UN Special Rapporteur on Disability

Health as a Human Right

Office of the United Nations Special Rapporteur on Disability

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“The enjoyment of the highest attainable standard of health is one of the
fundamental rights of every human being”
WHO Constitution
Human Rights relating to health have been set out in all the basic human rights treaties, instruments conventions:
The human right to:
- the highest attainable standard of physical, mental reproductive and sexual health
- equal access to adequate health care & health-related services, regardless of sex, race, or other status
- a safe and healthy environment
- access to information relating to health, including reproductive health and family planning
Every world conference has made a commitment to the right to health:
- Copenhagen Summit;
- Cairo Population Summit;
- Turkey Habitat Summit;
- Beijing Declaration;
- Rio Environment Summit;
- Durban World Conference;
- World Conference on Ageing;
- Global Action on HIV/AIDS (to name a few)
Importance of health care
- level of health is indicator of development
- development level is determined by health of the population
- Development level is determined by prevalence, availability, accessibility, coverage of health care services
The existence of medical health services does not imply access for all even in the most industrialized countries
The right to health is experienced differently by different segments of society, with regard to access, quality, entitlement, information. Depending on:
- Gender
- Race
- Ethnicity
- Nationality
- Legal status
- Socio-economic status
- Geographic location
- Age
- Disability
Many factors contribute to lack of access:
- Location of medical & health service centers (urban centers vs rural areas)
- Poor information about health & services
- Lack of information in accessible forms
- Lack of awareness about the right to health & health services
- Economic inaccessibility to health services
- Health professionals not culturally sensitive to needs of some segments
- Social attitudes, stigma and discrimination
- Lack of experience in dealing with compound health issues
- Lack of understanding of persons with psycho-social disabilities
- Limited understanding among medical professionals of the relationship between poverty, mental health, physical health, disability…etc.
- Tendencies to devalue the lives of persons with multiple or developmental disabilities
The worldwide disability movement Provides the answer through the concept of The equalization of opportunities for persons with disabilities and the motto
“what’s good for us is good for all”
What can be done:
- Adoption of the equalization of opportunities
  – As a social construct
  – As a philosophical approach
  – As a design for health planning
  – As an answer to access issues
- Using the Standard Rules as the blueprint for a more equitable society
The right to health for persons with disabilities:
- Standard Rules on the Equalization of Opportunities for Persons with Disabilities
  
  Rule 2. Medical care
  – States should ensure the provision of effective medical care to persons with disabilities.
  – States should ensure that persons with disabilities…are provided with the same level of medical care within the same system as other members of society
Standard Rules
- Rule 3. Rehabilitation
  – States should ensure the provision of rehabilitation services to persons with disabilities in order for them to reach and sustain their optimum level of independence and functioning.
Standard Rules
- Rule 4. Support services
  – States should ensure the development and supply of support services, including assistive devices for persons with disabilities, to assist them to increase their level of independence in their daily living and to exercise their rights
The pre-requisite to full participation:
- Rule 5. Accessibility
  – Access to the physical environment
  1- Medical centers
  2- Rehabilitation centers
  3- Health care services & personnel
  –Access to information & communication
  1- Health information
  2- Full understanding of diagnosis
  3- Full understanding of how to deal with the illness
Arriving at a new understanding of:
- Equity
- Poverty
- Equalization
- Health & medical care
- Access
- Effectiveness & efficiency
Strategies
Reviewing & Examining :
- Data
- Policies
- Legislations
Conducting research on:
- Policies
- Programmes
- Services
- Systems
- Effect people's health and well-being
- Coverage
- Budgeting (ideally 20% of social services allocations)
- Percentage of the population serviced
- Types of services provided
–Types of persons serviced
- Race
- Age
- Standard of living
- Socio-economic standing
- Etc.
– Efficiency of service provision
– Efficacy of output
Research should
Be Participatory
- Making the people most concerned with services active participants (Participatory Rapid Appraisal)
Include analysis
- Constant review
- Continuous monitoring
- Regular & periodic evaluation
Flexible
- Allowing for changes
- s Involving service receivers in identifying their needs & suggesting appropriate responses
The need for reliable measures
Health care as an indicator of
- Poverty
- Development
- Health
- Economic prosperity
Raising the awareness of link between development and heath care provision
- Policy & decision makers
- Health care planners
- Medical professionals
- Health care providers
- Health care users
- Researchers
- Activists
The need for new definitions & indicators
- Definitions: a broad definition of health as it relates to:
  –Quality of life
  –Productivity
  –Employment
  –Self-reliance
  –Psycho-social capacity
- Definitions that are human-rights based
- Definitions need to be workable, universal, operational
The need for new Indicators
Indicators need to be:
- Qualitative as well as quantitative
- Flexible
- Able to measure variables
- Applicable to different situations
- Conceptual as well as practical