On July 3, 2020, Ansar members at Mugda general hospital beat up a man waiting in queue with his mother to get their samples tested when he engaged into an altercation with the Ansar men after they stopped sample collection for the day, allegedly before fulfilling the day's quota. As photojournalists took photos of the incident, Ansar members assaulted them too, and broke a camera. The heavy handed approach by the security people was unprofessional and did not demonstrate the sensitivity it required during an ongoing pandemic. Numerous other incidents took place where people were refused admission in hospitals or refused treatment for other health related complications.
The catastrophic impact of the Covid-19 pandemic on the global economy has generated the dichotomous discussion about life and livelihood. This discussion is fallacious to some extent because one is not separate from the other. In a sense this debate has taken our eyes off many crucial issues including human rights. One may ask why human rights should be brought to the fore of the public discourse where people are grappling with more immediate problems of food, health and shelter. As these three issues are primarily linked with human existence with dignity it is more important today to discuss these issues as part of the larger human rights discourse as the pandemic has engulfed our present and the future.
Right to food and shelter are not within the scope of this article. Authors have aimed at presenting health rights as part of the core human rights. For the understanding of the wider audience it is important to dissect the idea of human rights before we can dive into linking health with human rights. Thomas Paine inked human rights as the natural rights of being human. His thoughts were later expanded by HLA Hart and other scholars who linked human rights with the natural rights of man and their dignity with human existence.
It must be understood that Human rights are not originating from any particular legislation or a document, it is a value system that must be upheld by the state and the society must respect human rights. UDHR and other sources of International bill of rights have provided a framework to define the extent of these rights of being human.
In the wider audience, the general understanding of the idea of human rights is associated with political rights only. It is important to have this clarity of understanding to synchronise the idea of the right to have universal health care with human rights. According to the World Health Organization (WHO), "The highest attainable standard of health is a fundamental right of every human being". Here, the right to the highest attainable standard itself implies a legal obligation towards state for ensuring an entertaining health without any discrimination. Right to health is one of a set which is internationally recognized and described by many organisations who are working to establish human rights.
Universal Declaration of Human Rights (UDHR) in its article 25 recognised health being part of standard of living for the overall wellbeing. It further mentions various forms of discriminations as a way of depriving people from their wellbeing through health rights. Right to health has been included in Article 12 of International Covenant on Economic, Social and Cultural Rights (ICESCR) and recognized the right of enjoyment of everyone for the highest attainable standard of physical and mental health. It also included creation of conducive infrastructure to reduce various types of health related risks. Similarly, the Committee on the Elimination of Discrimination against Women (CEDAW) in Article 16 recognised equal health right for women as part of human rights.
In three of eight millennium development goals (MDGs), health became relevant as a development goal and for the first time in modern history received so much attention as the central element of human development. Following the MDGs the Sustainable Development Goals (SDGs) have been adopted for the fulfilment of leaving no one behind. In SDG3 the right to have universal health coverage has been recognised and set as an achievable goal with its various targets. One may ask how the development and human rights nexus can be synchronised in highlighting human health as human rights.
One must remember that development policies cannot be devoid of human rights principles and both are mutually reinforcing. At the end of the day both paradigms work towards achieving the same objective: improving human wellbeing. Human rights standards incorporated in the development strategies put the obligation on the government to take a human centric approach in delivering the critical services for wellbeing of the people including the delivery of universal health coverage.
WHO has made a commitment to mainstream human rights into healthcare programmes and policies on national and regional levels by looking at underlying determinants of health and human rights. It highlights that health rights includes the agency of both men and women to decide on the protection of their health including mind and body. This is important from the point of Sexual and Reproductive Health Rights (SRHR) and equality of women. However, sometimes it gives an impression that WHO is the lone actor in ensuring this right whereas it should be the concern of every organisation created for global development.
Bangladesh constitution being inspired by UDHR, Covenants and other international documents have included health as a right in Article 18. Although the language in this article is quite archaic and somewhat influenced by the religious values of the majority population it has clearly indicated that the state has the responsibility to work towards the goal of providing universal health care. It is now imperative for Bangladesh to adopt a human rights based approach to health rights and create a legal and regulatory framework accordingly. This will establish a set of clear principles for setting and evaluating health policy and service delivery, targeting discriminatory practices and unjust power relations that are at the heart of inequitable health outcomes.
It is to be noted that incorporation of human rights principles in long term national development vision offers a country a more realistic chance of being successful in meeting its development goals to reduce poverty, hunger and disease and promote gender equality, education, environmental sustainability, justice and others.
The rights based approach to health policies should aim to ensure the accountability of state and other related actors in the sector which will enhance the trust and public confidence in the health system. The new approach to health rights should include participation of private sector and NGOs to reach out to the people at the grass root and make it a wider canvas of creating a better world for tomorrow.
Shahariar Sadat is the Programme Head of Human Rights and Legal Aid Services, BRAC.
Mohammad Riaz is an undergraduate student of law at London College of Legal Studies (South).