Health as a Human Right

One of the most striking differences between discussions about reproductive rights in the United States and similar discussions in an international context is the prominence internationally of the human rights framework of analysis. In the United States, politicians tend to refer to human rights only in discussions of problems in other countries.  They seem not to believe (or be willing to admit) that there might be human rights violations in the United States, and certainly would not apply that terminology to the failures of the American health care system.

However, at the 10th International Conference on Women and Health (IWHM) held in New Delhi, India, in September 2005, presenters argued forcefully for the use of the human rights framework in promoting a right to health, including women’s right to reproductive health.  The notion of reproductive rights as fundamental human rights has been endorsed at the 1994 International Conference of Population and Development in Cairo, Egypt, and at the 1995 Fourth World Conference on Women in Beijing, China. A summary of this action, and developments since, can be found on the website of IPAS, a United States-based organization that works internationally to promote women’s access to reproductive health services.

At the 2005  IWHM conference in India, Lakshmi Lingam, a professor at the Tata Institute of Social Sciences in Mumbai, India, discussed the differences between “choice” and “rights” as words to describe women’s ability to obtain needed health services. She said “choice” language is “profoundly market-friendly,” asking “Do we really want to get rights by going around buying things?” In developing nations, she said, women might well ask “Do we really have choices not to get married, not to have sex?” She praised the work of women from the “Global South” in expanding discourse on human rights to incorporate such issues as trade, debt, wars and structural adjustment policies, suggesting health should be the next issue.

Arguably the most passionate call for use of a human rights approach was made by UN Rapporteur for Human Rights Paul Hunt of New Zealand in the conference’s closing valedictory address. “The right to health is coming of age,” he said, predicting that “we are on the threshold of a new era for the right to health.” Soon, he predicted, the right of health will be viewed as no less of a universal human right than freedom of speech or the right to a fair trial.

The advantages of using a human rights framework to make health care policy, he said, are that it “brings a sense of fundamental principles, such as dignity,” it places individual and community well-being at the center of policymaking and it “places legal and moral obligations on states.” The right to health, he said, also “provides a powerful tool for identifying the gender dimension of health.”

He acknowledged that critics of the right to health often contend it is too vague, but argued that “it is no vaguer than freedom of speech or the right to privacy.” He contended that “the charge of imprecision is often used as an excuse for lack of action.”

In fact, he said, “We are learning to operationalize the right to health, to make it real.” Hunt offered a concrete proposal, challenging the human rights community to “mount a global campaign against avoidable maternal mortality,” noting that “the scale of maternal mortality is catastrophic – more than 500,000 deaths a year worldwide.”

U.S.-based reproductive health organizations are working to find ways to incorporate the notion of health as a human right into our work. One of the leaders in this work has been the New York-based Center for Reproductive Rights