Law Access to Health Care as a Human Rights Issue Professor Fons Coomans Maastricht University Centre for Human Rights

Law Convention on Human Rights and Biomedicine Article 3, Equitable access to health care Parties, taking into account health needs and available resources, shall take appropriate measures with a view to providing, within their jurisdiction, equitable access to health care of appropriate quality.

Law What are human rights? Values about the protection of human dignity, laid down in legal texts, that entail rights for individuals and obligations for states. Rights an individual has, because he/she is a human being.

Law Social and Economic Human Rights Different definitions: Rights relating to an adequate standard of living; Conditions under which people live and work; Claims to the fulfilment of basic needs; Claims relating to the quality of life from a material and immaterial perspective; Claims relating to opportunities to make a living and achieve welfare and wellbeing.

Law Right to Health as a Human Right Universal Declaration on Human Rights (1948) - Art. 25 Convention on the Elimination of All Forms of Discrimination Against Women (1979) – Art. 12 Convention on the Rights of the Child (1989) – Art. 24 International Covenant on Economic, Social and Cultural Rights (1966) – Art. 12

Law International Covenant on Economic, Social and Cultural Rights Article 12 1.The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. 2.The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right include those necessary for: (a)The provision for the reduction of the still-birth rate and of infant mortality and for the healthy development of the child; (b)The improvement of all aspects of environmental and industrial hygiene;

Law (c)The prevention, treatment and control of epidemic, endemic, occupational and other diseases; (d)The creation of conditions which would assure to all medical service and medical treatment in the event of sickness.

Law The Right to Health: Not to be understood as the right to be healthy. It is the right to the enjoyment of a variety of facilities, goods services and conditions necessary for the realization of the highest attainable standard of health. It contains both freedoms and entitlements.

Law Duties for States To take steps, individually and through international assistance and cooperation; To the maximum of its available resources; By all appropriate means; Aimed at achieving progressively the full realization of rights.

Law Key Features of Access to Health Care Relationship with underlying determinants of health. Availability of health care goods and services Accessibility: four overlapping dimensions: non-discrimination physical accessibility economic accessibility information accessibility

Law Acceptability of health facilities, goods and services Quality of health facilities, goods and services

Law Key role of non-discrimination From an access to health perspective the following prohibited grounds are particularly relevant: physical or mental disability health status sexual orientation social origin sex

Law Access to Health Care Related Obligations To Respect (negative obligation) To Protect (positive obligation) To Fulfil (positive obligation)

Law Core Obligations Core obligations to ensure the satisfaction of minimum essential levels of the right to health. They include, inter alia, to ensure the right of access to health facilities, goods and services on a non-discriminatory basis, especially for vulnerable and marginalized groups. to provide essential drugs. To adopt and implement a national public health strategy and plan of action.

Law Relationship with other Rights Universal Declaration on the Human Genome and Human Rights, Art. 12 (a) Universal Declaration on Bioethics and Human Rights, Art. 15 UN Womens Convention, Art. 12 (1) Universal Declaration of Human Rights, Art. 27 (1)

Law Challenge To ensure that the application of developments in biology and medicine is in accordance with human rights standards. to make them human rights proof.