A fundamental right
THE World Health Organization (WHO), a United Nations (UN) agency, was established on April 7, 1949, when its constitution was ratified by 26 nations.
The WHO’S membership is not restricted to UN member states, but also allows non-member states to join.
The WHO’S role is to connect “nations, partners and people to promote health, keep the world safe and serve the vulnerable – so everyone, everywhere can attain the highest level of health”.
The date of WHO’S establishment is commemorated annually as World Health Day.
The theme for this year’s World Health Day is “My health, my right”.
What is health?
The WHO defined health in 1948 as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”.
In response to criticism of this definition, the WHO clarified in 1986 that: “Health is seen as a resource for everyday life, not the objective of living.
“Health is a positive concept emphasising social and personal resources, as well as physical capacities.”
The right to health is related to, and dependent on, other human rights, which include the rights to life, food, housing, work, education, privacy, access to information, freedom from torture, and the freedoms of association, assembly and movement.
It includes both non-discriminatory access to quality, timely and appropriate health services and systems, and to the social determinants of health.
The WHO has emphasised that the core components of the right to health include the four interrelated factors below:
“Availability refers to the need for a sufficient quantity of functioning health facilities, goods
and services for all.
“Availability can be measured through the analysis of disaggregated data to different stratifiers, including by age, sex, location and socioeconomic status, and qualitative surveys to understand coverage gaps.
“Accessibility requires that health facilities, goods and services must be accessible to everyone.
“Accessibility has four dimensions: non-discrimination, physical accessibility, economic accessibility (affordability) and information accessibility.
“This is particularly important for persons with disabilities, who often encounter significant barriers to health related to the inaccessibility of services, facilities and health information.
“Assessing accessibility requires analysis of physical, geographical, financial and other barriers to health systems and services, and how they may affect people who are marginalised.
“It requires the establishment or application of clear norms and standards in both law and policy to address these barriers.
“Acceptability relates to respect for medical ethics, cultural appropriateness and sensitivity to gender.
“Acceptability requires that health facilities, goods, services and programmes are peoplecentred and cater to the specific needs of diverse population groups, and are in accordance with international standards of medical ethics for confidentiality and informed consent.
“Quality extends to the underlying determinants of health, for example, safe and potable water and sanitation, as well as requiring that health facilities, goods and services are scientifically and medically approved.
“Quality is a key component of universal health coverage (UHC).
“Quality health services should be:
> “Safe: avoiding injuries to people for whom the care is intended;
> “Effective: providing evidencebased services to those who need them;
> “People-centred: providing care that responds to individual needs;
> “Timely: reducing waiting
times and harmful delays; > “Equitable: providing care that does not vary in quality on account of age, gender, ethnicity, disability, geographic location and socioeconomic status; > “Integrated: providing a full range of health services throughout the life course; and
> “Efficient: maximising the benefit of available resources and avoiding waste.”
A right to health
The right to health is included in the articles of several human rights treaties, which are the: > International Covenant on Economic, Social and Cultural Rights
> Elimination of All Forms of
Racial Discrimination > International Convention on the Elimination of All Forms of Discrimination Against Women
> Convention on the Rights of
the Child
> International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families, and
> Convention on the Rights of Persons with Disabilities. Although at least 140 countries recognise the right to health in their constitutions, the WHO Council on the Economics of Health for All found that many do not have laws that ensure their population’s right to health services.
This was reflected in the fact that at least more than half the world’s population were not fully covered by essential health services in 2021.
In addition, the right to health of millions throughout the world is increasingly under threat from diseases and disasters that have caused, and continue to cause, death and disability.
Conflicts have aggravated the situation, causing destruction, deaths, hunger, pain, mental illness and displacements.
Climate change has impacted, and continues to impact, health in numerous ways, leading to disruptions in physical, biological and ecological systems.
The health effects of climate change include, among others: > Death and illness from increasingly frequent extreme weather events, like heatwaves, storms and floods > Disruption of food systems > Increases in zoonoses (diseases that jump from animals to humans)
> Increases in food-, water- and
vector-borne diseases, and > Mental health issues.
Climate change will intensify some existing health threats and will also lead to the emergence of new health threats.
Not everyone is at risk of the health effects of climate change though.
The important considerations include age, gender, economic resources and location.
The Covid-19 pandemic was the worst global public health disaster.
The WHO mandated in December 2021, the establishment of an Intergovernmental Negotiating Body from among its members, representing all regions of the world, to draft and negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response.
The Body is to submit its outcome to the World Health Assembly this May.
To date, the process is still mired in disagreements.
It appears that governments have not learnt from Covid-19.
The 2024 World Health Day theme focuses on the right of every human being, everywhere to “have access to quality health services, education and information, as well as safe drinking water, clean air, good nutrition, quality housing, decent working and environmental conditions, and freedom from discrimination”.
A pertinent question for the reader’s consideration: “Is Malaysia doing well in this?”
Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email starhealth@thestar.com.my. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care.
The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.