Realizing the Universal Right to Health

The Platform for a Framework
Convention on Global Health:
Realizing the Universal Right to
June 2014
 Why a global health treaty based in the right to
 The Framework Convention on Global Health (FCGH)
 The Platform for an FCGH
 The FCGH and the Sustainable Development Goals
 Get involved: Join the Platform for an FCGH
Why a global health treaty
based on the right to health?
Global and national health inequity
Health inequities
• Life expectancy in high-income countries (2012): 79 years
 Japan: 84 years
Life expectancy in low-income countries (2012): 62 years
• Sierra Leone: 46 years
Domestic inequities
 Life expectancy in the United States (2012): 79 years
 Life expectancy of Native Americans on the Pine Ridge Reservation in South
Dakota: upper 40s
 Under-5 mortality in India – top wealth quintile: 39/1,000
 Under-5 mortality in India – bottom wealth quintile: 117/1,000
 Under-5 mortality, global median – top wealth quintile: 50/1,000
 Under 5 mortality, global median – bottom wealth quintile: 102/1,000
International law outside the health
sector: Undermining the right to health?
 Intellectual property regime impedes access to medicine
 Added danger of TRIPS-plus bilateral and regional agreements
 Investment treaties enable corporations to challenge public
health regulations
 Trade treaties open foreign markets to cheap, unhealthy food
displacing local, healthier produce
 International narcotic regime impedes access to medicines
necessary to control pain
 The voluntary nature of the WHO Global Code of Practice on the
International Recruitment of Health Personnel may not prevent
recruitment from countries experiencing critical health worker
Accountability and claiming the right
to health
 Despite international right to health commitments of all
countries, implementation remains poor in many countries
 Populations, particularly those marginalized, are often
unable to participate in policy decisions affecting their
 Local health accountability mechanisms are frequently
non-existent or poorly functioning
 Discrimination against women, people with disabilities,
sexual minorities, and others, in and out of the health
sector, remains common, violating their right to health
Accountability and health financing
 Most higher-income countries do not adhere to global
commitment to international development assistance
 International health financing is often insufficiently
aligned with country strategies and systems
 Few African countries meet their 2001 Abuja
Declaration pledge of at least 15% of national budgets
being allocated to the health sector
Further benefits
 Establish model for equitable, accountable global
 Respond to growing demands of societies t0 reduce
 Contribute to economic productivity and growth
 Build national public health capacities contributing to
global health security
A Framework Convention on
Global Health
Overview of the Framework
Convention on Global Health
 Proposed global treaty based on the right to health and aimed at
national and global health equity
 Legally binding
 As framework convention, the initial treaty would be followed
by protocols (separately ratified) with greater detail on certain
issues or responding to unaddressed or emerging issues
 Financing, research and development, health worker migration?
 Could be adopted by the United Nations or World Health
 Would set forth a right to health for the 21st century
 Address right to health in a globalized world requiring
international responsibilities
 Respond to implementation shortcomings
Key elements of the FCGH
 Robust universal health coverage
 Include universal coverage for public health (such as clean water, adequate sanitation, healthy
environments, nutritious food)
 Could set global standards with national adaption through inclusive process
 Move towards system where level of coverage does not depend on wealth or other status
 Truly universal
 Domestic and international financing framework
 Align with national health strategies and systems
 Address social determinants of health
 Ensure other legal regimes (e.g., trade, investment, intellectual property, migration)
respect and promote right to health
 Ensure other sectors respect and promote right to health (Health in All Policies)
 Enforceable norms on transparency, participation, and other aspects of accountability
to empower people and civil society to assert and secure the right to health and
related rights
 Clarify responsibilities for ensuring transnational corporations respect right to health
 Strong mechanisms for monitoring compliance, including rigorous monitoring and
reporting and innovative incentives and sanctions
More FCGH features
 Right to health impact assessments to determine compliance with right for
health in health and non-health sector policies and projects
 Principles to enhance collaboration between health and other sectors to
advance the social determinants of health
 Health accountability strategies addressing community to global levels
 Standards on equitable financing and other measures to ensure equal access to
health care and public health interventions, including to overcome barriers for
disadvantaged populations
 Non-discrimination, including outside health sector in ways that undermine
right to health
 Requirements on transparency, public participation (including marginalized
communities), and effective accountability policies and mechanisms
 Ensure justiciability of right to health (can use courts to realize right to health)
 Right to health education for public, media, government, lawyers, judges,
health workers and other measures to enable people to claim their right to
 Empower WHO for global health leadership
More FCGH possibilities
 Right to health capacity-building funding mechanism to support NGOs,
government institutions, and others building public understanding of and
advocating for the right to health, and incorporating it into policies and
 Multi-sector forum with strong civil society participation to help integrate the
right to health into various international legal regimes
 National health equity strategies with action plans for equity for each
marginalized community
 Global Fund for Health for health care and public health interventions
 New accountability mechanisms such as increased number of regional human
rights special rapporteurs focused on equity, participation, and accountability
 Establish clearer standards for key elements of right to health
 “maximum of…available resources,” progressive realization, “highest attainable
standard of physical and mental health”
 Make binding key elements (such as participation and emphasis on marginalized
populations) in authoritative General Comment 14 of Committee on Economic,
Social and Cultural Rights
The Platform for a Framework
Convention on Global Health
Overview of the Platform for an
 Global steering committee directs overall strategy and
serves the needs of regions and national platforms
 Present interim steering committee
 Developing more democratic structure for future
 Possibility of future global advisory board
 National FCGH platforms
 Regional coordination
National FCGH platforms and
regional coordination
 National FCGH platforms
 Raise awareness about and advocacy for the FCGH at national
 Organize contributions to FCGH content at national level
 Regional coordination
 Ensure national platform content contributions feed into
global content development
 Coordinate national advocacy possibilities and actions with
global advocacy strategy
 Develop and work with national platforms to execute regional
FCGH activities and actions
The Framework Convention on
Global Health and the Sustainable
Development Goals
The FCGH and the Sustainable
Development Goals
 Sustainable Development Goals (SDGs) will set health and
development agenda 2015-2030
 FCGH addresses multiple expected SDGs
 Health, clean water, adequate sanitation, nutritious food
 Themes of equity, participation, accountability, human rights
 FCGH Platform seeking UN SDG declaration expected in
September 2015 to include process to launch an FCGH
 Calling for UN Secretary-General and WHO Director-General
to form a multi-stakeholder working group to evaluate the
value and benefits of, and propose the key principles, core
content, and scope of, the FCGH
Need for an FCGH in the context of the
SDGs: Governance and accountability
 Legally binding agreement with treaty compliance and national
accountability measures would provide stronger accountability in healthrelated areas than SDGs
 Capacity building measures for the right to health that empower people to
claim the right and governments to implement the right would advance
health aspects of the SDGs
 FCGH would fill in gaps in GGH governance in addition to accountability
 Intellectual property law and access to medicine and other medical
 Trade, such as in cheap and unhealthy foods that can displace healthier, local
 Health worker migration
 Research and development
 Investment treaties and protecting national health regulations
 Right to health assessments and other measures would protect and
promote health outside health sector
Need for an FCGH in the context of
the SDGs: Equity and financing
 Equity
 Ensuring universal health coverage is non-discriminatory with respect to all
populations, including frequently excluded (e.g., irregular migrants)
 Population-specific health equity strategies, participatory requirements, and
more to enhance health equity
 Universal health coverage that does not depend on level of a person’s wealth
 Ensure equitable approach and special concern for marginalized groups
through health and related SDGs
 Financing
 Develop binding domestic and international financing framework, ensuring
funds to support health-related SDGs
 Ensure equitable distribution of health financing
 Taxation, capital flight measures, innovative financing, capacity building to
increase resources for health and development
Get involved: Join the Platform for
a Framework Convention on Global
Take action
 Endorse the FCGH Platform statement
 Offer your views on the FCGH and the platform
 Join or initiate your national FCGH platform
 Circulate national sign-on letter on SDGs and FCGH
 For more information: [email protected]
“the right of everyone to the
enjoyment of the highest
attainable standard of physical and
mental health….”
Thank You

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