Highest Attainable Standard Of Health Research Articles

Is the right to health compatible with sustainability?

One of the fundamental human rights is the right of every individual to the enjoyment of the highest attainable standard of health, which we simplify to ‘HASH’ [1]. The HASH right was first articulated in the preamble to the WHO Constitution (1946) [2]. It appears in Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) (1966) [3]; and occurs in various human rights treaties (cf [4]).

Exploring the Cultural Dimensions of the Right to the Highest Attainable Standard of Health

The right to enjoying the highest attainable standard of health is incorporated in many international and regional human rights instruments. This right contains both freedoms and entitlements, including the freedom to control one's own health and body and the right to an accessible system of health care, goods and services. Both aspects of the right to health – freedoms and entitlements – have important cultural dimensions. The UN Committee on Economic, Social and Cultural Rights has for instance stated that the right to health implies that health facilities, goods and services must be culturally appropriate, in other words respectful of the culture of individuals and communities. At the same time, it should be noted that culture and health may have a problematic relationship. Cultural patterns, attitudes or stereotypes may severely limit the health freedoms of people or may prevent certain people from accessing health care. Furthermore, there are some cultural or traditional practices that are condoned but that are very harmful to people's health. It seems that international human rights law demands respect for the cultural dimensions of the right to health, while at the same time requiring protection of the right to health against negative aspects of cultures. How does this work out in practice? What does the concept of "culturally appropriate" health goods and services mean at the national level? Who decides on what is or is not culturally appropriate? How have international supervisory bodies elaborated on the freedoms and entitlements of the right to health and the obligations for States Parties to the treaties in relation to the cultural dimensions of the right to health? This article analyses several treaty provisions and the interpretation of these provisions by the treaty monitoring bodies. Apart from several UN treaties, several regional treaties in Africa are dealt with, notably the African Charter on Human and Peoples' Rights. The article concludes that various cultural dimensions of the right to health are recognised and elaborated upon in recommendations by treaty monitoring bodies both at UN and African level. These bodies have endorsed the idea that health facilities, goods and services must be respectful of the culture of individuals, peoples and communities. At the same time, the right to health should be protected against the negative impact that cultural values, patterns or practices may have, such as on access to health goods and services and on the health of people as such. The latter issue has received most attention at the UN as well as at African level, and there appears to be a clear consensus on several practices that are considered harmful. It is also realised, however, that the identification of a certain practice as harmful by an international body, even if agreed to by the State Party, is not sufficient to eradicate it. Cultural communities are crucial in promoting social and behavioural changes that may be needed to eradicate harmful practices. It is therefore important to involve the cultural communities concerned in the drafting, implementation and evaluation of health laws and policies. This could be more emphasised by the monitoring bodies. The involvement of the cultural community is also crucial to respecting and promoting the more positive cultural dimensions of the right to health. By consulting the cultural communities and individuals concerned, States can implement the right to the enjoyment of the highest attainable standard of health in a culturally sensitive, appropriate and responsible way.

Editorial

This issue of PER consists of 11 articles and one case note dealing with a wide range of topics in the global legal landscape. Monray Botha analyses the responsibility of South African companies towards their employees for achieving social justice in the corporate world. Fawzia Cassim examines how identity thieves use the personal information of individuals to commit identity fraud and theft, and looks at legislative solutions introduced in South Africa, the United States of America, the United Kingdom and India to combat identity theft crimes. Howard Chitimira discusses the regulation of market manipulation in Australia with the purpose of assessing if lessons can be learnt from it for South Africa. Leentjie de Jong deals with parenting coordination, a new alternative dispute resolution process to alleviate the negative effects of high-conflict co-parenting cases on the South African court system and the children of divorce. Yvonne Donders investigates the cultural dimensions of the right to health endorsed by several treaty provisions and treaty monitoring bodies and comes to the conclusion that states can implement the right to the enjoyment of the highest attainable standard of health in a culturally sensitive and responsible way by consulting cultural communities and individuals. Joel Modiri reflects on the development of a radical democratic political theory that shifts analytical and conceptual registers in which the relationship between law and poverty is conventionally addressed and argues for the creation of a radical alternative that defatalizes the present. Stephen Peté's unconventional historical examination of the Barberton Prison Complex during the 1980s is published in two parts. The first part deals with the deaths of three prisoners and the injury of many others during a day of violence at the Barberton prison farm on 29 December 1982 and the second part examines a string of violent incidents which occurred within the Barberton Prison Complex during the course of 1983, leading to nine inmate deaths. Robbie Robinson raises the question of whether or not the constitutionally entrenched right to make decisions concerning reproduction may be limited, as the continued existence of the State may ultimately be jeopardised if the size of the population is not limited to the available levels of subsistence. Olufemi Soyejudiscusses the incapacity of low-income countries to realise the Millennium Development Goals and seeks to make a case for the adoption of a development-driven approach to law as a linchpin for the post-2015 development agenda. Carmel van Niekerk considers the constitutionality of section 294 of the Children's Act 38 of 2005, which permits commissioning parents to engage in surrogacy arrangements only in instances where they are able to provide a genetic link to their future offspring. In the only case note, Salona Lutchman evaluates the implications ofSS v Litako 2014 SACR 431 (SCA): A Clarification on Extra Curial Statements and Hearsay.
 

Moving Theory into Practice: Human Rights Impact Assessment of Intellectual Property Rights in Trade Agreements

This article explores the development of methodologies for human rights and right to health-specific impact assessment of trade-related intellectual property rights. These methodologies seek to respond to the restrictive impact of international and bilateral trade rules on domestic and global policy options to ensure access to affordable medicines in low and middle-income countries. Methodologies for right to health-specific impact assessment are emerging from human rights impact assessments, themselves an offshoot from the broader field of social and health impact assessment. A right to health-specific impact assessment allows policymakers to prospectively predict the impact of intellectual property rights on domestic medicines policy, and therefore on the realization of legal duties under the international human right to the highest attainable standard of health. The effective implementation of such an assessment provides an evidence base for broadening policy space in these countries towards improving access to generic and affordable patented medicines. Yet there has been little consensus to date on key questions of principle, methodology and implementation. We overview current literature and practice in this regard in order to assess the current state of the field and the prospects for wider-scale implementation. We first assess the growing international focus on the impact of trade-related intellectual property rights on access to medicines. We then explore the emergence of impact assessments in relation to health and human rights. Finally, we analyse the practical, methodological, political and theoretical challenges of right to health-specific impact assessment, and overview developments in practice and scholarship that suggest effective responses to these challenges.

Editorial: Nurse education: Meeting the needs of people with intellectual disabilities?

Abstract

The right to mental health and parity.

Byline: Dinesh. Bhugra, Jonathan. Campion, Antonio. Ventriglio, Sue. Bailey Introduction The prevalence of mental disorders is common, but although many policies and settings cover patients with psychoses, other psychiatric conditions are put to one side. Furthermore, majority of people with common mental disorders (which include anxiety and depressive disorders), addictions, intellectual disabilities and co-morbidities receive no intervention ven in best-resourced countries. Although mental disorders are defined by diagnostic criteria, social and value-laden personal constructs usually override these so that stigma, discrimination and ignorance result in a lack of access to evidence-based interventions to treat mental disorder, prevent mental disorder and promote mental health. In this paper, we highlight need for both policy makers and those who provide services to consider issues related to parity between resources allocated to physical and mental health. Right to Health Right to health incorporates civil, social and health dimensions. Regarding right to health, World Health Organization (WHO, 1946) constitution made it clear that the enjoyment of highest attainable standard of health is one of fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. Governments have a responsibility for health of their people, which can be fulfilled only by provision of adequate health and social measures. [sup][1] The Universal Declaration of Human Rights (1948) also reads: Everyone has right to a standard of living adequate for health of himself and of their family, including food, clothing, housing and medical care and necessary social services. [sup][2] Subsequently, Alma Alta declaration [sup][3] of 1978 reiterated fundamental right to enjoyment of highest attainable standard of health and is widely recognized in many human rights declarations (International Convention on Elimination of All Forms of Racial Discrimination: ICEAFRD, 1965; [sup][4] Convention on Elimination of All Forms of Discrimination against Women: CEAFDAW, 1979; [sup][5] Convention on Rights of Child: CORC, 1989; [sup][6] European Social Charter, 1965; [sup][7] African Charter, 1981; [sup][8] American Convention, 1988 [sup][9] ). These charters and amendments are often used as basis of legal framework, but regrettably not all time. The Universal Declaration of Human Rights has at its core three key aspects important to health care: *Preserve, extend and improve life of people in need based on equality (for treatment and cure irrespective of gender, race, language, religion and opinions and socioeconomic conditions) *Quality (high quality, up-to-date interventions) *Social responsibility (health and well-being of citizens as a well-funded priority and effective in health promotion and prevention of ill health). In looking at human rights based parity across all health - be it physical or mental or psychosomatic - policymakers must bear these three facets in mind. Hogerzeil in 2006 has pointed out that human rights are legally guaranteed by international, regional and national human rights laws through which individuals are protected especially against actions, which may interfere with human dignity and fundamental freedoms. [sup][10] The right to a disability-free life and to health is closely associated with right to life, and these rights are indispensable for exercise of most other human rights. Freedom from discrimination is at core of all rights. Evolution of Rights It is important to acknowledge that these frameworks and associated changes take a considerable period to be implemented. Higgins in 2012 has highlighted that recognition of rights at an international level gathered pace after Nazi atrocities and mass migration after Second World War. …

Bioethics, Human Rights, and Childbirth

The global reproductive justice community has turned its attention to the abuse and disrespect that many women suffer during facility-based childbirth. In 2014, the World Health Organization released a statement on the issue, endorsed by more than 80 civil society and health professional organizations worldwide.The statement acknowledges a growing body of research that shows widespread patterns of women's mistreatment during labor and delivery-physical and verbal abuse, neglect and abandonment, humiliation and punishment, coerced and forced care-in a range of health facilities from basic rural health centers to tertiary care hospitals. Moreover, the statement characterizes this mistreatment as a human rights violation. It affirms: "Every woman has the right to the highest attainable standard of health, which includes the right to dignified, respectful health care throughout pregnancy and childbirth."The WHO statement and the strong endorsement of it mark a critical turn in global maternal rights advocacy. It is a turn from the public health world of systems and resources in preventing mortality to the intimate clinical setting of patient and provider in ensuring respectful care.

The Foundations of a Human Right to Health: Human Rights and Bioethics in Dialogue

Human rights, including the right to health, are grounded in protecting and promoting human dignity. Although commitment to human dignity is a widely shared value, the precise meaning and requirements behind the term are elusive. It is also unclear as to how a commitment to human dignity translates into specific human rights, such as the right to the highest attainable standard of health, and delineates their scope and obligations. The resulting lack of clarity about the foundations of and justification for the right to health has been problematic in a number of ways. This article identifies the strengths of and some of the issues with the grounding of the right to health in human dignity. It then examines ethical and philosophical expositions of human dignity and several alternative foundations proposed for the right to health, including capability theory and the work of Norman Daniels, to assess whether any offer a richer and more adequate conceptual grounding for the right to health.

What is it to practise good medical ethics? A Muslim's perspective

Good medical ethics should aim at ensuring that all human beings enjoy the highest attainable standard of health. With the development of medical technology and health services, it became necessary...

Zdrowie jako prawo człowieka

The subject matter of this article is the right to health as one of the moral rights granted to all human beings. In the first part, I provide an overview of selected international documents that consider health (or “the highest attainable standard of health”) a human right and, in the second part, I investigate the most significant commentaries on these documents. Accordingly, I attempt to bring out and arrange in an order the main ethical claims contained in these documents and commentaries, discussing such issues as the kinds of rights related to health, the conditions of access to health-related goods or the duties of the states implicated by the right to health.

Trade policy and public health.

Twenty-first-century trade policy is complex and affects society and population health in direct and indirect ways. Without doubt, trade policy influences the distribution of power, money, and resources between and within countries, which in turn affects the natural environment; people's daily living conditions; and the local availability, quality, affordability, and desirability of products (e.g., food, tobacco, alcohol, and health care); it also affects individuals' enjoyment of the highest attainable standard of health. In this article, we provide an overview of the modern global trade environment, illustrate the pathways between trade and health, and explore the emerging twenty-first-century trade policy landscape and its implications for health and health equity. We conclude with a call for more interdisciplinary research that embraces complexity theory and systems science as well as the political economy of health and that includes monitoring and evaluation of the impact of trade agreements on health.

Health for All by the Year 2000 - Where has the WHO gone?

Enjoyment of the highest attainable standard of health is a fundamental human right of all people 2 . This is seen as an important outcome as well as a goal of sustainable human development. Yet at the dawn of the 21st century massive worldwide disparities in the provision of health care continue to exist; 800 million people still lack access to health services 3. The rate of development of the first world has been greater than that of the third world so the gap between “haves” and “have nots” is greater than ever; the richest 1.2 billion people in the world account for 82.7% of the total global wealth 4 .

Abstinence education.

The American College of Pediatricians strongly endorses abstinence-until-marriage sex education and recommends adoption by all school systems in lieu of "comprehensive sex education." This position is based on "the public health principle of primary prevention-risk avoidance in lieu of risk reduction," upholding the "human right to the highest attainable standard of health" (Freedman 1995).

Air pollution, health, and human rights

Worldwide, the problem of air pollution is heterogeneous in its sources and in the populations affected, but consistent in that there is an urgent need for action. In this Comment, we address whether framing air pollution as a human rights issue would more quickly and efficiently motivate and direct actions than what is done at present. We conclude that rights-based approaches merit deeper consideration to advance control for air pollution worldwide at a time when air quality is notably deteriorating in many parts of the world.

Achieving universal health coverage is a moral imperative

In the past few decades, important policies and strategic initiatives in health and development have been embraced by Latin America, with the active participation and support of the Pan American Health Organization (PAHO), WHO, and other partners. As democratic processes in the region are consolidated, with increasing decentralisation and greater social inclusion in decision making, there is an increasingly large and structured social demand for equity in access to health care, consistent with the principles of the WHO Constitution of 1948: “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being…”.

Stigmatisation as a public health tool against obesity--a health and human rights perspective.

The right to health is recognised in human rights law and is also part of the catalogue of patients' rights. It imposes a duty on governments to put in place a system of health protection making it possible for individuals to enjoy the highest attainable standard of health. However, disease patterns are constantly changing, and more and more attention is being paid to so-called lifestyle diseases. Individuals may expose themselves to health threats due to personal choices like eating and smoking habits, and this raises the issue of the individual's obligation with regard to ill health. Hence, is there not only a right to health but also a duty to be healthy? Using obesity as an example, and based on a cross-disciplinary research project, the article analyses selected European and national public health policy papers to see how individual rights and duties are framed and to analyse the use of stigmatisation as a public-health strategy from a health and human rights perspective.

The International Legal Responsibility of Pharmaceutical Companies for Human Rights Violations

The pharmaceutical sector plays an important role in ensuring the right to health by creating conditions for access to medicines. However, the policy and practice of a number of big pharmaceutical companies creates additional problems for the States in realisation of citizens’ rights to the highest attainable standard of health and as a result interferes with their efforts to ensure access to medicines. In contemporary international law there are virtually no provisions allowing making pharmaceutical companies accountable for human rights violations. However, in a growing number of human rights violations on the part of pharmaceutical companies and the lack of effective national legal remedies, the need of an effective international mechanism, which will take into account the national experience acquired in this fi eld and make pharmaceutical companies accountable for violations of human rights, becomes increasingly apparent.

Public health challenges for universal health coverage.

The effective functioning of any health system requires an efficient public health service. Every human being has the right to enjoy "the highest attainable standard of health," which can be fulfilled by giving every man an affordable and equitable health system he deserves and demands. In these years, complex health changes have complicated the situation in India. Most important gaps in the health care include an understanding of the burden of the disease and what leads to and causes ill health, the availability and use of appropriate technology in the management of disease, ill health and health systems that have an impact on service delivery. Universal Health Coverage (UHC) has the potential to increase economic growth, improve educational opportunities, reduce impoverishment and inequalities, and foster social cohesion. Steps taken for achieving UHC will address the public health challenges and vice versa.

Health care economics in Serbia: current problems and changes.

One of the fundamental rights of every human being is to enjoy "the highest attainable standard of health". Achieving better health requires no only adequate medical knowledge and technologies, laws and social measures in the field of health care, but also sufficient funding for fulfilling people's right to health. However, economic crisis has left every community with limited possibility of investing in health care and forced them to use the available resources more efficiently. This is the reason why health financing policy represents an important and integral part of the health system concerned with how financial resources are generated, allocated and used. Development of new drugs and medical technologies, population aging, increased incidence of chronic diseases as well as the peoples' rising demands from health care providers lead to a constant increase of health system costs worldwide. In these circumstances, countries in transition, like Serbia, face difficult challenges in financing their health systems. Current economic crisis and budget constraints do not allow the Government to simply allocate more public revenues for health and solve the people's expectations by increasing the spending. Instead, Serbia is forced to start reforms to provide a more efficient health system. The reform processes are positioned within the wider context of European integration and public administration reforms. This paper provides a short description of the health care system in Serbia focusing on the healthcare economics and reforms and their influence on financial sustainability.

Comparing Health Care Financing in Indonesia and Thailand from 1995-2010: What Lessons Could Be Learned?

Purpose: In 2010, the World Health Organization (WHO) released its report about health system financing and identified universal coverage as the best way to attain the right of every human being to enjoy “the highest attainable standard of health”. Over the past decade, Thailand has successfully implemented a universal health coverage scheme for its population, while its neighbor country, Indonesia, is still struggling to achieve the same goal. The purpose of this paper is to compare the health financing systems between Thailand and Indonesia. Both countries almost have similar socioeconomic conditions and suffered from severe financial crisis during the late 1990s. The objective of this study is to examine health systems in each country and to determine lessons on how health care financing can affect the health status of a population. Methods: The study is based on statistical data from various publicly available resources. For analysis, the authors followed The Health Systems Assessment Approach: A How-To Manual Version 1.0 issued by Health Systems 20/20 supported by United States Agency for International Development (USAID). The countries were compared using three groups of indicators in health systems performance and functioning: 1. Health Insurance System, 2. Amount and Sources of Financial Resources, and 3. Health Outcomes and Health Workforce Density. Results: In comparing the health financing of the two countries, we found that Thailand initiated much earlier health systems reforms in order to achieve universal health coverage. Indonesia, while on the right track, has moved at a slower pace than Thailand. Thailand and Indonesia have shown improving trends over time in all indicators, but Thailand outperformed Indonesia, especially in the groups of indicators regarding the amount and sources of financial resources. Conclusions: One important lesson identified in this study is that health care reform is unlikely to succeed without strong political support and constant pressure from the nation as a whole, which can be represented by local organizations or professional associations. However, the mere increase of available resources devoted to the health sector does not guarantee significant improvements of health outcomes of a population.