1. The Right to Health: Expanding the
Scope of Prevention Teaching
Teaching Prevention 2013
Annual Meeting of the Association
for Prevention Teaching and
Research
March 11, 2013
Robert S. Lawrence, MD

2. Universal Declaration
of Human Rights
• Adopted by United Nations General Assembly
on December 10, 1948
– Represented aspirations of founders of the United
Nations
– Staked out domain for human rights

3. Article 3
• Everyone has the
right to
– Life
– Liberty
– And security of
person

4. Article 22
• Everyone, as a member of society, has the right to
social security and is entitled to realization, through
national effort and international cooperation and in
accordance with the organization and resources of
each state, of the economic, social and cultural
rights indispensable for his dignity and the free
development of his personality

5. Article 25
• 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, medical care, and
necessary social services
Continued

6. Article 25
– … and the right to security in the event of
unemployment, sickness, disability,
widowhood, old age, or other lack of
livelihood in circumstances beyond his
control
Continued

7. Article 25
• Motherhood and
childhood are
entitled to
special care
and assistance
– All children,
whether born in or out of wedlock, shall
enjoy the same social protection

8. United Nations Covenants
UN proposed two covenants on December 16,
1966
• International Covenant on Economic, Social,
and Cultural Rights
• International Covenant on Civil and Political
Rights
Continued

9. International Covenant on Economic,
Social, and Cultural Rights
Article 12
• 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
Continued

10. Article 12 (cont)
• The steps to be taken by the States Parties
to the present Covenant to achieve the full
realization of this right shall include those
necessary for:
a. The provision for the reduction of the stillbirth
rate and of infant mortality and for the
healthy development of the child
Continued

11. Article 12 (cont)
b. The improvement of all aspects of
environmental and industrial hygiene
Continued

12. Article 12 (cont)
c. The prevention,
treatment, and
control of
epidemic,
endemic,
occupational,
and other
diseases
Continued

13. Article 12 (cont)
d. The creation of conditions which would assure
to all medical service and medical attention in
the event of sickness

14. Respect, Protect, and Fulfil
• 1999 UN Economic and Social Council,
Twentieth Session (a UN Charter Body)
• General Comment 12 on the Right to Adequate
Food (Article 11 ICESCR)
• The Right imposes three types or levels of
obligations on States parties:
– The obligation to respect
– The obligation to protect
– The obligation to fulfil, which incorporates the
obligations to facilitate and to provide

15. 2000 UN Economic and Social Council,
Twenty-second Session
General Comment 14 on the Right to the Highest
Attainable Standard of Health
• The right to health includes the right to a system of health
protection
• The right to health is closely related and dependent upon other
rights, including the rights to human dignity, non discrimination,
equality, education, housing, privacy, access to information, and
freedom of association
• The right to health extends beyond health-care services to the
underlying determinants of health (access to safe and potable
water, sanitation, food, housing, education, and healthy
occupational and environmental conditions)

16. Dimensions of the
Right to Health (UN, 2002)
Availability Acceptability
Right to Health
Accessibility Quality
Source: United Nations (2000) General Comment No. 14 on the right to health

17. Availability
“Public health and health-care facilities, goods
and services, as well as programmes, have to be
available in sufficient quantity within the State
party”

18. Acceptability
“All health facilities, goods and services must be
respectful of medical ethics and culturally
appropriate, i.e. respectful of the culture of
individuals, minorities, peoples and communities,
sensitive to gender and life-cycle requirements, as
well as being designed to respect confidentiality
and improve the health status of those concerned”

19. Quality
“As well as being culturally acceptable, health
facilities, goods and services must also be
scientifically and medically appropriate and of
good quality”

20. Accessibility
Non-discrimination
“Health facilities, goods and services must be accessible to all,
especially the most vulnerable or marginalized sections of the
population”
Physical accessibility
“Health facilities, goods and services must be within safe physical
reach for all sections of the population, especially vulnerable or
marginalized groups”

21. Accessibility (cont’d)
Economic accessibility (Affordability)
“Payment for health-care services, as well as services related to the
determinants of health, has to be based on equity, ensuring that these
services, whether privately or publicly provided, are affordable for all,
including socially disadvantaged groups”
Information accessibility
“Accessibility includes the right to seek, receive and impart information
and ideas concerning health issues”

22. Article 12.2 (b). The right to healthy natural and
workplace environments
• The improvement of all aspects of environmental and
industrial hygiene (art. 12.2 (b)) comprises, inter alia,
preventive measures in respect of occupational
accidents and diseases; the requirement to ensure an
adequate supply of safe and potable water and basic
sanitation; the prevention and reduction of the
population's exposure to harmful substances such as
radiation and harmful chemicals or other detrimental
environmental conditions that directly or indirectly
impact upon human health.

23. Article 12.2 (b). The right to healthy natural and
workplace environments
• Furthermore, industrial hygiene refers to the
minimization, so far as is reasonably practicable, of the
causes of health hazards inherent in the working
environment. Article 12.2 (b) also embraces adequate
housing and safe and hygienic working conditions, an
adequate supply of food and proper nutrition, and
discourages the abuse of alcohol, and the use of
tobacco, drugs and other harmful substances.

24. Article 12.2 (c). The right to prevention, treatment
and control of diseases
• The prevention, treatment and control of epidemic,
endemic, occupational and other diseases requires the
establishment of prevention and education
programmes for behavior-related health concerns such
as sexually transmitted diseases, in particular
HIV/AIDS, and those adversely affecting sexual and
reproductive health, and the promotion of social
determinants of good health, such as environmental
safety, education, economic development and gender
equity.

25. Article 12.2 (c). The right to prevention, treatment
and control of diseases
• The control of diseases refers to States’ individual and
joint efforts to, inter alia, make available relevant
technologies, using and improving epidemiological
surveillance and data collection on a disaggregated
basis, the implementation or enhancement of
immunization programmes and other strategies of
infectious disease control.