The Right to Health, Europe, and Greece

Following capital controls and the partial shutdown of the financial system after Greek’s default last week on a loan payment to the IMF, food and medicine are becoming scarce. The threat to health from austerity  are far from new with the latest phase of Greek’s economic disaster, however. A 2014 study in the Lancet “found evidence of rising infant mortality rates, soaring levels of HIV infection among drug users, the return of malaria, and a spike in the suicide count,” along with 800,000 people without access to health care, as reported in the UK’s Independent newspaper. This echoed an earlier study on the effects of austerity in Greece and elsewhere. Last night, the PBS NewsHour reported on the 50% increase in suicides among Greeks during much of the period of austerity and the devastating budget cuts for Greece’s hospitals just this year – from $735 million during the first four months of 2014 to only $50 million for the country’s 132 hospitals during the first four months of this year.
I will not address here the issue of Greek responsibility, from tax avoidance to poor policy choices leading to its heavy debt burden. For now, one point only: whether Greeks begins to recover their health – I mean human health – depends on the European Union. Require more austerity, and after Sunday’s referendum and the Greek people’s rejection of more of the same, and the economic collapse could only worsen, and with it, people’s health. More could – and almost surely would – die.
Germany, France, and other European countries will make choices in the coming days that will either lead to more or less ill health for the people of Greece. If they choose the path of ill health, then the countries of Europe, generally among the most concerned about human rights, will be violating their human rights obligations.
A group of international human rights experts explained in the Maastricht Principles on Extraterritorial Obligations in the area of Economic, Social and Cultural Rights, which “clarify extraterritorial obligations of States on the basis of standing international law”:
States must refrain from adopting measures, such as embargoes or other economic sanctions, which would result in nullifying or impairing the enjoyment of economic, social and cultural rights… States must refrain in all circumstances from embargoes and equivalent measures on goods and services essential to meet core obligations. [Principle 22]
The austerity measures that the Eurozone countries have required Greece to undertake these past years for the country to receive European Commission, European Central Bank, and IMF loans are in a sense measures equivalent to economic sanctions – forced economic harm, punishing Greece for past economic errors – that are not supposed to impair the right to health elsewhere.
Perhaps you disagree with the comparison. It is not only economic sanctions and the like that must not impair the right to health, and other rights, extraterritorially, however. The obligation is more general:
States must desist from acts and omissions that create a real risk of nullifying or im­pairing the enjoyment of economic, social and cultural rights extraterritorially. The responsibility of States is engaged where such nullification or impairment is a fore­seeable result of their conduct. Uncertainty about potential impacts does not consti­tute justification for such conduct. [Principle 13]
And there is this, from General Comment 14 of the UN Committee on Economic, Social and Cultural Rights:
States parties have to respect the enjoyment of the right to health in other countries, and to prevent third parties from violating the right in other countries, if they are able to influence these third parties by way of legal or political means, in accordance with the Charter of the United Nations and applicable international law….States parties which are members of international financial institutions, notably the International Monetary Fund, the World Bank, and regional development banks, should pay greater attention to the protection of the right to health in influencing the lending policies, credit agreements and international measures of these institutions. [Paragraph 39]
Just this past May, German Chancellor Angela Merkel stated elegantly at the World Health Assembly: “Every single person is vitally needed to fight for the human right to health….Let us work together in a spirit of cooperation, and not seek to undermine each other’s deeds. The task is so immense and the endeavour so important that every helping hand is needed.”
Let us hope such sentiments carry the day.