INTERNATIONAL HUMAN RIGHTS LAW

SIR NIGEL RODLEY

Outline 155

REQUIRED READINGS (printed format)

Legal instruments and documents

1. Charter of the United Nations, 1945

For text, see Charter of the United Nations and Statute of the International Court of

Justice

2. United Nations Economic and Social Council resolution 75(V) of 5 August 1947

(Communications concerning human rights)

158

3. Universal Declaration of Human Rights, 1948

For text, see The Core International Human Rights Treaties, United Nations

Publication, 2014, p. 3

4. United Nations Economic and Social Council resolution 728 F of 30 July 1959

(Communications concerning human rights)

160

5. International Covenant on Economic, Social and Cultural Rights, 1966

For text, see The Core International Human Rights Treaties, p. 29

6. Optional Protocol to the International Covenant on Economic, Social and Cultural

Rights, 2008

For text, see The Core International Human Rights Treaties, p. 43

7. International Covenant on Civil and Political Rights, 1966

For text, see The Core International Human Rights Treaties, p. 57

8. Optional Protocol to the International Covenant on Civil and Political Rights, 1966

For text, see The Core International Human Rights Treaties, p. 83

9. Second Optional Protocol to the International Covenant on Civil and Political

Rights, aiming at the abolition of the death penalty, 1989

For text, see The Core International Human Rights Treaties, p. 89

10. United Nations Economic and Social Council resolution 1235 (XLII) of 6 June

1967 (Question of the violation of human rights and fundamental freedoms,

including policies of racial discrimination and segregation and of apartheid, in all

countries, with particular reference to colonial and other dependent countries and

territories)

162

11. United Nations Economic and Social Council resolution 1503 (XLVIII) of 27 May

1970 (Procedure for dealing with communications relating to violations of human

rights and fundamental freedoms)

166

151

12. Safeguards guaranteeing protection of the rights of those facing the death penalty

(United Nations Economic and Social Council resolution 1984/50 of 25 May 1984,

annex)

170

13. Body of Principles for the Protection of All Persons under Any Form of Detention

or Imprisonment, resolution (General Assembly resolution 43/173 of 9 December

1988, annex)

172

14. Principles on the Effective Prevention and Investigation of Extra-legal, Arbitrary

and Summary Executions (Economic and Social Council resolution 1989/65 of 24

May 1989, annex)

178

15. Basic Principles on the Use of Force and Firearms by Law Enforcement Officials

(adopted by the Eighth United Nations Congress on the Prevention of Crime and

the Treatment of Offenders, Havana, Cuba, 27 August to 7 September 1990

(A/CONF.144/28/Rev.1))

182

16. General Comment No. 3 on the nature of States parties’ obligations (art. 2, para. 1,

of the Covenant), (adopted by the Committee on Economic, Social and Cultural

Rights, 14 December 1990 (E/1991/23))

186

17. Vienna Declaration and Programme of Action (adopted by the World Conference

on Human Rights, Vienna, 25 June 1993 (A/CONF.157/23)), paras. 1 and 5

190

18. General Comment No. 14 on the right to the highest attainable standard of health

(art 12 of the Covenant), (adopted by the Committee on Economic, Social and

Cultural Rights, 11 May 2000 (E/C.12/2000/4))

194

19. General Comment No. 29 on article 4 on derogations during a state of emergency

(adopted by the Human Rights Committee, 24 July 2001

(CCPR/C/21/Rev.1/Add.11))

206

20. General Comment No. 31[80] on the nature of the general legal obligation imposed

on States parties to the Covenant (adopted by the Human Rights Committee, 29

March 2004 (CCPR/C/21/Rev.1/Add. 13))

212

21. United Nations General Assembly resolution 60/251 of 15 March 2006 (Human

Rights Council)

218

22. United Nations Human Rights Council resolution 5/1 of 18 June 2007 (Institution-

building of the United Nations Human Rights Council)

222

23. United Nations General Assembly resolution 68/268 of 9 April 2014

(Strengthening and enhancing the effective functioning of the human rights treaty

body system)

236

24. General Comment No. 35 on article 9 on liberty and security of person (adopted by

the Human Rights Committee, 28 October 2014 (CCPR/C/GC/35)

242

Case law

25. Barcelona Traction, Light and Power Company, Limited (Belgium v. Spain),

Judgment, I.C.J. Reports 1970, paras. 33-34

254

152

26. United States Diplomatic and Consular Staff in Tehran (United States of America

v. Iran), Judgment, I.C.J. Reports 1980, para. 91 and paras. 85-86

256

27. Case of Velásquez-Rodríguez v. Honduras, Judgment, IACHR, 17 August1990 (Interpretation of the Judgment of Reparations and Costs)

260

28. McCann and Others v. United Kingdom ([GC] Application No. 18984/91),

Judgment, ECHR, 27 September 1995, paras. 145-214268

29. Legality of the Threat or Use of Nuclear Weapons, Advisory Opinion, I.C.J.

Reports 1996, paras. 24-25

278

30. Case of Aksoy v. Turkey ([C] Application No. 21987/93), Judgment, ECHR, 18December 1996, paras. 65-87

282

31. Thompson v. St Vincent & the Grenadines (Communication No. 806/1998), Views, HRC, 18 October 2000

286

32. Judge v. Canada (Communication No. 829/1998), Views, HRC, 5 August 2002 298

33. Arrest Warrant of 11 April 2000 (Democratic Republic of the Congo v. Belgium),

Judgment, I.C.J. Reports 2002, paras. 56-61

320

34. Armed Activities on the Territory of the Congo (Democratic Republic of the Congo

v. Uganda), Judgment, I.C.J. Reports 2005, paras. 215-221

324

35. Amirov v. Russian Federation (Communication No. 1447/2006), Views, HRC, 2 April 2009

328

36. Ahmadou Sadio Diallo (Republic of Guinea v. Democratic Republic of the Congo),

Judgment, I.C.J. Reports 2010, paras. 63-85

340

37. Questions relating to the Obligation to Prosecute or Extradite (Belgium v.

Senegal), Judgment, I.C.J. Reports 2012, paras. 96-105

346

153

United Nations International Law Fellowship Programme

INTERNATIONAL HUMAN RIGHTS LAW

Course Outline

A. Origins of International Human Rights Law

1. United Nations Charter, especially arts. 1, 55 and 56

2. The International Bill of Human Rights‐ Universal Declaration of Human Rights‐ International Covenants on Economic, Social and Cultural Rights and on

Civil and Political Rights and Optional Protocol(s) ‐ Other ‘core’ human rights treaties

B. Conceptual Challenges

3. Civil and political rights v economic, social and cultural rights‐ Human Rights Committee General Comment 31 (2004)‐ Committee on Economic, Social and Cultural Rights General Comment 3

(1990) ‐ Committee on Economic, Social and Cultural Rights General Comment 14

(2000)

4. Universality v cultural specificity‐ World Conference on Human Rights, Vienna Declaration and Programme of

Action (1993), paragraphs 1 & 5

5. Vertical v horizontal obligations‐ Human rights Committee General Comment No. 31, paragraph 8

6. Relevance in armed conflict‐ ICJ, Nuclear Weapons Advisory Opinion, paragraphs 24-25‐ ICJ, Armed Activities in the Territory of the Congo (DRC v Uganda),

paragraphs 215-221 ‐ Human Rights Committee, General Comment No. 31 (2004), paragraph 11‐ Human Rights Committee, General Comment No. 35 (2014), paragraphs 15

and 64

C. Status of International Human Rights Law

7. General International Law‐ ICJ, Barcelona Traction (Belgium v Spain), paragraphs 33-34‐ ICJ, United States Diplomatic and Consular Staff in Tehran (United States v

Iran), paras. 85-86, 91

8. Jus cogens? Eg, prohibition of torture and cruel, inhuman or degrading treatmentor punishment‐ ICJ, Obligation to Prosecute or Extradite (Belgium v Senegal), paragraphs

96-105 ‐ ICJ, Arrest Warrant Case (DRC v Belgium), paragraphs 56-61

155

United Nations International Law Fellowship Programme

D. Selected Other Human Rights

9. Right to life‐ United Nations Principles on the Effective Prevention and Investigation of

Extra-legal, arbitrary and summary executions ‐ United Nations Basic Principles on the Use of Force and Firearms by Law

Enforcement Officials ‐ United Nations Economic and Social Council Safeguards Guaranteeing the

Rights of Those Facing the Death Penalty ‐ Human Rights Committee, Amirov v Russian Federation‐ Human Rights Committee, Thompson v St Vincent & the Grenadines‐ Human Rights Committee, Judge v Canada‐ European Court of Human Rights, McCann & Ors v United Kingdom,

paragraphs 145-214

10. Right to liberty and security of person‐ United Nations Body of Principles for the Protection of All Persons under

Any Form of detention or Imprisonment ‐ Human Rights Committee, General Comment No. 35 (2014)‐ Inter-American Court of Human Rights, Velasquez Rodriguez v Honduras

11. The state under stress: states of emergency‐ Human Rights Committee, General Comment No. 29 (2001)‐ European Court of Human Rights, Aksoy v Turkey, paragraphs 65-87

E. The International Protection System

12. Treaty monitoring bodies‐ the ‘core’ United Nations human rights treaties‐ ICJ, Diallo case (Guinea v DRC), paragraphs 63-85‐ United Nations General Assembly resolution 68/268 (2014)

13. Charter-based bodies‐ United Nations Economic and Social Council resolutions 75 (V) (1947),

728F (1959), 1235 (XLII) (1967) and 1503 (XLVIII) (1970) ‐ United Nations General Assembly resolution 60/251 (2006) ‐ United Nations Human Rights Council resolution 5/1 (2007)

14. Treaty monitoring bodies and Charter-based bodies compared

156

158

United Nations Economic and Social Council resolution 728 F of 30 July 1959

(Communications concerning human rights)

160

162

163

166

167

170

172

173

174

175

178

179

182

183

184

186

187

188

Distr.

GENERAL

A/CONF.157/23

12

July

1993

Original:

ENGLISH

WORLD

CONFERENCE

ON

HUMAN

RIGHTS

Vienna,

14-25

June

1993

VIENNA

DECLARATION

AND

PROGRAMME

OF

ACTION

Note

by

the

secretariat

Attached

is

the

text

of

the

Vienna

Declaration

and

Programme

of

Action,

as

adopted

by

the

World

Conference

on

Human

Rights

on

25

June

1993.

GE.93-14233

(E)

190

A/CONF.157/23

page

3

Considering

the

major

changes

taking

place

on

the

international

scene

and

the

aspirations

of

all

the

peoples

for

an

international

order

based

on

the

principles

enshrined

in

the

Charter

of

the

United

Nations,

including

promoting

and

encouraging

respect

for

human

rights

and

fundamental

freedoms

for

all

and

respect

for

the

principle

of

equal

rights

and

self

-determination

of

peoples,

peace,

democracy,

justice,

equality,

rule

of

law,

pluralism,

development,

better

standards

of

living

and

solidarity,

Deeply

concernedby

various

forms

of

discrimination

and

violence,

to

which

women

continue

to

be

exposed

all

over

the

world,

Recognizing

that

the

activities

of

the

United

Nations

in

the

field

of

human

rights

should

be

rationalized

and

enhanced

in

order

to

strengthen

the

United

Nations

machinery

in

this

field

and

to

further

the

objectives

of

universal

respect

for

observance

of

international

human

rights

standards,

Having

taken

into

account

the

Declarations

adopted

by

the

three

regional

meetings

at

Tunis,

San

José

and

Bangkok

and

the

contributions

made

by

Governments,

and

bearing

in

mind

the

suggestions

made

by

intergovernmental

and

non-governmental

organizations,

as

well

as

the

studies

prepared

by

independent

experts

during

the

preparatory

process

leading

to

the

World

Conference

on

Human

Rights,

Welcomingthe

International

Year

of

the

World’s

Indigenous

People

1993

as

areaffirmation

of

the

commitment

of

the

international

community

to

ensure

their

enjoyment

of

all

human

rights

and

fundamental

freedoms

and

to

respect

the

value

and

diversity

of

their

cultures

and

identities,

Recognizing

also

that

the

international

community

should

devise

ways

and

means

to

remove

the

current

obstacles

and

meet

challenges

to

the

full

realization

of

all

human

rights

and

to

prevent

the

continuation

of

human

rights

violations

resulting

thereof

throughout

the

world,

Invoking

the

spirit

of

our

age

and

the

realities

of

our

time

which

call

upon

the

peoples

of

the

world

and

all

States

Members

of

the

United

Nations

to

rededicate

themselves

to

the

global

task

of

promoting

and

protecting

all

human

rights

and

fundamental

freedoms

so

as

to

secure

full

and

universal

enjoyment

of

these

rights,

Determined

to

take

new

steps

forward

in

the

commitment

of

the

international

community

with

aview

to

achieving

substantial

progress

in

human

rights

endeavours

by

an

increased

and

sustained

effort

of

international

cooperation

and

solidarity,

Solemnly

adoptsthe

Vienna

Declaration

and

Programme

of

Action.

I

1.

The

World

Conference

on

Human

Rights

reaffirms

the

solemn

commitment

of

all

States

to

fulfil

their

obligations

to

promote

universal

respect

for,

and

observance

and

protection

of,

all

human

rights

and

fundamental

freedoms

for

all

in

accordance

with

the

Charter

of

the

United

Nations,

other

instruments

A/CONF.157/23

page

4

relating

to

human

rights,

and

international

law.

The

universal

nature

of

these

rights

and

freedoms

is

beyond

question.

In

this

framework,

enhancement

of

international

cooperation

in

the

field

of

human

rights

is

essential

for

the

full

achievement

of

the

purposes

of

the

United

Nations.

Human

rights

and

fundamental

freedoms

are

the

birthright

of

all

human

beings;

their

protection

and

promotion

is

the

first

responsibility

of

Governments.

2.

All

peoples

have

the

right

of

self-determination.

By

virtue

of

that

right

they

freely

determine

their

political

status,

and

freely

pursue

their

economic,

social

and

cultural

development.

Taking

into

account

the

particular

situation

of

peoples

under

colonial

or

other

forms

of

alien

domination

or

foreign

occupation,

the

World

Conference

on

Human

Rights

recognizes

the

right

of

peoples

to

take

any

legitimate

action,

in

accordance

with

the

Charter

of

the

United

Nations,

to

realize

their

inalienable

right

of

self-determination.

The

World

Conference

on

Human

Rights

considers

the

denial

of

the

right

of

self-determination

as

aviolation

of

human

rights

and

underlines

the

importance

of

the

effective

realization

of

this

right.

In

accordance

with

the

Declaration

on

Principles

of

International

Law

concerning

Friendly

Relations

and

Cooperation

Among

States

in

accordance

with

the

Charter

of

the

United

Nations,

this

shall

not

be

construed

as

authorizing

or

encouraging

any

action

which

would

dismember

or

impair,

totally

or

in

part,

the

territorial

integrity

or

political

unity

of

sovereign

and

independent

States

conducting

themselves

in

compliance

with

the

principle

of

equal

rights

and

self-determination

of

peoples

and

thus

possessed

of

aGovernment

representing

the

whole

people

belonging

to

the

territory

without

distinction

of

any

kind.

3.

Effective

international

measures

to

guarantee

and

monitor

the

implementation

of

human

rights

standards

should

be

taken

in

respect

of

people

under

foreign

occupation,

and

effective

legal

protection

against

the

violation

of

their

human

rights

should

be

provided,

in

accordance

with

human

rights

norms

and

international

law,

particularly

the

Geneva

Convention

relative

to

the

Protection

of

Civilian

Persons

in

Time

of

War,

of

14

August

1949,

and

other

applicable

norms

of

humanitarian

law.

4.

The

promotion

and

protection

of

all

human

rights

and

fundamental

freedoms

must

be

considered

as

apriority

objective

of

the

United

Nations

in

accordance

with

its

purposes

and

principles,

in

particular

the

purpose

of

international

cooperation.

In

the

framework

of

these

purposes

and

principles,

the

promotion

and

protection

of

all

human

rights

is

alegitimate

concern

of

the

international

community.

The

organs

and

specialized

agencies

related

to

human

rights

should

therefore

further

enhance

the

coordination

of

their

activities

based

on

the

consistent

and

objective

application

of

international

human

rights

instruments.

191

A/CONF.157/23

page

5

5.

All

human

rights

are

universal,

indivisible

and

interdependent

and

interrelated.

The

international

community

must

treat

human

rights

globally

in

afair

and

equal

manner,

on

the

same

footing,

and

with

the

same

emphasis.

While

the

significance

of

national

and

regional

particularities

and

various

historical,

cultural

and

religious

backgrounds

must

be

borne

in

mind,

it

is

the

duty

of

States,

regardless

of

their

political,

economic

and

cultural

systems,

to

promote

and

protect

all

human

rights

and

fundamental

freedoms.

6.

The

efforts

of

the

United

Nations

system

towards

the

universal

respect

for,

and

observance

of,

human

rights

and

fundamental

freedoms

for

all,

contribute

to

the

stability

and

well-being

necessary

for

peaceful

and

friendly

relations

among

nations,

and

to

improved

conditions

for

peace

and

security

as

well

as

social

and

economic

development,

in

conformity

with

the

Charter

of

the

United

Nations.

7.

The

processes

of

promoting

and

protecting

human

rights

should

be

conducted

in

conformity

with

the

purposes

and

principles

of

the

Charter

of

the

United

Nations,

and

international

law.

8.

Democracy,

development

and

respect

for

human

rights

and

fundamental

freedoms

are

interdependent

and

mutually

reinforcing.

Democracy

is

based

on

the

freely

expressed

will

of

the

people

to

determine

their

own

political,

economic,

social

and

cultural

systems

and

their

full

participation

in

all

aspects

of

their

lives.

In

the

context

of

the

above,

the

promotion

and

protection

of

human

rights

and

fundamental

freedoms

at

the

national

and

international

levels

should

be

universal

and

conducted

without

conditions

attached.

The

international

community

should

support

the

strengthening

and

promoting

of

democracy,

development

and

respect

for

human

rights

and

fundamental

freedoms

in

the

entire

world.

9.

The

World

Conference

on

Human

Rights

reaffirms

that

least

developed

countries

committed

to

the

process

of

democratization

and

economic

reforms,

many

of

which

are

in

Africa,

should

be

supported

by

the

international

community

in

order

to

succeed

in

their

transition

to

democracy

and

economic

development.

10.

The

World

Conference

on

Human

Rights

reaffirms

the

right

to

development,

as

established

in

the

Declaration

on

the

Right

to

Development,

as

auniversal

and

inalienable

right

and

an

integral

part

of

fundamental

human

rights.

As

stated

in

the

Declaration

on

the

Right

to

Development,

the

human

person

is

the

central

subject

of

development.

While

development

facilitates

the

enjoyment

of

all

human

rights,

the

lack

of

development

may

not

be

invoked

to

justify

the

abridgement

of

internationally

recognized

human

rights.

States

should

cooperate

with

each

other

in

ensuring

development

and

eliminating

obstacles

to

development.

The

international

community

should

promote

an

effective

international

cooperation

for

the

realization

of

the

right

to

development

and

the

elimination

of

obstacles

to

development.

192

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fund

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uman

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t ind

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exe

rcis

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righ

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man

bei

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itled

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may

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purs

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thro

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s, co

mpl

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app

roac

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he fo

rmul

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dev

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the

right

to h

ealth

incl

udes

cer

tain

com

pone

nts w

hich

are

lega

lly e

nfor

ceab

le.1

2.Th

e hu

man

righ

t to

heal

th is

reco

gniz

ed in

num

erou

s int

erna

tiona

l ins

trum

ents

.A

rticl

e 25

.1 o

f the

Uni

vers

al D

ecla

ratio

n of

Hum

an R

ight

s aff

irms:

“Ev

eryo

ne h

as th

e rig

ht to

ast

anda

rd o

f liv

ing

adeq

uate

for t

he h

ealth

of h

imse

lf an

d of

his

fam

ily, i

nclu

ding

food

, clo

thin

g,ho

usin

g an

d m

edic

al c

are

and

nece

ssar

y so

cial

serv

ices

”. T

he In

tern

atio

nal C

oven

ant o

nEc

onom

ic, S

ocia

l and

Cul

tura

l Rig

hts p

rovi

des t

he m

ost c

ompr

ehen

sive

arti

cle

on th

e rig

ht to

GE.

00-4

3934

(E)

E/C

.12/

2000

/4pa

ge 2

heal

th in

inte

rnat

iona

l hum

an ri

ghts

law

. In

acc

orda

nce

with

arti

cle

12.1

of t

he C

oven

ant,

Stat

espa

rties

reco

gniz

e “t

he ri

ght o

f eve

ryon

e to

the

enjo

ymen

t of t

he h

ighe

st a

ttain

able

stan

dard

of

phys

ical

and

men

tal h

ealth

”, w

hile

arti

cle

12.2

enu

mer

ates

, by

way

of i

llust

ratio

n, a

num

ber o

f“s

teps

to b

e ta

ken

by th

e St

ates

par

ties .

.. to

ach

ieve

the

full

real

izat

ion

of th

is ri

ght”

.A

dditi

onal

ly, t

he ri

ght t

o he

alth

is re

cogn

ized

, int

er a

lia, i

n ar

ticle

5 (e

) (iv

) of t

he In

tern

atio

nal

Con

vent

ion

on th

e El

imin

atio

n of

All

Form

s of R

acia

l Dis

crim

inat

ion

of 1

965,

in a

rticl

es 1

1.1

(f)

and

12 o

f the

Con

vent

ion

on th

e El

imin

atio

n of

All

Form

s of D

iscr

imin

atio

n ag

ains

t Wom

enof

197

9 an

d in

arti

cle

24 o

f the

Con

vent

ion

on th

e R

ight

s of t

he C

hild

of 1

989.

Sev

eral

regi

onal

hum

an ri

ghts

inst

rum

ents

als

o re

cogn

ize

the

right

to h

ealth

, suc

h as

the

Euro

pean

Soc

ial C

harte

rof

196

1 as

revi

sed

(art.

11)

, the

Afr

ican

Cha

rter o

n H

uman

and

Peo

ples

’ Rig

hts o

f 198

1 (a

rt. 1

6)an

d th

e A

dditi

onal

Pro

toco

l to

the

Am

eric

an C

onve

ntio

n on

Hum

an R

ight

s in

the

Are

a of

Econ

omic

, Soc

ial a

nd C

ultu

ral R

ight

s of 1

988

(art.

10)

. Si

mila

rly, t

he ri

ght t

o he

alth

has

bee

npr

ocla

imed

by

the

Com

mis

sion

on

Hum

an R

ight

s,2 a

s wel

l as i

n th

e V

ienn

a D

ecla

ratio

n an

dPr

ogra

mm

e of

Act

ion

of 1

993

and

othe

r int

erna

tiona

l ins

trum

ents

.3

3.Th

e rig

ht to

hea

lth is

clo

sely

rela

ted

to a

nd d

epen

dent

upo

n th

e re

aliz

atio

n of

oth

erhu

man

righ

ts, a

s con

tain

ed in

the

Inte

rnat

iona

l Bill

of R

ight

s, in

clud

ing

the

right

s to

food

,ho

usin

g, w

ork,

edu

catio

n, h

uman

dig

nity

, life

, non

-dis

crim

inat

ion,

equ

ality

, the

pro

hibi

tion

agai

nst t

ortu

re, p

rivac

y, a

cces

s to

info

rmat

ion,

and

the

free

dom

s of a

ssoc

iatio

n, a

ssem

bly

and

mov

emen

t. T

hese

and

oth

er ri

ghts

and

free

dom

s add

ress

inte

gral

com

pone

nts o

f the

righ

t to

heal

th.

4.In

dra

fting

arti

cle

12 o

f the

Cov

enan

t, th

e Th

ird C

omm

ittee

of t

he U

nite

d N

atio

nsG

ener

al A

ssem

bly

did

not a

dopt

the

defin

ition

of h

ealth

con

tain

ed in

the

prea

mbl

e to

the

Con

stitu

tion

of W

HO

, whi

ch c

once

ptua

lizes

hea

lth a

s “a

stat

e of

com

plet

e ph

ysic

al, m

enta

l and

soci

al w

ell-b

eing

and

not

mer

ely

the

abse

nce

of d

isea

se o

r inf

irmity

”. H

owev

er, t

he re

fere

nce

inar

ticle

12.

1 of

the

Cov

enan

t to

“the

hig

hest

atta

inab

le st

anda

rd o

f phy

sica

l and

men

tal h

ealth

” is

not c

onfin

ed to

the

right

to h

ealth

car

e. O

n th

e co

ntra

ry, t

he d

rafti

ng h

isto

ry a

nd th

e ex

pres

sw

ordi

ng o

f arti

cle

12.2

ack

now

ledg

e th

at th

e rig

ht to

hea

lth e

mbr

aces

a w

ide

rang

e of

soci

o-ec

onom

ic fa

ctor

s tha

t pro

mot

e co

nditi

ons i

n w

hich

peo

ple

can

lead

a h

ealth

y lif

e, a

ndex

tend

s to

the

unde

rlyin

g de

term

inan

ts o

f hea

lth, s

uch

as fo

od a

nd n

utrit

ion,

hou

sing

, acc

ess t

osa

fe a

nd p

otab

le w

ater

and

ade

quat

e sa

nita

tion,

safe

and

hea

lthy

wor

king

con

ditio

ns, a

nd a

heal

thy

envi

ronm

ent.

5.Th

e C

omm

ittee

is a

war

e th

at, f

or m

illio

ns o

f peo

ple

thro

ugho

ut th

e w

orld

, the

full

enjo

ymen

t of t

he ri

ght t

o he

alth

still

rem

ains

a d

ista

nt g

oal.

Mor

eove

r, in

man

y ca

ses,

espe

cial

lyfo

r tho

se li

ving

in p

over

ty, t

his g

oal i

s bec

omin

g in

crea

sing

ly re

mot

e. T

he C

omm

ittee

reco

gniz

es th

e fo

rmid

able

stru

ctur

al a

nd o

ther

obs

tacl

es re

sulti

ng fr

om in

tern

atio

nal a

nd o

ther

fact

ors b

eyon

d th

e co

ntro

l of S

tate

s tha

t im

pede

the

full

real

izat

ion

of a

rticl

e 12

in m

any

Stat

espa

rties

.

6.W

ith a

vie

w to

ass

istin

g St

ates

par

ties’

impl

emen

tatio

n of

the

Cov

enan

t and

the

fulfi

lmen

t of t

heir

repo

rting

obl

igat

ions

, thi

s Gen

eral

Com

men

t foc

uses

on

the

norm

ativ

e co

nten

tof

arti

cle

12 (P

art I

), St

ates

par

ties’

obl

igat

ions

(Par

t II)

, vio

latio

ns (P

art I

II) a

nd im

plem

enta

tion

194

E/C

N.4

/200

0/4

page

3

at th

e na

tiona

l lev

el (P

art I

V),

whi

le th

e ob

ligat

ions

of a

ctor

s oth

er th

an S

tate

s par

ties a

read

dres

sed

in P

art V

. Th

e G

ener

al C

omm

ent i

s bas

ed o

n th

e C

omm

ittee

’s e

xper

ienc

e in

exam

inin

g St

ates

par

ties’

repo

rts o

ver m

any

year

s.

I. N

OR

MA

TIV

E C

ON

TEN

T O

F A

RTI

CLE

12

7.A

rticl

e 12

.1 p

rovi

des a

def

initi

on o

f the

righ

t to

heal

th, w

hile

arti

cle

12.2

enu

mer

ates

illus

trativ

e, n

on-e

xhau

stiv

e ex

ampl

es o

f Sta

tes p

artie

s’ o

blig

atio

ns.

8.Th

e rig

ht to

hea

lth is

not

to b

e un

ders

tood

as a

righ

t to

be h

ealth

y. T

he ri

ght t

o he

alth

cont

ains

bot

h fr

eedo

ms a

nd e

ntitl

emen

ts.

The

free

dom

s inc

lude

the

right

to c

ontro

l one

’s h

ealth

and

body

, inc

ludi

ng se

xual

and

repr

oduc

tive

free

dom

, and

the

right

to b

e fr

ee fr

om in

terf

eren

ce,

such

as t

he ri

ght t

o be

free

from

tortu

re, n

on-c

onse

nsua

l med

ical

trea

tmen

t and

exp

erim

enta

tion.

By

cont

rast

, the

ent

itlem

ents

incl

ude

the

right

to a

sys

tem

of h

ealth

pro

tect

ion

whi

ch p

rovi

des

equa

lity

of o

ppor

tuni

ty fo

r peo

ple

to e

njoy

the

high

est a

ttain

able

leve

l of h

ealth

.

9.Th

e no

tion

of “

the

high

est a

ttain

able

stan

dard

of h

ealth

” in

arti

cle

12.1

take

s int

o ac

coun

tbo

th th

e in

divi

dual

’s b

iolo

gica

l and

soci

o-ec

onom

ic p

reco

nditi

ons a

nd a

Sta

te’s

ava

ilabl

ere

sour

ces.

The

re a

re a

num

ber o

f asp

ects

whi

ch c

anno

t be

addr

esse

d so

lely

with

in th

ere

latio

nshi

p be

twee

n St

ates

and

indi

vidu

als;

in p

artic

ular

, goo

d he

alth

can

not b

e en

sure

d by

aSt

ate,

nor

can

Sta

tes p

rovi

de p

rote

ctio

n ag

ains

t eve

ry p

ossi

ble

caus

e of

hum

an il

l hea

lth.

Thus

,ge

netic

fact

ors,

indi

vidu

al su

scep

tibili

ty to

ill h

ealth

and

the

adop

tion

of u

nhea

lthy

or ri

sky

lifes

tyle

s may

pla

y an

impo

rtant

role

with

resp

ect t

o an

indi

vidu

al’s

hea

lth.

Con

sequ

ently

, the

right

to h

ealth

mus

t be

unde

rsto

od a

s a ri

ght t

o th

e en

joym

ent o

f a v

arie

ty o

f fac

ilitie

s, go

ods,

serv

ices

and

con

ditio

ns n

eces

sary

for t

he re

aliz

atio

n of

the

high

est a

ttain

able

stan

dard

of h

ealth

.

10.

Sinc

e th

e ad

optio

n of

the

two

Inte

rnat

iona

l Cov

enan

ts in

196

6 th

e w

orld

hea

lth si

tuat

ion

has c

hang

ed d

ram

atic

ally

and

the

notio

n of

hea

lth h

as u

nder

gone

subs

tant

ial c

hang

es a

nd h

asal

so w

iden

ed in

scop

e. M

ore

dete

rmin

ants

of h

ealth

are

bei

ng ta

ken

into

con

side

ratio

n, su

ch a

sre

sour

ce d

istri

butio

n an

d ge

nder

diff

eren

ces.

A w

ider

def

initi

on o

f hea

lth a

lso

take

s int

o ac

coun

tsu

ch so

cial

ly-r

elat

ed c

once

rns a

s vio

lenc

e an

d ar

med

con

flict

.4 M

oreo

ver,

form

erly

unk

now

ndi

seas

es, s

uch

as H

uman

Imm

unod

efic

ienc

y V

irus a

nd A

cqui

red

Imm

unod

efic

ienc

y Sy

ndro

me

(HIV

/AID

S), a

nd o

ther

s tha

t hav

e be

com

e m

ore

wid

espr

ead,

such

as c

ance

r,as

wel

l as t

he ra

pid

grow

th o

f the

wor

ld p

opul

atio

n, h

ave

crea

ted

new

obs

tacl

es fo

r the

real

izat

ion

of th

e rig

ht to

heal

th w

hich

nee

d to

be

take

n in

to a

ccou

nt w

hen

inte

rpre

ting

artic

le 1

2.

11.

The

Com

mitt

ee in

terp

rets

the

right

to h

ealth

, as d

efin

ed in

arti

cle

12.1

, as a

n in

clus

ive

right

exte

ndin

g no

t onl

y to

tim

ely

and

appr

opria

te h

ealth

car

e bu

t als

o to

the

unde

rlyin

gde

term

inan

ts o

f hea

lth, s

uch

as a

cces

s to

safe

and

pot

able

wat

er a

nd a

dequ

ate

sani

tatio

n, a

nad

equa

te su

pply

of s

afe

food

, nut

ritio

n an

d ho

usin

g, h

ealth

y oc

cupa

tiona

l and

env

ironm

enta

lco

nditi

ons,

and

acce

ss to

hea

lth-r

elat

ed e

duca

tion

and

info

rmat

ion,

incl

udin

g on

sexu

al a

ndre

prod

uctiv

e he

alth

. A

furth

er im

porta

nt a

spec

t is t

he p

artic

ipat

ion

of th

e po

pula

tion

in a

llhe

alth

-rel

ated

dec

isio

n-m

akin

g at

the

com

mun

ity, n

atio

nal a

nd in

tern

atio

nal l

evel

s.

E/C

.12/

2000

/4pa

ge 4

12.

The

right

to h

ealth

in a

ll its

form

s and

at a

ll le

vels

con

tain

s the

follo

win

g in

terr

elat

ed a

ndes

sent

ial e

lem

ents

, the

pre

cise

app

licat

ion

of w

hich

will

dep

end

on th

e co

nditi

ons p

reva

iling

in a

parti

cula

r Sta

te p

arty

:

(a)

Avai

labi

lity.

Fun

ctio

ning

pub

lic h

ealth

and

hea

lth-c

are

faci

litie

s, go

ods a

ndse

rvic

es, a

s wel

l as p

rogr

amm

es, h

ave

to b

e av

aila

ble

in su

ffic

ient

qua

ntity

with

in th

e St

ate

party

. Th

e pr

ecis

e na

ture

of t

he fa

cilit

ies,

good

s and

serv

ices

will

var

y de

pend

ing

on n

umer

ous

fact

ors,

incl

udin

g th

e St

ate

party

’s d

evel

opm

enta

l lev

el.

They

will

incl

ude,

how

ever

, the

unde

rlyin

g de

term

inan

ts o

f hea

lth, s

uch

as sa

fe a

nd p

otab

le d

rinki

ng w

ater

and

ade

quat

esa

nita

tion

faci

litie

s, ho

spita

ls, c

linic

s and

oth

er h

ealth

-rel

ated

build

ings

, tra

ined

med

ical

and

prof

essi

onal

per

sonn

el re

ceiv

ing

dom

estic

ally

com

petit

ive

sala

ries,

and

esse

ntia

l dru

gs, a

sde

fined

by

the

WH

O A

ctio

n Pr

ogra

mm

e on

Ess

entia

l Dru

gs.5

(b)

Acce

ssib

ility

. H

ealth

faci

litie

s, go

ods a

nd se

rvic

es6 h

ave

to b

e ac

cess

ible

toev

eryo

ne w

ithou

t dis

crim

inat

ion,

with

in th

e ju

risdi

ctio

n of

the

Stat

e pa

rty.

Acc

essi

bilit

y ha

s fou

rov

erla

ppin

g di

men

sion

s:

(i)N

on-d

iscr

imin

atio

n: h

ealth

faci

litie

s, go

ods a

nd se

rvic

es m

ust b

eac

cess

ible

to a

ll, e

spec

ially

the

mos

t vul

nera

ble

or m

argi

naliz

ed se

ctio

nsof

the

popu

latio

n, in

law

and

in fa

ct, w

ithou

t dis

crim

inat

ion

on a

ny o

f the

proh

ibite

d gr

ound

s.7

(ii)

Phys

ical

acc

essi

bilit

y: h

ealth

faci

litie

s, go

ods a

nd se

rvic

es m

ust b

e w

ithin

safe

phy

sica

l rea

ch fo

r all

sect

ions

of t

he p

opul

atio

n, e

spec

ially

vul

nera

ble

or m

argi

naliz

ed g

roup

s, su

ch a

s eth

nic

min

oriti

es a

nd in

dige

nous

popu

latio

ns, w

omen

, chi

ldre

n, a

dole

scen

ts, o

lder

per

sons

, per

sons

with

disa

bilit

ies a

nd p

erso

ns w

ith H

IV/A

IDS.

Acc

essi

bilit

y al

so im

plie

s tha

tm

edic

al se

rvic

es a

nd u

nder

lyin

g de

term

inan

ts o

f hea

lth, s

uch

as sa

fe a

ndpo

tabl

e w

ater

and

ade

quat

e sa

nita

tion

faci

litie

s, ar

e w

ithin

safe

phy

sica

lre

ach,

incl

udin

g in

rura

l are

as.

Acc

essi

bilit

y fu

rther

incl

udes

ade

quat

eac

cess

to b

uild

ings

for p

erso

ns w

ith d

isab

ilitie

s.

(iii)

Econ

omic

acc

essi

bilit

y (a

ffor

dabi

lity)

: he

alth

faci

litie

s, go

ods a

ndse

rvic

es m

ust b

e af

ford

able

for a

ll. P

aym

ent f

or h

ealth

-car

e se

rvic

es, a

sw

ell a

s ser

vice

s rel

ated

to th

e un

derly

ing

dete

rmin

ants

of h

ealth

, has

to b

eba

sed

on th

e pr

inci

ple

of e

quity

, ens

urin

g th

at th

ese

serv

ices

, whe

ther

priv

atel

y or

pub

licly

pro

vide

d, a

re a

ffor

dabl

e fo

r all,

incl

udin

g so

cial

lydi

sadv

anta

ged

grou

ps.

Equi

ty d

eman

ds th

at p

oore

r hou

seho

lds s

houl

d no

tbe

dis

prop

ortio

nate

ly b

urde

ned

with

hea

lth e

xpen

ses a

s com

pare

d to

rich

erho

useh

olds

.

(iv)

Info

rmat

ion

acce

ssib

ility

: ac

cess

ibili

ty in

clud

es th

e rig

ht to

seek

, rec

eive

and

impa

rt in

form

atio

n an

d id

eas8

con

cern

ing

heal

th is

sues

. H

owev

er,

acce

ssib

ility

of i

nfor

mat

ion

shou

ldno

t im

pair

the

right

to h

ave

pers

onal

heal

th d

ata

treat

ed w

ith c

onfid

entia

lity.

195

E/C

N.4

/200

0/4

page

5

(c)

Acce

ptab

ility

. A

ll he

alth

faci

litie

s, go

ods a

nd se

rvic

es m

ust b

e re

spec

tful o

fm

edic

al e

thic

s and

cul

tura

lly a

ppro

pria

te, i

.e. r

espe

ctfu

l of t

he c

ultu

re o

f ind

ivid

uals

, min

oriti

es,

peop

les a

nd c

omm

uniti

es, s

ensi

tive

to g

ende

r and

life

-cyc

le re

quire

men

ts, a

s wel

l as b

eing

desi

gned

to re

spec

t con

fiden

tialit

y an

d im

prov

e th

e he

alth

stat

us o

f tho

se c

once

rned

.

(d)

Qua

lity.

As w

ell a

s bei

ng c

ultu

rally

acc

epta

ble,

hea

lth fa

cilit

ies,

good

s and

serv

ices

mus

t als

o be

scie

ntifi

cally

and

med

ical

ly a

ppro

pria

te a

nd o

f goo

d qu

ality

. Th

is re

quire

s,in

ter a

lia, s

kille

d m

edic

al p

erso

nnel

, sci

entif

ical

ly a

ppro

ved

and

unex

pire

ddr

ugs a

nd h

ospi

tal

equi

pmen

t, sa

fe a

nd p

otab

le w

ater

, and

ade

quat

e sa

nita

tion.

13.

The

non-

exha

ustiv

e ca

talo

gue

of e

xam

ples

in a

rticl

e 12

.2 p

rovi

des g

uida

nce

in d

efin

ing

the

actio

n to

be

take

n by

Sta

tes.

It g

ives

spec

ific

gene

ric e

xam

ples

of m

easu

res a

risin

g fr

om th

ebr

oad

defin

ition

of t

he ri

ght t

o he

alth

con

tain

ed in

arti

cle

12.1

, the

reby

illu

stra

ting

the

cont

ent o

fth

at ri

ght,

as e

xem

plifi

ed in

the

follo

win

g pa

ragr

aphs

.9

Arti

cle

12.2

(a).

The

righ

t to

mat

erna

l, ch

ild a

nd re

prod

uctiv

e he

alth

14.

“The

pro

visi

on fo

r the

redu

ctio

n of

the

still

birth

rate

and

of i

nfan

t mor

talit

y an

d fo

r the

heal

thy

deve

lopm

ent o

f the

chi

ld”

(art.

12.

2 (a

))10

may

be

unde

rsto

od a

s req

uirin

g m

easu

res t

oim

prov

e ch

ild a

nd m

ater

nal h

ealth

, sex

ual a

nd re

prod

uctiv

e he

alth

serv

ices

, inc

ludi

ng a

cces

s to

fam

ily p

lann

ing,

pre

- and

pos

t-nat

al c

are,

11 e

mer

genc

y ob

stet

ric se

rvic

es a

nd a

cces

s to

info

rmat

ion,

as w

ell a

s to

reso

urce

s nec

essa

ry to

act

on

that

info

rmat

ion.

12

Arti

cle

12.2

(b).

The

righ

t to

heal

thy

natu

ral a

nd w

orkp

lace

env

ironm

ents

15.

“The

impr

ovem

ent o

f all

aspe

cts o

f env

ironm

enta

l and

indu

stria

l hyg

iene

” (a

rt. 1

2.2

(b))

com

pris

es,i

nter

alia

, pre

vent

ive

mea

sure

s in

resp

ect o

f occ

upat

iona

l acc

iden

ts a

nd d

isea

ses;

the

requ

irem

ent t

o en

sure

an

adeq

uate

supp

ly o

f saf

e an

d po

tabl

e w

ater

and

bas

ic sa

nita

tion;

the

prev

entio

n an

d re

duct

ion

of th

e po

pula

tion’

s exp

osur

e to

har

mfu

l sub

stan

ces s

uch

as ra

diat

ion

and

harm

ful c

hem

ical

s or o

ther

det

rimen

tal e

nviro

nmen

tal c

ondi

tions

that

dire

ctly

or i

ndire

ctly

impa

ct u

pon

hum

an h

ealth

.13 F

urth

erm

ore,

indu

stria

l hyg

iene

refe

rs to

the

min

imiz

atio

n, so

far

as is

reas

onab

ly p

ract

icab

le, o

f the

cau

ses o

f hea

lth h

azar

ds in

here

nt in

the

wor

king

envi

ronm

ent.1

4 A

rticl

e 12

.2 (b

) als

o em

brac

es a

dequ

ate

hous

ing

and

safe

and

hyg

ieni

c w

orki

ngco

nditi

ons,

an a

dequ

ate

supp

ly o

f foo

d an

d pr

oper

nut

ritio

n, a

nd d

isco

urag

es th

e ab

use

ofal

coho

l,an

d th

e us

e of

toba

cco,

dru

gs a

nd o

ther

har

mfu

l sub

stan

ces.

Arti

cle

12.2

(c).

The

righ

t to

prev

entio

n, tr

eatm

ent a

nd c

ontro

l of d

isea

ses

16.

“The

pre

vent

ion,

trea

tmen

t and

con

trol o

f epi

dem

ic, e

ndem

ic, o

ccup

atio

nal a

nd o

ther

dise

ases

” (a

rt. 1

2.2

(c))

requ

ires t

he e

stab

lishm

ent o

f pre

vent

ion

and

educ

atio

n pr

ogra

mm

es fo

rbe

havi

our-

rela

ted

heal

th c

once

rns s

uch

as se

xual

ly tr

ansm

itted

dis

ease

s, in

par

ticul

ar H

IV/A

IDS,

and

thos

e ad

vers

ely

affe

ctin

g se

xual

and

repr

oduc

tive

heal

th, a

nd th

e pr

omot

ion

of so

cial

dete

rmin

ants

of g

ood

heal

th, s

uch

as e

nviro

nmen

tal s

afet

y, e

duca

tion,

eco

nom

ic d

evel

opm

ent

and

gend

er e

quity

. Th

e rig

ht to

trea

tmen

t inc

lude

s the

cre

atio

n of

a s

yste

m o

f urg

ent m

edic

alca

re in

cas

es o

f acc

iden

ts, e

pide

mic

s and

sim

ilar h

ealth

haz

ards

, and

the

prov

isio

n of

dis

aste

rre

lief a

nd h

uman

itaria

n as

sist

ance

in e

mer

genc

y si

tuat

ions

. Th

e co

ntro

l of d

isea

ses r

efer

s to

Stat

es’ i

ndiv

idua

l and

join

t eff

orts

to, i

nter

alia

, mak

e av

aila

ble

rele

vant

tech

nolo

gies

, usi

ng a

nd

E/C

.12/

2000

/4pa

ge 6

impr

ovin

g ep

idem

iolo

gica

l sur

veill

ance

and

dat

a co

llect

ion

on a

dis

aggr

egat

ed b

asis

, the

impl

emen

tatio

n or

enh

ance

men

t of i

mm

uniz

atio

n pr

ogra

mm

esan

d ot

her s

trate

gies

of i

nfec

tious

dise

ase

cont

rol.

Arti

cle

12.2

(d).

The

righ

t to

heal

th fa

cilit

ies,

good

s and

serv

ices

15

17.

“The

cre

atio

n of

con

ditio

ns w

hich

wou

ld a

ssur

e to

all

med

ical

serv

ice

and

med

ical

atte

ntio

n in

the

even

t of s

ickn

ess”

(art.

12.

2 (d

)), b

oth

phys

ical

and

men

tal,

incl

udes

the

prov

isio

n of

equ

al a

nd ti

mel

y ac

cess

to b

asic

pre

vent

ive,

cur

ativ

e, re

habi

litat

ive

heal

th se

rvic

esan

d he

alth

edu

catio

n; re

gula

r scr

eeni

ng p

rogr

amm

es; a

ppro

pria

te tr

eatm

ent o

f pre

vale

nt d

isea

ses,

illne

sses

, inj

urie

s and

dis

abili

ties,

pref

erab

ly a

t com

mun

ity le

vel;

the

prov

isio

n of

ess

entia

ldr

ugs;

and

app

ropr

iate

men

tal h

ealth

trea

tmen

t and

car

e. A

furth

er im

porta

nt a

spec

t is t

heim

prov

emen

t and

furth

eran

ce o

f par

ticip

atio

n of

the

popu

latio

n in

the

prov

isio

n of

pre

vent

ive

and

cura

tive

heal

th se

rvic

es, s

uch

as th

e or

gani

zatio

n of

the

heal

th se

ctor

, the

insu

ranc

e sy

stem

and,

in p

artic

ular

, par

ticip

atio

n in

pol

itica

l dec

isio

ns re

latin

g to

the

right

to h

ealth

take

n at

bot

hth

e co

mm

unity

and

nat

iona

l lev

els.

Arti

cle

12.

Spec

ial t

opic

s of b

road

app

licat

ion

Non

-dis

crim

inat

ion

and

equa

l tre

atm

ent

18.

By

virtu

e of

arti

cle

2.2

and

artic

le 3

, the

Cov

enan

t pro

scrib

es a

ny d

iscr

imin

atio

n in

acce

ss to

hea

lth c

are

and

unde

rlyin

g de

term

inan

ts o

f hea

lth, a

s wel

l as t

o m

eans

and

ent

itlem

ents

for t

heir

proc

urem

ent,

on th

e gr

ound

s of r

ace,

col

our,

sex,

lang

uage

, rel

igio

n, p

oliti

cal o

r oth

erop

inio

n, n

atio

nal o

r soc

ial o

rigin

, pro

perty

, birt

h, p

hysi

cal o

r men

tal d

isab

ility

, hea

lth st

atus

(incl

udin

g H

IV/A

IDS)

, sex

ual o

rient

atio

n an

d ci

vil,

polit

ical

, soc

ial o

r oth

er st

atus

, whi

ch h

as th

ein

tent

ion

or e

ffec

t of n

ullif

ying

or i

mpa

iring

the

equa

l enj

oym

ent o

r exe

rcis

e of

the

right

tohe

alth

. Th

e C

omm

ittee

stre

sses

that

man

y m

easu

res,

such

as m

ost s

trate

gies

and

pro

gram

mes

desi

gned

to e

limin

ate

heal

th-r

elat

ed d

iscr

imin

atio

n, c

an b

e pu

rsue

d w

ith m

inim

um re

sour

ceim

plic

atio

ns th

roug

h th

e ad

optio

n, m

odifi

catio

n or

abr

ogat

ion

of le

gisl

atio

n or

the

diss

emin

atio

nof

info

rmat

ion.

The

Com

mitt

ee re

calls

Gen

eral

Com

men

t No.

3, p

arag

raph

12,

whi

ch st

ates

that

even

in ti

mes

of s

ever

e re

sour

ce c

onst

rain

ts, t

he v

ulne

rabl

e m

embe

rs o

f soc

iety

mus

t be

prot

ecte

d by

the

adop

tion

of re

lativ

ely

low

-cos

t tar

gete

d pr

ogra

mm

es.

19.

With

resp

ect t

o th

e rig

ht to

hea

lth, e

qual

ity o

f acc

ess t

o he

alth

car

e an

d he

alth

serv

ices

has t

o be

em

phas

ized

. St

ates

hav

e a

spec

ial o

blig

atio

n to

pro

vide

thos

e w

ho d

o no

t hav

esu

ffic

ient

mea

ns w

ith th

e ne

cess

ary

heal

th in

sura

nce

and

heal

th-c

are

faci

litie

s, an

d to

pre

vent

any

disc

rimin

atio

n on

inte

rnat

iona

lly p

rohi

bite

d gr

ound

sin

the

prov

isio

n of

hea

lth c

are

and

heal

th se

rvic

es, e

spec

ially

with

resp

ect t

o th

e co

re o

blig

atio

ns o

f the

righ

t to

heal

th.16

Inap

prop

riate

hea

lth re

sour

ce a

lloca

tion

can

lead

to d

iscr

imin

atio

n th

at m

ay n

ot b

e ov

ert.

For

exam

ple,

inve

stm

ents

shou

ld n

ot d

ispr

opor

tiona

tely

favo

ur e

xpen

sive

cur

ativ

e he

alth

serv

ices

whi

ch a

re o

ften

acce

ssib

le o

nly

to a

smal

l, pr

ivile

ged

frac

tion

of th

e po

pula

tion,

rath

er th

anpr

imar

y an

d pr

even

tive

heal

th c

are

bene

fitin

g a

far l

arge

r par

t of t

he p

opul

atio

n.

196

E/C

N.4

/200

0/4

page

7

Gen

der p

ersp

ectiv

e

20.

The

Com

mitt

ee re

com

men

ds th

at S

tate

s int

egra

te a

gen

der p

ersp

ectiv

e in

thei

rhe

alth

-rel

ated

pol

icie

s, pl

anni

ng, p

rogr

amm

es a

nd re

sear

ch in

ord

er to

pro

mot

e be

tter h

ealth

for

both

wom

en a

nd m

en.

A g

ende

r-ba

sed

appr

oach

reco

gniz

es th

at b

iolo

gica

l and

soci

o-cu

ltura

lfa

ctor

s pla

y a

sign

ifica

nt ro

le in

influ

enci

ng th

e he

alth

of m

en a

nd w

omen

. Th

e di

sagg

rega

tion

of h

ealth

and

soci

o-ec

onom

ic d

ata

acco

rdin

g to

sex

is e

ssen

tial f

or id

entif

ying

and

rem

edyi

ngin

equa

litie

s in

heal

th.

Wom

en a

nd th

e rig

ht to

hea

lth

21.

To e

limin

ate

disc

rimin

atio

n ag

ains

t wom

en, t

here

is a

nee

d to

dev

elop

and

impl

emen

t aco

mpr

ehen

sive

nat

iona

l stra

tegy

for p

rom

otin

g w

omen

’s ri

ght t

o he

alth

thro

ugho

ut th

eir l

ifesp

an.

Such

a st

rate

gy sh

ould

incl

ude

inte

rven

tions

aim

ed a

t the

pre

vent

ion

and

treat

men

t of

dise

ases

aff

ectin

g w

omen

, as w

ell a

s pol

icie

s to

prov

ide

acce

ss to

a fu

ll ra

nge

of h

igh

qual

ity a

ndaf

ford

able

hea

lth c

are,

incl

udin

g se

xual

and

repr

oduc

tive

serv

ices

. A

maj

or g

oal s

houl

d be

redu

cing

wom

en’s

hea

lth ri

sks,

parti

cula

rly lo

wer

ing

rate

s of m

ater

nal m

orta

lity

and

prot

ectin

gw

omen

from

dom

estic

vio

lenc

e. T

he re

aliz

atio

n of

wom

en’s

righ

t to

heal

th re

quire

s the

rem

oval

of a

ll ba

rrie

rs in

terf

erin

g w

ith a

cces

s to

heal

th se

rvic

es, e

duca

tion

and

info

rmat

ion,

incl

udin

g in

the

area

of s

exua

l and

repr

oduc

tive

heal

th.

It is

als

o im

porta

nt to

und

erta

ke p

reve

ntiv

e,pr

omot

ive

and

rem

edia

l act

ion

to sh

ield

wom

en fr

om th

e im

pact

of h

arm

ful t

radi

tiona

l cul

tura

lpr

actic

es a

nd n

orm

s tha

t den

y th

em th

eir f

ull r

epro

duct

ive

right

s.

Chi

ldre

n an

d ad

oles

cent

s

22.

Arti

cle

12.2

(a) o

utlin

es th

e ne

ed to

take

mea

sure

s to

redu

ce in

fant

mor

talit

y an

d pr

omot

eth

e he

alth

y de

velo

pmen

t of i

nfan

ts a

nd c

hild

ren.

Sub

sequ

ent i

nter

natio

nal h

uman

righ

tsin

stru

men

ts re

cogn

ize

that

chi

ldre

n an

d ad

oles

cent

s hav

e th

e rig

ht to

the

enjo

ymen

t of t

hehi

ghes

t sta

ndar

d of

hea

lth a

nd a

cces

s to

faci

litie

s for

the

treat

men

t of i

llnes

s.17 T

he C

onve

ntio

non

the

Rig

hts o

f the

Chi

ld d

irect

s Sta

tes t

o en

sure

acc

ess t

o es

sent

ial h

ealth

serv

ices

for t

he c

hild

and

his o

r her

fam

ily, i

nclu

ding

pre

- and

pos

t-nat

al c

are

for m

othe

rs.

The

Con

vent

ion

links

thes

ego

als w

ith e

nsur

ing

acce

ss to

chi

ld-f

riend

ly in

form

atio

n ab

out p

reve

ntiv

e an

d he

alth

-pro

mot

ing

beha

viou

r and

supp

ort t

o fa

mili

es a

nd c

omm

uniti

es in

impl

emen

ting

thes

e pr

actic

es.

Impl

emen

tatio

n of

the

prin

cipl

e of

non

-dis

crim

inat

ion

requ

ires t

hat g

irls,

as w

ell a

s boy

s, ha

veeq

ual a

cces

s to

adeq

uate

nut

ritio

n, sa

fe e

nviro

nmen

ts, a

nd p

hysi

cal a

s wel

l as m

enta

l hea

lthse

rvic

es.

Ther

e is

a n

eed

to a

dopt

eff

ectiv

e an

d ap

prop

riate

mea

sure

s to

abol

ish

harm

ful

tradi

tiona

l pra

ctic

es a

ffec

ting

the

heal

th o

f chi

ldre

n, p

artic

ular

ly g

irls,

incl

udin

g ea

rly m

arria

ge,

fem

ale

geni

tal m

utila

tion,

pre

fere

ntia

l fee

ding

and

car

e of

mal

e ch

ildre

n.18

Chi

ldre

n w

ithdi

sabi

litie

s sho

uld

be g

iven

the

oppo

rtuni

ty to

enj

oy a

fulfi

lling

and

dec

ent l

ife a

nd to

par

ticip

ate

with

in th

eir c

omm

unity

.

23.

Stat

es p

artie

s sho

uld

prov

ide

a sa

fe a

nd su

ppor

tive

envi

ronm

ent f

or a

dole

scen

ts, t

hat

ensu

res t

he o

ppor

tuni

ty to

par

ticip

ate

in d

ecis

ions

aff

ectin

g th

eir h

ealth

, to

build

life

-ski

lls, t

oac

quire

app

ropr

iate

info

rmat

ion,

to re

ceiv

e co

unse

lling

and

to n

egot

iate

the

heal

th-b

ehav

iour

choi

ces t

hey

mak

e. T

he re

aliz

atio

n of

the

right

to h

ealth

of a

dole

scen

ts is

dep

ende

nt o

n th

ede

velo

pmen

t of y

outh

-frie

ndly

hea

lth c

are,

whi

ch re

spec

ts c

onfid

entia

lity

and

priv

acy

and

incl

udes

app

ropr

iate

sexu

al a

nd re

prod

uctiv

e he

alth

serv

ices

.

E/C

.12/

2000

/4pa

ge 8

24.

In a

ll po

licie

s and

pro

gram

mes

aim

ed a

t gua

rant

eein

g th

e rig

ht to

hea

lth o

f chi

ldre

n an

dad

oles

cent

s the

ir be

st in

tere

sts s

hall

be a

prim

ary

cons

ider

atio

n.

Old

er p

erso

ns

25.

With

rega

rd to

the

real

izat

ion

of th

e rig

ht to

hea

lth o

f old

er p

erso

ns, t

he C

omm

ittee

, in

acco

rdan

ce w

ith p

arag

raph

s 34

and

35 o

f Gen

eral

Com

men

t No.

6 (1

995)

, rea

ffirm

s the

impo

rtanc

e of

an

inte

grat

ed a

ppro

ach,

com

bini

ng e

lem

ents

of p

reve

ntiv

e, c

urat

ive

and

reha

bilit

ativ

e he

alth

trea

tmen

t. S

uch

mea

sure

s sho

uld

be b

ased

on

perio

dica

l che

ck-u

ps fo

r bot

hse

xes;

phy

sica

l as w

ell a

s psy

chol

ogic

al re

habi

litat

ive

mea

sure

s aim

ed a

t mai

ntai

ning

the

func

tiona

lity

and

auto

nom

y of

old

er p

erso

ns; a

nd a

ttent

ion

and

care

for c

hron

ical

ly a

ndte

rmin

ally

ill p

erso

ns, s

parin

g th

em a

void

able

pai

n an

d en

ablin

g th

em to

die

with

dig

nity

.

Pers

ons w

ith d

isab

ilitie

s

26.

The

Com

mitt

ee re

affir

ms p

arag

raph

34

of it

s Gen

eral

Com

men

t No.

5, w

hich

add

ress

esth

e is

sue

of p

erso

ns w

ith d

isab

ilitie

s in

the

cont

ext o

f the

righ

t to

phys

ical

and

men

tal h

ealth

.M

oreo

ver,

the

Com

mitt

ee st

ress

es th

e ne

ed to

ens

ure

that

not

onl

y th

e pu

blic

hea

lth se

ctor

but a

lso

priv

ate

prov

ider

s of h

ealth

serv

ices

and

faci

litie

s com

ply

with

the

prin

cipl

e of

non-

disc

rimin

atio

n in

rela

tion

to p

erso

ns w

ith d

isab

ilitie

s.

Indi

geno

us p

eopl

es

27.

In th

e lig

ht o

f em

ergi

ng in

tern

atio

nal l

aw a

nd p

ract

ice

and

the

rece

nt m

easu

res t

aken

by

Stat

es in

rela

tion

to in

dige

nous

peo

ples

,19 th

e C

omm

ittee

dee

ms i

t use

ful t

o id

entif

y el

emen

tsth

at w

ould

hel

p to

def

ine

indi

geno

us p

eopl

es’ r

ight

to h

ealth

in o

rder

bet

ter t

o en

able

Sta

tes w

ithin

dige

nous

peo

ples

to im

plem

ent t

he p

rovi

sion

s con

tain

ed in

arti

cle

12 o

f the

Cov

enan

t. T

heC

omm

ittee

con

side

rs th

at in

dige

nous

peo

ples

hav

e th

e rig

ht to

spec

ific

mea

sure

s to

impr

ove

thei

rac

cess

to h

ealth

serv

ices

and

car

e. T

hese

hea

lth se

rvic

es sh

ould

be

cultu

rally

app

ropr

iate

, tak

ing

into

acc

ount

trad

ition

al p

reve

ntiv

e ca

re, h

ealin

g pr

actic

es a

nd m

edic

ines

. St

ates

shou

ld p

rovi

dere

sour

ces f

or in

dige

nous

peo

ples

to d

esig

n, d

eliv

er a

nd c

ontro

l suc

h se

rvic

es so

that

they

may

enjo

y th

e hi

ghes

t atta

inab

le st

anda

rd o

f phy

sica

l and

men

tal h

ealth

. Th

e vi

tal m

edic

inal

pla

nts,

an