The Rights-Based Approach to Global Health
Discussions about health and human rights since the 1980s, even within the limitation of the lack of a truly integrated approach, have led to real progress: the rights-based approaches to health and development have made human rights integral to many discussions of global health work.
There is no single, canonical rights-based approach: rights-based approaches are many and diverse. However, while keeping this in mind, some common elements can be identified.
As the name implies, the rights-based approach uses human rights as its starting point for discussions about health: it looks at health through a ‘human rights lens'. As a result, it demands attention for many societal root causes for health issues. However, it does not address explicitly the impact of health on human rights conditions, nor does it readily recognise the interdependent relationship of the two. It puts a strong emphasis on process, making it as important as the health outcomes per se.
Its success has also been its failure. It has been immensely successful in putting human rights in the limelight as a determining factor for health and as a valuable tool for discussions about health and health policies. However, in doing so, it has neglected the intricate links between the two, to the point where it is sometimes accused of doing away with the classical public health approach, or even with ‘social justice', even when those approaches are more productive. Although advocates of the approach contend that the rights-based approach never meant to protect individual rights at all costs, they do not address the fact that this is how it works out in many practical cases - nor that even when it doesn't work out like that, its practitioners still tend to put more weight on individual human rights than on collective rights.
A last word
This was the last posting in the series on health and human rights. The series is the condensation of a personal search for the interface between two of my most abiding interests. This search, although satisfying by itself, has left me less satisfied with where we are today. Although the intricate and interdependent nature of health and human rights is recognised, the most important exponent of the movement, the rights-based approach, is highly rights-focussed; in practice, its entails primacy of (individual) human rights over (global) public health.
In my view, a new, practical synthesis of health and human rights needs to be found. My vision of an integrated field of health with human rights is output-oriented, but not solely output in the health sense: human rights and health outputs are treated as equal and (more importantly) mutually reinforcing. It integrates the fields in any health or human rights program from start to finish:
- When selecting a possible issue for intervention, by querying implications for health and human rights.
- When first designing the program, by continuously querying the intended and likely results for both health and human rights.
- When implementing the program, by linking back to public health and human rights theory and practice.
- When monitoring and evaluating the program, by incorporating both health and human rights indicators.
This is an ambitious (perhaps over-ambitious) program. However, it will deliver a new challenge to practitioners of both (global) health and human rights; hopefully making us practitioners of health-with-human-rights.
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