Human Rights Education Must Become Central to the Health Curriculum
Lawrence O. Gostin, Hanna Huffstetler, and Benjamin Mason Meier
The health and human rights movement has united the world to realize health-related human rights. Yet, the current age of populist nationalism has challenged long-held assumptions about the overarching importance of human rights and the rights-based imperative of global solidarity. It is necessary to look to the next generation of leaders to sustain (and reinvigorate) the commitment to universal rights in global health. In preparing the next generation of leaders to face mounting challenges, human rights education will become crucial to health policy, research, and advocacy.
Through education on the inextricable linkages between human rights and public health, students are challenged to see global health through the lens of universal dignity, community empowerment, and social justice. New educational resources can provide a foundation for greater inclusion of human rights in health professional studies, engaging the next generation in human rights learning and practice. Empowering health professionals to place human rights at the center of their work, human rights education can facilitate a future of global health with justice.
Incorporating Human Rights in Health Education
The academic discipline of health and human rights builds upon international efforts to support universal human rights education. During its founding era, the United Nations (UN) recognized that global justice had to be founded upon the intellectual and moral solidarity of humankind, establishing the United Nations Educational, Scientific and Cultural Organization (UNESCO) with a mandate to facilitate mutual understanding and rapprochement among peoples through human rights.[1] UNESCO’s mandate would be amplified by the 1948 Universal Declaration of Human Rights, which enshrined education as a principal vehicle to foster respect for human rights and promote “understanding, tolerance and friendship among all nations, racial or religious groups.”[2]
In the years that followed, UNESCO spearheaded UN efforts to advance human rights education, coordinating with other UN specialized agencies to promote health-related human rights.[3] Through this coordination, UNESCO joined with the World Health Organization (WHO) in 1949 to establish the Council for International Organizations of Medical Sciences (CIOMS), which would come to support the development of programs and methodologies for teaching human rights and ethics in schools of medical sciences.[4] WHO’s reassertion of the right to health in the 1978 Declaration of Alma-Ata made clear the implications of human rights training for the realization of primary health care, with WHO and UNSECO thereafter partnering to promote human rights education in healthcare settings.[5]
As human rights education expanded, the health and human rights movement began to take shape. Responding to the rapidly unfolding AIDS pandemic, civil society claimed human rights as a common language to underpin demands for health justice. Human rights discourse took root in WHO and expanded into the public health workforce. Drawing from his leadership of WHO’s Global Program on AIDS, Jonathan Mann led early efforts to establish an academic discipline through which human rights and public health could be seen as complementary fields—with human rights promotion supporting public health advancement.[6]
These linkages between health and human rights broadened the operationalization of human rights in health practice.[7] Academic efforts to establish human rights coursework in graduate health education soon followed. The first course on health and human rights was developed in 1991 to offer students insight into this nascent discipline—examining the history of human rights, the codification of international human rights law, and the debate between universalism and relativism.[8] Supporting these initial academic efforts, interdisciplinary scholars came together to discuss the intersections between health and human rights, exploring both the conceptual dimensions and practical applications of the field.[9] Health and human rights teaching expanded rapidly in the next decade, leading to dozens of health and human rights courses across academic disciplines.[10]
Mainstreaming Human Rights in Health Education
Faculty have now established a wide range of health and human rights courses in universities throughout the world—within schools of law, policy, public health, social work, nursing, and medicine. These courses cover a wide breadth of topics, including courses that focus on a specific set of rights (such as sexual and reproductive rights); the health-related human rights of specific groups (including the rights of children and adolescents); the promotion and protection of health and human rights in individual countries or regions (addressing the right to health in Latin America); and the intersections of human rights with related disciplines (drawing from complementary teaching on bioethics, law, and social justice).[11]
While curricula in health already embraced issues of justice, these new courses began to examine both the ethical responsibilities of health professions to respect human rights and the legal implementation of human rights obligations to frame public health policy. Employing distinct approaches to health and human rights across disciplines, these courses would seek, inter alia, to develop legal competencies for human rights; to examine how human rights violations shape the lived reality of health, especially for the most marginalized populations; and to enable students to translate key human rights norms and principles into action-oriented health policies, programs, and practices.[12]
Health and human rights education has been catalyzed by health professional associations, supporting rights-based courses to mainstream human rights in health practice. The World Medical Association and the International Council of Nurses have called on medical and nursing schools respectively to incorporate medical ethics and human rights as core components of graduate education.[13] In public health education, the American Public Health Association has galvanized human rights initiatives, convening symposia to examine approaches to teaching health and human rights.[14] Human rights analysis is now included as a core competency of the US master of public health (MPH) curriculum—and in curricula throughout the world.[15]
This support across professional organizations has brought legitimacy to human rights as a foundation and framework for health education. As the field of health and human rights expands—in parallel with broader efforts to advance human rights education, across health-related disciplines and throughout the world—there arises an imperative to harmonize human rights courses and standardize educational resources.
Standardizing Human Rights in Health Education
Building from the evolving field of health and human rights and the increasing incorporation of human rights into health education, there is now a need for standardized curricula—harmonizing teaching materials and methods in health and human rights. Standardization would provide a unified foundation for understanding global norms to defend individual rights and hold governments accountable for rights realization. By creating standard curricula for human rights education, faculty can promote a common terminology and core knowledge for health policy, research, and advocacy. While diversity across health and human rights courses will remain necessary—reflecting discipline-specific needs and promoting innovative pedagogies—a consistent foundation of human rights education would promote universal understanding of human rights in global health.
Standardized educational resources will be necessary to facilitate consistent understanding across courses and common approaches across disciplines. While many courses currently draw upon articles written over the years in the Health and Human Rights Journal, these articles were written for an expert audience and can be difficult to adapt for educational purposes. Educational resources in health and human rights can provide a basis for active learning in the field, explaining basic norms and principles and including experiential pedagogies such as case studies and simulations. When developed collectively by faculty to encompass the range of health and human rights issues, such standardized resources can create a foundation for future developments in the field.
In providing an authoritative educational resource that can be employed by students entering the field, a foundational textbook would provide an academic basis to teach courses without prerequisite expertise in the field—vastly increasing the number of courses, students, and professionals at the intersection of health and human rights. The use of a common textbook, along with harmonized teaching methods and instructional resources, can thus accelerate health and human rights education.[16] Through this universal foundation for global health and human rights education, it will be possible to prepare the next generation of policymakers, researchers, and advocates to face ongoing challenges to the promotion of health and human rights.
Lawrence O. Gostin is the O’Neill Chair in Global Health Law, Director of the O’Neill Institute for National and Global Health Law, and Director of the WHO Collaborating Center on National and Global Health Law at Georgetown University.
Hanna Huffstetler is a Master of Public Health candidate at the University of North Carolina Gillings School of Global Public Health.
Benjamin Mason Meier is an Associate Professor of Global Health Policy at the University of North Carolina at Chapel Hill and a Scholar at the O’Neill Institute for National and Global Health Law at Georgetown University.
References
[1] Constitution of the United Nations Educational, Scientific and Cultural Organization (UNESCO), (1945).
[2] Universal Declaration of Human Rights (UDHR), G.A. Res. 217A (III) (1948), Art. 26.
[3] A. Chapman and K. Tararas. “The United Nations Educational, Scientific and Cultural Organization: Advancing Global Health through Human Rights Education and Science.” in B.M. Meier and L.O. Gostin (eds) Human Rights in Global Health: Rights-Based Governance for a Globalizing World (New York: Oxford University Press, 2018), pp. 221-242.
[4] A. Gellhorn, T. Fülöp, and Z. Bankowski. “Health needs of society: a challenge for medical education, 10th CIOMS Round Table Conference, Ulm, Federal Republic of Germany, 6-10 July, 1976.” (Geneva: World Health Organization, 1977).
[5] Summary of the Deliberations of the Preparatory Meeting of Medical Personnel Concerned with Health and Human Rights, 16-17 September (Geneva: Henry Dunant Institute, 1980).
[6] L. O. Gostin “Public Health, Ethics, and Human Rights: A Tribute to the Late Jonathan Mann.” Journal of Law, Medicine, and Ethics 29 (2001), pp. 121-130.
[7] J. Mann, L. O. Gostin, S. Gruskin, T. Brennan, Z. Lazzarini, and H. V. Fineberg. “Health and Human Rights.” Health and Human Rights 1 (1994), pp. 6-23.
[8] J. Brenner. “Human Rights Education in Public Health Graduate Schools: 1996 Survey.” Health and Human Rights 2 (1996), pp. 129-139.
[9] Harvard Law School Harvard Law School Human Rights Program and François-Xavier Bagnoud Center. Economic and Social Rights and the Right to Health: an Interdisciplinary Discussion Held at Harvard Law School in September, 1993 (Boston: Harvard Law School Human Rights Program, 1995).
[10] E. L. Cotter, J. Chevrier, W. N. El-Nacher, R. Radhakrishna, L. Rahangdale, S. D. Weiser, and V. Iacopino. “Health and Human Rights Education in U.S. Schools of Medicine and Public Health: Current Status and Future Challenges.” PLoS One 4 (2009), p. e4916; L. Forman. “Making the Case for Human Rights in Global Health Education, Research and Policy.” Canadian Journal of Public Health 102 (2011), pp. 207-209.
[11] Health and Human Rights Syllabi Database (University of Southern California Institute on Inequalities in Global Health, n.d.). Available at: https://sites.google.com/view/hhrsyllabi/home.
[12] D. Tarantola and S. Gruskin. “Health and Human Rights Education in Academic Settings.” Health and Human Rights 9 (2006), pp. 297-300.
[13] WMA Resolution on the Inclusion of Medical Ethics and Human Rights in the Curriculum of Medical Schools World-Wide (WMA General Assembly, 66th session, 1999); Position statement: nurses and human rights (International Council of Nurses, adopted 1998, revised 2006 and 2011).
[14] American Public Health Association and François-Xavier Bagnoud Center, Health and human rights: The educational challenge (2002).
[15] Association of Schools and Programs of Public Health Education Committee, Master’s Degree in Public Health Core Competency Development Project, Version 2.3. (Washington, DC: Association of Schools and Programs of Public Health, 2006).
[16] L. O. Gostin and B. M. Meier. Foundations of Global Health & Human Rights (New York: Oxford University Press, 2020).