Recognising health as a fundamental human right

What do our regional neighbours have in common that we do not share? They are all among the 120 or more countries across the globe that recognise health as a fundamental human right, and it is enshrined in their constitutions. Unfortunately, such a recognition is missing from our own Constitution — an egregious omission that perhaps reflects the failure of successive governments to recognise the importance of health. The results are evident in our appalling health indicators: we are one of the six countries of the world that together account for 50% of global maternal deaths; we have the highest deaths among babies less than one month of age; and we are still trying to eradicate polio, which most other countries eliminated long ago.

Constitutional recognition of health as a fundamental human right per se is important for several reasons. Apart from elevating health to the status of a higher national priority, it also facilitates the array of systematic and sustained efforts needed to ensure universal access of citizens to affordable, accessible, and respectful healthcare services. Constitutional recognition provides the foundation for a right-based approach, in which health is seen as a fundamental entitlement that the state is obligated to fulfil. This influences the national vision and provincial policies, and provides programmatic direction for inducting health goals into national development plans. The right to healthcare moreover helps elevate healthcare financing to the priority list of budgetary allocations. Once the constitutional right is acknowledged, appropriate legislation can be framed to enforce mechanisms to protect it and also put in place accountability measures. In some countries, strong constitutional protection has helped individuals and organisations to successfully plead in court their right to seek specific healthcare services from the government.

Constitutional recognition of health as a specific legislative subject can also help sustain political commitment across successive governments, providing a degree of insulation against the vicissitudes and wavering resolve that in the past have badly affected social sector funding and support. Furthermore, as health encapsulates not just curative but also promotional, preventive, and rehabilitative aspects, a right-based approach can help shift our current treatment-centered paradigm of public health services towards preservation of optimal well-being. As adverse health outcomes disproportionately affect women in Pakistan; every 27 minutes, a woman dies due to pregnancy-related issues, often associated with closely spaced and unintended pregnancies due to a high unmet need for family planning. Therefore, the right to health must specifically include the right to reproductive healthcare, including access to voluntary family planning information and services.

If an amendment is tabled in the assembly,   it should be supported by the majority of the political parties represented in the parliament as it’s a non-controversial subject. A review of provisions in other constitutions in the region reveals varying degrees of emphasis in the wording of the right to health, from purely aspirational and programmatic statements to more specific binding statements that clearly hold the state responsible for taking all necessary steps to provide and safeguard citizens’ right to health. We will need emphatic wording to help enforce the right to health as a duty of the State.

The present government, which has articulated a deep commitment to upholding the principles of justice, must focus on effective means to remove inequalities in our society, especially inequalities in healthcare through a strong constitutional backing. Pakistan can no longer afford to be singled out in the region for lack of recognition of health as a fundamental right — it is high time we rectify this anomaly.

Published in The Express Tribune, January 9^th, 2020.

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