Highest Attainable Standard Of Health Research Articles

Introduction: Mental Health and Human Rights: Social Policy and Sociological Perspectives

Recognition of the effects of social, economic, political and cultural conditions on mental health and the personal, social and economic costs of a growing global mental health crisis (WHO, 2001; EC, 2005) mean that mental health and well-being are a current feature of social policy agendas at UK, European and world levels, with debate increasingly becoming framed in human rights terms. In the UK, policy drives to address social exclusion and health inequalities as key social and economic rights issues have encompassed attention to mental health and distress (DoH, 2003; Social Exclusion Unit, 2004) and mental health has been identified as a priority area for the new Equality and Human Rights Commission (Diamond, 2007; DRC, 2007). At the European level too, rights-based social policy approaches to promoting social cohesion (European Committee for Social Cohesion, 2004) and policy directives on the ‘right to health’ (Commission of the European Communities, 2007) have been centrally concerned with mental health and well-being, and have been accompanied by a European strategy on mental health for the EU (EC, 2005). At a global level, the World Health Organisation has declared enjoyment of the highest attainable standard of health to be a fundamental human right (WHO, 2006). It has launched a new appeal on mental health which draws attention to the impact of human rights violations and cites social isolation, poor quality of life, stigma and discrimination as central issues for those with mental health needs (Dhanda and Narayan, 2007; Horton, 2007; WHO, 2007).

Participation and the Right to Health: Lessons from Indonesia

The right to participation is the "the right of rights"--the basic right of people to have a say in how decisions that affect their lives are made. All legally binding international human rights treaties explicitly recognize the essential role of participation in realizing fundamental human rights. While the substance of the human right to health has been extensively developed, the right to participation as one of its components has remained largely unexplored. Should rights-based health advocacy focus on participation because there is a relationship between an individual's or a community's active involvement in health care decision-making and the highest attainable standard of health? In the context of the human right to health, does participation mean primarily political participation, or should we take the right to participation to mean more specifically the right of persons, individually and as a group, to shape health care policy for society and for themselves as patients? Decentralization of health care decision-making promises greater participation through citizen involvement in setting priorities, monitoring service provision, and finding new and creative ways to finance public health programs. Between 1999 and 2008, Indonesia decentralized health care funding and delivery to regional governments, resulting in substantial exclusion of its poor and uneducated citizens from the health care system while simultaneously expanding the opportunities for political participation for educated elites. This article explores the tension between the right to participation as an underlying determinant of health and as a political right by reviewing the experience of Indonesia ten years after its decision to decentralize health care provision. It is ultimately argued that rights-based advocates must be vigilant in retaining a unified perspective on human rights, resisting the persistent tendency to separate and prioritize the civil and political aspects of participation over its social component.

Rights-based approaches to improve people's health in Peru

Peru is challenged by poverty, discrimination, and inequity, including starkly different morbidity and mortality rates and a high prevalence of avoidable illnesses and deaths in people who are poor, indigenous populations, and excluded groups. 1 Cotlear D A new social contract for Peru: an agenda for improving education, health care, and the social safety net. A World Bank country study. January, 2006http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/LACEXT/0,,contentMDK:20823300∼pagePK:146736∼piPK:146830∼theSitePK:258554,00.html Crossref Google Scholar , 2 UN High Commissioner for Human RightsUN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. http://www2.sx.ac.uk/human_rights_centre/rth/docs/3pagerupdate%2003%2008.docDate: March 11, 2008 Google Scholar Raising the importance of the right to health as a core obligation to be fulfilled and implementing rights-based approaches within health-sector development in Peru has proven helpful to tackle these challenges. Rights-based approaches, and their principles of inclusion, participation, and fulfilment of obligation, tackle the underlying causes of poverty and disadvantage, and work in partnership with a wide range of stakeholders to address these causes. The right to health: from rhetoric to realityHuman Rights Day on Dec 10 marks the 60th anniversary of the Universal Declaration of Human Rights (UDHR). A year ago, in the run up to this important milestone, UN Secretary-General Ban Ki-moon launched a campaign that aimed to increase knowledge and awareness of human rights. During the course of the year, many governments and educational, cultural, and human rights institutions have reaffirmed their commitment to the values and principles of the UDHR. The health sector has been strikingly silent, which is tremendously disappointing given that the foundation for the right to health is laid out in this historic document. Full-Text PDF Health systems and the right to health: an assessment of 194 countries60 years ago, the Universal Declaration of Human Rights laid the foundations for the right to the highest attainable standard of health. This right is central to the creation of equitable health systems. We identify some of the right-to-health features of health systems, such as a comprehensive national health plan, and propose 72 indicators that reflect some of these features. We collect globally processed data on these indicators for 194 countries and national data for Ecuador, Mozambique, Peru, Romania, and Sweden. Full-Text PDF

Health systems and the right to health: an assessment of 194 countries

60 years ago, the Universal Declaration of Human Rights laid the foundations for the right to the highest attainable standard of health. This right is central to the creation of equitable health systems. We identify some of the right-to health features of health systems, such as a comprehensive national health plan, and propose 72 indicators that reflect some of these features. We collect globally processed data on these indicators for 194 countries and national data for Ecuador, Mozambique, Peru, Romania, and Sweden. Globally processed data were not available for 18 indicators for any country, suggesting that organisations that obtain such data give insufficient attention to the right-to-health features of health systems. Where they are available, the indicators show where health systems need to be improved to better realise the right to health. We provide recommendations for governments, international bodies, civil-society organisations, and other institutions and suggest that these indicators and data, although not perfect, provide a basis for the monitoring of health systems and the progressive realisation of the right to health. Right-to-health features are not just good management, justice, or humanitarianism, they are obligations under human-rights law.

Why and how is health a human right?

In doing a special issue on the right to health, The Lancet is helping to draw attention to an extraordinarily important subject that does not get as much attention as it deserves. There are understandable reasons why the perspective of the right to health seems to many to be remote. First, there is what we might call the legal question: how can health be a right since there is no binding legislation demanding just that? Second, there is the feasibility question: how can the state of being in good health be a right, when there is no way of ensuring that everyone does have good health? Third, there is the policy question: why think of health, rather than health care, as a right, since health care is under the control of policy making, not the actual state of health of the people? The right to health: from rhetoric to realityHuman Rights Day on Dec 10 marks the 60th anniversary of the Universal Declaration of Human Rights (UDHR). A year ago, in the run up to this important milestone, UN Secretary-General Ban Ki-moon launched a campaign that aimed to increase knowledge and awareness of human rights. During the course of the year, many governments and educational, cultural, and human rights institutions have reaffirmed their commitment to the values and principles of the UDHR. The health sector has been strikingly silent, which is tremendously disappointing given that the foundation for the right to health is laid out in this historic document. Full-Text PDF Health systems and the right to health: an assessment of 194 countries60 years ago, the Universal Declaration of Human Rights laid the foundations for the right to the highest attainable standard of health. This right is central to the creation of equitable health systems. We identify some of the right-to-health features of health systems, such as a comprehensive national health plan, and propose 72 indicators that reflect some of these features. We collect globally processed data on these indicators for 194 countries and national data for Ecuador, Mozambique, Peru, Romania, and Sweden. Full-Text PDF

Health Is a Human Right, Right?

The constitution of the World Health Organization states that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.”1(p1) Although this perspective is notable and has proven to be significant in promoting the quality of life among individuals worldwide, it is unfortunate that this resounding message is often not heard—and too often overlooked—by many parts of American society. Sadly, this basic human right is even more difficult to achieve for the estimated 43.3 million uninsured persons in the United States, 2 many of whom are poor, underserved, and underrepresented. Furthermore, the individuals who do have health insurance experience major difficulties navigating a fragmented health care system, accessing culturally responsive and quality health care, and securing associated finances. Every day, working people struggle to make ends meet with health ailments that progressively worsen, in part because of their inability to comfortably connect with a health care provider and establish a medical “base.” In some cases, the fear of receiving bad news about their health from a physician or the stigma associated with seeking mental health treatment may prevent individuals from expeditiously moving forward for health care. Yet, what may be even more daunting is the reality of the medical bills that will most certainly accompany any visit to a health care facility. Sociocultural, economic, political, and environmental tribulations continue to plague our communities and infect our health care systems, resulting in public health crises, disease epidemics, and enduring health disparities, placing vulnerable populations at increased risk of premature mortality and lives filled with suffering. The distribution of health outcomes is extremely unbalanced across population groups in regard to race and gender.3 African American men have the shortest life expectancy (69.2 years) among the four major race–gender groups in the United States (White women, 80.5 years; White men, 75.4 years; African American women, 76.1 years).4 It is essential to understand that pervasive inequities have a detrimental impact on the physical and mental health status of many individuals, families, and communities. We must adopt the principle that health requires more than just health care. Needed attention to selected social determinants of health has been offered to the general public through provocative documentaries such as Unnatural Causes … Is Inequality Making Us Sick? 5 and Sicko.6 Nonetheless, much more remains to be done. In addition to honing in on micro-level connections between exposures and outcomes, there remains an enormous need to examine, at a macro level, the interrelated research, practice, and policy issues that are important for societies that seek to achieve social justice for all and health as a human right.

Development as Health: Employing the Collective Right to Development to Achieve the Goals of the Individual Right to Health

Although there exists widespread recognition that the shared benefits of economic development can improve health, health advocates rarely appreciate the connections between the right to health and the right to development. The collective right to development, transcending the right to health's focus on the individual, offers public health actors an opportunity to work through development discourses to obligate and empower states to allocate public goods for the public's health. This article concludes that health scholars and advocates could employ the right to development to ensure that development policies guide states in realizing the highest attainable standard of health, fulfilling underlying determinants of health through the strengthening of national public health systems.

Celebrating the World Health Organization

On April 7, 2008, World Health Day, the World Health Organization (WHO) will mark its 60th anniversary. What better occasion to celebrate WHO’s major contributions to international and global health? Several items in this issue relate to this celebratory theme. Fitzgerald, for example, indirectly underscores WHO’s critical role in monitoring international weapons conventions in his gripping essay on the history of chemical warfare. Bu et al.’s Voices From the Past offering focuses on a selection from John B. Grant’s presentation to a 1951 WHO staff meeting, which provides important historical insights into the organization’s longstanding interest in the most effective models for the organization of health services. A more direct celebration of WHO is Fee et al.’s “birthday card” in the form of an extended Images of Health essay. Here we find visual evidence and supporting text for some of WHO’s most notable achievements: the creation of a global network for the facilitated communication of epidemiological information, the impressive campaign to reduce malaria worldwide, the successful promotion of both comprehensive and selective primary health care, the mobilization of extensive immunization programs, the control of onchocerciasis (“river blindness”) and other tropical diseases, and the leadership in recent decades of efforts in global public health. These achievements over the course of its first 60 years have established WHO’s unquestioned importance as the preeminent international health agency and augur well for the future. There is, however, still more about WHO that we should celebrate on this occasion. These are its lofty ideals captured in the language of the preamble to its constitution, now 60 years old, and of the Alma Ata Declaration, now 30 years old. The former declared that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being,” (http://www.who.int/governance/eb/who_constitution_en.pdf), and the latter stated that “economic and social development . . . is of basic importance to the fullest attainment of health for all and to the reduction of the gap between the health status of the developing and developed countries” (http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf). These stirring words have captured the attention of people all over the world and have inspired several generations of health workers. They helped forge an image of WHO as an agency aspiring to the highest idealism, well above the budget-constrained pragmatism and realpolitik that often, of necessity, mark its daily operations. Perhaps no one captured the ideals of WHO better than did Frank G. Boudreau in a December 1951 Journal essay (1951:41;1477–1482): Two-thirds of the world’s population is crying for relief from disease, hunger, premature death, and poverty but does not know where to turn for relief. WHO, above all other international agencies, is fitted to show the way, for its jurisdiction is in one of the few areas where men of all races and creeds can work easily together. . . . Joining hands with our colleagues in other countries, we must take our people up to the mountaintop where they can see the promised land of good health, peace, and freedom stretching before them. Now, we too need to remember not only what WHO has done but also what it has inspired. If its ideals are taken as seriously as they should be, WHO will contribute not only to achieving better health for all but also to creating a better world in which all can live.

Health Systems and the Right to the Highest Attainable Standard of Health

The right to the highest attainable standard of health should be the cornerstone of any consideration of health and human rights. The content of this fundamental human right is now sufficiently well understood to be applied in an operational, systematic, and sustained manner. At the heart of the right to the highest attainable standard of health lies an effective and integrated health system, encompassing medical care and the underlying determinants of health, which is responsive to national and local priorities and accessible to all. Yet in many countries, health systems are failing and collapsing, giving rise to an extremely grave human rights problem. This article outlines the general approach of the right to the highest attainable standard of health toward the strengthening of health systems. It identifies some of the key right-to-health features of a health system, such as transparency, participation, equity and equality, a comprehensive national health plan, a minimum "basket" of health-related services and facilities, disaggregated data, monitoring and accountability, and so on. This general approach has to be consistently and systematically applied across the "building blocks" that together constitute a functioning health system. By way of illustration, the article applies this approach to one of these "building blocks:" leadership, governance, and stewardship. There are numerous health movements and approaches, including health equity, primary health care, social determinants, and so on. All are very important. But it is misconceived to regard human rights as yet another approach with the same status as the others. Like ethics, the right to the highest attainable standard of health is not optional--and, like ethics, it recurs throughout all other approaches. The right to the highest attainable standard of health is the only perspective that is both underpinned by universally recognized moral values and reinforced by legal obligations.

The right to health of prisoners in international human rights law

This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise the highest attainable standard of health. It examines this right as articulated within United Nations and regional human rights treaties, non-binding or so-called soft law instruments from international organisations and the jurisprudence of international human rights bodies. It explores the use of economic, social and cultural rights mechanisms, and those within civil and political rights, as they engage the right to health of prisoners, and identifies the minimum legal obligations of governments in order to remain compliant with human rights norms as defined within the international case law. In addressing these issues, this article adopts a holistic approach to the definition of the highest attainable standard of health. This includes a consideration of adequate standards of general medical care, including preventative health and mental health services. It also examines the question of environmental health, and those poor conditions of detention that may exacerbate health decline, disease transmission, mental illness or death. The paper examines the approach to prison health of the United Nations human rights system and its various monitoring bodies, as well as the regional human rights systems in Europe, Africa and the Americas. Based upon this analysis, the paper draws conclusions on the current fulfilment of the right to health of prisoners on an international scale, and proposes expanded mechanisms under the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment to monitor and promote the health rights of prisoners at the international and domestic levels.

Poverty, health and development in dermatology

The WHO Constitution states that "The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political, economic or social condition." The right to health means that governments must generate conditions in which everyone can be as healthy as possible. Such conditions range from ensuring availability of health services, healthy and safe working conditions, adequate housing and nutritious food. In this report the author analyzes the relationship among health, dermatology and development and tries to find out what the scientific world, including dermatologists, could do for the improvement of health systems.

Right to the highest attainable standard of health

Right to the highest attainable standard of health

Paul Hunt: UN Special Rapporteur on the right to health

Paul Hunt: UN Special Rapporteur on the right to health

Right to the highest attainable standard of health

This chapter introduces the right to the highest attainable standard of health, which is enshrined in several international treaties, as well as numerous national constitutions, giving rise to legally binding obligations on States. It outlines the complementary relationship between public health and the right to the highest attainable standard of health, and provides a framework for analysing this human right. This analytical framework, which deepens understanding of, and helps to identify appropriate responses to, public health issues, is then applied, by way of illustration, to neglected diseases, mental disability, sexual and reproductive health, and water and sanitation. The conclusion identifies the key features of a health system from the perspective of the right to the highest attainable standard of health.

The International Covenant on Economic, Social and Cultural Rights and the right to health: is Australia meeting its obligations to Aboriginal peoples?

There is evidence that Australia is not meeting its obligations to Aboriginal and Torres Strait Islander peoples for their right to the "highest attainable standard" of health, required under the International Covenant on Economic, Social and Cultural Rights (ICESCR). Poor access to primary health care for Aboriginal peoples and substantial shortfalls in government spending to address this are in violation of the ICESCR. Aboriginal and Torres Strait Islander peoples' share of the universal health coverage expenditure offered to all Australians is less per person than for other Australians. The failure to monitor the provision of mainstream health services to Aboriginal peoples and inequitable distribution of health facilities and services compound these violations. Equality in health between Indigenous and non-Indigenous Australians is achievable, but not until the shortfall in health services expenditure for Indigenous Australians is addressed.

The value of a human rights perspective in health and foreign policy

What could public health advocates do more effectively to encourage governments to act on underprioritized global health concerns? One important component largely missing from current strategies is the international human rights framework. Human rights principles and standards, including the right to the highest attainable standard of health, offer powerful moral arguments which can reinforce calls for action made on humanitarian grounds. In addition, the human rights framework brings into play established systems of national and international legal obligations and tools to assess performance by governments and international institutions. This enables the private sector and civil society to hold accountable all actors involved in achieving sustainable progress on major health challenges.

Inequity and unwanted fertility in developing countries

The persistence of inequities in health, with poor and other disadvantaged population groups bearing a disproportionately high burden of ill-health, remains a public health, ethical and human rights challenge.1 The WHO Constitution enshrines equity thus: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” Addressing inequities in health has been a central concern of development aid and government policies. The Millennium Development Goals (MDGs) have further galvanized efforts to eliminate poverty and to reduce inequities. There has been a quantum increase in the published literature on health inequities, and “pro-poor” programmes have been initiated to redress them. Yet consensus is lacking on many aspects of inequity — its conceptual and operational definitions, its classification criteria and ways to alleviate it. Most professionals accept that inequities are “differences which are unnecessary and avoidable, but in addition are considered unfair and unjust”.2 However, some argue that it is impossible to formulate irrefutable criteria by which health inequities can be recognized.3 Moreover, they assert, what is viewed as unjust or unfair may depend on subjective values, political ideologies or normative considerations.3 Others say “pro-poor” policies oversimplify the problem by focusing only on income disparities, thus ignoring more intricate structural factors which underlie the inequity dynamics in a given context.4 The evidence from six countries (Cambodia, the Dominican Republic, Ethiopia, Ghana, Kenya and Tajikistan) indicates that differences in health outcomes by ethnic group, educational attainment and region were more pronounced than the differences caused by wealth, the factor which work on inequity generally addresses.4 Against this backdrop, Gillespie et al.5 examine through an equity lens the prevailing differences by wealth quintile in total fertility, unwanted fertility, use of modern contraceptives and access to family planning services in developing countries. More specifically, they consider whether unwanted fertility among the poor compared with wealthier population segments is a case of an inequality (that is, a difference that has no moral implications) or an inequity. Using data from Demographic and Health Surveys in 41 developing countries, the authors conclude that for reproduction and family planning interventions, the equity concept needs to be “applied more cautiously than in the case with health”. They further state that this equity analysis is useful in countries where poor segments have high actual and unwanted fertility, low contraceptive use and limited access to family planning information or services. By extending the equity analysis to fertility and modern contraceptive use by wealth quintile, Gillespie et al. have broadened the discourse on inequities. The countries included in the study show a range from low to high fertility and modern contraceptive use. However, the equity analysis proved useful only for countries with high fertility and low contraceptive use. It is unclear whether this implies that the equity framework has limited application or whether family planning programmes in other countries have succeeded in reducing inequities in fertility. A cross-national comparative analysis omits country-specific social, cultural and economic peculiarities which may mediate the impact of inequities. Also, wealth indices across countries in absolute terms do not indicate how poor the poorest quintile is in one country compared to another. A country-specific analysis would permit a better understanding of linkages at the individual level, rather than the macro-level broad associations found in this study. Moreover, additional information on factors such as social marketing, social health insurance and public financing of services can also be considered, together with other information on variables relating to fertility and family planning. Perhaps the most significant findings are the persistent differentials in access to and use of modern contraceptives by wealth quintile, especially in sub-Saharan Africa but also in some countries in other regions. Public-sector family planning programmes have existed for nearly 50 years and have received major international and national funding. By providing free or subsidized services and through innovative social marketing and other initiatives, family planning programmes aim to reduce inequity in access to services. Effective family planning programmes reduce the fertility differential between the wealthiest and the poorest quintiles and make a major contribution to poverty reduction.6 Impressive achievements in reducing fertility and increasing contraception have been noted.7 However, success has continued to elude much of sub-Saharan Africa, where inequities in health, fertility and contraception are most pronounced. Long-term commitment and investment are needed to provide culturally appropriate interventions to remove these inequities. Much progress needs to be made to redress inequity in access to family planning services in order to reach the MDG target of “universal access to reproductive health by 2015”.7 Further work at the country level will help clarify the dynamics of prevailing inequities and enable effective interventions by taking into account contextual factors. ■

The Imperial – Emancipatory Paradox of International Human Rights: How Useful is the Right to Health in Sub-Saharan Africa?

AbstractIn thinking of and formulating strategies for tackling the problem of access to good health care services in Sub-Saharan Africa, it is very tempting to look to the right to health as part of such strategies. However, given the genealogy and practices of the international human rights corpus, the question as to the value of utilising the right to health in such endeavours necessarily comes to the fore and demands investigation. Using the trajectory of the right to health, the paper analyses the usefulness or otherwise of international human rights in seeking solutions to problems relating to health in Sub-Saharan Africa. An argument is made that the right to health has low utility value despite the promises it makes. The paper concludes with the argument that an appreciation of the imperial-emancipatory paradox that is inherent in the corpus of international human rights not only enables one to expect less from the right to health but also opens up possibilities of crafting more productive strategies in the struggle to achieve the 'highest attainable standard of health' for the people of Sub-Saharan Africa.

Health and Human Rights

International human rights law has a good deal to say about matters of health. Even a cursory examination of the leading instruments shows us article 25 of the Universal Declaration of Human Rights (UDHR): everyone has the right to a standard of living adequate for the health and well-being of himself and his family; and article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR): states recognize the rights of everyone to the enjoyment of the highest attainable standard of physical and mental health. The rights of especially vulnerable people to health care are also identified, for example in The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), article 12: states are to take all appropriate measures to eliminate discrimination against women in the field of health care to ensure equality of access to health care services. There are further particular measures with respect to the health care of pregnant and lactating women, and provisions relating to children, most notably The Convention on the Rights of the Child (CRC), article 24, the right of the child to enjoyment of the highest attainable standards of health and facilities for the treatment of illness and rehabilitation of health. There are provisions on health in conventions on the rights of migrant workers and their families and rights not to be discriminated against in access to health care. Similarly at the regional level, instruments such as the European Social Charter and the African Charter on Peoples’ and Human Rights provide for a right to health care and health services. What is important about these instruments is they are international treaties creating legally binding obligations, making clear that the right to the highest attainable standard of physical and mental health is now well entrenched within the canon of international human rights law. The instruments have been supplemented by a range of soft law, non-binding institutional mechanisms, for example the establishment in 2002 by the UN Commission on Human Rights of a special rapporteur on health. This position provides a link between the UN human rights machinery and other UN agencies more obviously associated with health, self-evidently the WHO but also FAO, UNICEF, and UNHCR. Given the existence of international specialized agencies, the question must be what the body of human rights law entails for issues of public health, or, to put it another way, what is the value added of including health within human rights law? Why locate health care issues within this international legal framework when they might appear to belong more properly to social, economic, and political policy-making? The most immediate answer to this question is that international human rights law moves an issue ARTICLE IN PRESS

Highly active anti-retroviral treatment as a bridge towards education for all in sub-Saharan Africa

The dual campaigns of Education for All (EFA) and the Millennium Development Goals (MDG) have made universal primary school enrolment for boys and girls a priority for developing countries. The HIV/AIDS epidemic has affected millions of people in sub-Saharan Africa and has depleted the teaching corps. As a result, the HIV/AIDS pandemic has pushed the targets of EFA and MDG further out of reach for many medium and high HIV-prevalence countries. The provision of highly active antiretroviral therapy (HAART) in developing countries, however, has given hope to thousands who have not had access to treatment. The Commission on Human Rights in 2001 and again in 2002 confirmed that access to AIDS medication is a key component of the right to the highest attainable standard of health, enshrined in the Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights and the Convention on the Rights of the Child. This article explores how scaling up of HAART for teachers can make the EFA and MDG targets attainable. A HAART programme for teachers can produce substantial fiscal savings in sick leave pay, the cost of training new teachers, and funeral expenses, even under high HIV prevalence situations.