Is universal health coverage the practical expression of the right to health care?

Abstract

The present Millennium Development Goals are set to expire in 2015 and their next iteration is now being discussed within the international community. With regards to health, the World Health Organization proposes universal health coverage as a ‘single overarching health goal’ for the next iteration of the Millennium Development Goals.The present Millennium Development Goals have been criticised for being ‘duplicative’ or even ‘competing alternatives’ to international human rights law. The question then arises, if universal health coverage would indeed become the single overarching health goal, replacing the present health-related Millennium Development Goals, would that be more consistent with the right to health? The World Health Organization seems to have anticipated the question, as it labels universal health coverage as “by definition, a practical expression of the concern for health equity and the right to health”.Rather than waiting for the negotiations to unfold, we thought it would be useful to verify this contention, using a comparative normative analysis. We found that – to be a practical expression of the right to health – at least one element is missing in present authoritative definitions of universal health coverage: a straightforward confirmation that international assistance is essential, not optional.But universal health coverage is a ‘work in progress’. A recent proposal by the United Nations Sustainable Development Solutions Network proposed universal health coverage with a set of targets, including a target for international assistance, which would turn universal health coverage into a practical expression of the right to health care.

Global constitutionalism, applied to global health governance: uncovering legitimacy deficits and suggesting remedies

“…It enshrines fundamental human rights principles of participation, accountability, non-discrimination, transparency and shared responsibility: national and international obligations, the latter related to development assistance and cooperation for health. The importance of the concept of ‘core obligations’ – what states need to do to realise minimum essential levels of the right to health-and the existence of international obligations of assistance from wealthier states to states that are unable to live up to their core obligations, are both of vital importance for advancing the right to health for all [41, 42]. When using constitutionalist principles to assess global health governance, we would argue that the realisation of these minimum essential levels, through shared national and international responsibility, is the minimum standard by which achievements, or lack thereof, of global health governance should be assessed, before one can claim that global health governance is or is not constitutional.…”

Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?

“…Our aim was to assess whether the use of right to health language was associated with health goals and targets proposing UHC, given our belief that this concept has a strong affinity with the normative prescriptions of the right to health. 39 While caution about the conditions in which UHC could realize this right is appropriate, 40,41 we consider the fact that key actors in the SDG process also view UHC as a relative proxy for the right to health as sufficient justification to do so here. For example, in 2012, the UN General Assembly called on all states to realize UHC while reaffirming the right to health.…”

Health Rights and Realization Comment on "Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?"

“…They (with colleagues) have also written elsewhere that the concept of UHC represents a significant improvement on the MDGs. 8,9 But -as they acknowledge -there may be an element of danger in drawing too close parallels between what is in the SDGs and what we might wish had been there in terms of the right to health. 'Ensuring healthy lives, ' the overall title of Goal 3, does indeed sound very like 'health for all. '…”