October 18, 2016
In his annual report to the UN General Assembly, the Special Rapporteur on the right to health, Dainius Puras, assesses the opportunity for the improvement of the right to health and human rights to contribute to the attainment of the Sustainable Development Goals (SDGs). We have written a summary of this report.
The Sustainable Development Goals were brought forward as part of the 2030 Agenda for Sustainable Development, and call on all countries to protect the planet in their economic pursuits.
Goal #3, focusing on health, is to “ensure healthy lives and promote well-being for all at all ages”, however, the SR notes that almost all the Goals can be linked to health. An important observation made early in the report is that the SDGs, unlike the right to health, are non-binding political commitments. Unfortunately, as is apparent in Goal #3, the Agenda itself does not define health as a human right. However, the SR does remind States that the right to health is a fundamental right enshrined within the international human rights framework.
Health systems
The SR goes on to underline the necessity of a well-functioning health system. Indeed, this is fundamental to the right to health and therefore the realisation of other SDGs, as is the need for focused investment in developing such systems. As a matter of fact, States are already legally obliged under the International Covenant on Economic, Social and Cultural Rights (ICESCR) to “devote maximum available resources to the right to health”, which includes funding struggling health systems. Additionally, the SR mentions the binding development commitments that require States to assist developing countries, and says these obligations add weight to the SDG to revitalize the global partnership for sustainable development (Goal #17).
Accountability and participation
Puras’ more general criticisms of the Agenda include that certain health targets lack critical elements, which opens the possibility of undermining the SDGs. Additionally, he notes that some targets lay insufficient emphasis on human rights requirements and modern public health, and says that the Agenda provides “weak accountability requirements” and little implementation guidance. The SR also expresses concern about the limited capacity for participation by civil society in many countries, and insists on the need, in pursuit of these goals, for States to ensure the decision-making processes that affect individuals’ health and development are left open to such individuals.
Challenges
The SR sheds light in detail on four challenges (affecting developed and developing countries alike), which arise as the result of the SDG—right to health relationship. These issues include 1) inequity and equality, 2) accountability, 3) universal health coverage, and 4) violence. Puras considers that, in terms of implementation, these issues are inadequately addressed by the Agenda. However, he argues that a framework to address this shortcoming can be found in aspects of human rights and the right to health that relate to the Agenda’s indicators and targets.
1) Inequity and inequality – The right to health requires States to prioritise vulnerable populations in terms of health resources, law and policy, participation and empowerment, and in disaggregated data.
2) Accountability – As regards holding duty bearers accountable, the global health and human rights fields have mechanisms which can be used to inspire accountability for the SDGs’ health aspects.
3) UHC – In implementing universal health coverage, under the right to health, States must meet numerous requirements and, furthermore, this must be monitored. The SR recommends the three-part strategy proposed by WHO to realise this coverage.
4) Violence – Finally, as for violence as a public health issue in the SDGs, he asserts that this affects all areas of health, in various settings and takes place in many forms. Violence is one of the “most compelling barriers” to the right to health.
Download the annual report (in English, French, Spanish, Arabic, Chinese or Russian)