Global Health

The Place of Human Rights in Global Health Policy

Guest Post by Professor John Tasioulas The international community is currently in the process of formulating the Sustainable Development Goals that will guide the post-2015 development agenda. Many UN bodies, NGOs, governments and members of civil society have in the past stressed the vital need to embed the SDGs in a human rights framework. However, in July 2014,  the UN’s…

Guest Post by Professor John Tasioulas

The international community is currently in the process of formulating the Sustainable Development Goals that will guide the post-2015 development agenda. Many UN bodies, NGOs, governments and members of civil society have in the past stressed the vital need to embed the SDGs in a human rights framework. However, in July 2014,  the UN’s Open Working Group on Sustainable Developments Goals, of which UK Prime Minister David Cameron is co-chair, issued an outcome document that largely shunned use of the words ‘human rights’.  Some have interpreted this as a major set-back for the role of human rights in the post-2015 development agenda. Indeed, one distinguished human rights lawyer, speaking at the Harvard Human Rights Program’s recent 30th anniversary event, was moved regretfully to announce that human rights are now out of fashion. The absence of any serious engagement with human rights in the outcome document is disturbing and highlights the urgent need to clarify the role that human rights should play in the development agenda.

In an article published in the Lancet, Effy Vayena and I focus specifically on the place of human rights in global health policy. Understanding human rights in the first instance as universal moral rights, we argue for two main propositions. First, global health policy needs to attend to more than just human rights, vitally important though such rights are. For example, it needs to encourage compliance with duties people have to themselves (e.g. to maintain a healthy diet and exercise regimen) and to foster health-related common goods (e.g. a compassionate culture of organ donation or participation in clinical trials). Human rights do not all by themselves exhaust the values that should guide global health policy.

Second, insofar as human rights are important in shaping global health policy, the salient rights go beyond the human right to health. The human right to health, we contend, is primarily a right to certain medical services and public health measures. It does not include, as some UN bodies and activists assert, rights to education, employment, housing, and to be free from gender discrimination and torture. Instead, these entitlements are secured by other rights, such as the rights to education and freedom from torture. Shoehorning them under the right to health is problematic both conceptually and as a practical matter. In short, there is more to human rights in global health policy than the human right to health.

It follows from these two points that sometimes the best way to promote people’s interest in health is not through securing their human rights; or, even when it is, this will not necessarily be by means of the human right to health, but some other health-enhancing right, such as the right to education. Consider, in this connexion, the crucial influence of women’s adult education in reducing female morality. Human rights, including the right to health, are vitally important in the repertoire of global health policy, but they cannot reasonably be made to do all the work.

By understanding human rights in this way, we believe, they can be rescued from over-ambitious claims made on their behalf by some of their most influential advocates in global health policy. Characteristic of such claims in the proposal, advanced by Lawrence Gostin and his associates, for a framework convention on health grounded exclusively in the human right to health. This proposal seems to commit both of the errors criticised in our article, over-stretching both the human right to health, and human rights generally, in the process.

It is only by re-examining the place of human rights within a broader context of ethical concerns that their distinctive significance can be re-captured. It is also clear that this process must be an interdisciplinary one. The conceptual and normative concerns of philosophers will need to be allied to empirical and institutional insights from economists, lawyers, political scientists and health professionals, among others.​ Only in this way is there some chance of arresting and reversing the disturbing trend away from human rights represented by the SDG Open Working Group’s outcome document.

Professor John Tasioulas is the Yeoh Professor of Politics, Philosophy & Law and the inaugural director of the Yeoh Tiong Lay Centre for Politics, Philosophy & Law at the Dickson Poon School of Law, King’s College London.