Ratification of human rights treaties: the beginning not the end

Abstract

I appreciate Alexis Palmer and colleagues' empirical research on the effects of ratification of human rights treaties on population health (June 6, p 1987).1Palmer A Tomkinson J Phung C et al.Does ratification of human-rights treaties have effects on population health?.Lancet. 2009; 373: 1987-1992Summary Full Text Full Text PDF PubMed Scopus (51) Google Scholar Despite their conclusion that ratification has no benefits on health, issues surrounding the effect of human rights norms within treaties are complex and might not be fully captured through an analysis of correlations between ratifications of international treaties and selected aggregated indicators.Quantifiable improvements require a range of measures, including incorporation of treaty obligations into domestic legislation and, just as importantly, appropriate public spending on health personnel and infrastructure, policy development, and national plans of action. One major advantage of treaty ratification is that it obliges states to have their progress—or lack of it—periodically examined by independent experts on the various committees (or “Treaty Bodies”) that assess whether or not states are doing what they said they would do.The Treaty Bodies receive information from a broad range of sources, including civil society. Although not an enforcement process in the strict sense, reporting has had profound effects on the enjoyment of human rights in many states, and I would encourage more health specialists to make better use of this means to stimulate change in their national health systems.I hope Palmer and colleagues' study stimulates further debate and, more importantly, further concerted action by doctors, lawyers, health administrators, and non-governmental organisations to push states into making tangible improvements in public health around the world. I appreciate Alexis Palmer and colleagues' empirical research on the effects of ratification of human rights treaties on population health (June 6, p 1987).1Palmer A Tomkinson J Phung C et al.Does ratification of human-rights treaties have effects on population health?.Lancet. 2009; 373: 1987-1992Summary Full Text Full Text PDF PubMed Scopus (51) Google Scholar Despite their conclusion that ratification has no benefits on health, issues surrounding the effect of human rights norms within treaties are complex and might not be fully captured through an analysis of correlations between ratifications of international treaties and selected aggregated indicators. Quantifiable improvements require a range of measures, including incorporation of treaty obligations into domestic legislation and, just as importantly, appropriate public spending on health personnel and infrastructure, policy development, and national plans of action. One major advantage of treaty ratification is that it obliges states to have their progress—or lack of it—periodically examined by independent experts on the various committees (or “Treaty Bodies”) that assess whether or not states are doing what they said they would do. The Treaty Bodies receive information from a broad range of sources, including civil society. Although not an enforcement process in the strict sense, reporting has had profound effects on the enjoyment of human rights in many states, and I would encourage more health specialists to make better use of this means to stimulate change in their national health systems. I hope Palmer and colleagues' study stimulates further debate and, more importantly, further concerted action by doctors, lawyers, health administrators, and non-governmental organisations to push states into making tangible improvements in public health around the world.