SeriesHistory, principles, and practice of health and human rights
Introduction
Blatant violation of human rights affecting the health of both individuals and populations continues. Examples include the torture of detainees in Abu-Ghraib prison in Iraq;1 systematic rapes and murders in the Balkans,2 Rwanda,3 Chechnya,4 and Darfur;5 physician involvement in torture,6 botched executions;7 inhumane experimentation;8 and questionable interrogation techniques in the so-called war on terror.1, 9, 10 Such violations of human rights can be engineered by or endorsed by governments, institutions of power, and individuals. These deplorable violations exist alongside more subtle activities that also have severe and longlasting effects on health and human rights such as absence of basic health-care systems;11 policies keeping medicines unaffordable;12 and tolerance of discrimination against groups such as injecting drug users,13 people with mental-health disorders,14, 15 illegal immigrants,16 or homeless people.17 The continuing and foreseeable absence of access to effective care for most people living with most diseases in poor countries can also be viewed as a violation of human rights.18 Therefore human rights should be imperative in delivery of care and implementation of public-health programmes.
Three main relations between health and human rights exist: the positive and negative effects on health of promotion, neglect, or violation of human rights; the effect of health on the delivery of human rights; and the effects of public-health policies and programmes on human rights.19 Despite the advances in the study and advocacy of health and human rights we still do not fully understand the nature of these relationships, how they interact, or their value to medicine and public-health practice. In this article we address the public health aspects of these relations, and highlight where further research and action are needed.
Section snippets
A brief history of health and human rights
Since the Nuremberg trials and the creation of the UN more than 50 years ago, interest in the association between health and human rights has grown. Until the beginning of the AIDS epidemic in the 1980s and the end of the Cold War, these two issues evolved along parallel but distinctly separate tracks,20 perhaps as a consequence of the state-centric (ie, greater political concern for general state and public interests than for specific individuals or communities) view of the world that
Human rights and health policy
The links between human rights and health are best understood by referring to the preface to the WHO constitution, which states that health is the “state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity” and “the highest attainable level of health is the fundamental right of every human being.”31 Governments are therefore responsible for enabling their populations to achieve better health through respecting, protecting, and fulfilling rights
Applying human rights to health
The idea of health and human rights as a subject of study is fairly new, and we need to recognise the different ways in which advances in health and human rights can be achieved. Human rights feature in many different ways in the health work of international non-governmental organisations, governments, civil society groups, and individuals. These ways can be broadly categorised as advocacy, application of legal standards, and programming (including service delivery).45 Some stakeholders use one
Concerns for the future
Government roles and responsibilities are increasingly delegated to non-state actors (eg, biomedical research institutions, health insurance companies, health management organisations, the pharmaceutical industry, and care providers) whose accountability is defined poorly and monitored inadequately. No objective measures are available of the commitment and capacity of governments to ensure that actions taken by the private sector and other players, including civil society, are informed by and
Steps forward
Attention to human rights can be a way to enhance the value and effects of health work by health policymakers, programme developers, health practitioners, and students. Nonetheless, three topics urgently need that further work. The first is the development of adequate monitoring instruments that measure both health and human rights concerns; the second is building evidence of the effects of application of the health and human rights frameworks to health practice; and the third is the creation
References (77)
Abu Ghraib: its legacy for military medicine
Lancet
(2004)Russian soldiers blamed for civilian rape in Chechnya
Lancet
(2004)- et al.
Violence and mortality in West Darfur, Sudan (2003–04): epidemiological evidence from four surveys
Lancet
(2004) - et al.
Inadequate anaesthesia in lethal injection for execution
Lancet
(2005) A stain on medical ethics
Lancet
(2005)- et al.
The politics of terror
Lancet
(2004) - et al.
Determinants of socioeconomic differences in change in physical and mental functioning
Soc Sci Med
(1999) - et al.
What is the relevance of women's sexual and reproductive rights to the practising obstetrician/gynaecologist?
Best Pract Res Clin Obstet Gynaecol
(2006) The human right to the highest attainable standard of health: new opportunities and challenges
Trans R Soc Trop Med Hyg
(2006)- et al.
Drug development for neglected diseases: a deficient market and a public-health policy failure
Lancet
(2002)
What are health and human rights?
Lancet
Is access to essential medicines as part of the fulfillment of the right to health enforceable through the courts?
Lancet
New guidance on recommended HIV testing and counselling
Lancet
Shadow on the continent: public health and HIV/AIDS in Africa in the 21st century
Lancet
Do human rights have a role in public health work?
Lancet
Balkan briefing. Abuses of human rights in the Kosovo region of the Balkans
J Epidemiol Community Health
Death and survival during the 1994 genocide in Rwanda
Popul Stud (Camb)
How complicit are doctors in abuses of detainees?
Lancet
Heimlich's Audacious Maneuver. Los Angeles Times
World health survey results
Medication costs as a primary cause of nonadherence in the elderly
Consult Pharm
Displacement of Canada's largest public illicit drug market in response to a police crackdown
CMAJ
Why we must end insurance discrimination against mental health care
Harvard J Legis
Challenging stigma and discrimination in communities: a focus group study identifying UK mental health service users' main campaign priorities
Int J Soc Psychiatry
Left out: immigrants' access to health care and insurance
Health Aff (Millwood)
Gender differences in health risks and physical symptoms among the homeless
J Health Soc Behav
Antiretroviral therapy coverage in low- and middle-income countries, by region. Situation as of June 2005
Health and human rights
Health Hum Rights
Human Rights: an interdisciplinary approach
Health and human rights
Responding to HIV/AIDS: A Historical Perspective, 2
Health and Human Rights
Droits de l'homme et santé, la synergie
The Global Strategy Framework on HIV/AIDS, 2001
Cited by (179)
Association between perceived discrimination in health services and oral health-related quality of life in older adults
2022, Journal of DentistryCitation Excerpt :From a legal perspective, the state establishes the context for discriminatory acts. It can enforce or condone discrimination; alternatively, it can outlaw discrimination and seek to rectify its effects [33]. It is important to note that the present study investigated only interpersonal discrimination.
The Politics of Transgender Health Misinformation
2024, Political CommunicationAddressing neglected tropical diseases in Africa: a health equity perspective
2023, Global Health Research and PolicyPatient Participation in Forensic Psychiatric Care: The Initial Development and Content Validity of a New Instrument
2023, Journal of Forensic Nursing