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

Abstract

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.

Patient Satisfaction and the Right to Health: A Survey in a Rehabilitation Clinic in Switzerland

“…During this period, research first addressed civil laws, policies and democracy [5,6]. More recently, economic, social and cultural rights, as well as indicators of development, have been studied [1,[7][8][9]. Studies assessed some of the relevant indicators (Freedom House Index, Efficient Democracy Index etc...), and they also helped to identify conceptual, methodological and technical challenges of the realisation of these rights.…”

“…The number of ratified international treaties on the right to health, the proportion of urban versus rural populations with access to drinking water, the prevalence of violence against women, the infantile *Address correspondence to this author at the Institute of Social and Preventive Medicine, Faculty of Medicine, Geneva University, Michel-Servet 1, 1211 Geneva 4, Switzerland; Tel: 41 22 379 04 63; Fax: 41 22 379 04 52; E-mail: Emmanuel.kabengele@unige.ch death rate, and life expectancy at birth have among others been proposed as possible indicators of the right to health [7,10,11]. Critical voices have underlined that 18 out of the proposed 72 indicators are not monitored by any of the 194 states and even basic indicators such as maternal mortality rates are monitored by less than half of the states [12].…”

The Reflection of Human Rights in the Health System from the Angle of Patients’ Rights

“…Governments are obliged to provide information on health issues, information from both the state and private health service providers [8].…”

Imagining Global Health with Justice: In Defense of the Right to Health

“…The principles of good governance are fundamental to all human rights, which include transparency, accountability, and participation among their own core features [30]. ''International assistance and co-operation,'' entailing shared responsibility, is part of treaty obligations for economic, social, and cultural rights [57, art.…”