Facilitating Accountability for the Right to Health: Mainstreaming WHO Participation in Human Rights Monitoring

By Neha Acharya and Benjamin Mason Meier

Where human rights are central to the Sustainable Development Goals (SDGs), accountability frameworks are necessary to assure the progressive realization of the human right to health. In creating accountability for realization of the right to health, human rights monitoring mechanisms exist through the UN to assess implementation of state human rights obligations. The World Health Organization (WHO) should mainstream its participation with these monitoring mechanisms to support Member States in implementing their human rights obligations and facilitating accountability for the highest attainable standard of health.

The seminal codification of a human right to the “highest attainable standard of health” in the 1948 WHO Constitution has framed an organizational drive to redress health inequities.1 WHO has come to hold this right as essential to its mission, employing human rights to advance global health. Building from WHO’s evolving work to advance health under the UN human rights system, the 2012 creation of WHO’s Gender, Equity and Rights team has focused the WHO Secretariat on mainstreaming gender, equity and human rights across all organizational activities.2 In mainstreaming the right to health in its work with national governments, WHO is uniquely situated to support states in examining public health obligations through the UN’s human rights monitoring mechanisms.

Facilitating accountability through international monitoring, the UN assesses the progressive realization of rights through:

  • Charter-based bodies—derived from the UN Charter to oversee the condition of rights worldwide, as seen through the Universal Periodic Review (UPR) process of reviewing state practices and forming international recommendations.3  
  • Treaty-based bodies—derived from specific human rights treaties to monitor and advise Member States, as seen through the Committee on Economic, Social and Cultural Rights process of reviewing state reports on the International Covenant on Economic, Social and Cultural Rights.

Having ratified the UN Charter and core human rights treaties, states acknowledge legal obligations to respect, protect and fulfill specific rights. These charter-based and treaty-based monitoring mechanisms track state implementation in national policy and offer recommendations for best practices.4 Where these mechanisms have faced challenges in monitoring states, recent reform initiatives have renewed the promise of more effective and efficient monitoring for human rights accountability.

UN human rights monitoring mechanisms can assist states in realizing the right to health, but these mechanisms require technical assistance to influence the implementation of the right to health across member states. In mainstreaming human rights in global health, WHO can advance its global health agenda by collaborating with these human rights monitoring mechanisms.

Both charter-based and treaty-based bodies call on member states to report on the national public health situation and—following dialogue with the national government—publish recommendations for state human rights implementation. Offering points of engagement for WHO, these monitoring mechanisms provide a path for WHO to advance global health through its participation in the:

  • Charter-based UPR—where all 193 UN Member States are subject every 4½ years to interactive dialogue with the UPR Working Group on the full range of human rights, offering a universal approach for building state capacity and sharing best practices in rights-based health policy.5
  • Treaty-based periodic reporting—where member states submit reports every five years on the rights within their respective treaties, engaging in constructive dialogue with treaty bodies and receiving concluding observations to ensure progressive realization of the right to health.

Although distinct monitoring mechanisms will be developed under the SDGs, WHO could complement the assessment of health-related SDGs through systematic collaboration with human rights monitoring mechanisms to assure realization of the right to health. Where select WHO thematic areas have long collaborated with UN monitoring mechanisms,  this role could be mainstreamed across WHO’s regional and country offices: assisting national governments in formulating state reports, submitting health statistics before charter-based and treaty-based proceedings, suggesting health-related questions for the working group or treaty body, and working with Member States to implement recommendations.

Challenges remain in the UN human rights monitoring system—with inconsistencies in UN funding, weaknesses in reporting capacity, and delays in state review—however, WHO could help bridge efforts across the UN and SDGs to support implementation of the right to health. Where WHO maintains a clear and active role in UN mechanisms to monitor human rights implementation, its systematic participation could facilitate accountability for realizing the highest attainable standard of health.

Neha Acharya is an MPH student in Global Health at the Emory Rollins School of Public Health, Atlanta, GA, USA.

Benjamin Mason Meier is an Associate Professor of Global Health Policy at the University of North Carolina, Chapel Hill, NC, USA.

References

  1. Constitution of the World Health Organization. Geneva: World Health Organization; 1948.
  2. Meier, B. M., & Onzivu, W. (2014). The evolution of human rights in World Health Organization policy and the future of human rights through global health governance. Public Health Journal, 128, 179-187. Retrieved from https://www.researchgate.net/publication/259977114_Meier_Onzivu_2014.
  3. “Universal Periodic Review.” Universal Periodic Review. N.p., n.d. Web. 17 July 2015 http://www.ohchr.org/EN/HRBodies/UPR/Pages/UPRMain.aspx
  4. Meier, B. M., & Kim, Y. (2015). Human Rights Accountability Through Treaty Bodies: Examining Human Rights Treaty Monitoring for Water and Sanitation. Duke Journal of Comparative and International Law, 26, 141st ser. Retrieved from http://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=1478&context=djcil
  5. “Basic Facts about the UPR.” Basic Facts about the UPR. OHCHR, n.d. Web. 17 July 2015 http://www.ohchr.org/EN/HRBodies/UPR/Pages/BasicFacts.aspx