Access to health care as a human right in international policy: critical reflections and contemporary challenges.

Camilo Hernán Manchola Castillo,Volnei Garrafa,Fernando Hellmann,Thiago Cunha

doi:10.1590/1413-81232017227.04472017

Abstract

Using the United Nations (UN) and its subordinate body, the World Health Organization (WHO), as a frame of reference, this article explores access to healthcare as a human right in international intergovernmental policies. First, we look at how the theme of health is treated within the UN, focusing on the concept of global health. We then discuss the concept of global health from a human rights perspective and go on to outline the debate surrounding universal coverage versus universal access as a human right, addressing some important ethical questions. Thereafter, we discuss universal coverage versus universal access using the critical and constructivist theories of international relations as a frame of reference. Finally, it is concluded that, faced with the persistence of huge global health inequalities, the WHO began to reshape itself, leaving behind the notion of health as a human right and imposing the challenge of reducing the wide gap that separates international intergovernmental laws from reality.

Highlights

A wide array of organizations and authors have addressed the theme of human rights and health in international policy in recent years[1,2,3,4]
We discuss the concept of global health from a human rights perspective and go on to outline the debate surrounding universal coverage versus universal access as a human right, addressing some important ethical questions
This article departs from a definition of international policy that is not circumscribed by the foreign policy of nation states, but rather determined by the multilateral bodies – and other exclusive non-state actors – that make up the supranational system that governs the modern international system, with particular reference to the most important supranational institution in terms of representativeness and historical relevance: the United Nations (UN)[9], and, its subordinate body, the World Health Organization (WHO)

Summary

Introduction

A wide array of organizations and authors have addressed the theme of human rights and health in international policy in recent years[1,2,3,4]. In other words, drawing on critical and constructivist theories of international relations and considering some important ethical questions, this article attempts to examine the right to health as a fundamental human right in intergovernmental international policy. The second section discusses the concept of global health adopted by the WHO from a human rights perspective and outlines one of the most controversial debates therein: universal coverage versus universal access. The fourth section discusses universal coverage versus universal access using the critical and constructivist theories of international relations as a frame of reference. We outline some of the challenges and possible scenarios

Health inside the UN and the concept of global health

Global health and health as a human right

Final considerations