible controversial assumptions about religion, metaphysics, ideology, and intrinsic value see the entry public reason. Beitz emphasizes the practical good that human rights do, not their grounds in some underlying moral reality. This helps make human rights attractive to people from around the world with their diverse religious and philosophical traditions.

This section discusses the question of which rights belong on lists of human rights. A seventh category, minority and group rights, has been created by subsequent treaties. These rights protect women, racial and ethnic minorities, indigenous peoples, children, migrant workers, and the disabled. Not every question of social justice or wise governance is a human rights issue. For example, a country could have too many lawyers or inadequate provision for graduate-level education without violating any human rights.

Deciding which norms should be counted as human rights is a matter of considerable difficulty. And there is continuing pressure to expand lists of human rights to include new areas. Many political movements would like to see their main concerns categorized as matters of human rights, since this would publicize, promote, and legitimize their concerns at the international level.

One way to avoid rights inflation is to follow Cranston in insisting that human rights only deal with extremely important goods, protections, and freedoms. A supplementary approach is to impose several justificatory tests for specific human rights. This approach restrains rights inflation with several tests, not just one master test. In deciding which specific rights are human rights it is possible to make either too little or too much of international documents such as the Universal Declaration and the European Convention.

One makes too little of them by proceeding as if drawing up a list of important rights were a new question, never before addressed, and as if there were no practical wisdom to be found in the choices of rights that went into the historic documents. And one makes too much of them by presuming that those documents tell us everything we need to know about human rights.

There is little reason to take international diplomats as the most authoritative guides to which human rights there are. The treaty may suggest that the right is supported by weighty considerations, but it cannot make this so. If an international treaty enacted a right to visit national parks without charge as a human right, the ratification of that treaty would make free access to national parks a human right within international law. But it would not be able to make us believe that the right to visit national parks without charge was sufficiently important to be a real human right see Luban The least controversial family of human rights is civil and political rights.

These rights are familiar from historic bills of rights such as the French Declaration of the Rights of Man and the Citizen and the U. Bill of Rights , with subsequent amendments. Some representative formulations follow:. Most civil and political rights are not absolute—they can in some cases be overridden by other considerations.

For example, the right to freedom of movement can be restricted by public and private property rights, by restraining orders related to domestic violence, and by legal punishments. Further, after a disaster such as a hurricane or earthquake free movement is often appropriately suspended to keep out the curious, permit access of emergency vehicles and equipment, and prevent looting.

But it excludes some rights from suspension including the right to life, the prohibition of torture, the prohibition of slavery, the prohibition of ex post facto criminal laws, and freedom of thought and religion. Their inclusion has been the source of much controversy see Beetham The European Convention did not include them although it was later amended to include the right to education. Instead they were put into a separate treaty, the European Social Charter. When the United Nations began the process of putting the rights of the Universal Declaration into international law, it followed the same pattern by treating economic and social standards in a treaty separate from the one dealing with civil and political rights.

Article 2. The contrast between these two levels of commitment has led some people to suspect that economic and social rights are really just valuable goals. Why did the Social Covenant opt for progressive implementation and thereby treat its rights as being somewhat like goals? For many countries, noncompliance due to inability would have been certain if these standards had been treated as immediately binding.

Social rights have often been defended with linkage arguments that show the support they provide to adequate realization of civil and political rights. This approach was first developed philosophically by Henry Shue Shue ; see also Nickel and Linkage arguments defend controversial rights by showing the indispensable or highly useful support they provide to uncontroversial rights.

Lack of education is frequently a barrier to the realization of civil and political rights because uneducated people often do not know what rights they have and what they can do to use and defend them. Lack of education is also a common barrier to democratic participation. Education and a minimum income make it easier for people near the bottom economically to follow politics, participate in political campaigns, and to spend the time and money needed to go to the polls and vote. Do social rights yield a sufficient commitment to equality? Objections to social rights as human rights have come from both the political right and the political left.

A common objection from the left, including liberal egalitarians and socialists, is that social rights as enumerated in human rights documents and treaties provide too weak of a commitment to material equality Moyn ; Gilabert Realizing social rights requires a state that ensures to everyone an adequate minimum of resources in some key areas but that does not necessarily have strong commitments to equality of opportunity, to strong redistributive taxation, and to ceilings on wealth see the entries equality , equality of opportunity , distributive justice , and liberal feminism.

The egalitarian objection cannot be that human rights documents and treaties showed no concern for people living in poverty and misery. That would be wildly false. One of the main purposes of including social rights in human rights documents and treaties was to promote serious efforts to combat poverty, lack of education, and unhealthy living conditions in countries all around the world see also Langford on the UN Millenium Development Goals.

The objection also cannot be that human rights facilitated the hollowing out of systems of welfare rights in many developed countries that occurred after Those cuts in welfare programs were often in violation of the requirements of adequately realizing social rights. Perhaps it should be conceded that human rights documents and treaties have not said enough about positive measures to promote equal opportunity in education and work. A positive right to equal opportunity, like the one Rawls proposed, would require countries to take serious measures to reduce disparities between the opportunities effectively available to children of high-income and low-income parents Rawls A strongly egalitarian political program is best pursued partially within but mostly beyond the human rights framework.

One reason for this is that the human rights movement will have better future prospects for acceptance and realization if it has widespread political support. That requires that the rights it endorses appeal to people with a variety of political views ranging from center-left to center-right.

Support from the broad political center will not emerge and survive if the human rights platform is perceived as mostly a leftist program. Do social rights protect sufficiently important human interests? Maurice Cranston opposed social rights by suggesting that social rights are mainly concerned with matters such as holidays with pay that are not matters of deep and universal human interests Cranston , Treatments of objections to social rights include Beetham ; Howard ; and Nickel It is far from the case, however, that most social rights pertain only to superficial interests.

Consider two examples: the right to an adequate standard of living and the right to free public education. These rights require governments to try to remedy widespread and serious evils such as severe poverty, starvation and malnutrition, and ignorance. The importance of food and other basic material conditions of life is easy to show. Without adequate access to these goods, interests in life, health, and liberty are endangered and serious illness and death are probable. Are social rights too burdensome? Another objection to social rights is that they are too burdensome on their dutybearers.

It is very expensive to guarantee to everyone basic education and minimal material conditions of life. Frequently the claim that social rights are too burdensome uses other, less controversial human rights as a standard of comparison, and suggests that social rights are substantially more burdensome or expensive than liberty rights.

Suppose that we use as a basis of comparison liberty rights such as freedom of communication, association, and movement. These rights require both respect and protection from governments. And people cannot be adequately protected in their enjoyment of liberties such as these unless they also have security and due process rights. The costs of liberty, as it were, include the costs of law and criminal justice.

Once we see this, liberty rights start to look a lot more costly. Further, we should not generally think of social rights as simply giving everyone a free supply of the goods they protect. Guarantees of things like food and housing will be intolerably expensive and will undermine productivity if everyone simply receives a free supply. A viable system of social rights will require most people to provide these goods for themselves and their families through work as long as they are given the necessary opportunities, education, and infrastructure.

Note that education is often an exception to this since many countries provide free public education irrespective of ability to pay. Countries that do not accept and implement social rights still have to bear somehow the costs of providing for the needy since these countries—particularly if they recognize democratic rights of political participation—are unlikely to find it tolerable to allow sizeable parts of the population to starve and be homeless.

If government does not supply food, clothing, and shelter to those unable to provide for themselves, then families, friends, and communities will have to shoulder this burden. It is only in the last hundred or so years that government-sponsored social rights have taken over a substantial part of the burden of providing for the needy. The taxes associated with social rights are partial replacements for other burdensome duties, namely the duties of families and communities to provide adequate care for the unemployed, sick, disabled, and aged.

Deciding whether to implement social rights is not a matter of deciding whether to bear such burdens, but rather of deciding whether to continue with total reliance on a system of informal provision that distributes assistance in a very spotty way and whose costs fall very unevenly on families, friends, and communities. Are social rights feasible worldwide? Another objection to social rights alleges that they are not feasible in many countries on how to understand feasibility see Gilabert Many governments will be unable to provide these guarantees while meeting other important responsibilities.

Rights are not magical sources of supply Holmes and Sunstein As we saw earlier, the Social Covenant dealt with the issue of feasibility by calling for progressive implementation, that is, implementation as financial and other resources permit. Does this view of implementation turn social rights into high-priority goals?