PAHO Staff Urged to Promote Health as a Human Right

Staff of the Pan American Health Organization (PAHO) were told that a human rights approach can help speed health progress, in a panel discussion led by Paul Hunt, United Nations special rapporteur on the right to health. Also present was Claudio Grossman, dean of the Washington College of Law at the American University and former president of the Inter-American Commission on Human Rights (IACHR).

Hunt, who monitors progress worldwide on "the right of everyone to the enjoyment of the highest attainable standard of physical and mental health," noted that PAHO member countries have defined health as a human right in key documents including the Constitution of the World Health Organization (WHO), the Alma Ata Declaration of 1978, the Ottawa Charter of 1986, and the American Convention on Human Rights. At least 19 of 35 PAHO member countries' constitutions define health as a human right.

He said the challenge is to make the principle "more than a slogan," through good public health policies and programs and more effective advocacy. "Obviously, the right to health cannot be achieved without public health programs. But public health objectives can benefit from the newer dynamic of human rights," said Hunt.

Most public health advocates accept health as a human right, Grossman said, but not all understand how the perspectives and tools of the human rights movement can help boost public health advocacy. He urged public health advocates to hold governments accountable to commitments in this area, ideally through binding legal instruments such as treaties, constitutions, and legislation. But nonbinding accords such as the Millennium Development Goals are also incentives, as are recommendations and guidelines on human rights, which "can add legitimacy by creating an expectation of behavior," said Grossman.

The human rights approach has already been used successfully to advance a number of major health causes, including HIV/AIDS and the rights of people with disabilities.

In 2003, for example, the IACHR issued measures that prompted Paraguay to confer human rights protection on 400 patients confined to the state psychiatric hospital. The country subsequently embarked on a reform of its mental health system consistent with the provisions of the American Convention on Human Rights.

Similarly, HIV activists have, in a number of PAHO member countries, worked successfully with national ombuds offices to compel their governments to provide antiretroviral treatment as a matter of human rights.

Hunt's own work recently included drafting nonbinding guidelines for pharmaceutical companies on the right to access to medicines, for eventual approval by U.N. member countries.

One of the main challenges, Hunt said, was the need for health policymakers to find ways of systematizing and operationalizing a human rights approach in their routine health policymaking and monitoring.

"As you devise policy, how do you ensure that the voices of women and children are heard, access is ensured, and indicators are disaggregated to ensure good health outcomes for minority groups?" he asked.

Hunt said every country should develop a "comprehensive national health plan" prepared through a participatory process and grounded in human rights.

"We need to raise the profile of the health system as a core institution underpinned by human rights," he said.

Educating health workers on the ground is also important, so they will adhere to and promote human rights principles in their work. Also, consumers need to be made more aware of the human rights approach to health, to spur new grassroots action on these issues.

"We need creative thinking about processes by which individuals can claim their rights," said Hunt.

Grossman praised recent PAHO efforts to collaborate with national ombuds offices in eight member countries to help establish country-level mechanisms for monitoring progress on health as a human right.

PAHO also assisted the United Nations secretariat and U.N. member countries in drafting the latest U.N. treaty on the human rights of people with disabilities, PAHO human rights advisor Javier Vásquez noted. In addition, PAHO andWHO have submitted technical opinions to several U.N. treaty bodies on issues related to the right to health.

Currently, PAHO is developing a project to promote and protect the right to health and related human rights of vulnerable groups throughout the PAHO region, including people with disabilities, older people, adolescents, and people living with HIV.

The panel discussion on health as a human right, held at PAHO headquarters on March 5, was the first in a new series of learning sessions for PAHO staff on key public health issues.