Human Rights: A Potentially Powerful Force for Essential Medicines
Nygren-Krug, Helena, Hogerzeil, Hans V., Bulletin of the World Health Organization
Health policy-makers need ways to increase access peoples' access to essential medicines. The human rights framework provides new tools for analysis, action, accountability, alignment of policies, and advocacy.
To support the analysis of how well access to essential medicines is being realized in countries, the UN human rights treaty bodies work with WHO to identify appropriate indicators for the right to the enjoyment of the highest attainable standard of health (the right to health).
These indicators will incorporate measures to increase access to essential medicines and form an integral component of the regular State Party reports. National benchmarks will be set against these indicators in order to monitor progress.
One article in this issue of the Bulletin argues for benchmarks to monitor implementation of various World Health Assembly resolutions on access to medicines and amendments to the Agreement on the Trade-Related Aspects of Intellectual Property Rights (TRIPS). (1) The UN Special Rapporteur on the Right to Health, Paul Hunt, also works with WHO to set appropriate actions and indicators on essential medicines before the UN Human Rights Council.
Human rights notes and principles offer a useful framework for action at the national level by providing guidance both on the content of the health programmes and on the process by which programmes are developed. Guiding human rights principles include freedom from discrimination, attention to vulnerable populations (including their right to participate at "all stages of the programming cycle), and the rights to information and to education.
The human rights-based approach also includes capacity-building to enable duty bearers to meet their human rights obligations and to enable rights-holders to enjoy and claim their rights. (2)
Systems of accountability, are also part of a human rights-based approach.
International accountability comes through country reports by the UN treaty bodies; international scrutiny of Failure to meet human rights obligations can spur governments to make corrections.
National accountability and redress can be provided through the courts. Judicial decisions in several low- and middle-income countries have already been rendered in support of access to essential medicines. National and international accountability requirements can therefore help the Ministry of Health to put access to medicines higher on the national political agenda, as part of the government's overall human rights performance.
Recognizing that access to essential medicines is part of government-wide human rights obligations also encourages alignment of policies with the obligation to move towards the highest attainable standard of health. Ministries of finance, trade and planning are equally responsible for safeguarding the right to health; they need to work with the ministry of health to ensure intersectoral cooperation and policy coherence. Intersectoral efforts to make best use of TRIPS' flexibilities are a good example of such cooperation.
Finally, the debates about how different intellectual property regimes could stimulate innovation and also increase access to essential medicines highlight the powerful advocacy role that human rights can play in achieving health objectives. One of the articles in this issue describes medicines as knowledge goods and the author argues that we should separate incentives to innovate, from market forces to sell. (3) Everyone has the right to enjoy the benefits of scientific progress and its applications. (4) This right could be used to more effect in ensuring equitable access to such benefits. …