The Pan American Health Organization and the Mainstreaming of Human Rights in Regional Health Governance

Abstract

In the absence of centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have stepped forward to advance the rights-based approach to health. Reviewing the efforts of the Pan American Health Organization (PAHO), this article explores the evolution of human rights in PAHO policy, assesses efforts to mainstream human rights in the Pan American Sanitary Bureau (PASB), and analyzes the future of the rights-based approach through regional health governance, providing lessons for other regional health offices and global health institutions. This article explores PAHO's 15-year effort to mainstream human rights through PASB technical units, national capacity-building, the Inter-American human rights system, and the PAHO Directing Council. Through documentary analysis of PAHO policies and semi-structured interviews with key PASB stakeholders, the authors analyze the understandings and actions of policymakers and technical officers in implementing human rights through PAHO governance. Analyzing the themes arising from this narrative, the authors examine the structural role of secretariat leadership, state support, legal expertise, and technical unit commitment in facilitating a rights-based approach to the health in the Americas. Human rights are increasingly framing PAHO efforts, and this analysis of the structures underlying PAHO's approach provides an understanding of the institutional determinants of the rights-based approach to health, highlighting generalizable themes for the mainstreaming of human rights through regional health governance. With this regional-level understanding of health governance, future national-level research can begin to understand the causal forces linking regional human rights work with national policy reforms and public health outcomes.

Social inequities and contemporary struggles for collective health in Latin America

“…Offering a further framework through which to oppose neoliberalism's impact on health, the LASM-CH central tenet of health as a universal, human right increasingly has taken a central role in state-level and regional health policy through the 1990s and into the twenty-first century (Meier & Ayala, 2014). This is perhaps not surprising in light of the important role that Latin American thinkers and activists have historically had in advocating for human rights considerations in international relations (Sikkink, 2015).…”

“…Heavily influenced by LASM-CH approaches, policy-making in the region related to HIV and AIDS was also at the forefront of pioneering rights-based approaches to the global epidemic (Berkman, Garcia, Muñoz-Laboy, Paiva, & Parker, 2005;Cueto, 2001Cueto, , 2019Parker, 2009;Smallman, 2007). Rightsbased policy-making related to mental health also underpinned a restructuring of psychiatric care throughout the Americas (Meier & Ayala, 2014). In addition, Latin American policymakers and activists have played an especially important role in questioning intellectual property rights and trade regimes that have limited access to medicines (Loyola, 2008;Vieira & Di Giano, 2019), and in promoting flexibilities such as the Doha Declaration on TRIPS and Public Health (Amorim, 2017a(Amorim, , 2017b.…”

Governance and mental health: contributions for public policy approach

“…There has been increasing world literature on this subject, but there is not a consensus on the definition of governance. Some international organizations equate the concept of governance with that of stewardship, management and governability, still bearing in mind important semantic differences 7 , 24 , 30 , a , b , c .…”

Human rights education for nurses: An example from Finland

“…The Pan American Health Organization, with human rights experts, has developed health and human rights programs that apply to mental health, sexual and reproductive health, adolescent health, and elderly people's health. [18] Tenets of a health and human rights approach include (1) health policy makers, administrators, and providers should be knowledgeable about human rights and (2) policies and practice will be better if human rights principles are followed. [19] Many argue that all health professionals need education about health and human rights, and there have been calls for medical schools to include this education for doctors.…”