(Re)Invigorating the World Health Organization’s Governance of Health Rights: Repositing an Evolving Legal Mandate, Challenges and Prospects

Abstract

State centred discourse on international law and human rights often diminishes the obligations of global health institutions in international law to advance health related human rights and as sites for the progressive development and implementation of health rights. The constitution of the World Health Organization (WHO) provides an expansive role for human rights protection and promotion in realizing public health, but WHO has faced hurdles in effectively carrying out this role. Current scholarship continues to underscore the normative challenges facing WHO concerning its limited use of international law including human rights to promote health. This article goes a step further and explores the evolving international legal and institutional basis for WHO’s future direction in strengthening the governance of human rights. It revisits WHO’s evolving and expanding human rights mandate, challenges and prospects within WHO law, the broader United Nations law, policy and practice as well as general international law. Despite the limitations, WHO has evolving institutional mechanisms rooted in international law that comprise a pivotal site for human rights normative and operational work at the global, regional and domestic levels. The article examines these mechanisms and suggests concrete ways and options in which WHO can advance health rights.

Global Health and International Community

“…The Asian values movement is contentious and we do not wish to enter the debate about its status and validity here, as to do so would be to merely reproduce earlier work. 67 As discussed in previous papers, those who espouse the 'neo-colonialism' argument, 68 claim that the West endorses broadly individual moral valuesthose of autonomy, freedom and choice -and that the East endorses broadly communal values -respect for community, relationships and family and the 'good life' rooted in community. 69 To give a caricature of this debate, the moral agents who exhibit these values are diametrically opposed.…”

“…The complex organic crisis, to which Stephen Gill has referred, 68 and the implications of such for the future of our planet and of all life provide yet another lens through which to perceive some of the moral obligations (based on their access to knowledge and resources) for wealthy nations to accept and act on their role to ameliorate the human condition and improve the future.…”

An Agenda for Normative Policy Analysis in the Study of Global Health Governance

“…At the international level, the United Nations has sought a cross-cutting commitment to 'mainstream' human rights in all programs, policies, and activities, with the WHO adopting this commitment as a way of incorporating key human rights principles in its health programming. 61 As states have incorporated health-related rights under national constitutions and laws, 62 this rights-based approach to health is explicitly shaping accountability for government efforts-framing the legal and policy environment, integrating core rights-based norms into policy and programming, and evaluating the implementation of programs and budgets. 63 This rights-based approach has come to influence a wide range of national policy implementation efforts for underlying determinants of health, 64 and to assure this implementation, a global accountability regime has evolved to encompass treaty monitoring bodies, rights-based litigation, and 'naming and shaming' advocacy.…”

Reinforcing Global Health Normative Frameworks and Legal Obligations

“…67 WHO's mandate increasingly emphasizes the importance of prevention and promotion that focus on communities, groups and populations. 68 WHO has adapted its institutional mechanisms to cope with changes resulting from globalization of public health, 69 but these require a versatile framework. Adaptive governance offers it.…”