Right to the Highest Attainable Standard of Health

A primary, guiding text on the right to the highest attainable standard of health is article 12 of the International Covenant on Economic, Social and Cultural Rights which provides:

1. The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

2. The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for:

(a) The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child;

(b) The improvement of all aspects of environmental and industrial hygiene;

(d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness.

An additional resource on this topic is Module 14 of Circle of Rights on “The Right to Health”.

Minimum Core Content

States parties to the International Covenant on Economic, Social and Cultural Rightsbear non-derogable core obligations with respect to the right to health. States are obligated:

to ensure the right of physical and economic access to health facilities, goods and services on a non-discriminatory basis, especially for vulnerable or marginalized groups. This core obligation includes the right to access to trained medical and professional personnel who receive domestically competitive salaries;

to ensure access to the minimum essential food which is nutritionally adequate and safe, to ensure freedom from hunger to everyone;
to ensure access to basic shelter, housing and sanitation, and an adequate supply of safe and potable water;
to provide essential drugs, as from time to time defined under the World Health Organisation Action Programme on Essential Drugs;
to ensure equitable distribution of all health facilities, goods and services; and
to adopt and implement a national public health strategy and plan of action, on the basis of epidemiological evidence, addressing the health concerns of the whole population; the strategy and plan of action shall be devised, and periodically reviewed, on the basis of a participatory and transparent process; they shall include methods, such as right to health indicators and benchmarks, by which progress can be closely monitored; the process by which the strategy and plan of action are devised, as well as their content, shall give particular attention to all vulnerable or marginalized groups.

The full realization of the right to the highest attainable standard of health also requires that:

health services be culturally appropriate, taking into account traditional preventative care, healing practices and medicines (See Module 17 of Circle of Rights on “Cultural Rights”);
the right to control’s one’s health and body, including treatment refusals, and sexual and reproductive freedoms be respected;
reproductive, maternal (pre-natal as well as post-natal) and child health care are ensured;
immunization against the major infectious diseases occurring in the community be provided;
measures to prevent, treat and control epidemic and endemic diseases be taken;
education and access to information concerning the main health problems in the community, including methods of preventing and controlling them be provided;
appropriate training for health personnel, including education on health and human rights be provided;
healthy occupational and environmental conditions be assured;
equal and timely access to basic preventative, curative, rehabilitative health services and health education be ensured;
the right to be free from interference such as torture and non-consensual medical treatment and experimentation be protected;
the confidentiality of personal health data be assured; and
the right to seek, receive and impart information about health issues be protected.

Some important quantifying and qualifying tools that are useful when monitoring program service delivery on the right to health include the:

Right to Health Dossier

Articles 12(1), 12(2) of the International Covenant on Economic, Social and Cultural Rights
Article25(1) of the Universal Declaration of Human Rights
Article 5(e)(iv) of International Convention on the Elimination of All Forms of Racial Discrimination
Articles 11.1(f), 12 of Convention on the Elimination of All Forms of Discrimination Against Women
Article 24 of the Convention on the Rights of the Child
Article 11 of the European Social Charter
Article 16 of the African Charter on Human and Peoples’ Rights
Article 10 of the Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights; “Protocol of San Salvador”
Principles for the Protection of Persons with Mental Illnesses and the Improvement of Mental Health Care
Fourth World Conference on Women: Beijing Declaration
1978 Declaration of Alma-Ata on Primary Health Care
Article 34 of the Organisation of American States Charter

Potential Right to Health Violations

Some potential right to health violations include:

the State outlawing all forms of traditional healthcare
forced sterilizations
the trafficking of human beings, including the sale of human organs
In addition, the Public Services International Research Unit is a good resource on specific ways that privatization in the healthcare sector can further marginalize the poor and other vulnerable groups.

Key Health Rights Developments and Sample Best Practices

Significant advances toward the full realization of the right to health continue to be made. Some initial resources on the right are:

The following case studies and summaries illustrate how human rights defenders have used the ESC rights approach to promote and protect the right to health:

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Side Links

Primary links

Right to the Highest Attainable Standard of Health

Minimum Core Content

Right to Health Dossier

Potential Right to Health Violations

Key Health Rights Developments and Sample Best Practices