04.03.18

Human Rights in Global Health: Rights-Based Governance for a Globalizing World

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This article was written by Benjamin Mason Meier, Associate Professor of Global Health Policy, University of North Carolina at Chapel Hill, and Lawrence Gostin, Faculty Director, O’Neill Institute for National and Global Health Law, Georgetown University. 
Human rights impact global health.  By advancing human rights under international law as a basis for public health, international human rights law offers global standards by which to frame government responsibilities and evaluate health policies.  An evolving “health and human rights” movement has grown to become a powerful force for promoting those human rights that underlie global health.  Yet despite the dramatic growth of this movement, human rights scholarship and advocacy has focused largely on national governments, neglecting the global governance institutions that structure the realization of rights.  These institutions matter for the advancement of human rights in global health, raising an imperative to understand the implementation of human rights law through global health governance.
Cover, Human Rights in Global Health: Rights-Based Governance For a Globalizing WorldLaunching this blog series to engage with the forthcoming volume on Human Rights in Global Health: Rights-Based Governance for a Globalizing World (Oxford University Press, 2018), our introductory post frames the human rights responsibilities of institutions of global health governance.  Global governance has been instrumental to the development of human rights under international law, and these governing institutions are now essential to implementing human rights in organizational policies, programs, and practices. This edited volume is the first to systematically examine the role of these global institutions in operationalizing human rights for global health.
Human rights have become central to global health practice, offering universal frameworks for the advancement of justice in public health. As a basis for global justice under international law, human rights codify normative standards by which to articulate government duties and assess national practices.  This rights-based analysis shifts the policy debate in health from political aspiration to legal accountability.  Drawing from the birth of a human right to health in the Constitution of the World Health Organization, the United Nations has advanced public health obligations through the development of an expansive and reinforcing set of international standards.  Health-related human rights have thereby evolved under international treaty law, establishing norms and principles over a wide range of determinants of health.
Where human rights treaty ratification alone is insufficient to realize public health outcomes, it becomes necessary to consider the processes by which human rights are implemented.  Following from the groundbreaking development of human rights, the United Nations has shifted from the development of human rights under international law to the implementation of those rights through public policy.  In this “era of implementation,” the United Nations now looks beyond state duty-bearers to implement health-related human rights, assigning responsibilities to institutions of global governance.
Global governance has sought to realize the broader social, economic, and political determinants that underlie global health. Consequently, this global health governance landscape encompasses a proliferating range of intergovernmental organizations, funding agencies, and international bureaucracies working across an expanding range of economic, social, and cultural fields.  Structuring public health in a globalizing world, these global governance institutions are not party to human rights treaties; however, they recognize their essential role in securing the realization of health-related human rights.
This larger global health governance landscape is necessary to implement human rights for global health. These global institutions assist states in implementing human rights, providing states with the international norms, technical assistance, and accountability mechanisms to support the realization of rights. Beyond support for state duty-bearers, these organizations have independent responsibilities—as embodiments of the global community—to implement human rights through their institutional policies, programs, and practices. Yet, human rights scholarship has long neglected institutional theory and organizational practice.  Given the evolving development of human rights under international law and the parallel proliferation of global institutions for public health, it is imperative that we understand the implementation of human rights law through global health governance.
This blog series explores the relationship between human rights, global governance, and public health – examining an array of governance institutions that exercise their organizational mandate in ways that influence global health. The contributing authors will examine institutional dynamics to mainstream human rights in organizational actions and analyze institutional factors that facilitate or impede human rights mainstreaming for public health advancement. Following the structure of Human Rights in Global Health, this blog series examines distinct organizational approaches to human rights in:

  • The World Health Organization – describing the evolution of the World Health Organization’s (WHO’s) efforts to develop human rights for public health, current efforts to mainstream human rights in the Geneva Secretariat and regional offices, and the future of WHO’s rights-based role in an expanding global health governance landscape.
  • Inter-Governmental Organizations – surveying the diverse ways in which United Nations (UN) specialized agencies and ancillary organizations have mainstreamed human rights to promote an expansive set of underlying determinants of health through the United Nations Children’s Fund (UNICEF), the International Labor Organization (ILO), the United Nations Educational, Scientific and Cultural Organization (UNESCO), the United Nations Population Fund (UNFPA), the Food and Agriculture Organization of the United Nations (FAO), and the Joint United Nations Programme on HIV/AIDS (UNAIDS).
  • Global Economic Governance and Global Health Funding Agencies – recognizing the influence of a human right to development and a rights-based approach to development on global health through the World Bank, the World Trade Organization, national foreign assistance programs, and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
  • Global Health in Human Rights Governance – considering how global health has been advanced by the UN human rights system through the Office of the UN High Commissioner for Human Rights (OHCHR), UN special procedures mandate holders, the UN human rights treaty bodies, and the UN Human Rights Council’s Universal Periodic Review (UPR).

The contributing authors represent an unprecedented collection of experts on a range of global governance institutions that operationalize human rights to promote global health, and their respective analyses of organizational policies, programs, and practices provide a basis to understand how global health governance is constituted by health-related human rights.
Framing a new field of inquiry at the intersection of health and human rights, such comparative experiences provide a research base for institutionalizing human rights in global health.  Through such a comprehensive survey of human rights in global health governance, it is possible to recognize varied approaches to human rights mainstreaming, analyze underlying determinants of human rights implementation, and develop an empirical basis to assess the effects of human rights in global health institutions.  Comparative analysis across these institutions can elucidate the causal pathways linking international human rights law to rights-based policy implementation through organizational practice, highlighting generalizable institutional factors that structure the operationalization of human rights in global health.  These institutional factors provide evidence of institutional strength for human rights implementation as a basis for global health advancement, renewing the promise of global governance in the face of unprecedented political challenges and engaging scholars, practitioners, and advocates to advance rights-based governance for global health.
Benjamin Mason Meier is an Associate Professor of Global Health Policy and the Zachary Taylor Smith Distinguished Professor of Public Policy at the University of North Carolina at Chapel Hill. To contact: bmeier@unc.edu
Lawrence O. Gostin is the O’Neill Chair in Global Health Law, Director of the O’Neill Institute for National and Global Health Law, and Director of the WHO Collaborating Center on National and Global Health Law at Georgetown University. To contact: gostin@law.georgetown.edu
Human Rights in Global Health: Rights-Based Governance for a Globalizing World (2018) is now available from Oxford University Press or Amazon.com.

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The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.

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