Another Look at Health As a Human Right

(Photo credit: Hugo de C. (h de c @ flickr)

Let's for the moment forget the legal definition of human rights, and look at health-as-a-human-right from the perspective of a moral obligation, as commenter Jon Shaffer wants us to do. The first question is, of course, whether there is such a moral obligation. This is highly problematic, and depends greatly on how you define a moral obligation. Is it something ‘objective', external to ourselves, and more or less the same for everybody in the same situation in - becoming, in fact, a moral duty? Or is it ‘subjective', something that is relative and internal to us and that can change from person to person (and perhaps even from day to day)?

In the latter case, of course, there is no use discussing a generalised moral obligation to provide or assist with global health. However, if you see moral obligations as objective and general, the next questions to ask are whether there is such an objective moral obligation and, if so, what is its extent. The first question, concerning existence of a moral obligation to support and improve global health, is hardly disputed at all and would be supported by most people. The extent of this duty, however, is very much open to discussion. To give (and to a certain extent, caricaturise) two extreme but still valid points of view:

• Many global health practitioners would argue that we should direct every available dollar towards global health: a dollar spent there would increase general human well-being more than spent on anything else, and hence we should invest as much as possible in global health (definitely much more than we do now).
• Others would contend that, in the end, every present dollar spent on global health is a dollar not spent on stimulation of the economy, which means fewer future dollars to spend on human wellbeing; and that hence we need to limit the amount spent on global health to the absolute minimum required to keep populations sufficiently healthy to be able to generate income. (This is sometimes caricaturised as the ‘wealth-is-health' school of thought.)

Both views, although extreme, are defendable, and occasionally are brought forward.

A rather more difficult to defend point of view is that the extreme differences in health status between e.g. most Western populations on the one hand, versus many populations in sub-Saharan Africa on the other hand, are inacceptable and that we should not stop investing in global health until these disparities have been fully resolved. This is a very extreme and problematic view for many reasons, not the least of which is that it will obviously involve us in a never-ending cycle.

So accepting global health as a moral human right, what is the extent of the obligation placed on Western societies? Allow me to climb my ivory tower here for a moment, only to observe that we really don't know. There are too many unresolved questions concerning the efficiency and effectiveness of aid in general, and different types of aid (e.g. health versus economic aid) specifically, to be able to say with any amount of certainty where our moral obligation towards global health stops. However, I think we can say with a certain amount of certainty that our obligations do go quite a lot further than what we do now.