The WHO Constitution (1948) and Universal Declaration of Human Rights (1948) were the first international instruments to enshrine health as a fundamental right of every human being. The right to the highest attainable standard of physical and mental health was subsequently incorporated into the International Covenant on Economic, Social and Cultural Rights (1966). In international human rights law, the right to health is an inclusive right, extending beyond healthcare to the underlying determinants of health, such as access to potable water, sanitation, adequate food, nutrition and housing, healthy occupational and environmental conditions, and access to health-related education and information, including on sexual and reproductive health.
The normative scope and content of the right to health (i.e., the standard for the human right to health) is comprised of four interrelated elements which require that public health and healthcare facilities, goods, services and programmes, in addition to the underlying determinants of health, be: Available, Accessible, Acceptable and Quality.
The right to health requires time and resources to fully achieve. However, this right also imposes on states various obligations of immediate effect, such as the guarantee of non- discrimination, and the obligation to take deliberate, concrete and targeted steps towards its full realization.
The human rights-based approach (HRBA) to sustainable development is summarized by the following principles:
- Goal: All programmes of development cooperation, policies and technical assistance should further the realization of human rights.
- Process: Human rights standards and principles derived from international human rights mechanisms (e.g., treaty bodies, special procedures, Universal Periodic Review) should guide all development cooperation and programming in all sectors and in all phases of programming.
- Outcome: Development cooperation contributes to developing the capacity of ‘duty-bearers’ to meet their obligations and/or of ‘rights-holders’ to claim their rights.
- analyses inequalities which lie at the heart of development problems and works to redress discriminatory practices and unjust distributions of power that impede development progress and result in groups of people being left behind;
- requires human rights principles (universality, indivisibility/interrelatedness, equality and non-discrimination, participation, accountability) to guide UN development work with Member States, focusing on developing the capacities of both ‘duty-bearers’ to meet their obligations, and ‘rights-holders’ to claim their rights;
- ensures that plans, policies and processes of development cooperation are anchored in a system of rights and corresponding obligations established by international law, including all civil, cultural, economic, political and social rights (including the right to the highest attainable standard of physical and mental health), and supports Member States in meeting their obligations under international human rights treaties.
WHO works with Member States and other partners to support the realization of the right to health through technical assistance, normative guidance and support. WHO based its 13th General Programme of Work (2019 – 2025) on Sustainable Development Goal 3, including mainstreaming human rights, gender and health equity in all policies and programmes at headquarters (HQ), Regional Offices and Country Offices, as well as in its internal policies and operations.
The United Nations 2030 Agenda for Sustainable Development includes human rights, gender equality/women’s empowerment and the commitment to Leave No One Behind (LNOB) as core principles. Implementing the HRBA in the 2030 Agenda requires that all programmes further the realisation of human rights, prioritizing pervasive gender inequality and communities and populations in vulnerable contexts and settings, which are often not considered or engaged in national health policy and programme development, implementation and monitoring.
The LNOB commitment is based in human rights standards and principles and operationally directed to reach not only the poorest of the poor, but also to combat discrimination and rising inequalities within and among countries, and their root causes.
Meeting the commitment to LNOB at the country level requires a comprehensive approach to identify who is being left behind and why; effective measures to address root causes; monitoring and measuring progress; and accountability.