resenLed on !

une 21
sL
2014 ln SouLh asadena aL Lhe
LML8CLnC? uSA nauonal volunLeer Conference
!"!#$!%&' )*+ belleves access Lo
medlcal LreaLmenL ls a baslc and
lnallenable human rlghL.

Human rights:
are primarily about the relationship between the individual and the
state
are universal, interrelated and indivisible
imposes on governments the obligation to respect, protect and fulfill
human rights
International human rights law:
defines what governments can do to us, cannot do to us, and
should do for us
is meant to be equally applicable to everyone, everywhere in the
world, across all borders and across all cultures and religions
consists of the obligations that governments have agreed they have
in order to be effective in promoting and protecting our rights

uenlng 1erms: Puman 8lghLs
uenlng 1erms: PealLh


,-./01 .2 .3 .2456.783./ 98./: PealLh ls a sLaLe of compleLe physlcal, menLal and soclal
well-belng and noL merely Lhe absence of dlsease"
ConsuLuuon of Lhe World PealLh Crganlzauon, adopLed by Lhe lnLernauonal PealLh Conference, new ?ork, 19 !une-22 !uly 1946

,-./01 .2 .3 53206;<-30./ 98./: Lnsurlng Lhe condluons ln whlch people can be
healLhy=
lnsuLuLe of Medlclne, luLure of ubllc PealLh, Summary and 8ecommendauons, WashlngLon, uC: nauonal Academy ress, 1988 uS lnsuLuLe
of Medlclne

>30-63.783./ ,-./01: 1radluonally dened by Lhe relauons beLween sLaLes"
Lee k. LanceL World healLh: shaplng Lhe fuLure of global healLh cooperauon: where can we go from here?, "#$%&', vol. 331, no. 9106, pp.
899-902

$/8?./ ,-./01: 8elaLes Lo healLh lssues LhaL Lranscend nauonal borders, class, race,
eLhnlclLy and culLure. 1he Lerm sLresses Lhe commonallLy of healLh lssues and requlres a
collecuve (parLnershlp-based) acuon"
Clobal PealLh Lducauon Consoruum, 'Clobal vs. lnLernauonal,' hup://globalhealLhedu.org/ages/ClobalvslnL.aspx

,-./01 .2 . 65910: (1he rlghL of everyone Lo Lhe en[oymenL of Lhe hlghesL aualnable
sLandard of physlcal and menLal healLh"
un. Arucle 12, lnLernauonal CovenanL on Lconomlc, Soclal and CulLural 8lghLs, adopLed and opened for slgnaLure, raucauon and accesslon
by unlLed nauons Ceneral Assembly 8esoluuon 2200 A(xxl). new ?ork: unlLed nauons, 1966



Customary law
Consistent practice with a sense of legal
obligation
General Assembly Resolutions like the Universal
Declaration of Human Rights (UDHR) are
evidence of customary law they are not legally
binding
International agreements (treaties, conventions,
covenants)
Can serve as codification of international
customary law or be valid international law even if
no custom precedes it
Legally binding for countries who sign on to them
Sources and Evidence
of International Law
In 1945, human rights was set out as one of the purposes and
principles of the UN
Took human rights out of national concern and placed squarely into
international law spoke only of promotion, not protection
The Universal Declaration of Human rights (UDHR) is a
declaration, not a treaty. It has a special place in international
law and may have risen to the level of proof of customary law
The 2 Covenants further elaborate the rights set out in the
UDHR: International Covenant on Civil and Political Rights
(CCPR); International Covenant on Economic, Social and
Cultural Rights (CESCR)
The UN Charter, UDHR and 2 Covenants are often called the
International Bill of Human Rights
Over 25 other international human rights treaties exist that
further elaborate the concepts set out in the International Bill
of Human Rights
Modern Human Rights Law
Fundamental Values Underpinning
Human Rights
Respect for the physical and mental integrity of
the person
Respect for individual autonomy, including
personal and group self-determination
Guarantees of the material conditions of
existence necessary to lead a productive and
fulfilling life
Equality and non-discrimination
lnLernauonal Puman 8lghLs uocumenLs
8elevanL Lo PealLh
1948: unlversal ueclarauon of Puman 8lghLs (uuP8)

"#$%&$'( "&)#**+ ,-$.-$) /$ $#0/$1 '2#' 2#3& 4#05&.

1963: lnLernauonal Convenuon on Lhe Lllmlnauon of All lorms of 8aclal
ulscrlmlnauon
1966: lnLernauonal CovenanL on Lconomlc, Soclal, and CulLural 8lghLs
1966: lnLernauonal CovenanL on Clvll and ollucal 8lghLs
1979: lnLernauonal Convenuon on Lhe Lllmlnauon of All lorms of
ulscrlmlnauon AgalnsL Women
1983: Convenuon AgalnsL 1orLure
1990: Convenuon on Lhe 8lghLs of Lhe Chlld
2000: Convenuon on Lhe roLecuon of MlgranL Workers and Lhelr lamllles
(2006) Convenuon on Lhe 8lghLs of ersons wlLh ulsablllues
(2006) lnLernauonal Convenuon for Lhe roLecuon of All ersons
AgalnsL Lnforced ulsappearances

Human Rights Relevant to Health
The right to life, survival, and
development
The right to equality and
non-discrimination
The right to travel
The right to bodily integrity
and security of the person
The right to an identity
The right to privacy
The right to seek, receive
and impart information

The right to food
The right to housing
The right to social security
The right to be free from
torture
The right to association
The right to the benefits of
scientific progress
The right to education
The right to health

>3 #-@ are lLems dlrecLly relevanL Lo Lhe programs
and lnluauves LML8CLnC? uSA supporLs
Further Defining The Right to Health
As stated by the UN Committee on Economic, Social,
and Cultural Rights, bringing human rights into health
programming includes ensuring the
availability,
accessibility,
acceptability and
quality of health services; and
ensuring attention to the underlying determinants of health, such
as access to safe and potable water and adequate sanitation, an
adequate supply of safe food, nutrition and housing, and healthy
occupational and environmental conditions


Human rights, such as the right to the highest attainable
standard of health, are understood to be progressively
implemented by the state to the maximum of its available
resources.
States must take steps, individually and through international
assistance and cooperation, especially economic and technical,
to the maximum of its available resources, with a view to
achieving progressively the full realization of the rights
recognized in the [Economic, Social, and Cultural Rights]
covenant by all appropriate means, including particularly the
adoption of legislative measures. ICESCR, Art 2 (1)
Progressive Realization
credibility stems from impartial application of universal
norms
methods of work relevant to health include:
research
legal representation
publicity
training
investigation
provision of direct assistance
intervention at national and international level
lobbying
Human Rights NGOs
UN Mechanisms Overseeing Health-Related Human Rights
UNITED NATIONS HUMAN RIGHTS MECHANISMS
&1.60-6A?.2-@ ?8@5-2 B6-.0C ?8@5-2
General Assembly
Human Rights Council
Special Rapporteurs/Working groups
Country specific

B1- )% *4-D5./ #.44860-;6 83 01-
65910 08 1-./01

Sub-Commission on Protection and
Promotion of Human Rights
Human Rights Committee (HRC)
Committee on Economic, Social
and Cultural Rights (CESCR)
Committee on the Elimination of
Discrimination Against Women
(CEDAW)
Committee of the Rights of the
Child (CRC)
Committee on the Elimination of
Racial Discrimination (CERD)
Committee Against Torture (CAT)
Committee on Migrant Workers (CMW)
Thematic: e.g.
Accountability
What do we mean by it?
Who ensures it?
- National level courts
-International reporting mechanisms
(including treaty monitoring bodies)
- Media
- NGOs
- World Bank Inspection Panels etc..
A (the) Human Rights-Based Approach

The Genesis of (H)RBAs
Rights-based approach to child growth and development
(UNICEF 1990s)

RBAs in health and development programs (International
Organizations, NGOs!)
Human-rights based approach to development
programming (UNDP 1998)
UN Secretary General Kofi Annans
Definition of a RBA (1997)
A rights-based approach to development describes
situations not simply in terms of human needs, or of
developmental requirements, but in terms of society's
obligations to respond to the inalienable rights of
individuals, empowers people to demand justice as a
right, not as charity, and gives communities a moral
basis from which to claim international assistance when
needed.
UN Statement of Common Understanding of the
Human Rights-Based Approach to Development
(1)
1. All programmes of development co-operation, policies and
technical assistance should further the realisation of human
rights as laid down in the Universal Declaration of Human Rights
and other international human rights instruments.
2. Human rights standards contained in, and principles derived
from the Universal Declaration of Human Rights and other
international human rights instruments guide all development
cooperation and programming in all sectors and in all phases of
the programming process.
Human rights standards include the minimum level of programmatic and/or
policy-level activity necessary to be able to affirm that a right is being
fulfilled. For example, one of the minimum core obligations of the right to
health is that health facilities, goods, and services are available,
accessible, acceptable, and of high quality (3AQ).
UN Statement of Common Understanding (2)
3. Human rights principles are:
Universality and inalienability
Indivisibility
Inter-dependence and Inter-relatedness
Equality and Non-discrimination
Participation and Inclusion
Accountability and Rule of Law
4. Development cooperation contributes to the development of the
capacities of duty-bearers to meet their obligations and/or of
rights-holders to claim their rights.
Every individual is a rights-holder
Duty-bearers are primarily State actors and institutions at
various levels of government, and certain non-state actors
who have responsibilities to carry out in response to other
actors exercising their rights

In General, a HRBA!
Emphasises the process as well as the outcome of
programming
Draws attention to the most marginalized populations
Works towards equitable service delivery
Extends and deepens participation
Ensures local ownership of development processes
Strengthens the accountability of all actors
A Human Rights-Based Approach
to Health and Development
Intrinsic rationale: A HRBA is the right thing to do, morally and
legally.
Instrumental Rationale: A HRBA can lead to better and more
sustainable outcomes because it:
Has a special focus on groups subjected to discrimination
and suffering from disadvantage and exclusion;
Emphasizes participation;
Counts on the accountability of the State and its institutions;
Gives attention to the capacities and needs of both rights-
holders and duty-bearers, and thus fosters a lasting sense of
shared ownership in efforts to improve the communitys well-
being, and prepares the actors to work together in other ways to
address new challenges arising in the future.
)*)+,)-./( % +0123' 4%'$5 677#8%92:
Manifesto for a Human Rights Based Medicine

After the International Workshop Building Medicine in Africa. Principles and
Strategies hosted at San Servolo Island, Venice, Italy, on May 14 -15, 2008
and in accordance with the spirit and the principles of the
Universal Declaration of Human Rights, stating that
All human beings are born free and equal in dignity and rights (art.1)
Everyone has the right... to medical care (art.25)
The recognition of the inherent dignity and of the equal and inalienable
rights of all members of the human family is the foundation of freedom,
justice and peace in the world (Preamble)

WE HEREBY DECLARE
the Right to be Treated as a basic and inalienable right belonging to each
and every member of the human community.

WE THEREFORE ADVOCATE
the implementation of health systems and projects solely devoted to
preserve, extend and improve the life of the people in need and based on the
following principles:
Equality
Every human being has the right to be cured regardless his
economic and social condition, gender, race, language, religion
and opinions. Standards of health care, set by the progress of
medical knowledge, must be delivered equally and without
discrimination to all patients.

Quality
High quality health systems must be based on communitys
needs, up to date with the achievements of medical science, and
not oriented, shaped or determined by lobbies and corporations
involved in the health industry.

Social Responsibility
Governments must have the health and well being of their citizens
as their priority, and allocate adequate human and financial
resources. The services provided by health systems and
humanitarian projects in the health sector must be accessible to
and free of charge for all.
As PealLh AuLhorlues and PumanlLarlan Crganlzauons

E! #!&F$%>G!
LCS (LquallLy, CuallLy, Soclal responslblllLy) based healLh sysLems and pro[ecLs as
respecuul of human rlghLs, approprlaLe Lo develop medlcal sclence and eecuve
ln promoung healLh by sLrengLhenlng and generaung human, sclenuc and
maLerlal resources.

E! &F"">B
1o plan and develop LCS based pollcles, healLh sysLems and pro[ecLs. 1o
cooperaLe among us Lo ldenufy common needs ln Lhe healLh secLor and deslgn
[olnL programs.

E! +HH!+I
1o oLher PealLh AuLhorlues and PumanlLarlan Crganlsauons Lo slgn Lhls
ManlfesLo and Lo [oln ln promoung an LCS based medlclne. 1o donors and Lo Lhe
lnLernauonal ald communlLy Lo supporL, fund and paruclpaLe ln deslgnlng and
lmplemenung LCS based programs.
AfghanlsLan: SLaLus of 8aucauon
AfghanlsLan has raued Lhe followlng:
CL8u: Convenuon on Lhe Lllmlnauon of all forms of 8aclal ulscrlmlnauon
CC8: CovenanL on Clvll and ollucal 8lghLs
CLSC8: CovenanL on Lconomlc, Soclal and CulLural 8lghLs
CA1: Convenuon AgalnsL 1orLure
CLuAW: Convenuon on Lhe Lllmlnauon of All lorms of ulscrlmlnauon
agalnsL Women
C8C: Convenuon on Lhe 8lghLs of Chlldren
C8u: Convenuon on Lhe 8lghLs of ersons wlLh ulsablllues
noL raued:
CMW: Convenuon on Lhe roLecuon of Lhe 8lghLs of All MlgranL Workers and
Members of Lhelr lamllles
CLu: Convenuon for Lhe roLecuon of All ersons from Lnforced
ulsappearance
l8AC: SLaLus of 8aucauon
lraq has raued Lhe followlng:
CL8u: Convenuon on Lhe Lllmlnauon of all forms of 8aclal ulscrlmlnauon
CC8: CovenanL on Clvll and ollucal 8lghLs
CLSC8: CovenanL on Lconomlc, Soclal and CulLural 8lghLs
CA1: Convenuon AgalnsL 1orLure
CLuAW: Convenuon on Lhe Lllmlnauon of All lorms of ulscrlmlnauon
agalnsL Women
C8C: Convenuon on Lhe 8lghLs of Chlldren
CLu: Convenuon for Lhe roLecuon of All ersons from Lnforced
ulsappearance
noL raued:
C8u: Convenuon on Lhe 8lghLs of ersons wlLh ulsablllues
CMW: Convenuon on Lhe roLecuon of Lhe 8lghLs of All MlgranL Workers and
Members of Lhelr lamllles
CenLral Afrlcan 8epubllc:
SLaLus of 8aucauon
CA8 has raued Lhe followlng:
CL8u: Convenuon on Lhe Lllmlnauon of all forms of 8aclal ulscrlmlnauon
CC8: CovenanL on Clvll and ollucal 8lghLs
CLSC8: CovenanL on Lconomlc, Soclal and CulLural 8lghLs
CLuAW: Convenuon on Lhe Lllmlnauon of All lorms of ulscrlmlnauon
agalnsL Women
C8C: Convenuon on Lhe 8lghLs of Chlldren
noL raued:
CA1: Convenuon AgalnsL 1orLure
C8u: Convenuon on Lhe 8lghLs of ersons wlLh ulsablllues
CMW: Convenuon on Lhe roLecuon of Lhe 8lghLs of All MlgranL Workers
and Members of Lhelr lamllles
CLu: Convenuon for Lhe roLecuon of All ersons from Lnforced
ulsappearance
Sudan: SLaLus of 8aucauon
Sudan has raued Lhe followlng:
CL8u: Convenuon on Lhe Lllmlnauon of all forms of 8aclal ulscrlmlnauon
CC8: CovenanL on Clvll and ollucal 8lghLs
CLSC8: CovenanL on Lconomlc, Soclal and CulLural 8lghLs
CA1: Convenuon AgalnsL 1orLure
CLuAW: Convenuon on Lhe Lllmlnauon of All lorms of ulscrlmlnauon
agalnsL Women
C8C: Convenuon on Lhe 8lghLs of Chlldren
C8u: Convenuon on Lhe 8lghLs of ersons wlLh ulsablllues
noL raued:
CMW: Convenuon on Lhe roLecuon of Lhe 8lghLs of All MlgranL Workers
and Members of Lhelr lamllles
CLu: Convenuon for Lhe roLecuon of All ersons from Lnforced
ulsappearance
Slerra Leone: SLaLus of 8aucauon
Slerra Leone has raued Lhe followlng:
CL8u: Convenuon on Lhe Lllmlnauon of all forms of 8aclal ulscrlmlnauon
CC8: CovenanL on Clvll and ollucal 8lghLs
CLSC8: CovenanL on Lconomlc, Soclal and CulLural 8lghLs
CA1: Convenuon AgalnsL 1orLure
CLuAW: Convenuon on Lhe Lllmlnauon of All lorms of ulscrlmlnauon
agalnsL Women
C8C: Convenuon on Lhe 8lghLs of Chlldren
C8u: Convenuon on Lhe 8lghLs of ersons wlLh ulsablllues
noL raued:
CMW: Convenuon on Lhe roLecuon of Lhe 8lghLs of All MlgranL Workers
and Members of Lhelr lamllles
CLu: Convenuon for Lhe roLecuon of All ersons from Lnforced
ulsappearance
unlLed SLaLes: SLaLus of 8aucauon
1he u.S. has raued Lhe followlng:
CL8u: Convenuon on Lhe Lllmlnauon of all forms of 8aclal ulscrlmlnauon
CC8: CovenanL on Clvll and ollucal 8lghLs
CA1: Convenuon AgalnsL 1orLure
C8u: Convenuon on Lhe 8lghLs of ersons wlLh ulsablllues
noL raued:
CLSC8: CovenanL on Lconomlc, Soclal and CulLural 8lghLs
CLuAW: Convenuon on Lhe Lllmlnauon of All lorms of ulscrlmlnauon
agalnsL Women
C8C: Convenuon on Lhe 8lghLs of Chlldren (Lhe u.S. has slgned Lhe
Cpuonal roLocols C8C:CSC and C8C:CAC)
CMW: Convenuon on Lhe roLecuon of Lhe 8lghLs of All MlgranL Workers
and Members of Lhelr lamllles
CLu: Convenuon for Lhe roLecuon of All ersons from Lnforced
ulsappearance
AcknowledgmenLs:
Appreclauon Lo rofessor Soa Cruskln
lor permlsslon Lo adapL and use Lhe conLenL ln Lhls presenLauon

Source: uSC Sprlng 2014 Course
Clobal PealLh, Law and Puman 8lghLs

And 1hank ?ou
1o Lhe conference's speclal guesL presenLer
keely 8adger