Inequality in health is a morally significant fact in itself. Yet the current status of health inequality trends among and within countries shows that health inequalities are increasing. The long-term solutions to this worrisome situation are not with political leaders and policy makers worldwide. Read here who must address these issues to demand actions from the latter.
From the human rights perspective, power imbalances underlie health inequalities.1
If you as a reader recognise and agree with a) the indivisibility of human rights, b) the equal importance of people’s socio-economic entitlements, and c) the principle of equity, you must accept that this runs counter to market-oriented development health policies still fostered by many a national and international development agency.
Therefore, what the adoption of the human rights framework brings to public health is that it ensures that social justice is made a constant counterbalance to the unchallenged utilitarianism at the root of obscene inequalities. Its adoption also ensures that checks on power relations are made routinely and that these checks are the main way to protect the vulnerable by opening avenues that confer communities the power to get actively and de-facto involved in setting and monitoring the policies and programmes that affect their health and wellbeing.
This basically makes human rights (HR) the centre piece of early twenty first century development struggles against inequalities in health. But mind you, the HR framework will only become a meaningful instrument to assure accountability in health if strong civil society pressures on government ultimately turn HR codes and standards into national laws and regulations.
Furthermore, HR are not just about empowering individual duty bearers, but are, by extension, a framework for the contestation of power, at local, national and international level. And where power is contested, we should expect that the products of this contestation will actually reflect the relative balance of forces (or power) of the different actors. Therefore, empowering claim holders in the health sector we must.
About the Author
Claudio Schuftan, M.D. is a freelance consultant in public health. He is the author of two books, several book chapters and over 85 scholarly papers plus over four hundred other assorted publications. He has carried out over 110 consulting assignments 50 countries in five continents. He has worked long term in the US, Cameroon, Kenya and Vietnam. He is currently an active member of he Steering Group of the People’s Health Movement He is the author of a long-running blog, the Human Rights Reader counting over 420 issues. www.claudioschuftan.com
1. “Human rights and public health: More than just about civil liberties”, EQUINET AFRICA Newsletter Editorial, 2006. http://www.equinetafrica.org/
2. Chapter 18 of the International Panel on Social Progress, 2016. https://www.ipsp.org/wp-content/uploads/2016/04/IPSP-Outline-April-2016.pdf
5. The social, economic and political determinants of health (SDH) are those circumstances in which individuals are born, grow, work and age. They also pertain to all those forces and systems that affect those circumstances like the economic, social and development policies and the cultural norms. In general, also key are the political systems that regulate how wealth and power, prestige (status) and (natural) resources are distributed globally, nationally and locally. From a more formal perspective, the social determinants of health are the structural components of a major model of causality arrived-at to specifically explain and understand (give a rational basis) to our observations and actions with regards to the health of a population at multiple levels and contexts, i.e. how these factors determine health and well-being. This new eco-epidemiological paradigm recognises the social and historic determination of health centred around risk factors that cannot be ignored and, particularly, recognising the distributive inequality of the opportunities to succeed in achieving good health outcomes. The SDH paradigm replaces the obsolete paradigm under which our observations about the interactions between the physical and social environments are considered “difficult to frame and to appropriately match”. (Oscar Mujica, PAHO)