How does the right to health relate to the sustainable development goals?
The Sustainable Development Goals (SDGs) address the major challenges the world faces, including those related to poverty, inequality, climate, environmental degradation, prosperity, and peace and justice. The Goals interconnect and in order to leave no one behind, it is important that we achieve each Goal and target by 2030.
The August 2016 report of the Special Rapporteur on the Right to Health to the UN General Assembly [1] states that health is a central part of the SDGs, since it is both an outcome and a prerequisite for the reduction of poverty and the achievement of development goals at the global level. SDG Goal 3 (“ensuring healthy lives and well-being for all at all ages”) is highly dependent on the implementation of the goals of the 2030 Agenda for Sustainable Development, and it is also a vital element leading towards the successful implementation of these goals through the principles of equity, non-discrimination, and equality. The underlying determinants and targets of Goal 3 are indivisible from and interdependent on the following SDGs:
- Poverty eradication (Goal 1)
- Food security and nutrition (Goal 2)
- Inclusive and equitable quality education (Goal 4)
- Gender equality (Goal 5)
- Sustainable water and sanitation (Goal 6)
- Reducing inequalities within and between countries (Goal 10)
- Making cities and settlements safe (Goal 11)
- Climate change and access to energy (Goal 13)
- Peaceful and inclusive societies, access to justice, and inclusive and accountable institutions (Goal 16)
- Global partnerships (Goal 17)
What are the current weaknesses of the SDGs when viewed from a human rights perspective?
According to the Special Rapporteur’s 2016 report, the weaknesses that stand in the way of fulfilling the obligations of the right to health and related human rights are reflected in a ‘flawed’ approach that does not recognize the vital importance of the values of equity, non-discrimination, equality, and accountability. Prior to the implementation of the Sustainable Development Goals Agenda, the Millennium Development Goals further deepened the gap of inequalities within and between countries by pushing vulnerable populations further towards precarity and marginalization.
Currently, many of the targets and indicators developed within the SDGs to guide states to achieve the principles of equity, non-discrimination and equality are vague, and they fail to clearly map the synergies between all related SDGs. The 2030 Agenda also lacks accountability requirements and a clear guidance framework for the successful implementation of these goals. This lack of clarity is also reflected in the failure to demonstrate commitment and offer guidance on the transformation of the global financial system to support the health-related SDGs.
How can the right to health framework contribute to the effective implementation and achievement of the health-related SDGs?
The report suggests that the standards and obligations embedded in the right to health legal framework, in particular equity, non-discrimination, equality, participation, and accountability, should be integrated into the body of health-related SDGs to support their progress towards successful implementation. The right to health framework is a highly relevant and powerful guiding tool for the effective achievement of the health-related SDGs.
First, using this framework would clearly address all underlying health determinants and targets, such as the promotion of social and psychosocial wellbeing, the promotion of mental health (target 3.4) and the reduction of communicable and non-communicable diseases (target 3.3 and 3.4). In addition, the framework would support and be supported by the health-related goals, including access to water and sanitation (Goal 6), education (Goal 4), decent work (Goal 8), food (Goal 2), peace (Goal 16), access to energy (Goal 13), gender equality (Goal 5), and reduced inequalities (Goal 10).
Integration of the right to health framework into the SDGs would ensure the prioritization of resources for health and provision of equal access to good quality and adequate healthcare goods, services, and facilities that should be financially and geographically accessible based on the principle of non-discrimination. This principle is relevant to many targets of the SDGs, such as the commitment to increase training and recruitment of health workers in the developing world to promote Universal Health Coverage. The SDGs are highly dependent on integrated and effective health systems, and the implementation of the right to health framework would ensure that these systems are based on the human rights principles of equality, transparency, accountability, participation, empowerment, and access to information.
The core obligations of the framework would significantly support health-related goals within the 2030 Agenda through the introduction of accountability and monitoring measures, the improvement and transformation of national and subnational policy environments, and the adoption or amendment of laws that ensure the implementation of consistent and viable health strategies in support of the core principles of equity, non-discrimination, and equality.
Which groups are especially vulnerable with regards to fulfilling SDG Goal 3?
A 2017 resolution by the Human Rights Council states that achieving Goal 3 is still very far away for women and girls.[2] Other specific groups such as children, indigenous people, the elderly, people with disabilities, people living with HIV, and people of African descent still face ‘multifaceted’ forms of discrimination in their right to health and healthcare. People with mental or psychosocial health problems still have to deal with stigma, prejudice, violence, segregation, unlawful or arbitrary institutionalization, and over-medicalization. Among the health concerns mentioned in the resolution are the high mortality rate among women, girls, and children under the age of 5, and the inability to provide affordable access to safe and effective healthcare services, such as vaccines, for at least one third of the world’s population, especially for vulnerable and marginalized groups.
The resolution stresses the need to encourage the participation of women in decision-making processes in the health sector and urges states to cooperate with international organizations and civil society to guarantee the right to health for all. States must also focus their policies and laws on achieving all health-related goals; they are urged to increase citizens’ involvement in increased accountability and to involve people in vulnerable situations in the design, implementation and monitoring of any laws, policies or programmes developed to serve this population’s healthcare needs. A report issued in 2018 by the United Nations High Commissioner for Human Rights provides some examples of good practices in this regard [3].
This page was written by Somaya Bahji in May 2019.
Notes
[1] Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health. Annual report of the Special Rapporteur to the UN General Assembly, 2016.
[2] The Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health in the Implementation of the 2030 Agenda for Sustainable Development. Resolution adopted by the Human Rights Council on 23 June 2017.
[3] Contributions of the right to health framework to the effective implementation and achievement of the health-related Sustainable Development Goals. Report of the United Nations High Commissioner for Human Rights, 2018.