A New Angle: Public Health and Human Rights

When we idealistically discuss the prospect of universal health care, we rarely extend our reach beyond the borders of our own nation. We look internationally only to scrutinize the healthcare systems of foreign countries that claim to do it better than we do. Opposition claims that foreign systems are socialist and that we are beyond that, while champions of the cause continue to point at the inverse relationship of money spent and quality of health care in our country. It is difficult to blame the policy makers for focusing on such immediate concerns. After all, we are ushering in a Bush-less era and have big plans for our healthcare system with Obama at the forefront. If we take a step back however, we realize that our very constitution doesn’t even address the health of our country’s citizens. Life, liberty and the pursuit of happiness seem to sidestep the prospect of health for all. Now let’s take another look internationally. There exist countries that have enshrined the right to health in their very constitution and have owed it to an approach emphasizing the “Human Right to Health”. There exist international treaties that “recognize access to health services and health information, among other health areas, as human rights.” (Skolnik, 60) This blog will discuss the powerful combination of health and human rights and the approach that has given entire nations the ability to call health a right.
The idea to include health among enforceable human rights can be most fundamentally assigned to the notion of instable compassion. “Compassion is undoubtedly a great virtue. But it is also notoriously unstable and historically, reliance on it has ill-served the interests of the oppressed. Particularly in times of great economic crisis — like the present — the needs of the poorest and most marginalized tend to get short shrift regardless of such sentiments.” (Yamin, 1) Though a noble aspiration, reliance on the compassion of the benevolent can not guarantee results for populations that require assistance. Yamin incorporates the much more serious idea of accountability as the method by which states and governments can be held responsible for human rights violations. Yamin states that “failures of beneficence and “compassion fatigue” do not trigger accountability; human rights violations do.” (Yamin, 1) The very preamble of the constitution of the World Health Organization states that “The enjoyment of the highest attainable standarad of health is one of the fundamental rights of every human being.” (Skolnik, 62) The problem lies in the lack of a mechanism to hold countries accountable. By placing responsibilities on those that are signatories of international human rights treaties, accountability is established and subsequent consequences can be enacted on those that fail to address these rights for their citizens. As Yamin stated, human rights violations are easier to punish than absent compassion. The Universal Declaration of Health, signed by most countries in 1948, is what forces its signatories to “see health and human rights as inextricably linked and bring this notion to consideration of the determinants of health and ways in which health issues may be addressed.” (Skolnik, 61) This combination of health and human rights involves bringing together the realms of public health and human rights and adopting a view previously untapped in public health approaches.
Such a paradigm shift is evident when we see what new avenues the human rights angle generates for public health professionals. Whereas traditionally, public health sought “to identify risk factors associated with disease, disability and premature death,” at an individual level and “to stimulate individual behavior change through information, education, and clinic-based services,” (Mann, 1940) this new human rights angle forced health professionals to examine rights violations and “consider a whole human being made vulnerable to a wide variety of pathogens and unhealthy conditions as a result of how the person is treated by society—expressed and articulated in the language of human rights and dignity.” (Mann, 1941) This new syntax was the launching point from which laws could be enacted to defend citizens’ right to health and take action against diseases like HIV/AIDS. We have been mostly aware of the idea that the highest attainable standard of health is dependent on sufficient working conditions and access to healthy resources, but we need to acknowledge the impact of “the dignity of the individual and the rights to education, free speech, and participation in the political process. Conversely, the ability to fully exercise other fundamental human rights depends on the right to health. Violation of any human right, including the right to health, contributes to the infringement of other rights.” (Easley, 1922) This understanding is what a significant portion of the ‘health as a human right’ proposal rests upon and has made it possible to discuss pandemics at a different, more approachable level.
With the HIV/AIDS pandemic polarizing the world population and stigmatizing the diseased individuals, the human rights angle became all-important in guaranteeing that government care for the ill was based on science rather than stereotypes. (Stone, 2) Unfortunately, a stigmatized and marginalized population is much less inclined to seek testing and proper treatment, especially if some doctors and dentists refuse to see patients due to their inaccurate fear of possible disease transmission. The HIV/AIDS pandemic is difficult enough to quell without stereotypes disenfranchising members of population that could potentially get treatment and become active members of society. As seen in the documentaries presented in class, a motivated individual, especially one who is personally affected by the disease, is a valuable asset to spreading information, increasing awareness and affecting change among their target populations. The advantage of providing legal protection to this population existed in their mindset, as “people will feel secure in their rights and dignity—and be more willing to seek testing and treatment. Enshrining human rights principles at the national level therefore may serve to change the culture of stigmatization that can surround the disease.” (Stone, 2) Beyond the much more tangible issue of providing drugs and treatment to infected populations, removing the social stigma attached to the disease has benefits that are just as important. In the case study of mother-to-child-transmission of HIV, we saw yet another example of how health as a human right could be used to attain and distribute the proper drugs to help prevent premature infant death.
With a number of public health problems growing in magnitude, public health professionals are forced to include the contributions of other groups, especially human rights professionals, if they are to achieve the goals that the groups share. This understanding can significantly tip the balance in our favor in the struggle against disease.

References:

Mann, JM, Voice from the Past, Health and Human Rights: If Not Now, When? American Journal of Public Health, Vol 96, No.11. 2006

Skolnik, R., Essential of Global Health: Ethical and Human Rights Concerns in Global Health., PG 59-71., Massachusetts., Jones and Bartlett Publishers. 2008

Easley, Cheryl E., Marks, Stephen P., Morgan, Russell E. The Challenge and Place of Human Rights in Public Health. December 2001, Vol 91, No. 12 | American Journal of Public Health 1922-1925

Stone, Lesley, Ostin, Lawrence O. Using Human Rights to Combat the HIV/AIDS Pandemic. Human Rights Magazine Volume 31, Number 4 Fall 2004

Yamin, Alicia. "Beyond compassion: The central role of accountability in applying a human rights framework to health" Health and Human Rights: An International Journal [Online], 10 19 Feb 2009