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Does the idea of a human right to health help illuminate the obligations to assist people in poor health in the developing world?

Importance of human right to health

Health is the fundamental human right. World Health Organization had described human right to health as the “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition” (Acharya et al. 2017). From the day one of the origin of this concept of human health ethics of human right to health, WHO had centralized this principle and had worked in close associations with the United Nations to ensure that people of all nations have equal access to quality healthcare services and live better quality life. In simple terms, the right to health for all people mainly means that everyone should have the access to the health service they need, irrespective of the time and place of the need, without suffering from any form of financial hardship.

Human health ethics and values state that no human beings should suffer more or die because they are poor or they are from other cultural background or because they cannot access the healthcare services, they need. Researchers are of the opinion that good health is mainly determined by different basic human rights that need to include safe drinking water and sanitation, having proper access to nutritious foods, adequate education, housing and safe working conditions (Haberland and Rogow 2015). The human right to health should be ensuring that everyone should be having control over their own health and body and should include access to different sexual and reproductive information and services and being free from violence and discrimination.

Therefore, it becomes extremely important for every nation to assure that their healthcare services are designed in ways by which human right to health can be maintained and people of all strata live higher qualities of life successfully. However, it is mainly noted that in the developing countries the healthcare services are not designed appropriately and that not all people can enjoy equal rights in seeking services from the healthcare professionals. This incidence is more common in the low socio-economic people, culturally background people and people living in the remote areas. It has huge impact on the quality of their lives making them suffer more than the well-to-do classes. Hence, the research question is “Does the idea of a human right to health help illuminate the obligations to assist people in poor health in the developing world?”

Components of human right to health

The assignment will first help in illuminating the concept of human right to health. Following this, it will highlight various cases in the developing countries where the human right to health had been breached and violated leading to increased suffering and poor quality health of [people. Following this, the assignment will recommend how different important components need to be inculcated in designing the healthcare services so that all people irrespective of class, creed and religion, enjoy equal human right to health, and develop better quality life.

Human right to health can be explained as the ethical principle that shows that everyone has the right towards highest attainable standard of both mental and physical health. Such principle includes access to all forms of medical services, sanitation, decent housing, adequate food as well as clean environment. The human right to health has three specific principles that every developing nations need to incorporate in their strategies as the foundation principles. Human right to health needs to guarantee a system of protection for all (Acharya et al. 2017). Moreover, everyone should have the right to the healthcare and need to have access to living conditions that enable them to be healthy. This should be including adequate food, housing and even healthy environment.  Healthcare must also be provided as a public good for all and should be financed publicly and equitably (Drahos et al. 2017). The human right to health care actually means that all healthcare centers like clinics, hospitals, medicines as well as services of the doctors should be accessible, acceptable, available as well as good quality for everyone on an equitable basis where and whenever required.

However, still in the developing countries, the situations for ensuring human rights to healthcare are not met successfully. Equality and non-discrimination are the two main aspects that the “human right to health” needs to include in their strategies to meet up the healthcare needs of the poorer section. Human rights standards  and principles define all the individuals as equal and that everyone should be entitled to their human rights without discrimination of any kinds like that of race, sex, color, age, ethnicity, religion , language, political as well as other opinion irrespective of national or political origin (Chandra et al. 2015). They should not face discrimination based on disability, birth, physical or mental disability, health status like HIV or aids, sexual orientation or any other status defined under the international laws. In the developing countries, inequality and discrimination is seen to be prevalent which had impeded people to enjoy equal rights and access to the healthcare services in the nation.     

Challenges in ensuring human right to health in the developing world

 A recent study was conducted to find out how different countries were responding to “rights to human health” principles developed by WHO and were contributing in development of a disease free nation. An interesting data was obtained about the healthcare services designed for HIV affected people in the developing nations. It has been found that expensive and targeted HIV-AIDs treatment programs had successfully reached large number of people in the rich and developed countries. This had been mainly possible because of the coinciding of the viable pharmaceutical markets with that of the well-resourced healthcare systems (Haberland and Rogow 2015). However, the scenario had been quite different in the developing nations. In the majority of the developing countries, researchers have found that self-financing markets and robust healthcare systems are not present in place. Therefore, millions of poor people who are not having access and financial stability to afford expensive treatments are perishing for the want of treatment. The researchers have found out that such treatments could indeed be made available if adequate resources were brought to fear. This had made World Health Organization conclude that despite their enormous advocacy efforts as well as their commitment towards some public and even private sectors, there remains the need for the additional strategies to confront the HIV disorder (Mehta et al. 2015).

An interesting BBC report had shown how the nation of India had failed to overcome the issues of untouchability, discrimination and prejudices that had always acted as barriers in ensuring “rights to human health” in the different healthcare services. The report shows that although the United Nations had talked about the importance for ensuring human right to health to all people of every developing nation, there have been no successful attempts in many countries. India has severely failed in eliminating the concept of casts and untouchability. Although the metro cities, the capitals, and other urban areas are gradually overcoming the discrimination and stigmatization, the sub-urban and rural areas experience strong prejudices. For centuries, the Dalits have been outcast from the Indian society and had been often labeled as the “untouchables”. Numerous laws have been introduced since 1850 for effective protection of the Dalits as well as to end the caste-based discrimination as well as segregation that starts from the very early age at the school (Fussler et al. 2017).   The BBC had recovered a report where it as seen found that colored wristbands were being used in the schools for differentiating between the students from the different castes. Majority of the Dalits are often found to be segregated to the core remote rural areas that are quite far away from the higher caste living areas and also do not have proper healthcare services in the areas. Secondly, the Dalits are not provided access to the safe drinking water. This is often seen to result in different forms of fatal illness like that of malaria, cholera as well as diarrhea. These disorders had also been also seen to severely affect the child mortality rate as diarrhea has been found to be the second leading cause of the child death in the world. They are not allowed to access the healthcare services as the concept of untouchability makes them to keep away from the general citizen (Rotich and Tugumisirise 2017). Moreover, the humiliation and discrimination they had faced over the years had made them adapted to the inhuman behavior from the society and they do not want to experience it further from the healthcare sectors. They are not allowed to have equal access to the healthcare services and are often discriminated by the professionals as well. Therefore, human rights to health are severely violated for this people in the nation. About 167 million people face the injustice everyday in the nation that is about twice the number of people that live in many of the developed countries as well.

Impact of discrimination on healthcare services in India

The growth of the population in Asia had slowed down to the rate of 5.7% from 6.3% in the year 2016 to that of 2017. Asia is seen to be grappling with the different issues of prosperity as well as that of the human rights. It has been home to some of the world’s poorest countries and had been currently considered to be the hotbed of crime, corruption, various types of exploitations of the human rights, dignity and principles, weak monitoring as well as the implementation of the regulation of law and paying no attention to of the environment (Ottersen et al. 2014). Severe violations of human rights to health had been found in the different countries in the different neighboring countries in Asia through the poor working conditions and absolute lack of safety maintenance. One of the greatest barriers to quality health life of the labor classes in these countries is the poorly maintained and weakened implementation of the labor laws and the monitoring. This had often resulted the different organizations in exploiting their workers along with the high level of disrespect for health and protection. The human rights to human health had been completely violated as none of the many of the organizations harboring the labor workforce had shown a high level of disregard for the health as well as safety concerns of the employees (Reich et al. 2016). Studies have shown that the workers who are mostly from the low socio-economic background or are rural migrants have to ensure substandard working conditions and even longer hours of work. They are even seen to be working for seven days a week without any legal defense and even be exposed to different health hazards. They are even seen to have no access to the healthcare services and no interventions are taken up by the employers to help them to have proper access to healthcare issues as well. Not developing proper health safety systems and not allowing enough scope for the laborers to enjoy a healthy quality life through equal access to healthcare opportunities is indeed a violation to human rights to health and need to be prosecuted under the law.

In the year 2013, an illicitly built eight-storey clothing factory in the nation of Bangladesh had collapsed and this had resulted to the death of 1100 workers along with the injuring of the 2000 people and 104 people are still found to be missing. Half of the international brands who were found to be linked with the tragedy are yet to pay into the $40 million compensation fund that had been set up by the UN due to the violation of human health to rights for different survivors and dependents (Lundgren and Amin 2015).  Another incident had been also reported. In the Northeast India, about 100 deaths due to starvation between the ages of 2015 to 2016 have been highlighted due to the poor working condition of the tea workers at the closed tea plantations in the west Bengal. The tea-garden employees were mostly tribal in origin and belonged to poor –socio-economic classes. They are seen to suffer from isolation as well as inability to access to different healthcare services and these results in aggravation of the situations further. However, the state government did not accept their inability to access healthcare centers and rather contended that the deaths were due to “prolonged malnutrition”.

Striking examples can be provided to show how violation of human rights to health had become clearly visible in the different African countries and where the poorer sections of the society are mostly vulnerable. The biggest irony had been pointed out by the WHO's Director General, Tedros Adhanom Ghebreyesus. WHO general director had clearly noted the tendency of the African leaders to leave their country, travel to the developed countries for their own healthcare treatments, and then come back to their own country (Abuya et al. 2015). This states that they are themselves aware of the need for improvement of the healthcare services in their own nations in ways by which all, the sections of the society can have equal access to quality healthcare services that meets their needs and requirements. Therefore, WHO had asked the nations to develop a focus on all the different types of building blocks of health system that would align with the needs of all people the nation irrespective of their socio-economic background. The General director had stated that "I do not like the fact that Africa is the only continent on this planet in which, when its heads of state are sick, they have to be taken care of in another country - or another continent for that matter".  He further added, “The only time when we will say the health systems in Africa are working is if everybody, including heads of state, is able to get treatment within the continent"  (Mokdad et al. 2016).  They had raised questions about the safety and quality of the healthcare services that are provided to the general ordinary citizens to the nation as the leaders are not themselves sure of the quality of healthcare services they would get when they would be ill.

The different studies that had been conducted on the different nations in the continent of Africa. This had shown that healthcare access is widely perceived to be about how far the individuals have to travel for getting help from the healthcare facility. The researchers have also stated that although physical distance is one important hindrance, access to healthcare by all people irrespective of the backgrounds mainly transcend different geographical factors. The socio-cultural and the socio-economic forces are seen to play important determining roles on the distribution of healthcare services across the nations (Cotlear et al. 2015). Another set of study had supported the claim and had stated that other greatest impediment to healthcare accessibility in the country is the higher prevalence of poverty. They have argued that although individuals who are living near to the healthcare services cannot always avail the care and service from professionals from the hospitals due to the cost, as they cannot afford it always. WHO had stated that Africa is suffering from the grip of tuberculosis, different non-communicable disorder and even poor access of mental healthcare services. WHO's regional director for Africa, Matshidiso Moeti  had confirmed that the health inequalities and violation of the human right to health are fast growing on most of the African countries owing to the social gap between the poor and the rich (Buse et al. 2015). However, he had also accepted the fact that funding was quite less for the healthcare services and the different issues faced by the people from different backgrounds in accessing healthcare services can be resolved by proper allocation of funds and other resources.

Therefore, the different developing nations have to ensure that they are taking effective evidence based interventions that can assure effective healthcare services and support systems for protecting their human right to health (Beck et al. 2018). A healthcare system should be designed in every developing nation should incorporate few important components that would ensure human right to health to every people irrespective of the socio-economic background.

The first component is the universal access. Researchers are of the opinion that access to health care need to be universal and should be assured for all on the unbiased basis. Healthcare services should be such that it is affordable and all-inclusive care for everyone and needs to be physically available where and whenever required (Wronka, 2016).

The second component is called the availability. Proper adequate healthcare infrastructures (community health facilities, hospitals, clinics, trained healthcare professionals), goods (like drugs, equipments) and services (like metal healthcare, primary services) need to be available for all people in every geographical area in every communities.

The third community is called the acceptability and dignity. The different healthcare institutions and the providers of health should be respecting the dignity or people and assure a culturally competent care to the people. The care should be such that it would be responsive to the needs and requirements of the people based in the gender, age, culture, language and even the dissimilar ways of living and their respective abilities. Respecting medical moral principles and assuring maintenance of confidentiality becomes important(Okafur et al. 2015).

The fourth component is called the quality of the care. The healthcare that needs to be provided  should be medically appropriate and should be of high quality. This should be guided by the different quality standards and control mechanisms. Moreover, it should be provided in a timely, safe and patient centered manner to ensure best health outcomes of the patients.

The fifth component is called the non-discrimination. The healthcare that should be provided to people should be without any forms of discrimination about the health status, race, ethnicity, sexuality, disability, religion, language, income, national origin and even social status (Schaper 2016).  

The sixth component is the transparency. Researchers are of the opinion that health information needs to be easily accessible for every person. it should be also enabling people in protecting their health and also claim different types of quality health services. It is also seen advised that the institutions, which participate in organizing, financing or delivering health care, must operate in a transparent procedures (Gilbert et al. 2015).

The seventh component is the participation. Studies are of the opinion that in order to ensure human rights to health, communities and individuals should be able to participate and take active roles in decision making regarding aspects that affect their health. This should be including organization and implementation of healthcare services, decisions and policies in the nations (Thornicroft et al. 2016)

The eighth component is called accountability. Private companies and public agencies must be  held accountable for effective protection of the right to health. This should be assured through enforceable standards, regulations, and independent compliance monitoring.

From the above discussion, it becomes clear that people belonging to low socioeconomic background, different racial and culturally different groups, migrant populations and many others cannot enjoy equal human rights to healthcare. This is more prominent in the developing countries then the developed countries. Therefore, it is extremely important for the healthcare organizations and the government to design healthcare services that align with important components of human rights and dignity. Accountability, transparency, participation, universal access, non0doscrimination and many others aspects should be inculcated in the healthcare services for ensuring that all people of all strata can enjoy best healthcare services.

References:

Abuya, T., Warren, C.E., Miller, N., Njuki, R., Ndwiga, C., Maranga, A., Mbehero, F., Njeru, A. and Bellows, B., 2015. Exploring the prevalence of disrespect and abuse during childbirth in Kenya. PloS one, 10(4), p.e0123606.

Acharya, B., Maru, D., Schwarz, R., Citrin, D., Tenpa, J., Hirachan, S., Basnet, M., Thapa, P., Swar, S., Halliday, S. and Kohrt, B., 2017. Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal. Globalization and health, 13(1), p.2.

Beck, E.J., Shields, J.M., Tanna, G., Henning, G., de Vega, I., Andrews, G., Boucher, P., Benting, L., Garcia-Calleja, J.M., Cutler, J. and Ewing, W., 2018. Developing and implementing national health identifiers in resource limited countries: why, what, who, when and how?. Global health action, 11(1), p.1440782.

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Chandra-Mouli, V., Svanemyr, J., Amin, A., Fogstad, H., Say, L., Girard, F., and Temmerman, M. 2015. Twenty years after International Conference on Population and Development: where are we with adolescent sexual and reproductive health and rights?. Journal of Adolescent Health, 56(1), S1-S6.

Cotlear, D., Nagpal, S., Smith, O., Tandon, A. and Cortez, R., 2015. Going universal: how 24 developing countries are implementing universal health coverage from the bottom up. The World Bank.

Drahos, P., and Braithwaite, J. 2017. Information feudalism: Who owns the knowledge economy. Routledge.

Fussler, C., Cramer, A. and Van der Vegt, S., 2017. Raising the bar: creating value with the UN Global Compact. Routledge.

Gilbert, B.J., Patel, V., Farmer, P.E. and Lu, C., 2015. Assessing development assistance for mental health in developing countries: 2007–2013. PLoS medicine, 12(6), p.e1001834.

Haberland, N., and Rogow, D. 2015. Sexuality education: emerging trends in evidence and practice. Journal of adolescent health, 56(1), S15-S21.

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Reich, M.R., Harris, J., Ikegami, N., Maeda, A., Cashin, C., Araujo, E.C., Takemi, K. and Evans, T.G., 2016. Moving towards universal health coverage: lessons from 11 country studies. The Lancet, 387(10020), pp.811-816.

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Wronka, J., 2016. Human rights and social justice: Social action and service for the helping and health professions. Sage Publications.

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