World Health Day 2024 was observed on the 7th of April this year with the theme: My health, my right. The World Health Organisation (WHO) has noted that at least 140 countries recognize health as a human right in their constitution, yet are lacking in legislation or its implementation to ensure that their populations have access to quality health services.
As of 2021, 4.5 billion or more than more than half of the world’s population were not fully covered by essential health services. This is therefore a good time to champion the right of everyone to have access to quality health services and pay attention to essential socio-economic determinants of health such as education, information, safe drinking water, clean air, good nutrition, quality housing, decent working and environmental conditions, privacy, access to information, freedom from torture, freedom of association, and freedom from discrimination. Most of the deficiencies in these areas stem from poverty, making the latter incompatible with human rights.
Meanwhile, people living in low- and middle-income countries find themselves under considerable threats from natural or man-made disasters, conflicts, rampant communicable and non-communicable diseases, disabilities, psychological distress, climatic crises, and indoor air pollution. Nonetheless, the WHO has robust evidence that that countries invest in universal healthcare not only truly improve someone’s health and life expectancy, but also protect their citizens from epidemics, reduce poverty, enhance food security, generate employment, remove gender inequities and generally drive economic growth.
Good or bad people can be democratically elected, but it is always easy to fight for human rights under this system.
In Pakistan, although the Right to Health is not explicitly mentioned in our constitution, the Right to Life has been protected. Health is a fundamental right of every human being and is therefore the most important element of the WHO’s Constitution since 1948. Global health and human rights are mutually reinforcing approaches. While Pakistan has an ethical, moral and legal obligation to protect the nation’s health, it has also ratified several international treaties, conventions and the Sustainable Development Goals calling for Universal Health Coverage, TB, HIV and diabetes elimination and gender mainstreaming using a human rights-based approach (HRBA).
Pakistan has a Federal Ministry of Human Rights, which promotes the United Nation’s HRBA while monitoring progress towards attaining goals related to several international treaties and commitments. Foremost among these are the International Covenant on Economic, Social and Cultural Rights, Elimination of All Forms of Racial Discrimination, International Convention on the Elimination of All Forms of Discrimination Against Women, Convention on the Rights of the Child, International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families and Convention on the Rights of Persons with Disabilities. They have also conducted several surveys on child employment and gender inequalities. However, governments at all levels may also sometimes erroneously feel intimidated by excessive mention of human rights, of any sort, forcing them to not highlight certain facts and generally adopt a defensive posture.
Rapid population growth and the general macroeconomic situation are challenging factors currently forcing the government to reduce its recurrent or non-development expenditure and rely more on its partners or donors for its developmental sector needs. Health having been devolved to the provincial level, makes it incumbent upon provincial governments to increase their health spending. Currently, the health spending of Sindh is far more than other provinces, although there is a general need for policymakers and parliamentarians to view investments in health as the legitimate pathway towards overall economic development and an integral element of their poverty reduction strategies. The private sector and non-governmental organizations also have human rights obligations, particularly about health, together with a universal understanding that these are for all citizens of Pakistan regardless of race, colour, sex, language, religion, political, national or social origin, property, birth or socio-economic status.
Since its existence on the 7th of April 1948, the WHO has been stressing that every human being has the right to the highest attainable standard of physical & mental health, making it mandatory for countries to develop and implement legislation and policies that guarantee universal access to quality health services and address the root causes of health disparities, including poverty, stigma and discrimination together with their rights to education, food, housing, employment and information. Pakistan has also ratified the WHO Framework Convention on Tobacco Control and needs to accelerate progress in this regard.
While we are striving to attain universal health coverage by 2030, we must ensure that the health services provided are of adequate quality, equitable, safe, timely, effective, efficient, and integrated to avoid fragmentation, duplication and wastage of precious resources. The Health Insurance coverage also needs to be enhanced to provide protection, particularly to the economically deprived population segments and encompass the right to prevention, treatment and control of diseases; access to essential medicines and provision of health-related information.
Since independence, Pakistan has rightly accorded priority to maternal, neonatal, child, adolescent and reproductive health and communicable disease control. However, we should by no means ignore the prevention and control of noncommunicable diseases like cardiovascular diseases, cancers, diabetes, chronic respiratory illnesses or mental health issues as these constitute the largest slice of our burden of disease, mortality and morbidity. Moreover, most non-communicable diseases can be prevented and contained by inculcating a healthy lifestyle through behaviour change, involving physical activity and avoiding harmful foods and substances, such as illicit drugs, tobacco, alcohol, sugar-sweetened beverages and foods with high salt, unsaturated fats or sugar content. Enhancing taxation on some of those products may yield positive dividends for the economy as well.
Efforts for polio eradication and TB elimination need to be accelerated given national and international concerns. Lastly, Pakistan must derive advantage of its democratic dispensation. As our human rights activist, the late Asma Jahangir, once pointed out: Good or bad people can be democratically elected, but it is always easy to fight for human rights under this system.
The writer is a senior global health and public policy specialist.