Director-General

Statement to the 59th Commission on Human Rights

Geneva, Switzerland
20 March 2003

Chair, High Commissioner,
Honourable Delegates,

Already fifty-five years ago, the creators of WHO’s Constitution stated that the enjoyment of the highest attainable standard of health is a fundamental right of every human being. In our daily work, WHO is striving to make this right a reality. And we are paying particular attention to the poorest and most vulnerable.

Today, I would like to make an appeal for the most vulnerable citizens of Iraq - the elderly, women and children, and people with disabilities. With Iraq’s vital infrastructure already devastated, the most basic human rights to clean water or to basic health care cannot be met. We must do everything we can to mitigate this humanitarian disaster. I reiterate yesterday’s call from the UN Secretary-General, Kofi Annan, to the international community to protect Iraq’s most vulnerable citizens, and respond with generosity and speed.

The right to health is a goal for which all governments, rich and poor, should strive. Of course, this cannot be achieved overnight. All nations face constraints, in many cases posed by limited resources. This is why the principle of progressive realization is central to the achievement of all human rights.

But this principle is not an excuse for inaction. The right to health also contains immediate obligations to take concrete, deliberate and targeted steps towards full realization. This is why we need good benchmarks and indicators.

Over the last few years, we have become clearer as to what the right to health should actually mean. The adoption of General Comment 14 by the Committee on Economic, Social and Cultural Rights, is an important step in this direction. The right to health was interpreted as an inclusive right: it is not just about health care services; it is also about the underlying determinants of health. These are much broader and include access to safe drinking water, adequate sanitation, an adequate supply of safe and nutritious food, healthy occupational and environmental conditions, and access to information, including information about sexual and reproductive health.

The Committee observed that health facilities, goods and services must be available, acceptable and of good quality, paying particular attention to the most vulnerable and marginalized groups in society. What we have is the beginning of a practical framework for national governments as they face the challenge of turning universal principles into practical laws and action.

Developments at the international level have been matched at the regional and national levels, with a significant amount of jurisprudence being generated, which sets out the scope and content of the right to health.

Chair,

During my time as Director-General of WHO, our thinking on human rights has continued to evolve. Human rights instruments are not just seen as legal obligations, but as useful tools that can help us as we work with countries to achieve national development goals. Human rights need to be seen not just as an inspirational framework, but as a useful guide for analysis and action.

Health as a human right has been neglected. Now health is becoming more central to the international human rights agenda. Too often it has not been given the same recognition as other human rights, particularly civil and political rights.

We find that it is not always useful to stress the distinction between civil and political rights on the one hand, and economic, social and cultural rights on the other. Yet, we have a long way to go before we can speak of civil, cultural, economic, political and social rights with the same emphasis, let alone act on this basis.

Ensuring that health is at the heart of the development agenda has been a central theme of WHO’s corporate strategy. We have made significant progress. But we have to continue to make the case for health as a key to peoples’ future. There is still much to be done to keep health at the centre of the political frame - internationally and, even more so, in individual countries.

The Millennium Development Goals provide important milestones towards the progressive realization of the right to the highest attainable standard of health. They cover areas that directly concern the work of WHO: reducing child mortality, improving maternal health, combating HIV/AIDS, malaria and other diseases, improving access to water and sanitation, as well as access to essential drugs at prices that poor countries can afford.

The Report of the Commission on Macroeconomics and Health produced the first detailed costing of the resources needed to reach some of the key goals set in the Millennium Declaration. We are talking about a total annual investment of $66 billion from year 2007. Half of this will come from the developing countries’ own resources. But about half must be contributed by the rich countries of the world. This need for a partnership for development, in which rich and poor countries alike must play their part, is also reflected in the Millennium Development Goals.

The Commission for Macroeconomics and Health showed that scaling up investments in health is feasible. It also showed that such investments will yield tremendous gains in economic development. Improving people's health may be the single most important determinant of development in Africa. Improved health status has been shown to have been a key factor behind the economic development of East Asia over the past four decades.

This speaks to national decision-makers concerned with the wider social and economic benefits to their country. Understanding these findings, in the context of the right to health, can generate further momentum and heighten accountability for all partners.

The principle of a right to health helps us as we work to address the complex link between poverty and ill-health. It reminds us of the need to reveal the anonymous face of the poor, to recognize and identify vulnerable groups, and to engage them as active participants and generators of change.

Take gender. Millions of women accept poor health status as their lot in life and bring up their daughters to do the same. Why ? Because they have been ascribed an inferior status and are victims of a persistent devaluing of women's contribution to society.

Discrimination against women manifests itself in inadequately targeted policies, programmes and access to health services. Tackling stigma and discrimination in society is a good starting point for any government committed to ensuring a healthy and productive population.

We recommend that all governments review their laws, policies and practices to see whether they contribute to stigma and discrimination. Discrimination for any reason - race, colour, sex, religion, political opinion, social status, physical or mental disability or health status, such as HIV/AIDS - can have a devastating impact on people’s lives. Pushing for change, human rights law is one of the most powerful instruments we have at our disposal.

At the root of the concern for equality and freedom from discrimination in human rights thinking and practice lies the notion of human dignity: the equal and inherent value of every human being.

Human dignity is a notion that is generally accepted. Yet almost 11 million children die every year of preventable causes. Only 10 per cent of medical research expenditure is spent on diseases which affect 90% of the world’s population. Millions of people die when lifesaving vaccines and medicines exist, but do not get to those who need them because they - or the countries they live in - are too poor to pay for, or distribute, them.

Our world is rich. We can afford to bridge this chasm between our stated principles and the reality we live in. The world can spend $15 billion each year to control the AIDS epidemic. We can spend the extra few billion dollars that it will take to tackle malaria, and TB, and which would bring immunization to every child and make mothers and infants safe.

With globalization, free trade in goods and services, the development of increasingly sophisticated heath care technologies, and the revolution in information technology, new issues have emerged in global health. International law provides an important framework for addressing these issues. The fundamental human right to the highest attainable standard of health should be at the centre of this framework.

Using the WHO mandate and the general international legal framework, WHO Member States recently negotiated a vital new mechanism to protect and promote the individual’s right to health - the Framework Convention on Tobacco Control. It will support governments in fulfilling their obligations under the right to health, enabling them to regulate the tobacco industry that currently kills half of its consumers. This is an urgent matter. The entire increase in deaths over the coming 20 years will occur in the developing world, generating an intolerable burden on societies already struggling against poverty to build viable health systems.

The appointment of the UN Special Rapporteur on the Right to Health, is an important development towards strengthening the right to health. I welcome his appointment. His mandate will serve as an important mechanism and platform to elevate the status, and broaden the understanding, of the right to health. We applaud his recent report and look forward to working with him as he continues his mandate. Chair,

WHO is taking the call to integrate human rights into its global agenda on public health very seriously. The right to health will continue to be at the heart of this endeavour. We are committed to furthering our human rights activities across the Organization. We are exploring the intersection between human rights and the health challenges of a rapidly changing world: from mental health to reproductive rights and communicable diseases. WHO stands ready to support its Member States in advancing the right to health and further integrating human rights in health development.

Thank you.

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