This chapter examines the historical origins of human rights as a basis for public health. Tracing the idea of rights from philosophical notions of natural rights to human rights under international law, the normative foundations underlying rights have long been seen as central to health and well-being—from the political engagement with underlying determinants of health in 1848 to the international codification of the Universal Declaration of Human Rights (UDHR) in 1948. The modern human rights system that frames public health arose in response to the deprivations and atrocities of World War II. Giving rise to the notion of human rights under international law, the postwar creation of the United Nations (UN) provided the structure for a new legal regime under which individuals were seen as having certain rights by virtue of their humanity, ensuring a foundation for the evolution of rights to advance health.

This chapter addresses the international organizations that have accepted human rights obligations as a way of framing their global health policies, programs, and practices. International organizations within the United Nations (UN) system are engaged in implementing human rights—in both the mission they carry out and the way in which they carry out that mission. The UN has called on all programs, funds, and specialized agencies to mainstream human rights across their efforts, and various agencies have taken up this call to advance human rights for public health – beginning with the evolving role of the World Health Organization and expanding to encompass a sweeping set of international organizations that address health determinants. While there remain obstacles to the systematic operationalization of human rights across the global health governance landscape, international organizations are seeking to integrate their efforts to mainstream human rights in global health.

This chapter examines the threat of populism to global health and human rights. Out of the ashes of World War II, institutions of global health and human rights have brought the world together in unprecedented cooperation, giving rise to the successes and opportunities detailed throughout this text. However, the current populist age threatens these successes and raises obstacles to future progress. In violent contrast with the shared goals of a globalizing world, populism seeks to retrench nations inward, with right-wing populist nationalism directly challenging institutions of global health, violating the rights of vulnerable populations, and spurring isolationism in international affairs. Such retrenchment could lead to a rejection of both global governance and human rights as a basis for global health. Yet, with hope for the future, there remains enduring strength in institutions of global health and human rights, with these institutional bulwarks capable of facing the challenges to come.

This chapter discusses the evolving understanding of human rights to encompass determinants of health through the human rights to water and sanitation, which are vital to the prevention of both communicable and non-communicable disease. In 2002, the United Nations Committee on Economic, Social and Cultural Rights argued that the right to water is a distinct human right derived from the right to an adequate standard of living and the right to health. Solidified by the UN General Assembly and the Human Rights Council, states have provided a normative framework for efforts to realize the human rights to water and sanitation. This recognition of the human rights to water and sanitation has provided a foundation to implement these rights through national policy and international organizations. With advocates now seeking accountability for these rights, human rights advocacy, litigation, and monitoring will be crucial for meeting water, sanitation, and hygiene needs.

This chapter analyzes the fundamental importance of monitoring and review procedures to assess the implementation of human rights to advance public health. Recognizing monitoring and review as central to human rights accountability, the evolving functions of human rights monitoring highlight the range of national, regional, and international review mechanisms that provide oversight to support the realization of health-related human rights. While these mechanisms often do not have judicial powers—their recommendations are advisory rather than legally binding—the interpretive role entrusted to these review procedures has endowed their health-related recommendations with legitimacy in clarifying human rights treaty provisions and reviewing state efforts to meet treaty obligations. Assessing the implementation of international human rights law through national practice, monitoring institutions can facilitate human rights accountability for public health promotion and operationalize public health data to press governments to implement rights.