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08 May 2000
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CESCR
22nd Session
8 May 2000
Morning
The Committee on Economic, Social and Cultural Rights this morning started its consideration of a draft general comment on the right to health -- a right stipulated in article 12 of the International Covenant on Economic, Social and Cultural Rights.
Deputy United Nations High Commissioner for Human Rights, Bertrand Ramcharan, said it was important to have a concrete monitoring mechanism to gauge how the right to health was being implemented in a country. A State party, he said, must be able to show, in relation to each right, that the right was recognized in the national legal order of the country. There had to be a component that watched over the achievement of the right to health in a State, Mr. Ramcharan said. There was a tendency in human rights today to think that a policy of good intentions or a policy of pious statements was adequate. But they were not good enough.
Introducing the draft text, Committee expert Eibe Riedel explained that it dealt with the normative comment and States parties obligations, as well as violations of the right to health, and the implementation of the right at the national levels. He added that while issues such as medical ethics or bio-medicine in human rights could have been addressed in the draft general comment, that temptation had to be resisted. Those issues would and should be addressed in other forums soon.
Daniel Tarantola, Senior Policy Advisor to the Director-General of the World Health Organization, said WHO had a difficult time in collecting health indicators. Some indicators, he said, reflected different health trends, but different countries used different instruments, and comparisons could not be made. He explained that WHO had begun a programme two years ago to identify health indicators, whether they were from routine demographic and health surveys, or other kinds of studies. The need to look at disparity in health in countries was very important, he said.
Other speakers raised issues ranging from the right to public health information to special protection concerning the right to food.
The United Nations Educational, Scientific and Educational Organization (UNESCO) and the United Nations Children’s Fund (UNICEF) addressed the Committee, as did the following non-governmental organizations (NGOs): FIAN International, Habitat International Coalition and the Commonwealth Medical Association.
The Committee regularly adopts general comments on the various articles of the Covenant to help States parties better understand and implement the provisions of the treaty.
When the Committee reconvenes at 3 p.m., it will continue its consideration of the draft general comment.
Discussion
BERTRAND RAMCHARAN, Deputy United Nations High Commissioner for Human Rights, said it was feared that the concreteness of the Covenant had been lost sight of in recent years. There had been a number of reports about how to implement the provisions of the Covenant. But the quest for concreteness was the challenge for this Committee. A State party must be able to show, in relation to each right, that the right was recognized in the national legal order of the country. There had to be a component that watched over the achievement of the right to health in a State. There was a tendency in human rights today to think that a policy of good intentions or a policy of pious statements was adequate. But they were not good enough. All parties had to map concrete paths toward the fuller enjoyment of human rights. One must be able to watch and monitor the progress as it unfolded.
EIBE RIEDEL, Committee expert and rapporteur to the general comment, said the draft general comment on article 12 had a long history, beginning in 1993. Initially, it was hoped the comment would be shorter, but the complexity of the issue forced it to be otherwise. This draft interpreted existing legal provisions in article 12 of the Covenant. While it could have addressed new issues such as medical ethics or bio-medicine in human rights, and while such topics were important and should be addressed soon, the temptation to do so in this comment had to be resisted. This was not the proper place to do that. This draft closely followed the drafting outlines as adopted by the Committee last year, and dealt with the normative comment, as well as States parties obligations. Other parts addressed violations and implementation at the national level.
DANIEL TARANTOLA, Senior Policy Adviser to the Director-General of the World Health Organization, said many people at WHO would use this general comment to learn more about health and human rights. WHO defined health for the practice of health practitioners, while article 12 had to define it in the context of the Covenant. So WHO would have to look beyond article 12 when discussing health and human rights. There was a gap between developing countries and the richest countries, so when setting the goals in the health and human rights terms, States should be made aware that they had to provide the most progressive standards of health. Concerning health promotion,it was welcomed in the draft general comment. One of the reasons its inclusion was so essential was because health promotion was not in article 12, the drafting of the article preceded the commitment to promotion by about 12 years. WHO had a difficult time in collecting indicators. Some reflected different health trends, but different countries used different instruments, and comparisons could not be made. About two years, WHO had again started to try to identify indicators, be they routine demographic and health surveys, or other kinds of studies. The need to look at disparity in health in countries was very important.
ANNAR CASSAM, of the United Nations Educational, Scientific and Cultural Organization (UNESCO), said the right to health was an international obligation. The gap between the rich and the poor was getting wider, and there was also a dichotomy between the capacity of the State and the private sector. It was the responsibility of the State to make sure that those who did not have access to the right to health were protected. It was UNESCO's job to make sure that economic, social and cultural rights were understood. The general comment was a document of good governance.
LESLIE MILLER, of the United Nations Children’s Fund (UNICEF), said the organization was pleased to see the emphasis in the draft general comment on equity and non-discrimination for the poorest and most marginalized populations. The general principles of the Convention on the Rights of the Child should be taken into consideration when considering the right to health. The right to access public health information was an important right to have.
MICHAEL WINDFUHR, of FIAN International, said the general comment was an excellent piece of work, and the organization was grateful that the Committee was starting to consider so many general comments. There were some parts which could be added or strengthened. Protection was an important element to the right of health -- for example, protection from bad food. FIAN also wanted to see a specific subcategory of vulnerable groups that had been excluded. There could also be reference to food additives and food quality.
MILOON KOTHARI AND JOSEPH SCHECHLA, of HABITAT International Coalition, said their organization primarily worked on housing and land rights, and it was pleased to see there were various mentions of housing, sanitation and water throughout the draft general comment. It could, however, be given its own section in the document. The number of people living in hazardous conditions was growing all the time, and it had severe implications on their health status. More and more people were being forced to live in life threatening conditions -- in flood zones and in earthquake zones. One of the problems in assessing the situation was the lack of data on the issue. Evictions and forced displacements also should be addressed in the general comment.
JOHN HAVAKD, of the Commonwealth Medical Association, said the requirement that health services should be provided with confidentiality should be included in the draft general comment.
General Comment
The draft general comment on article 12 of the International Covenant contains 49 paragraphs divided into normative contents and States parties' obligations and violations. With a view of assisting States parties' implementation of the Covenant and fulfillment of their reporting obligations, the draft general comment focuses on the normative content of article 12, some of the obligations arising from it, and some illustrative violations. The third part briefly remarks upon the obligations of actors other than States parties. The general comment is based on the Committee's experiences in examining numerous State party reports over many years.
Article 12 of the Covenant says States parties recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Parties agreed to take steps to reduce stillbirth and infant mortality rates, and to work towards the healthy development of the child, as well as improving all aspects of environmental and industrial hygiene, the prevention, treatment and control of epidemics, and the creation of conditions which would assure medical services and medical attention in the event of sickness.
The purpose of general comments was to assist States parties in fulfilling their reporting obligations in order to promote their further implementation of the provisions of the International Covenant. General comments also draw attention to insufficiencies disclosed in large numbers of reports and suggest improvements in reporting procedures.
In addition, general comments are intended to stimulate the activities of States parties and international organizations in the promotion and protection of economic, social and cultural rights. These comments should also be of interest to other States, especially those preparing to become parties to the Covenant. General comments thus strengthen the cooperation of all States in the universal promotion and protection of economic, social and cultural rights.
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22nd Session
8 May 2000
Morning
The Committee on Economic, Social and Cultural Rights this morning started its consideration of a draft general comment on the right to health -- a right stipulated in article 12 of the International Covenant on Economic, Social and Cultural Rights.
Deputy United Nations High Commissioner for Human Rights, Bertrand Ramcharan, said it was important to have a concrete monitoring mechanism to gauge how the right to health was being implemented in a country. A State party, he said, must be able to show, in relation to each right, that the right was recognized in the national legal order of the country. There had to be a component that watched over the achievement of the right to health in a State, Mr. Ramcharan said. There was a tendency in human rights today to think that a policy of good intentions or a policy of pious statements was adequate. But they were not good enough.
Introducing the draft text, Committee expert Eibe Riedel explained that it dealt with the normative comment and States parties obligations, as well as violations of the right to health, and the implementation of the right at the national levels. He added that while issues such as medical ethics or bio-medicine in human rights could have been addressed in the draft general comment, that temptation had to be resisted. Those issues would and should be addressed in other forums soon.
Daniel Tarantola, Senior Policy Advisor to the Director-General of the World Health Organization, said WHO had a difficult time in collecting health indicators. Some indicators, he said, reflected different health trends, but different countries used different instruments, and comparisons could not be made. He explained that WHO had begun a programme two years ago to identify health indicators, whether they were from routine demographic and health surveys, or other kinds of studies. The need to look at disparity in health in countries was very important, he said.
Other speakers raised issues ranging from the right to public health information to special protection concerning the right to food.
The United Nations Educational, Scientific and Educational Organization (UNESCO) and the United Nations Children’s Fund (UNICEF) addressed the Committee, as did the following non-governmental organizations (NGOs): FIAN International, Habitat International Coalition and the Commonwealth Medical Association.
The Committee regularly adopts general comments on the various articles of the Covenant to help States parties better understand and implement the provisions of the treaty.
When the Committee reconvenes at 3 p.m., it will continue its consideration of the draft general comment.
Discussion
BERTRAND RAMCHARAN, Deputy United Nations High Commissioner for Human Rights, said it was feared that the concreteness of the Covenant had been lost sight of in recent years. There had been a number of reports about how to implement the provisions of the Covenant. But the quest for concreteness was the challenge for this Committee. A State party must be able to show, in relation to each right, that the right was recognized in the national legal order of the country. There had to be a component that watched over the achievement of the right to health in a State. There was a tendency in human rights today to think that a policy of good intentions or a policy of pious statements was adequate. But they were not good enough. All parties had to map concrete paths toward the fuller enjoyment of human rights. One must be able to watch and monitor the progress as it unfolded.
EIBE RIEDEL, Committee expert and rapporteur to the general comment, said the draft general comment on article 12 had a long history, beginning in 1993. Initially, it was hoped the comment would be shorter, but the complexity of the issue forced it to be otherwise. This draft interpreted existing legal provisions in article 12 of the Covenant. While it could have addressed new issues such as medical ethics or bio-medicine in human rights, and while such topics were important and should be addressed soon, the temptation to do so in this comment had to be resisted. This was not the proper place to do that. This draft closely followed the drafting outlines as adopted by the Committee last year, and dealt with the normative comment, as well as States parties obligations. Other parts addressed violations and implementation at the national level.
DANIEL TARANTOLA, Senior Policy Adviser to the Director-General of the World Health Organization, said many people at WHO would use this general comment to learn more about health and human rights. WHO defined health for the practice of health practitioners, while article 12 had to define it in the context of the Covenant. So WHO would have to look beyond article 12 when discussing health and human rights. There was a gap between developing countries and the richest countries, so when setting the goals in the health and human rights terms, States should be made aware that they had to provide the most progressive standards of health. Concerning health promotion,it was welcomed in the draft general comment. One of the reasons its inclusion was so essential was because health promotion was not in article 12, the drafting of the article preceded the commitment to promotion by about 12 years. WHO had a difficult time in collecting indicators. Some reflected different health trends, but different countries used different instruments, and comparisons could not be made. About two years, WHO had again started to try to identify indicators, be they routine demographic and health surveys, or other kinds of studies. The need to look at disparity in health in countries was very important.
ANNAR CASSAM, of the United Nations Educational, Scientific and Cultural Organization (UNESCO), said the right to health was an international obligation. The gap between the rich and the poor was getting wider, and there was also a dichotomy between the capacity of the State and the private sector. It was the responsibility of the State to make sure that those who did not have access to the right to health were protected. It was UNESCO's job to make sure that economic, social and cultural rights were understood. The general comment was a document of good governance.
LESLIE MILLER, of the United Nations Children’s Fund (UNICEF), said the organization was pleased to see the emphasis in the draft general comment on equity and non-discrimination for the poorest and most marginalized populations. The general principles of the Convention on the Rights of the Child should be taken into consideration when considering the right to health. The right to access public health information was an important right to have.
MICHAEL WINDFUHR, of FIAN International, said the general comment was an excellent piece of work, and the organization was grateful that the Committee was starting to consider so many general comments. There were some parts which could be added or strengthened. Protection was an important element to the right of health -- for example, protection from bad food. FIAN also wanted to see a specific subcategory of vulnerable groups that had been excluded. There could also be reference to food additives and food quality.
MILOON KOTHARI AND JOSEPH SCHECHLA, of HABITAT International Coalition, said their organization primarily worked on housing and land rights, and it was pleased to see there were various mentions of housing, sanitation and water throughout the draft general comment. It could, however, be given its own section in the document. The number of people living in hazardous conditions was growing all the time, and it had severe implications on their health status. More and more people were being forced to live in life threatening conditions -- in flood zones and in earthquake zones. One of the problems in assessing the situation was the lack of data on the issue. Evictions and forced displacements also should be addressed in the general comment.
JOHN HAVAKD, of the Commonwealth Medical Association, said the requirement that health services should be provided with confidentiality should be included in the draft general comment.
General Comment
The draft general comment on article 12 of the International Covenant contains 49 paragraphs divided into normative contents and States parties' obligations and violations. With a view of assisting States parties' implementation of the Covenant and fulfillment of their reporting obligations, the draft general comment focuses on the normative content of article 12, some of the obligations arising from it, and some illustrative violations. The third part briefly remarks upon the obligations of actors other than States parties. The general comment is based on the Committee's experiences in examining numerous State party reports over many years.
Article 12 of the Covenant says States parties recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Parties agreed to take steps to reduce stillbirth and infant mortality rates, and to work towards the healthy development of the child, as well as improving all aspects of environmental and industrial hygiene, the prevention, treatment and control of epidemics, and the creation of conditions which would assure medical services and medical attention in the event of sickness.
The purpose of general comments was to assist States parties in fulfilling their reporting obligations in order to promote their further implementation of the provisions of the International Covenant. General comments also draw attention to insufficiencies disclosed in large numbers of reports and suggest improvements in reporting procedures.
In addition, general comments are intended to stimulate the activities of States parties and international organizations in the promotion and protection of economic, social and cultural rights. These comments should also be of interest to other States, especially those preparing to become parties to the Covenant. General comments thus strengthen the cooperation of all States in the universal promotion and protection of economic, social and cultural rights.
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