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ABSTRACT
This article evaluates the health targets identified in the Sustainable Development Goals (SDGs) adopted at a September 2015 UN summit from a human rights perspective. Although there is considerable overlap in the subject matter of these targets and human rights commitments, the SDG framers did not adopt a human rights approach to the realisation of the health-related targets. This article details human rights shortfalls and their implications for the implementation of the SDGs. Given the limitations of space, the article focuses on health targets of particular relevance to the right to health, specifically promoting the health rights of children; realising universal access to sexual and reproductive health services and reproductive rights; delivering the underlying determinants of health; achieving universal health coverage; and providing access to affordable essential medicines.
KEYWORDS:
Disclosure statement
No potential conflict of interest was reported by the author.
Note on contributor
Audrey R. Chapman is Professor of Community Medicine and Healthcare and holds the Healey Memorial Chair in Medical Ethics and Humanities at the UConn School of Medicine. She also has an adjunct appointment at the UConn School of Law and is an affiliate of the UConn Human Rights Institute. She is the author, coauthor, or editor of sixteen books and more than 70 peer-reviewed articles and reports. She has published extensively on economic and social rights, particularly the right to health. Her most recent book, Health, Human Rights, and the Challenge of Neoliberal Policies was published by Cambridge University Press in 2016.
Notes
1 ‘Transforming Our World: The 2030 Agenda for Sustainable Development’, Resolution adopted by the General Assembly on 25 September 2015, UN Doc. A/RES/70/1.
2 ‘Transforming Our World’, para. 8.
3 Ibid., para. 3.
4 Katherina Stepping and Nicole Rippin, ‘Goal 3: Ensure healthy lives and promote well-being for all at all ages’, in The Sustainable Development Goals of the Post 2015 Agenda: Comments on the OWG and SDSN Proposals, eds. Markus Loewe and Nicole Rippin (Bonn: German Development Institute, 2015), 21–25, https://www.oecd.org/pcd/DIE__Comments__on__SDG__proposals__150226.pdf.
5 Convention on the Rights of the Child, adopted by the United Nations General Assembly on 20 November 1989 and entered into force on 2 September 1990, UN Doc.A/RES/44/25, article 24.
6 Committee on the Rights of the Child, General comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health (art. 24), UN Doc. CRC/C/GC/15, Introduction.
7 UNICEF, ‘A Post-2015 World Fit for Children’, 2015, https://www.unicef.org/agenda2030/files/Post_2015_OWG_review_CR_FINAL.pdf (accessed March 19, 2017).
8 The Millennium Development Goals Report 2015, 32–3.
9 UNICEF, ‘A Post-2015 World Fit for Children’.
10 UN Statistical Office, ‘Tier Classification for Global SDG Indicators', 10 November 2016, https://unstats.un.org/sdgs/iaeg-sdgs/tier-classification/ (accessed March 15, 2007).
11 Rebecca Cook, Bernard Dickens and Mahmoud Fathalla, Reproductive Health and Human Rights: Integrating Medicine, Ethics, and Law (Oxford: Oxford University Press, 2003), 8–10.
12 UN, Convention on the Elimination of All Forms of Discrimination against Women, New York, 1979, 34 UN GAOR Suppl. No. 21, A/34/46 at 193, UN Doc A/Res/34/180.
13 Committee on the Elimination of All Forms of Discrimination against Women (CEDAW), General Recommendation 24, UN GAOR 1999, UN Doc. A/54/38/rev. 1.
14 Committee on Economic, Social and Cultural Rights (CESCR), General comment No. 22 (2016) on the right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social and Cultural Rights, UN Doc. E/C.12/CG22.
15 Ibid.
16 Ibid, article 5.
17 World Health Organisation (WHO), ‘Health in 2015: From MDGs to SDGs’, 2015, www:who.int/gho/publications/mdgs-sdgs/en/ (accessed April 6, 2016).
18 Ibid., 232.
19 WHO, ‘World Health Statistics 2016: Monitoring Health for the SDGs’, 74, www.who.int/gho/publications/world_world_health_statistics2016/en/.
20 WHO, ‘Health in 2015’.
21 Independent Accountability Panel, Old Challenges, New Hopes: Accountability for the Global Strategy for Women’s, Children’s and Adolescents’ Health, 2016, 22, iapewec.org/downloads/IAP_Report_September2016.pdf (accessed November 23, 2016).
22 Ibid., 74–5.
23 The Millennium Development Goals Report 2015, 41–42.
24 Ibid., 237.
25 Alicia Ely Yamin, ‘Sexual and Reproductive Health, Rights, and MDG 5: Taking Stock, Looking Forward’, in The Millennium Goals and Human Rights: Past, Present and Future, ed. Malcolm Langford, Andy Sumner and Alicia Ely Yamin (New York: Cambridge University Press, 2013), 232.
26 Alicia Ely Yamin and Vanessa M. Boulanger, ‘Why Global Goals and Indicators Matter: The Experience of Sexual and Reproductive Health and Rights in the Millennium Development Goals’, Journal of Human Development and Capabilities 15 (2014): 218–31.
27 UN Statistical Office, Tier Classification for Global SDG Indicators, 10 November 2016, unstats.un.org/sdgs/files/meetings/iaeg-sdgs-m (accessed March 10, 2016).
28 The section on Universal Health Coverage references two other of my publications: Audrey R. Chapman, ‘Assessing the Universal Health Coverage Target in the Sustainable Development Goals from a Human Rights Perspective’, forthcoming in BMC International Health and Human Rights; ‘Editorial: Contributions of Human Rights to Universal Health Coverage’, Health and Human Rights Journal 18 (2016): 1–5.
29 Chapman, Assessing the Universal Health Coverage Target and Contributions of Human Rights.
30 WHO, ‘Health in 2015’.
31 Ibid., para 26.
32 WHO, ‘Health in the Post-2015 Development Agenda', World Health Assembly, A66/47, 1 May 2013.
33 Committee on the Rights of the Child, General Comment 15 on the right to health, CRC/C/GC/15, para. 72.
34 CESCR (2000) General Comment No. 14, The right to the highest attainable standard of health (article 12 of the International Covenant on Economic, Social and Cultural Rights), 2000, para 12 (b) (iii), UN Doc. E/C.12/2000/4.
35 Ibid., para 12 (b) (iii).
36 Ibid.
37 WHO, World Health Report: Health Systems Financing, the Path to Universal Coverage (Geneva: WHO, 2010), 12.
38 International Covenant on Economic, Social and Cultural Rights, Article 12, para 2 (d).
39 Convention on the Rights of the Child, Article 24, paras 2 (b) and 2 (d)
40 International Covenant on Economic, Social and Cultural Rights (1966) Adopted and opened for signature, ratification and accession by United Nations General Assembly Resolution 2200 A (XXI) of 16 December and entered into force 3 January 1976, UN Doc. A/6316, para. 2.1; Convention on the Rights of the Child, para. 4.
41 International Covenant on Economic, Social and Cultural Rights, para 19.
42 WHO Consultative Group on Equity and Universal Health Coverage, ‘Making Fair Choices on the Path to Universal Coverage’, 2014, 37, www.who.int/choice/documents/ (accessed November 10, 2015).
43 World Health Organization, ‘Health in 2015’, 193–4, 45–6.
44 UN Statistical Office, ‘Tier Classification for Global SDG Indicators’, 8.
45 UN Statistical Commission (2016), Report of the Inter-Agency and Expert Group on Sustainable Development Goal Indicators, UN Doc. E/CN.3/2016/2, 18.
46 UN Statistical Commission (2016) Report of the Inter-Agency and Expert Group on Sustainable Goal Indicators.
47 A. Marriott and M. M. Kamal-Yanni, ‘Last Minute Change to the UHC Indicator for the SDGs is Raising Alarm Bells!’, Global Health Check, 7 March 2016, http://www.globalhealthcheck.org/?p=1854.
48 Consultation on Possible Refinements of Indicators Identified by the Inter-agency and Expert Group on Sustainable Development Goal Indicators, https://unstats.un.org/...consultation.../Consultation%20on%20Possible%20Refinement (accessed November 10, 2016).
49 UN Statistical Office, ‘Tier Classification for Global SDG Indicators’, 7.
50 Parts of this section are based on chapter 6 of my book, Global Health, Human Rights and the Challenges of Neoliberal Policies (Cambridge: Cambridge University Press, 2016).
51 World Trade Organization, Ministerial Conference Fourth Session, Doha, November 9–14, 2001, Declaration on TRIPS Agreement and Public Health, T/MIN(01)/DEC/2.
52 CESCR, General Comment No. 14, para. 43d.
53 Ibid., para. 44.
54 Anand Grover, Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Human Rights Council, 2009, A/HRC/11/12, para. 11.
55 MDG Gap Task Force Report, The Global Partnership for Development: Making Rhetoric a Reality (New York: United Nations Publications, 2012), xvi.
56 Audrey R. Chapman, Global Health, Human Rights, and the Challenge of Neoliberal Policies (Cambridge: Cambridge University Press, 2016), 202–03.
57 Grover, Report of the Special Rapporteur on the right of everyone, para 14.
58 MDG Gap Task Force Report, The Global Partnership for Development, 71.
59 Chapman, Global Health, Human Rights, 204–206.
60 Grover, Report of the Special Rapporteur on the right of everyone, para 7.
61 Ibid., para 23.
62 World Trade Organization, Ministerial Conference Fourth Session, Doha, 9–14 November, Declaration on the TRIPS Agreement and Public Health, T/MIN(01)/DEC/2 (2001), para 4.
63 Carlos M. Correa and Duncan Matthews, ‘The Doha Declaration Ten Years on and Its Impact on Access to Medicines and the Right to Health’ (discussion paper, United Nations Development Programme, 2011), 20, http://www.undp.org/content/dam/undp/library/hivaids/Discussion_Paper_Doha_Declaration_Public_Health.pdf
64 Reed Beall and Randall Kuhn, ‘Trends in Compulsory Licensing of Pharmaceuticals since the Doha Declaration: A Database Analysis’, PLoS Medicine 9 (2012): e1001154.
65 Global Policy Forum, ‘Means of Implementation nearly toppled process of SDG agenda’, July 23, 2014, https://www.globalpolicy.org/component/content/article/252-the-millenium-development-goals/52671-means-of-implementation-nearly-toppled-process-of-sdgs-agenda.html (accessed March 29, 2016).
66 ‘Transforming Our World’, paras 67–9.
67 UN Statistical Office, ‘Tier Classification for Global SDG Indicators’, 8.
68 Commission on the Social Determinants of Health, Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health (Geneva: WHO, 2008).
69 International Covenant on Economic, Social and Cultural Rights (1966) adopted and opened for signature, ratification and accession by United Nations General Assembly Resolution 2200A (XXI) of 16 December, entered into force on 3 January 1976, UN Doc. A/6316, Article 12.
70 Convention on the Rights of the Child, Article 24.
71 CESCR, General Comment No. 14, paras 11 and 43.
72 Claire E. Brolan, Peter S. Hill and Gorik Ooms, ‘“Everywhere But Not Specifically Somewhere”: A Qualitative Study On Why the Right to Health Is Not Explicit in the Post-2015 Negotiations’, BMC International Health & Human Rights 15 (2015): 22. doi:10.1186/212914-015-0061-z.