Under the (legal) radar screen: global health initiatives and international human rights obligations

Abstract

BackgroundGiven that many low income countries are heavily reliant on external assistance to fund their health sectors the acceptance of obligations of international assistance and cooperation with regard to the right to health (global health obligations) is insufficiently understood and studied by international health and human rights scholars. Over the past decade Global Health Initiatives, like the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) have adopted novel approaches to engaging with stakeholders in high and low income countries. This article explores how this experience impacted on acceptance of the international obligation to (help) fulfil the right to health beyond borders.MethodsThe authors conducted an extensive review of international human rights law literature, transnational legal process literature, global public health literature and grey literature pertaining to Global Health Initiatives. To complement this desk work and deepen their understanding of how and why different legal norms evolve the authors conducted 19 in-depth key informant interviews with actors engaged with three stakeholders; the European Union, the United States and Belgium. The authors then analysed the interviews through a transnational legal process lens.ResultsThrough according value to the process of examining how and why different legal norms evolve transnational legal process offers us a tool for engaging with the dynamism of developments in global health suggesting that operationalising global health obligations could advance the right to health for all.ConclusionsIn many low-income countries the health sector is heavily dependent on external assistance to fulfil the right to health of people thus it is vital that policies and tools for delivering reliable, long-term assistance are developed so that the right to health for all becomes more than a dream. Our research suggests that the Global Fund experience offers lessons to build on.

An open debate about the object and purpose of global health knowledge in the context of an interdisciplinary research partnership on HIV/STI prevention priorities in Peru

“…In considering the social context of global health, the connection with human rights is central. While the complex policy and legal interpretations of the right to health [ 38 ] is beyond the scope of this discussion, it is important to note that Article 25 of the Universal Declaration of Human Rights [ 39 ], considers not only medical care but also access to housing, food, clothing, and social services as the right that everyone has for a standard of living adequate for health and well-being. However, the global health emphasis on medical interventions has been to some extent distant from a rights-based approach that emphasizes action to the pre-conditions of health and the underlying social determinants of health.…”

Developing emergency care systems: a human rights-based approach

“…Although not legally binding, General Comment 14 is widely accepted as an authoritative guide to interpreting the right to health 15 , 26 . Numerous court cases concerned with the right to health have been successfully tried in national courts using General Comment 14 as customary practice, which may be enforced as if law 27 .…”

Global health governance in the sustainable development goals: Is it grounded in the right to health?

“…Shared responsibility to realize the right to health is emphasized in General Comment 14 which suggests that “it is particularly incumbent on States parties and other actors in a position to assist, to provide ‘international assistance and cooperation, especially economic and technical’ which enable developing countries to fulfil their core and [comparable priority obligations]”. Subsequent expert interpretations have emphasized that states hold extraterritorial obligations to enable the realization of “core obligations to realize minimum essential levels of economic, social and cultural rights” (International Commission of Jurists, ; Hammonds et al, ). In capacity building and technical assistance, and in particular in humanitarian interventions in crisis, this shared responsibility is assumed.…”

“…The advent of economic globalization in particular has meant that some states and other global actors exert considerable influence on the realization of economic, social and cultural rights across the world. The Maastricht Principles on the Extraterritorial Obligations of States in the Area of Economic, Social and Cultural Rights clarify the legal principles for states to respect, protect, and fulfil human rights both within their domestic territories and outside their national borders (Hammonds et al, ). In theory, the existing human rights legislation would enable the principles and basis for the global governance of health beyond the premise of the state.…”