Chairwoman Hautala spoke today in the European Commission seminar “Global Health – Together we can make it Happen”. [:]The objective of the conference was to discuss key challenges, goals and policy instruments to see how the EU can most effectively improve health at global level. Ms Hautala was asked to discuss health as a human right and the implications of this particular normative framework to the wider policy field.
I am glad to be invited to address the European Commission conference on Global Health and the EU’s role in making it reality.
Our panel has been asked to look into health as a human right. More specifically we have been instructed to better define the health right holders and duty-bearers at global and national levels, discuss how to eliminate the confusion around factors blurring roles, rights and responsibilities on the right to health. Furthermore, we have been asked to identify the opportunity for and limitations around consensus on basic criteria for the definition of a basic benefit package.
Health is an issue of great significance on the global scale. It cuts through most of the policies of a modern state and the field of foreign relations. It has presence in most fields of international human rights law. Indeed, no development or progress can be achieved on national or in international level if the issue of health is not addressed effectively.
Nevertheless, while the right to health has been agreed upon widely around the world, this right remains largely rhetoric. Indeed, while health issues have achieved more recognition over time and people live longer and are healthier, more than one billion people still live without even the most basic health care. This is an outright failure.
For example, a 1994 World Bank report estimated that women in the developing world are as likely to die at the hands of an abuser as they are from cancer. The study also found that the chances of women being incapacitated by abuse are greater than their combined chances of being incapacitated by traffic accidents or malaria. Moreover, 2002 World Health Organisation report showed that in some countries nearly two out of three women reported having been physically assaulted and nearly half reported that their first instance of sexual intercourse was forced. In June 2008 the United Nations estimated that four billion people live outside the protection of the rule of law. This has tremendous detrimental effects on protecting the wellbeing of people in all four corners of the world and most of all this vast failure leaves those in most vulnerable (children, minorities, women, disabled, refugees) exposed to abuse and neglect.
Health recognised as a right inherent to all human beings does not only cover the right to be healthy. Instead, the right to health also requires consideration of an individual’s biological and socio-economic preconditions for health as well as a state’s available resources to enable its citizens to realise their right to health.
World Health Organisation has listed general elements of health as right, among others they are: Promoting and protecting the right to education and information;
Ensuring equality and freedom from discrimination; Ensuring policies and programmes to address differences between genders and Ensuring that health services are accessible to all.
We must be clear on the fact that the right to health also guarantees both freedoms and entitlements to individuals, among others these are the right to control one’s body, including sexual and reproductive health and rights and the right to a general health care.
We have been instructed to define in our discussion the duty bearers of these rights. The primary duty bearer in this remit is the state. It is a duty of the state to ensure that the right to health is realised to all.
In 2000 the United Nations Committee on Economic, Social and Cultural Rights published General Comment 14, which defines in detail states’ obligations, patients’ health entitlements, and their ethical implementation using human rights principles.
According to this general comment 14 of the United Nations Committee on Economic, Social and Cultural Rights, the state obligations fall into three categories, to respect, to protect and to fulfil the right to health.
The obligation to respect the right to health obliges the State most obviously to refrain from obstructing access and enjoyment of this right. This means that if a woman wants to obtain contraceptives she should be allowed to get them. Protecting right to health again means that the State is obliged, for example, to step in to protect women from female genital mutilation. Lastly, the obligation to fulfil the right to health means that the State is responsible for setting up a health care system and protective measures that guarantee access to health.
In this context it is important to note that the States, when setting up a national health care system and policies, must ensure that all vulnerable groups have effective access to its services and protection. We must be clear on the fact that these must also cover sexual and reproductive health services.
To an alarming level, there is still resistance and wide obstruction for women to obtain reproductive health services. In my view such interference and refusals amount to violation of most fundamental human rights. It is highly worrying that as there are vast differences over this area of rights, many governments have not developed adequate standards for reproductive health services. Then again missing international and national standards hamper efforts to monitor quality of this sparse care. The health standards and guidelines in this remit could radically improve the right to health and save lives of many women around the world.
In this regard I would like to point out that women’s empowerment is crucial element in pursuit of universal right to health.
On another setting, the promotion of health as a right is a key component of promoting the health-related UN Millennium Development Goals. Naturally, as the development with regards achieving the universal health, neither has the standards of the health MDGs been achieved. It is a high time that the States increase and strengthen their efforts towards these MDGs. In this, more stronger commitment to rights-based approach is needed. Again, we must be clear on the fact that the health MDGs will only be reached if their gender dimension is fully taken into account. And lets be clear, they all have this.
The key question of the conference, how the EU can most effectively engage with all actors to improve health at global level, is in my view also the key question in achieving better health at global level.
The notion in the European Commission Communication on Global Health, that the EU’s social model, its strong safety norms, and its global trade and development aid position allow it to play a major role in improving global health, must be the starting point in the discussion on how to respond to challenges in improving health at global level. The EU can do more and the EU should do more.
There are many things the EU can do more and better in the fields of migration, security, trade, research and maximise its impact. However, what is necessary beyond these matters is for the EU to defend a single position at a global arena. Together we are stronger do protect and promote even the most violated rights.
In this line, I fully support the Communication from the Commission and the Council Conclusions on the EU role in Global Health concerning calls on EU Member States to act together in all relevant internal and external policies and actions by prioritising their support and strengthening comprehensive health systems in partner countries.
Moreover, I fully join my voice to the Council call on EU Member States and the Commission to support an increased leadership of the World Health Organisation at global, regional and country level.
As I mentioned in the introduction, health is an issue of great significance on the global scale and it cuts through most of the policies of a modern state and the field of foreign relations. It is a great misfortune that the political leaders and policy makers do not seem to be aware of this. These rights will never be universal nor can there can there ever be tangible development if the promotion and protection of health as human right is not addressed accordingly – as a fundamental human right.