TWN Info Service on UN Sustainable Development (Jul17/01)
4 July 2017
Third World Network

United Nations: States called upon to respect, protect and fulfil right to health
Published in SUNS #8491 dated 29 June 2017

Geneva, 28 Jun (Kanaga Raja) -- The United Nations Human Rights Council, on the final day of its thirty-fifth regular session (6-23 June) end of last week, adopted a resolution that amongst others called upon States to respect, protect and fulfil the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, with special attention to groups in vulnerable situations.

In a resolution (A/HRC/35/L. 18/Rev. 1), adopted without a vote, the Council urged States to work towards the full implementation of all Sustainable Development Goals and targets with a view to contributing to the realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, including the targets of the 2030 Agenda for Sustainable Development (relating to health).

The Council, while recognizing that the primary responsibility for promoting and protecting all human rights rests with States, (in operational paragraph 9) called upon the international community to continue to assist developing countries in promoting the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, including through access to medicines, in particular essential medicines, vaccines, diagnostics and medical devices that are affordable, safe, efficacious and of quality, and financial and technical support and training of personnel.

It recognized "the fundamental relevant importance of the transfer of environmentally sound technologies on favourable terms, including on concessional and preferential terms, as mutually agreed."

The Council requested the United Nations High Commissioner for Human Rights to prepare a report "which presents contributions of the right to health framework to the effective implementation and achievement of the health-related Sustainable Development Goals, identifying best practices, challenges and obstacles thereto", and to submit it to the Human Rights Council at its thirty-eighth session (in June 2018).

While the draft resolution was adopted without a vote, the United States, however, disassociated itself from the reference to technology transfer in operational paragraph 9 of the draft.

It said that for the United States, this language will have no standing in future negotiations (see below).

The draft resolution was tabled by Argentina, Belgium, Brazil, Bulgaria, Colombia, Ecuador, Egypt, Haiti, Honduras, Luxembourg, Malta, Mozambique, Paraguay, Peru, Portugal, Romania, Spain, Timor-Leste, Qatar, Thailand, and Turkey.

It was entitled "The right of everyone to the enjoyment of the highest attainable standard of physical and mental health in the implementation of the 2030 Agenda for Sustainable Development."

Introducing the draft resolution at the Council on behalf of Mozambique, Paraguay, Portugal, Thailand, Brazil and more than 40 co-sponsors, Brazil said that health is a fundamental human right, indispensable to the enjoyment of other human rights and necessary for living a life in dignity.

Nevertheless, millions of people throughout the world, especially women and girls, lack full enjoyment of the human right to health which still remains an elusive goal.

Brazil pointed out that this year's initiative is particularly timely as it addresses the realization of the right to health in the implementation of the 2030 Agenda for Sustainable Development.

It believes that the Human Rights Council has a positive contribution to give with regard to national, regional and global efforts for the implementation of the Sustainable Development Goals.

It said the draft resolution underscores that the implementation of the health-related Sustainable Development Goals contributes to the full realization of human rights but at the same time it highlights that the full realization of human rights, including the right to health, contributes to the implementation of the Sustainable Development Goals.

Brazil also said that the draft resolution recognizes the need for States to address the social, economic and environmental determinants of health, mindful of the inter-relatedness between poverty and health.

It refers to the goal of achieving universal health coverage, by ensuring that all people have access without discrimination to health-care, including sexual and reproductive health-care services.

It calls upon States to respect, protect and fulfill the right to health for everyone, with special attention to groups in vulnerable situations.

Therefore, according to Brazil, it also reaffirms the fundamental human right to health of refugees and migrants.

"Bearing in mind our commitment to leave no one behind and to reach the furthest behind first, we recognize the particular challenges and intersecting forms of discrimination in the enjoyment of the right to health faced by, inter alia, women, youth, children, indigenous peoples, older persons, persons with disabilities, persons living with HIV and people of African descent."

Guided by our human rights perspective, said Brazil, States are encouraged to use disaggregated data, while respecting human rights principles.

Finally, it added, the draft resolution recognizes the importance of international cooperation, and calls upon States to continue to provide assistance for the promotion of the right to health, including through access to medicines, vaccines, diagnostics and medical devices.

In an explanation of the vote before the vote, the United States expressed great appreciation for the extensive consultations conducted by Brazil, Portugal, Mozambique, Paraguay, and Thailand on this resolution and said that it will join the consensus on it.

However, the United States said that it disassociates from the reference to technology transfer in operational paragraph 9.

For the United States, this language will have no standing in future negotiations.

"The United States continues to oppose language that we believe undermines intellectual property rights."

The United States also expressed disappointment with respect to the report of the High Commissioner for Human Rights that was called for under operational paragraph 13 in the draft resolution.

The US said it is concerned with the report's focus on the "contributions of the right to health framework to the effective implementation and achievement of the health-related Sustainable Development Goals."

The United States does not see this as an appropriate task and responsibility for the High Commissioner, and it does not wish to frame the SDGs in a "right to health framework" when there is no "right to health framework" language in the SDGs themselves.

The United States encouraged governments and public institutions to work closely on implementation with regional and local authorities, sub-regional institutions, international institutions, academia, philanthropic organizations, volunteer groups, and others, as appropriate.

In an apparent reference to the UN Secretary-General's High Level Panel report on access to medicines released last September, the United States noted that "certain recent UN reports have put forward a flawed understanding on issues of healthcare access, particularly with respect to access to medicines, and have generated divisiveness among Member States and the UN."

The United States strongly urged the UN to consider a new approach to analyzing healthcare that seeks to unite all of the parties responsible for delivering critical healthcare solutions to patients around the world.

To this end, the UN Secretary-General's High-Level Panel on Access to Medicines should not be used as a model for this new work, it said.

On the other hand, the United States said it was pleased to see language specifically addressing persons with psycho-social disabilities in this text and continue to support the work that the Special Rapporteur does to advance the human rights of all persons with disabilities.

In the resolution adopted on 23 June, the Human Rights Council noted with concern that, for millions of people throughout the world, especially for women and girls, the full enjoyment of the right to the highest attainable standard of physical and mental health remains a distant goal.

It recognized that women, youth, children, indigenous persons, older persons, persons with disabilities, persons living with HIV and people of African descent face particular challenges and multifaceted and intersecting forms of discrimination in the enjoyment of the right to the highest attainable standard of physical and mental health.

The Council was deeply concerned that, despite the impressive reductions in maternal mortality rates achieved since 1990, according to the World Health Organization, in 2015, there were an estimated 303,000 maternal deaths of women and girls, which were largely preventable, and that many more women and girls suffer serious and sometimes lifelong injuries, which have severe consequences for their enjoyment of their human rights and their overall well-being.

It was deeply concerned further that more than 5,900,000 children under 5 years of age die each year, mostly from preventable and treatable causes, owing to inadequate access or lack of access to integrated and quality maternal, newborn and child health-care services, to early childbearing, and to health determinants, such as safe drinking water and sanitation, safe and adequate food and nutrition, and that mortality remains highest among children belonging to the poorest and most marginalized communities.

The Council regretted the high number of people still without access to affordable, safe, efficacious and quality medicines, vaccines, diagnostics and medical devices. It underscored that improving such access could save millions of lives every year.

It noted with deep concern that, according to the World Health Organization in its World Medicines Situations Report of 2011, at least one third of the world's population has no regular access to medicines, while recognizing that the lack of access to medicines is a global challenge that affects people not only in developing countries but also in developed countries, even though the disease burden is disproportionately high in developing countries.

The Council recognized that universal health coverage implies that all people have access without discrimination to nationally determined sets of the needed promotive, preventive, curative, palliative and rehabilitative essential health-care services, including sexual and reproductive health-care services, and essential, safe, affordable, efficacious and quality medicines, vaccines, diagnostics and medical devices, while ensuring that the use of these services does not expose the users to financial hardship, with a special emphasis on the poor, vulnerable and marginalized segments of the population.

It underscored that the implementation of the health-related Sustainable Development Goals contributes to the full realization of human rights and fundamental freedoms for all, including the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

In the operational parts of the resolution, the Council urged States to work towards the full implementation of all Sustainable Development Goals and targets with a view to contributing to the realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, including, inter alia, the following targets of the 2030 Agenda for Sustainable Development:

Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births;

Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births;

Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases;

Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being;

Target 3.5: Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol;

Target 3.6: By 2020, halve the number of global deaths and injuries from road traffic accidents;

Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes;

Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all;

Target 3.9: By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination;

Target 3. a: Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate;

Target 3. b: Support the research and development of vaccines and medicines for the communicable and non- communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade- Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all;

Target 3. c: Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States;

Target 3. d: Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks; and

Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.

The Council also urged States to bring their laws, policies and practices, including their strategies towards the implementation of the health-related Sustainable Development Goals, fully into compliance with their obligations under international human rights law, and to review and, where necessary, repeal those that are discriminatory.

The Council encouraged States to promote effective, full and meaningful participation of all, in particular those in vulnerable situations, in the design, implementation and monitoring of law, policies and programmes relevant to realizing the right of everyone to the enjoyment of the highest attainable standard of physical and mental health and to implementing the health-related Sustainable Development Goals, including strategies for universal health coverage.

It called upon States to fulfil their respective official development assistance commitments, including the commitments by many developed countries to achieve the target of 0.7 per cent of gross national income for official development assistance, and urged those developed countries that have not done so to make concrete efforts in this regard in accordance with their commitments.

The Council encouraged the Special Rapporteur, while considering the many ways towards the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, to continue to focus on the human rights dimension that could contribute to the effective implementation of the health-related Sustainable Development Goals and targets.

It also encouraged the Special Rapporteur to continue to advise States, intergovernmental organizations, civil society, the private sector and other stakeholders on effective and sustainable practices to respect, protect and fulfil the right of everyone to the enjoyment of the highest attainable standard of physical and mental health in the implementation of the 2030 Agenda and to follow up and participate in relevant international forums and major events in this regard, including the annual sessions of the World Health Assembly and of the high-level political forum.

The Council requested the United Nations High Commissioner for Human Rights to prepare a report which presents contributions of the right to health framework to the effective implementation and achievement of the health-related Sustainable Development Goals, identifying best practices, challenges and obstacles thereto, and to submit it to the Human Rights Council at its thirty-eighth session.

It encouraged the High Commissioner, when elaborating the above-mentioned report, to consult and take into account the views of Member States and all relevant stakeholders, including relevant United Nations bodies, agencies, funds and programmes, especially the World Health Organization, treaty bodies, special procedure mandate holders, national human rights institutions and civil society, as well as their work on the issue.

The Council called upon States and all relevant stakeholders, including relevant United Nations bodies, agencies, funds and programmes, treaty bodies, special procedure mandate holders, national human rights institutions and civil society, to contribute to the report of the High Commissioner. +