Human rights and health--the Universal Declaration of Human Rights at 50.
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The Universal Declaration on the Human Genome and Human Rights sets out generally agreed criteria in response to the human rights challenges posed by advances in molecular biology and genetics. The lynchpin of these criteria is respect for human dignity, a premise from which other principles are derived. The author examines and gives the justification for these principles, and refers to another crucial bioethics text, the recent Council of Europe Convention on the protection of human rights and the dignity of the human person in regard to applications of biology and medicine.
Using archival sources, the authors report on the debates and diverse perspectives of United Nations representatives responsible for formulating Article 25 (relating to health and medical care) and 27 (relating to science) of the Universal Declaration of Human Rights. These articles supply important normative guidelines for human rights and public health policy. The question of whether health-related rights should depend on state and/or private sponsorship was left open. There was agreement that scientists deserve freedom in their work but the elitist tone of Article 27 was modified by adding that the general public should share in its benefits. The political nature of drafting these articles shows they have no one dominant progenitor, but finally reflect hard-won consensus in a process ably chaired by Eleanor Roosevelt.
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Although several international and regional human rights instruments, including the Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights, give explicit recognition to a broad right to health, this right, at present, offers little real protection to interests in individual and community health, including reproductive and sexual health. This is so, the author argues, because the mechanisms now in place for supervision and enforcement of this and other "social human rights" are extremely weak. In these circumstances, better protection is available indirectly, through enforcement of certain "classical human rights," such as the right to life, the right to be free from inhuman and degrading treatment, and the right to found a family, that contribute to--and depend upon--realisation of a right to health.
Article 25 of the Universal Declaration of Human Rights clearly emphasizes health as a human right. Poverty and social exclusion are the most important drivers of ill-health. The causes of increasing poverty are complex but one significant factor is international debt. This affects mainly sub-Saharan Africa but, with the global economic crisis in South East Asia, may spread. Structural adjustment policies which cut social spending compound the health effects of debt and poverty. Privatization of health care and user charges particularly affect women, children, the disabled, and other marginalized communities. To improve health, governments and international institutions have a duty to examine the determinants of health, including human rights and economic policy.
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