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Statements Office of the High Commissioner for Human Rights

Global Challenges to Human Rights

Right to health

12 April 2017

Speech by Zeid Ra'ad Al Hussein, UN High Commissioner for Human Rights, delivered at Johns Hopkins Centre for Public Health and Human Rights

12 April 2017

Ladies and gentlemen,

What a moment to return to my first, and formative, university. I am trying to cast myself back to 30 years ago – when I was here in Baltimore anticipating but not knowing what I might do with my own small life; that I next would return as the UN Human Rights chief could not have been further from my mind. That I would return at a time of such tumult, failure and urgency for the defence of human rights? Not my most maudlin of musings would have foretold to me such a future. You just don’t know and you never know for sure.

To be speaking here - at one of the few universities worldwide to give prominence to this field, with Hopkins establishing in 2004 a centre for health and human rights here at the Bloomberg School of Public Health – it makes me wonder if I am not the unwitting accessory of a Hopkins conspiracy to dominate human rights! A Jason Bourne of human rights, minus the looks! It’s a cunning plan, which I more than support – assuming I have a choice!

But today’s challenges to human rights are not the stuff of cinematic fiction, although dizzying they are, in their scale and complexity. Nor will our success in the face of these attacks on human rights be thanks to the quest of some singular testosterone-d hero. To the contrary, our futures globally are intertwined, mutually dependent. It’s up to all of us to reach out to include each of us, to work together for our mutually assured dignity, not destruction. And that is a quest for the truly brave.

For conflicts are tearing apart nations and communities, destroying individual destinies – particularly in my home region, the Middle East. There and elsewhere leaders are violating, or undermining, global values – essential, longstanding, hard won international agreements and law. Law!

Inconvenient to prowling power, as it is designed to be, international law enshrines global values - foundational undertakings to uphold the equality of all human beings; to respect the universality of human rights; to use multilateral processes and work together to seek solutions to global problems. International human rights law, refugee law, humanitarian law, criminal law: these are the bedrock pledges of countries the world over – on which depend, even in time of war, the barest minima of humanity.

But today, States which wrote and agreed to these laws are increasingly challenging their fundamentals" or "increasingly seek to undermine, or even overthrow, these fundamental human rights standards. I speak of such matters not to deflate, or ignite. I am seeking neither your despair nor your ire. However, I do want to reveal to you a little of the symptomatology of what I consider to be now a global malaise – thanks to impacts and consequences of where and when power is at its most pernicious, at its most cruel.

The intensifying fighting in Syria, over more than six years has for the warring sides meant stooping to such low levels of depravity as to attack civilians and civilian objects, which are protected in law. In the last year, 336 attacks were reported against medical centres alone. So vicious and seemingly intentional are these attacks by the parties to the conflict that some say a clinic is now the most dangerous place to be in Syria.

Health-workers and ambulance personnel have been disappeared, abducted, tortured, killed. A report by the Safeguarding Health in Conflict Coalition, to which Johns Hopkins contributed, found that 27% of the health-workers killed in Syria in 2015 were shot, executed, or tortured to death. Humanitarian workers are prevented from bringing in essential medical supplies, even food, to the hundreds of thousands of people confined in besieged areas, all in direct violation of international law. Last week's aerial attack on civilians close to Idlib, which exposed them to prohibited chemical agents, also brought horrific consequences, yet again, to first responders and medical personnel.

Most – but not all – these attacks appear to have been committed by the Syrian government and its allies, as is the case with civilian casualties at large.

A report in the Lancet last month termed these sorts of attacks the "weaponisation" of health-care –the deliberate “booby-trapping” of people's need for medical care so that terror, indignity and agony might be all the more widespread. That violent extremists should do this is appalling enough; for governments to violate the principles of distinction, precaution and proportionality is just mind-numbing.

Yet civilian infrastructure and those who seek its protection – including medical facilities and health personnel - have come under armed attack recently in numerous conflicts. Last month's prolonged assault on a hospital in Kabul, Afghanistan was yet another horrific example. Under international law, medical facilities, health personnel and ambulances enjoy protective status. This obligation has also been ignored in the context of conflicts in Yemen, South Sudan, Ukraine and the Central African Republic.

Even in the midst of war, rules matter. In disregarding those rules, governments fighting Da’esh and other violent extremist groups on their territories could eventually become almost indistinguishable from their targets. Perhaps not matching individual acts of barbarism, so brutal is Da’esh, over time the differences will narrow in the memory of the affected peoples.

Are the many reports of torture including sexual violence, perpetrated by medical personnel in military hospitals in Syria so different from what we hear from detention facilities under Da’esh control?

What do we make of the extent of these cruelties in the first place? Can we properly understand them?

Overall revulsion at what the Nazi’s perpetrated was best described in the Nuremberg Tribunal’s judgement at the concluding session of the Einsatzgruppen trial in 1947, which expressed the barely comprehensible in these terms: "we have here participation in a crime of such unprecedented brutality and of such inconceivable savagery that the mind rebels against its own thought image and the imagination staggers in the contemplation of a human degradation beyond the power of language to adequately portray."1
The mind rebels against its own thought image. When faced with depths of human wickedness which, while sui generis in the case of the Einsatzgruppen, nonetheless find a chilling echo in conflicts everywhere, maybe it is all beyond our reasoning to fully understand this. But what we do know is this: if we are ever to prevent the repetitive surging of grievance and violence, there must be accountability and justice.
Last year, in response to the hideous siege of Aleppo, and six years of paralysis in the Security Council on the issue of criminal accountability for atrocities in the Syrian conflict, the UN General Assembly passed a resolution calling for the creation of an international, impartial and independent mechanism on international crimes in Syria. It was an unprecedented action by the Assembly. This mechanism – which my Office is establishing – will collect, consolidate, preserve and analyse evidence of most serious crimes, and seek to match that with individual suspects, in preparation for criminal investigations and prosecutions.
This work is absolutely essential, and demands the broadest possible support, because there will be resistance to it.
Contempt for international humanitarian and human rights law is being peddled by its champions as somehow muscular, robust, necessary. It is not that – not at all. It is only callous, myopic and foolhardy. Ultimately, it is self-defeating.
By dismantling the rules-based system in favour of political expediency, governments just eat away at the very underpinnings of our common humanity. They pull out the very pins holding global peace together. In such withering, there is no north or south, nor east or west – there is no right or left. There is only the humane and the inhumane.
Visible symptoms of governments who, under pressure would willingly shed justice, sign-post these descents into a chaotic world. Symptoms such as:

  • Widening of restrictions on fundamental freedoms of association and expression – squeezing the life out of democratic space in which voices of protest should be raised and participation in decision-making assured.
  • Targeting of racial, religious and gendered minorities and attacks on migrants – through campaigns waged to stoke hatred and divisiveness for political profit.
  • Restrictions on the rights of women and girls to make their own choices about their bodies and their sexual and reproductive health.
  • Ill health and disease left to thrive at the intersections of chronic poverty, discrimination and inadequate public services;
  • Urbanization that is not planned properly, and development that fails to consider the views of vulnerable groups or the impacts on indigenous persons,

These are the symptoms of sickening political and economic cultures evident in many countries whose political fabric is becoming more venomous, more intolerant, more hysterical and more untruthful.

To put it differently. Where States are unable or are unwilling to uphold human rights, they are laying the groundwork for social degradation and ill-health to intensify, and become active threats to human dignity, life and sustainable, peaceful development.

Nowhere is this more evident than in regards to the rights of women and girls. Principal actors for positive change in every society, yet almost every community is held back by irrational and damaging obstacles placed in the way of their rights. Preventable maternal and infant mortality is a particularly brutal expression of this injustice.

Hundreds of thousands of women and newborns die each year from entirely preventable causes related to pregnancy and childbirth.

As Mahmoud Fathalla, former president of the International Federation of Obstetricians and Gynecologists, has said:

 "Women are not dying of diseases we can't treat... They are dying because societies have yet to make the decision that their lives are worth saving."

Gains have been made in the past decade, but if a steady focus on human-rights based action is not maintained, these will readily be reversed. According to several recent studies, maternal mortality is moving in the wrong direction, even in a country as wealthy as the United States -- with higher rates of death among African American women in particular.

Friends, the complaint will not be our cure. The damage done from a lack of rights will not find a balm in the further denial of rights. And that is why we must uphold human rights.

Centuries of human folly and suffering paved the evolution of human rights. And emerging from tyranny, bloodshed and war, the Universal Declaration of Human Rights with its offspring - the two great international covenants and eight other core human rights treaties – have fostered what is today a whole ecosystem of rights, creating standards to be respected by all.

Because this system is now broadly under attack, we need, all of us, to become human rights brawlers, seeking to secure what rights we do not yet have, and protect those we already enjoy. We simply cannot stand by as universal values, and the multilateralism on which they depend, are tossed aside. Universities must pitch in and not just through scholarly exchanges, but publicly, as advocates, in the media and on the Internet.

Tolstoy thought it a mistake to look back at history as if it were a series of clear decisions and sharply defined turning points. Human experience is always a blur of shifting events, in which half-aware actors never fully grasp that they are making irreversible choices. Only with hindsight can we see with clarity that at some specific moment they teetered on the cusp of tragedy – still able to pull back, but then, caught up in a lethal churn of events, they blindly and tragically swept on.
Today, I see people the world over standing up to defend and uphold the human rights including the right to health.
But they cannot do that alone. They need us – all of us, here in this room, in this university, in all universities, in Parliaments, at home, and every sphere of life.

I know Johns Hopkins has participated in a number of recent amicus briefs on behalf of foreign students in this country. But we need more from you.

All of us need to be human rights defenders.

Doctors who provide dignified access to care regardless of a patient’s identity or social status.

Lawyers who cherish the impartial, independent rule of law, including equality before the courts.

Journalists and students who seek face, prize evidence, protect knowledge and diversify the voices which we hear.

Scientists who pursue knowledge without political bias, fear or favour, and who deploy its wonders to help a planet under strain and people enduring extreme suffering.

Innovators and creators who strive to replace unfairness and exclusion with more equal, inclusive and sustainable solutions.

Artists who disturb, provoke, illuminate and enchant.

Philosophers who challenge ancient practices of cruelty against each other.

Economists who seek a more just distribution of wealth.

Workers for rights rather than consumers of entitlements.
And all as dissidents who will speak the truth in the widening catacombs of lies, not for our own elevation but for the sake of that which we know to be true. Because it is right; and because it is in our very real interest to do so.
Some weeks ago, it was reported that this winter, a crack began accelerating across one of the four largest ice shelves in Antarctica. Parts of the crack across the Larsen C shelf are now two miles wide, over 100 miles long, and the massive force prising apart this immense expanse of solid ice is picking up speed. Soon Larsen C will break apart – because, like everything else, ice really is not as solid as we might wish it to be. And once Larsen C has broken and splintered, the glaciers behind it will be exposed – vulnerable to even greater and more catastrophic collapses.

The global institutions that protect us against chaos are cracking, abetted by withdrawals of membership, threatened withdrawals, the withholding of funding; they are splintering deeper by the day. If they break, the price paid by humanity could well be so profound, we could be placed beyond recovery. That price has already been paid by far too many. And none of us will find peace, development, dignity, safety, if we stand by and allow the human rights of the people – of all the people ­– to be trampled upon.
So, stand up we must – now, before it is too late. We must march in protest, and advocate, and push forward. We must care, now, for each other – actively, passionately, utterly and we must all be brave.

1 Nuremberg Military Tribunal (vol. IV), p. 412.