Health & Human Rights: Is Access to Medicines All We Got? Benjamin Mason Meier, JD, LLM, PhD Assistant Professor of Global Health Policy University of North Carolina – Chapel Hill World AIDS Day November 30, 2009

Treatment for All ?

Outline Background – Health and Human Rights Theory Analysis Discussion Outline Background – Health and Human Rights Theory – Limited Evolution of the Right to Health to Codify Prevention Analysis – Human Rights for Prevention Discussion – A Rights-Based Approach to HIV Prevention

International Law Human Rights Public Health BACKGROUND Theory Analysis Discussion International Law Human Rights Health & Human Rights Public Health

Human Rights-Based Approach BACKGROUND Theory Analysis Discussion Human Rights-Based Approach Human Right = Valid claim & Corresponding duty Rights holder Duty bearer E.g.: “A woman has a valid claim to a right to health, which is realized through the duties of the national government to provide HIV Treatment.” Goals – (1) Define duty-bearers and rights-holders, (2) Impose legal obligations on duty-bearers, (3) Inform rights-holders of their rights and how these rights can be claimed and enforced Programs to Realize Rights Demand of Rights

Health & Human Rights Human Rights Matter Human Rights Evolve BACKGROUND Theory Analysis Discussion Health & Human Rights The Health & Human Rights Movement Human Rights Matter Human Rights Evolve Evolution of Rights in International Law Disease Prevention through the Right to Health? International Law Human Rights Health & Human Rights Public Health

International Legal Framework for Health Background THEORY Analysis Discussion International Legal Framework for Health Second World War Four Freedoms UN Charter WHO Constitution UDHR The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Universal Declaration of Human Rights Background THEORY Analysis Discussion Universal Declaration of Human Rights Second World War Four Freedoms UN Charter WHO Constitution UDHR Article 25 Medical care Public health “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services…”

Evolution of the Right to Health Background THEORY Analysis Discussion Evolution of the Right to Health Declaration of Alma-Ata (1978) UDHR (1948) ICESCR (1966)

Legacy of Human Rights Neglect Background Theory ANALYSIS Discussion Legacy of Human Rights Neglect Right to Health Does Not Address Underlying Determinants of Health Dismantling Health Systems – Exacerbating Health Inequalities From Legal Obligation to Non- Binding “Commitment” Human Right to Health Treatment “Exceptional” Funding Distortions ✗ MDGs for Health

Human Rights for Prevention? Background Theory ANALYSIS Discussion Human Rights for Prevention? Is a Right to Medicines All We’ve Got? From Collective to Individual Models Structural determinants of health & Prevention Primary health care Curative medicine Prevention as a Means to Individual Health Capability Collective Utility From Public Health Discourses to Human Rights Obligations

Collective Rights-Based Approach Background Theory Analysis DISCUSSION Collective Rights-Based Approach Human Right = Valid claim & Corresponding duty Rights holder Duty bearer E.g.: “A state has a valid claim to a collective health rights, which are realized through the duties of the international community to provide HIV Prevention.” Programs to Realize Rights Demand of Rights

= Treatment + Prevention Background Theory ANALYSIS Discussion Vaccine = Treatment + Prevention

Test + Treatment Prevention Research Education Social Measures Condoms Background Theory Analysis DISCUSSION Research Treatment Education Test + Social Measures Prevention Condoms PrEPs Microbicides Circumcision

Treatment for All (+ Prevention) Benjamin Mason Meier Assistant Professor of Global Health Policy University of North Carolina – Chapel Hill bmeier@unc.edu