Radisson Fort George Hotel, Belize City
11 December 2009
The Pan American Health Organization/World Health Organization (PAHO/WHO) in Belize, in collaboration with the Ministry of Health, convened a seminar on 11 December 2009, in observance of Human Rights Day, 10 December 2009. The conference aimed to sensitize participants to the right to the highest attainable standard of health (the right to health), taking into consideration the theme of Human Rights Day: “Embrace diversity, end discrimination”. The seminar followed a similar half-day event on 10 December that also focused on the right to health and targeted the staff of United Nations (UN) agencies in Belize.
Ms. Sandra Jones, PAHO/WHO HIV/Gender Advisor, chaired the seminar and welcomed 46 participants, comprising representatives from the Ministry of Health, UN agencies, non-governmental agencies, and community-based organizations. Dr. D. Beverley Barnett, PAHO/WHO Representative in Belize and Mr. Simeon Sampson, Co-Chair of the Human Rights Commission of Belize (HRCB), made opening remarks.
Dr. Barnett noted that the Human Rights Day theme was critical to the progressive realization of human rights and reminded the participants of the Preamble to the Universal Declaration of Human Rights (UDHR) and Articles 2 and 25 of the Declaration, which dealt with non-discrimination and health, respectively. Mr. Sampson assured the group that, contrary to doubts expressed by some persons, the HRCB was still functioning despite its limited resources, and gave a brief history of the Commission. He indicated its continued focus on civil and political rights, though it was mindful of economic, social and cultural rights, given the interdependence and indivisibility of human rights.
Subsequent presentations by Dr. Barnett, Ms. Anita Zetina, UNICEF Officer-in-Charge, Mr. Alejandro Morlachetti, PAHO Human Rights Consultant, and panel presentations by Ms. Cynthia Pitts, Ombudsman; Dr. Jorge Polanco, Deputy Director of Health Services; Ms. Antoinette Moore, Secretary, HRCB; Ms. Joan Burke, Director, Belize Family Life Association; and Ms. Judith Alpuche, Chief Executive Officer, Ministry of Human Development and Social Transformation, highlighted the following points:
§ Despite the fact that Belize has signed, but not ratified, the International Covenant on Economic, Social, and Cultural Rights (ICESCR), which is the treaty with the major statement on the right to health, as set out in Article 12 and amplified through ICESCR General Comment 14, the right to health is recognized in several other treaties that Belize has ratified. In addition, through international customary law, non-ratification of a treaty does not mean that there is no obligation on the part of the main duty-bearer, the State Party (the government and its authorities and agencies) to ensure progressive realization of the rights set out in the treaty. In Belize, the Supreme Court has already used international human rights treaties in interpretative decisions, and is likely to continue to do so
§ The right to health does not mean the right to be healthy, since health depends on a number of factors, among them genetics, individual susceptibility, and lifestyles. The right to health therefore should be understood as the right to the enjoyment of a variety of facilities, goods, services, and conditions necessary for the realization of the highest attainable standard of health. The community has a responsibility to keep itself healthy through the adoption of relevant lifestyle, environmental, and other measures – health is a shared responsibility.
§ The 2003 UN Common Understanding of the Human Rights-Based Approach to Development Cooperation emphasizes analysis of the human rights claims of the rights holders and the corresponding obligations of the duty bearers, as well as the immediate, underlying, and root causes of the non-realization of rights; assessment of the capacity of the rights holders to claim their rights and of the duty bearers to fulfill their obligations, with development and implementation of strategies to build the capacities; monitoring and evaluation of both outcomes and process, guided by human rights principles; and incorporation of recommendations from treaty bodies and mechanisms into programming, including support for synchronizing national laws with treaty obligations.
§ The human rights system is not perfect, but it exists; it should be remembered that before the UN Charter and the UDHR (1948) there was no system for elucidating and monitoring human rights. General Comments by treaty bodies provide guidance to countries in how to fulfill their obligations, and the aim is to get the rights inserted into domestic law, taking alleged violations to international courts only as a last resort.
§ Though the Constitution of Belize, domestic law, and current health legislation and policy may not explicitly mention the words “right to health”, several of the principles are mentioned in these instruments, including non-discrimination. The Belize Health Agenda 2007-2011 speaks to availability, accessibility, and quality of health services, which are key aspects of the right to health. Notwithstanding the recognized need for significant strengthening of the knowledge and application of the right to health principles, there are many interventions and programs that are consistent with them.
§ There has also been greater collaboration and coordination among social sector ministries, and the move to multi-year and program budgeting will facilitate strengthening of these efforts.§ There is need for more effective alliances in reaching a common understanding, sharing the same vision, and taking a coordinated approach to the fulfillment of the right to health; many rights holders are not aware of their rights and how to claim them, and many duty bearers are not aware of their obligations and how to fulfill them.
§ Human rights should not be seen as “anti-government” – their observance is an integral part of good governance. We need to become more willing to uphold the rights of others, and we have an obligation to speak not only on our behalf, but on behalf of those whose right to health is being denied.
§ Some laws deny the right of some people to some health services, and other services are not user-friendly; this results in discrimination, which is against right to health principles.§ Caution should be exercised to avoid the erosion of non-citizen access to health services, which might be done inadvertently with the restructuring of the health system and the expansion of the National Health Insurance scheme. The following recommendations for the way forward came out of the spirited discussions that followed the presentations:
§ UN agencies should provide technical cooperation to:o Disseminate information on the right to health, the human rights treaty monitoring system, and treaty body reports and recommendations, which all Non-Governmental Organizations, Community-Based Organizations, and other organizations, agencies, and institutions can use to promote and advocate for the right to health, and implementation of the recommendations.o Disseminate information on the Constitution and its references to health.o Sensitize, educate, and train duty bearers and rights holders on their obligations and rights regarding the right to health, including health care workers as duty bearers.o Promote health and human rights, including to senior policy makers as a key target audience.o Carry out planned capacity assessment of some Ministries, to facilitate strengthening their capacity to fulfill their obligations as duty bearers.o Support the development of a national framework for monitoring the country’s progressive realization of human rights.
§ UN agencies should enhance integration of the human rights-based approach into its planning and programming cycles, including meaningful participation.
§ The status of the draft General Health Act and obstacles to its finalization and enactment should be determined.
§ Stakeholders should lobby for:o Advancement of the draft General Health Act;o Strengthening the Office of the Ombudsman and other national human rights institutions;o Belize’s ratification of the International Covenant on Economic, Social and Cultural Rights and the Convention on the Rights of Persons with Disabilities; ando Amendment of the Constitution to strengthen the inclusion of economic, social, and cultural rights.
§ The Ministry of Health should consider including aspects related to the right to health principles of availability, accessibility, acceptability, and quality in any evaluation of the National Health Insurance scheme.
PAHO/WHO Belize will continue to collaborate with national counterparts, partners, and other levels of PAHO and WHO in developing and implementing sensitization, education, and training strategies to strengthen national capacity for the progressive realization of the right to health.