On April 14th, Dr Henry Silverman presented a webinar on human rights and its relation to health and health equity. The session was part of a face-to-face course in Public Health Ethics at the University of Maryland Medical School. Participants from different countries (Egypt, Nigeria, Uganda, and Norway) “attended” the session via a live webinar.
Initially, Dr Silverman defined the nature of a ‘right’ and how a right includes not only the recipient of the right (the rights-holder), but also a person or an entity (e.g., the government) who has obligations to fulfill such a right. Rights are categorized as being “negative” if fulfillment of the right entailed that a person not be interfered with pursuing an activity (free speech or associate with others) by another person or entity. In contrast, rights are categorized as being positive if fulfillment of the right entailed that some entity has an obligation to provide something to the rights-holder, e.g., right to health care or food. Alternately, human rights can be classified into civil, political, economic, cultural and social rights.
Several international organizations (e.g., UN and WHO) put forth the notion of the existence of a right to health as part of a general concept of human rights in their statements. Indeed the right to health is merely a node in an interrelated network of other rights that complement each other. Accordingly, to attain health, one needs fulfillment of several rigths, e.g., the right to clean water and nutritious food, the right to education, the right to non violence, a right to vote, and a right to be free from torture.
All of these rights are instrumental in a concept of human development. Originally, only the Gross Domestice Product GDP) was used as an indicator of a country’s human development. But recognizing that human development entails more than just wealth, the United Nations Human Development Report developed in 1990 a more robust indicator of human well-being with its Human Development Index (HDI). The HDI encompasses indices of health (life expectancy), education (literacy rate) in addition to wealth (GDP). Hence, the HDI indirectly reveals a committment to a set of human rights.
Another concept disucssed in the webinar was health equity which is defined as the fair distribution of resources, opportunities, and power necessary to obtain a level of health needed to pursue one’s life’s goals. In contrast, inequities refer to the avoidable unequal provision of resources, which result from discriminatory or structural (systematic) differences in social or political status, gender, economic level, ethnicity or cultural status. Thus, achieving equity involves the removing of unfair, unjust differences between groups of people.
Non democratic nations are prone to less transparency, more corruption, non political empowerment of marginalized groups and less respect to human rights. As a result, such nations suffer from a major health equity problem.
In conlusion, the webinar introduced the new concepts public health and related them to health status under different political systems. Students, even those online, were encouraged to interact and share ideas. The webinar provided a rich learning environment, provoking many thoughts, particularly in the presence of students with diverse nationalities.
To access the taped webinar, please click here or go to: https://umm.webex.com/umm/ldr.php?AT=pb&SP=MC&rID=28560157&rKey=fbea976729ce6e0d
This is very interesting. One of the current discourse on this issue in Africa (especially Nigeria) is how health could actually be a fundamental human right vis-a-vis the holistic WHO definition.
As Dr Silverman correctly captured “the nature of a ‘right’ and how a right includes not only the recipient of the right (the rights-holder), but also a person or an entity (e.g., the government) who has obligations to fulfill such a right”, people really argue that inasmuch as the government should adequately provide for the health of her citizens, a typical African would not look upon the government or society to guarantee his “fundamental right to health” or even the means to achieve a health status. He would rather look-up to his personal efforts or his God.
Does this explain the reason why individual members of African societies, to a reasonable extent failed in getting their governments and leadership guarantee their right and access to health, or why many leaders in Africa pay near-lip service to the issue of health as a fundamental right to their fellow citizens?
The basic cultural notions of health across Africa should be reviewed, and compared with the promises and or shortfalls of the “holistic” definitions of health, as in the case of Aboriginal health concepts, with a view to determining to how extent the globalization of concepts like health has expectedly or otherwise affected our people.
Hi John
You really raise a good point. What do people expect from their governments and how individuals sort their health problems out rather than expect or demand from their inefficient governments.
I do not want to sound like a cynic but it seems our governments have made sure our expectations of them are minimal. Like we should be extremely grateful for whatever efforts they do to provide, if any, food and clean water.
In Egypt, our ex President has always justified the shortfalls of his government to the overpopulation of Egypt (estimated at 85 million) The budget for health and education combined is one third of the budget of the interior ministry. After his downfall, we are now aware of the extent of corruption and how much money was robbed off Egyptians. If that money was utilized to develop health structure of the Ministry of Health and population in Egypt. our health profile would have been totally different. Our expectations of the government would have been different. The research in Egypt would have been more advanced etc..etc…
Interestingly winds of change are hitting ME and Africa too. I understand Nigeria is electing a new President do you think health and scientific research will change with this new President? Does his program include upgrade of health and scientific research in Nigeria?