International Human Rights and the World Health Organization

Introduction

The World Health Organization (hereinafter called WHO) integrates acts as an agent which integrates health agencies throughout the world. The WHO is an agency of the United Nations (hereinafter the UN) which functions as a global health agency cooperating and coordinating with states. Enshrined in Article 1 of the Constitution of the World Health Organization is the promise to ensure “the highest attainable level of health” for all people. The functions of the WHO inter alia include to act as the directing and coordinating authority on international health, to assist Governments- upon request, to strengthening health services, to promote and conduct research in the field of health, and to provide information, counsel, and assistance. The World Health Assembly (hereinafter the Health Assembly), the Executives Boards (hereinafter the Board), and the Secretariat are the organs of the WHO. Its general determining body, the Health Assembly, is charged with coordinating international response efforts to unexpected outbreaks of disease, among other things. Although the WHO has no formal authority to bind its member nations, it has been granted considerably greater operational autonomy and quasi-legislative powers than its predecessors. The presence of the WHO nowadays is much more comprehensive than ever and its importance as a global health agency cannot be ignored but there has been several-times when it has come under severe criticism by the world leader and some international political scholars. The uproar reached new heights when in case of epidemic or pandemic broke out. The attention given to health as an international political issue during the twentieth century cannot be separated from the presence of security concern.

Although the WHO is viewed as a prominent organization in the field of global health governance by pioneering scientific research and development, it like any other international organization is not free from political consideration. The entire discipline of public health, according to WHO’s World Health Report 1998, is “the art of applying science in the context of politics to reduce inequalities in health while ensuring the best health the greatest number.” Of course, even that statement betrays clear political meaning; for it is by no means scientifically obvious that egalitarianism should hold such a central place in international public health.

The WHO has also opined, while dealing with the issue of global health coverage, that people also rate health as one of their highest priorities and in most countries, it’s only behind economic concerns, such as unemployment, low wages, and a high cost of living. As a result, health frequently becomes a political issue as governments try to meet peoples’ expectations.

Functionally, the WHO is principally administered through the Secretariat which is headed by the Director-General who, in turn, is appointed by the Health Assembly which is represented by the delegates of members. Even though every member possesses one vote, their influences through “lobbying” cannot be ignored. Even some mighty and relatively dominant States do not hesitate to “threaten” the Organization and some States do not directly threaten but try to “seduce” the Organization.  Ultimately, the organization seems to be losing its distinctive character, with global health appearing to become a secondary consideration.

WHO’s Role in Global Health and Human Rights

The constitution of the WHO provides two important principles which is declared by State parties, the principles provide (i) The enjoyment of the highest attainable standard of health which is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition, and, (ii) The health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest co-operation of individuals and States. Since one of the main objectives of the UN is to maintain international peace, establishing? human health as a human right is essential to the attainment of peace and security, which is consonance with the fundamental principles of the UN. Health as human right, is not only enshrined in the WHO’s Constitution but is mandated in various international instruments. In the Universal Declaration of Human Rights (UDHR), 1948, the General Assembly proclaimed that “everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

In order to understand why health is important, we need to understand the meaning of global health. David Fidler offers a concise, useful definition of global health governance as “the use of formal and informal institutions, rules, and processes by states, intergovernmental organizations, and non-state actors to deal with challenges to health that require cross-border collective action to address effectively. ”Global health governance is less a hierarchy and more a constellation of interconnected organizations and actors that work together to address issues. As for human rights, health is a concern as human rights approach to public health systems development has been a central theme to emerge from the explosive growth in global health awareness and funding in the last two decades. The notion that health care systems are both national and international public goods protecting the essential rights of all citizens, while not wholly embraced, has gained traction in global debates about health care financing, governance, and implementation.

Ensuring global health is necessary for mandating human rights and peace and security, which are the principles of the Constitution, but also for ensuring global health. This is not an easy task and it requires adequate funding from members and associate members as well as extensive cooperation from the implementing (host) countries. The WHO’s financial dilemmas and administrative and operational integrity, was to put light upon the budgetary imbalance created by the few power states. This is where the politics in the Organization starts and where we see that some Member States take for granted WHO and its mandate by threatening to, or even stopping their funding contributions. The question then is, why do a few States do this?

It is to be noted the WHO is not a funding organization that can provide grants or loans to governments to implement programs; that responsibility largely falls to the World Bank or other specialized agencies and it may not implement programs itself, it can partner with member States to turn programmatic ideas into realities. Under international law, states that are party to a variety of different treaties assume tripartite obligations: (i) to respect the right to health by refraining from direct violations,[1] such as systemic discrimination within the health system; (ii) to protect the right from interference by third parties, through such measures as environmental regulation of third parties; and (iii) to fulfill the right by adopting deliberate measures aimed at achieving universal access to care, as well as to preconditions for health. By withdrawing from an international global health organization, the US is attempting to escape its obligation toward global health and human rights and furthermore undermining the organizations credibility by calling it “China-centric”  which does not solve the problem. If the US is really eager to reform global health and human rights, there are ample spaces for reform within the WHO itself.

Conclusion

Financing global health is not a charity; instead, it is a shared responsibility of all members. It is true that the Organization’s success, to  a large extent, depends upon the cooperation from its members and by achieving its objective(s) through the tests of the organization’s usefulness, prestige, and authority will be found in (i) an increase or decrease of membership; (ii) the willingness of member states to support the reasonable financial needs of the organization; (iii) the attitudes and actions of member States on principal issues; and (iv) their compliance or non-compliance with action agreed upon. The WHO has reached almost every corner of the world, and its member also largely cooperate with the Organization. That said, it is not deniable that international politic shape the discourse of international organizations, and that the unilateral action of one or some State cannot change the fact that the WHO has acquired a great degree of “internationalism”. It is time for the WHO and its stakeholder to discuss administrative functions of the WHO’s constitutional framework, in order to give it more legitimacy and to remove the constraints placed on it by the political will of the more powerful contributing members? The stakeholders need to recognize that health is a basic human right, and its needs to be an unhindered function of the WHO, so that the organization can ensure global health and fulfill their human rights obligation, while fostering order in the world.