Progressive realization by using the maximum resources available
Progressive realization requires that governments take immediate action with the means at their disposal, regardless of their level, to realize these rights. Regardless of resource potential, urgent action is needed to eliminate discrimination and improve the legal and judicial system.
Non-retrogression
States may only allow existing systems for protecting economic, social and cultural rights to deteriorate if there are strong justifications for retrogressive measures. For example, imposing fees for secondary schooling, which was previously free, would be a deliberately regressive measure. To justify it, the State would need to demonstrate that such a measure was taken only after carefully weighing all options, assessing the impact and using the maximum resources available to it fully.
Key components of the right to health
The right to health (Article 12) was defined in General Comment 14 of the Committee on Economic, Social and Cultural Rights, the committee of independent experts monitoring the Covenant. This right has the following basic components:
Availability
This means a sufficient number of functioning health and medical facilities, goods and services, and programs for all. Availability can be measured by analyzing data disaggregated by multiple stratification factors, including age, gender, location, and socioeconomic status, and through qualitative surveys to understand coverage gaps and assess health workforce coverage.
Accessibility
Health care facilities, goods, and services must be accessible to everyone.
Accessibility has four mutually overlapping dimensions:
- Non-discrimination;
- physical accessibility;
- Economic accessibility (affordability);
- accessibility of information.
Assessing accessibility may require an analysis of existing barriers – physical, financial, and other – and their impact on the most vulnerable people. Clear norms and standards in both law and policy need to be established and applied to remove these barriers, and strong systems need to be put in place to monitor health-related information and ensure that this information reaches all population groups.
Acceptability
Acceptability refers to medical ethics and cultural and gender sensitivity. It requires that health facilities, goods, services and programs be people-centered and sensitive to the specific needs of different population groups, in accordance with international standards of medical ethics regarding confidentiality and informed consent.
Quality
Facilities, goods and services must be scientifically and medically approved. Quality is a key component of universal health care coverage and includes the experience as well as the perception of health care.
Quality health care services must be:
- Safe – preventing injury to the people for whom the health care services are intended;
- Effective – providing evidence-based health services to the people who need them;
- People-centered – providing health care according to individual preferences, needs, and values;
- Timely – reducing wait times and sometimes dangerous delays;
- Equitable – providing care that does not vary in quality based on gender, ethnicity, geographic location, and socioeconomic status;
- Integrated – providing care that provides a full range of health services throughout the life cycle;
- Effective – maximizing the benefits of available resources and preventing their loss.
WHO activities
WHO places human rights at the center of health programs and policies at the national and regional levels by addressing the underlying determinants of health in a comprehensive approach to health promotion and human rights.
In addition, WHO is actively reinforcing its technical, intellectual, and political leadership on the right to health, including:
Strengthens the capacity of WHO and Member States to integrate a rights-based approach to health;
strengthens the right to health in international law and international development processes; and
advocates for health-related human rights, including the right to health.
Addressing the needs and rights of people at different stages of the life cycle requires a comprehensive approach in the broader context of advancing human rights, gender equality and equity.
In this regard, WHO is pursuing a clear, comprehensive program that builds on existing approaches to gender, equity and human rights to identify more accurate and sustainable solutions to health inequities. The comprehensive nature of this program allows the fundamental strengths of these approaches and their complementarity to develop a holistic and effective approach to promoting health and well-being for all.