research project

Health and Human Rights

The Health and Human Rights Project aimed to accelerate the operationalisation of health-rights through multi-disciplinary collaboration.

The project continued work carried out by Professor Paul Hunt, firstly as a member of the UN Committee on Economic, Social and Cultural Rights, and later as the first UN Special Rapporteur on the right to the highest attainable standard of health. Since stepping down as UN Special Rapporteur, Professor Hunt continued to work on health-rights with Essex colleagues, such as Dr Linsey McGoey and Genevieve Sander.

When Professor Hunt served on the UN Committee on Economic, Social and Cultural Rights, the Committee adopted General Comment 14 on the right to the highest attainable standard of health. Later, when he was the first UN Special Rapporteur on the right to the highest attainable standard of health, Professor Hunt endeavoured to apply General Comment 14 in his thematic and country UN reports. In parallel, a small team of Essex-based researchers worked on related health-rights projects.

Archive of the UN Special Rapporteur

This archive contains material related to the work that Professor Paul Hunt carried out in his capacity as Special Rapporteur from August 2002-July 2008, as well as the work of other staff from the Right to Health Unit.

The role of Special Rapporteur

The Special Rapporteur on the right to the highest attainable standard of health, August 2002-July 2008

In 2002, the UN Commission on Human Rights decided to appoint a Special Rapporteur on the right to health. Paul Hunt from the Essex Law School and Human Rights Centre was appointed to this post in September 2002.

At its sixty-first session in 2005 the Commission on Human Rights decided to renew the mandate of the Special Rapporteur for a further period of three years. The Human Rights Council, by its decision 1/102 of 30 June 2006, extended all mandates of the former Commission on Human Rights, including that of the Special Rapporteur.

He was requested by the Human Rights Council to work in cooperation with States, inter-governmental organisations and civil society:

  • to report on the status of the right to health around the world
  • to make recommendations on appropriate measures to promote and protect the right to health

Themes

The Special Rapporteur’s work focuses on two main themes:

  • poverty and the right to health
  • stigma and discrimination and the right to health

Within these overarching themes, the Special Rapporteur, assisted by other staff at the Human Rights Centre, as well as the United Nations Office of the High Commission for Human Rights (OHCHR), carried out research into issues including:

  • the right to health dimensions of HIV/AIDS
  • maternal mortality
  • access to medicines
  • neglected diseases
  • mental health
  • the Millennium Development Goals
  • the World Trade Organization
  • poverty reduction strategies
  • indicators
  • sexual and reproductive health rights
  • health professionals

The main objectives of the Special Rapporteur were:

  • to raise the profile of the right to health as a fundamental human right
  • to clarify what the right to health means
  • to identify ways of operationalising the right to health

In his work, the Special Rapporteur undertook country missions and other visits, transmitted communications to States with regard to alleged violations of the human right to health, and submitted annual reports on his work to the Human Rights Council and the General Assembly.

For further information about the role of Special Rapporteur on the Right to Health, see the United Nations Office of the High Commission for Human Rights website:

Related documents

UN Reports of the Special Rapporteur

In his work, the Special Rapporteur undertook country missions and other visits, transmitted communications to States with regard to alleged violations of human right to health, and submitted annual reports on his work to the Human Rights Council and the General Assembly.

All the reports and preliminary notes listed below are links to .pdf versions on the website of the United Nations.

Paul Hunt's 2010 Supplementary Note on the UN Special Rapporteur's Report on Maternal Mortality in India (.pdf) is available on our University's Research Repository.

You can also search for individual documents using the Symbol (e.g. A/HRC/14/20/Add.2) in the Search by Symbol function on the United Nations documents website.

All reports and preliminary notes are also available on the website of the United Nation Office of the High Commission on Human Rights:

Reports, preliminary notes and supplementary documents submitted by Paul Hunt

2010

2009

2008

2007

2006

2005

2004

2003

Resolutions

The Human Rights Council, Commission on Human Rights, Economic and Social Council and General Assembly of the United Nations have adopted the following resolutions and decisions on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

2006

  • Decision 2/108 of Human Rights Council, adopted on 27 November 2006
  • Decision 1/102 of Human Rights Council Decision, adopted on 30 June 2006

2005

  • E/CN.4/2003/RES/2005/24, Commission on Human Rights resolution, adopted 15 April 2005

2004

  • E/DEC/2004/255, ECOSOC resolution, adopted 6 August 2004
  • E/CN.4/RES/2004/27, Commission on Human Rights resolution, adopted 16 April 2004
  • A/RES/58/173, General Assembly resolution, adopted 10 March 2004

2003

  • E/CN.4/2003/RES/2003/28, Commission on Human Rights resolution, adopted 22 April 2003

2002

  • E/DEC/2002/259, ECOSOC resolution, adopted 25 July 2002
  • E/CN.4/RES/2002/31, Commission on Human Rights resolution, adopted 22 April 2004

Press releases, statements and interviews

The following press releases, statements and interviews can be downloaded as a zip folder from our University's Research Repository, except those hosted by an external site:

2008

  • Paul Hunt and Edward Stourton 'right to health' discussion hosted by Merlin, 9 April

2007

  • UN Experts mark International Human Rights day with call for States to intensify efforts to combat discrimination and execution, 7 December
  • Paul Hunt, Oral remarks of UN Special Rapportuer on the right to the highest attainable standard of health to the press in Delhi, 3 December
  • International Initiative on Maternal Mortality unveiled, 19 October
  • Paul Hunt, Oral remarks of UN Special Rapporteur on the right to health to the press in Bogotá, 21 September, (English and Spanish)
  • Profile: Paul Hunt, UN Special Rapporteur on the right to health, perspectives, Vol. 370, Lancet, p.381, 4 August, (.pdf, The Lancet)
  • Paul Hunt, Oral remarks of UN Special Rapporteur on the right to the highest attainable standard of health, to the press in Sweden, 18 June
  • Paul hunt, Closing remarks of UN Special Rapporteur on the right to the highest attainable standard of health, to the press in Quito, 18 May
  • Paul Hunt, Opening remarks UN Special Rapporteur on the right to the highest attainable standard of health, to the press, Quito, Ecuador, 14 May
  • UN Special Rapporteur on health to visit Ecuador, 11 May
  • UN rights experts call for the release of Daw Aung San Suu Kyi and all remaining political prisoners, 10 May
  • Human rights mandate-holders deeply concerned about hostilities in Mogadishu, 1 May
  • Independent UN experts express serious concern over draft Nigerian Bill on outlawing same-sex relationships, 23 February
  • Paul Hunt, Oral remarks of UN Special Rapporteur on the right to the highest attainable standard of health to the press in Kampala, Uganda, 9 February
  • Special Rapporteur on the right to highest attainable standard of health to visit Uganda, 2 February

2006

  • Major violations on both sides in Israel-Lebanon conflict, say UN Experts, 4 October
  • Paul Hunt, Oral remarks of UN Special Rapporteur on the right to the highest attainable standard of health, supplementing 4 October press release
  • Joint report on a mission to Lebanon and Israel by four special procedure mandate holders, Human Rights Council, 4 October
  • Deteriorating security situation forces UN human rights experts to postpone mission to Lebanon, 7 August
  • UN Human Rights Experts urge parties to the current conflict in the Middle-East to fully respect and protect the rights of the civilian population, 21 July
  • UN Special Rapporteur on the right to the highest attainable standard of health comments on health situation, and calls for an independent enquiry into an alleged war crime in Gaza: BBC, World at One, Radio 4, 20 July, (interview with Paul Hunt begins in the eighth minute of the episode)
  • UN health rights expert calls for independent enquiry into alleged war crime in Gaza, 19 July
  • UN rights experts ask international community to aid with expeditious closure of Guantanamo detention centre, 6 July
  • UN health rights expert criticizes donors for failing to fulfil their humanitarian responsibilities in the Occupied Palestinian Territories, 22 June
  • Paul Hunt, Oral remarks of UN Special Rapporteur on the right to the highest attainable standard of health supplementing 22nd June press release
  • United Nations human rights experts request urgent closure of Guantanamo detention centre, 14 June
  • Interview with Paul Hunt, UN Human Rights Mechanisms: putting women's health on the agenda, Lesbian and Bisexual Women's Health: Common Concerns, Local Issues, ILGA Report, ILGA, Belgium, March 2006
  • Paul Hunt, Preliminary remarks by the Special Rapporteur on his visit to Sweden, 18 January
  • Press briefing: UN Special Rapporteur comments on right to health in Sweden, 18 January, (video .ram)
  • UN Special Rapporteur on right to health begins visit to Sweden, 12 January

2005

  • Poverty won’t be history if health isn’t included: Press release by BMA on the right to health Call to Action, 9 December
  • Human Rights Experts "Deeply Regret" United States Refusal of Terms for Fact-Finding Mission to Guantanamo, 18 November
  • Interview with Paul Hunt, interview with the UN Special Rapporteur, International Lesbian and Gay Association (ILGA), November
  • Guantanamo Bay Detainees: UN Human Rights Experts respond to US invitation, 31 October
  • UN Experts mark anniversary of the ICJ "Wall Opinion", call on Israel to hall construction of the wall, 4 August
  • Human rights experts express concern over reported denial of medical care to imprisoned Iranian journalist, 15 July
  • US-Peru Free Trade Pact: Special Rapporteur on right to health reminds parties of human rights obligations, 13 July
  • UN Experts address concerns regarding Guantanamo Bay detainees, 23 June
  • Annex A to 23 June Press Release: Chronology of Requests for Visits regarding detainees at Guantanamo Bay and other locations
  • Annex B to 23 June Press Release: Chronology of communications regarding détentes at Guantanamo Bay and other locations
  • Paul Hunt, Press Conference on Guantanamo Bay, held in Geneva, 23 June
  • UN Special Rapporteur on right to health begins visit to Uganda, 17 March
  • United Nations human rights experts express continued concern about situation of Guantanamo Bay detainees, 4 February
  • Human Rights Experts Call For Focusing Attention on Most Vulnerable Tsunami Victims, 11 January

2004

2003

  • Human Rights Day: Independent Experts remind States of obligation to uphold fundamental freedoms, 10 December
  • Human rights officials emphasize HIV/AIDS crisis: a worsening human rights emergency, 29 November
  • UN rights expert welcomes Canadian initiative on access to low-cost drugs in developing countries, 7 November
  • Paul Hunt, "Healthy Environments for Children" World Health Day Statement, 7 April
  • Third World Water Forum (Kyoto): Joint Statement by the Special Rapporteurs on adequate housing, the right to food and the right to health, 16-23 March

2002

  • Joint Statement by Sergio Vieira de Mello, UN High Commissioner for Human Rights, and Paul Hunt, UN Special Rapporteur on the right to health, on World AIDS Day

Conferences and presentations

The following conference papers and presentations can be downloaded from our University's Research Repository:

2008

2007

2006

2005

2004

2003

Publications

The following publciations can be downloaded from our University's Research Repository:

International assistance and cooperation in sexual and reproductive health: a human rights responsibility for donors

Judith Bueno de Mesquita and Paul Hunt

States' obligations under some international treaties extend beyond their national borders to international assistance and cooperation for human rights, including the rights to sexual and reproductive health, in other countries. This publication focuses on what is expected of donors in the context of this responsibility. It shows how many donors are taking important steps towards fulfilling this duty through measures they are taking to integrate the rights to sexual and reproductive health into their policies and programmes, but also argues that many donors can also do more. The publication concludes with a set of recommendations addressed to donors and their developing country partner governments.

Human rights guidelines for pharmaceutical companies in relation to access to medicines: the sexual and reproductive health context

Rajat Khosla and Paul Hunt

When Paul Hunt was UN Special Rapporteur (2002-2008), a recurrent theme in his work was access to medicines. For the most part, he - and colleagues in the Right to Health Unit - looked at the duties of States in relation to access to medicines e.g. his report to the UN General Assembly A/61/338, dated 13 September 2006. However, States reported that when endeavouring to enhance access to medicines the policies and practices of some pharmaceutical companies were a very considerable obstacle. Thus, he was urged to prepare access-to-medicines guidelines for pharmaceutical companies. After extensive research and wide-ranging consultations over some years, Paul Hunt and Rajat Khosla wrote 'Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines'. These Guidelines were published by the UN General Assembly in A/63/263, dated 11 August 2008. The present publication briefly discusses medicines and sexual and reproductive health, in particular medicines, HIV/AIDS and the human papillomavirus (HPV) - HPV being responsible for over 99% of cervical cancers. In this context, the publication then introduces, and reproduces, the 'Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines' that were published by the General Assembly in 2008.

Participation and the right to the highest attainable standard of health

Helen Potts

Active and informed participation is an integral component of health systems, as well as the right to the highest attainable standard of health. Despite its critical importance, health and human rights have not given participation the attention it deserves. While some health researchers have made more headway than those working in human rights, neither community has a widely accepted understanding of what the process of participation means in practice. The monograph is an accessible, practical, timely and original introduction to the process of participation; the need for a variety of participatory mechanisms; the relationship between fairness and transparency of the process; the relationship between participation and accountability and participation in accountability. The publication of the monograph was supported by the Ford Foundation.

Conscientious objection: protecting sexual and reproductive health rights

Judith Bueno de Mesquita and Louise Finer

Healthcare providers' conscientious objection to involvement in certain procedures is grounded in the right to freedom of religion, conscience and thought. However, such conscientious objection can have serious implications for the human rights of healthcare users, including their sexual and reproductive health rights. This briefing paper examines the implications of conscientious objection, by healthcare providers, for the protection of sexual and reproductive health rights, and concludes with a set of recommendations for States' policies and laws.

Health systems and the right to the highest attainable standard of health

Paul Hunt and Gunilla Backman

Today, there is growing recognition that a strong health system is an essential element of a healthy and equitable society. However, health systems in many countries are failing and collapsing. It is vital to find ways of strengthening health systems. This briefing looks at health systems from the perspective of the right to the highest attainable standard of health. It outlines how this fundamental human right underpins and reinforces an effective, integrated, accessible health system - and why this is important. In other words, the briefing signals a right-to-health approach to health systems strengthening.

Accountability and the right to the highest attainable standard of health

Helen Potts

Accountability is a central feature of human rights. Despite its critical role, little work has been done to explore its meaning and content. Even less work has been done in the context of the right to health. As a result, accountability is cloaked in misunderstandings. The monograph is an accessible, practical and timely study, addressing these misunderstandings by clarifying the process of accountability; the relationship between monitoring, mechanisms and redress; and the pre-conditions for effective accountability. The publication of the monograph was supported by OSI's Public Health Program and Law and Health Initiative.

The rights to sexual and reproductive health

Paul Hunt and Judith Bueno de Mesquita

Sexual and reproductive health are among the most sensitive and controversial issues in international human rights law, but they are also among the most important. This publication examines the outcomes of the International Conference on Population and Development held in Cairo in 1994 and the Fourth World Conference on Women held in Beijing held in Beijing in 1995 that can be applied alongside international human rights law standards in the context of sexual and reproductive health rights.

Reducing maternal mortality: the contribution of the right to the highest attainable standard of health

Paul Hunt and Judith Bueno de Mesquita

Over half a million women die each year due to complications during pregnancy and birth. The vast majority of these deaths are preventable. Despite longstanding international commitments to reducing maternal mortality, progress to date has been disappointing. This publication introduces the contribution of the right to the highest attainable standard of health to reducing maternal mortality.

Neglected diseases: a human rights analysis

Paul Hunt, Rebecca Steward, Judith Bueno de Mesquita and Lisa Oldring

This report was was published in the series Special topics in social economic and behavioural research in 2007. The research was funded by the WHO-World Bank-UNDP Special Programme for Research and Training in Tropical Diseases.

Our right to the highest attainable standard of health

Adriaan van Es and Paul Hunt

This briefing aims to provide a short, concise and accessible introduction to the right to the highest attainable standard of health and is available in English, French and Spanish versions. This project was a joint initiative of the Human Rights Centre and the International Federation for Health and Human Rights Organisations (IFHHRO).

 

Articles

Health systems and the right to health: an assessment of 194 countries

Gunilla Backman, Paul Hunt, Rajat Khosla, Anna Protano-Briggs, Camila Jaramillo-Strouss, Belachew Mekuria Fikre, Caroline Rumble, David Pevalin, David Acurio Páez, Mónica Armijos Pineda, Ariel Frisancho, Duniska Tarco, Mitra Motlagh, Dana Farcasanu, Cristian Vladescu

Published in The Lancet (13-19 December 2008), this report identifies some of the right-to-health features of health systems and proposes 72 indicators that reflect some of these features. Globally processed data on these indicators for 194 countries and national data for five countries (Ecuador, Mozambique, Peru, Romania and Sweden) were collected. Globally processed data were unavailable for 18 indicators for any country, suggesting that organisations that obtain such data give insufficient attention to the right-to-health features of health systems. Where they are available, the indicators show where health systems need to be improved to better realise the right to health. The report provides recommendations for governments, international bodies, civil society organisations, and other institutions and suggests that these indicators and data, although not perfect, provide a basis for evaluating health systems and monitoring the progressive realisation of the right to health. Right-to-health features are not just good management, justice, or humanitarianism, they are obligations under human rights law. Many of the features are reflected in the Alma-Ata Declaration (1978) and the recent World Health Report on primary health care (2008). In the same issue, The Lancet carries an editorial calling this "a landmark report", as well as short articles by Navanethem Pillay (UN High Commissioner for Human Rights), Amartya Sen (Harvard University), Hedia Belhadj and Aminata Toure (UNFPA), and Ariel Frisancho and Jay Goulden (CARE Peru).

Right to the highest attainable standard of health

Paul Hunt

The right to the highest attainable standard of health lies at the heart of the health and human rights movement. Of course, this right does not provide magic solutions to complex health issues, any more than do ethics or economics. Nonetheless, the right to health has a crucial constructive role to play.

The human right to the highest attainable standard of health: new opportunities and challenges

Paul Hunt

The health and human rights communities have much in common. Recently, the international community has begun to devote more attention to the right to the highest attainable standard of health (‘the right to health’). Today, this human right presents health and human rights professionals with a range of new opportunities and challenges. The right to health is enshrined in binding international treaties and constitutions. It has numerous elements, including the right to health care and the underlying determinants of health, such as adequate sanitation and safe water. It empowers disadvantaged individuals and communities. If integrated into national and international policies, it can help to establish policies that are meaningful to those living in poverty.

Using all the tools at our disposal: poverty reduction and the right to the highest attainable standard of health

Paul Hunt

For the most part, development practitioners fail to use the human rights tools at their disposal in the struggle against poverty. Of course, neither human rights nor anything else provide a magic solution to the immensely complex problem of global poverty. Nonetheless, human rights have a constructive contribution to make and a failure to use them is a missed opportunity of major proportions. There has been some progress at the policy level, much less progress at the operational level.

Projects

Human rights guidelines for pharmaceutical companies in relation to access to medicine

Paul Hunt submitted these Guidelines to the UN General Assembly in 2008. The Guidelines were prepared by way of a long consultative process, including a public consultation on 19 September 2007, at the University of Toronto.

Consultation documents

A zip folder containing .pdf versions of all documents related to the draft guidelines consultation process is available on our University of Essex Research Repository:

Contents of zip folder
  • Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines, draft for consultation
  • Press release: UN independent expert launches draft human rights guidelines for pharmaceutical companies, press release
  • Comments received on the draft Guidelines from the following respondents:
    • South African Human Rights Commission
    • Government of the United States of America
    • Oxfam International
    • Anja Rudiger, National Economic and Social Rights Initiative (NESRI)
    • HelpAge International
    • Joint submission from Medact and Wemos
    • Niels Ingerslev, Denmark Amnesty International
    • Beverly Snell, Centre for International health, Australia
    • Professor John S Yudkin, Emeritus Professor of Medicine, University College London
    • Robert Weissman, Essential Action
    • David Dubins, Assistant Professor, University of Toronto
    • Franciscans International
    • Health GAP (Global Access Project)
    • Health Action International (HAI)
    • Robert Reinhard, Community Advisory Board Member
    • BioIndustry Association (BIA)
    • Global Russian American Health Alliance (GRAHA)
    • Suerie Moon, Doctoral Research Fellow, Centre for International Development, Harvard University
    • American Autoimmune Related Disease Association (AARDA)
    • Alliance for Health Education and Development (AHEAD)
    • Community Development Medicinal Unit
    • Elisabeth Strohscheidt, Menschenrechtsreferentin, Human Rights Desk
    • Harvey Bale, International Federation of Pharmaceutical Manufacturers and Associations
    • Action Against AIDS, Germany
    • The AIDS Institute
    • MERCK
    • Shin Furuya, Asia Pacific Equities
    • Novo Nordisk
    • Dr Selina Namchee Lo, Independent Specialist
    • International Commission of Jurists
    • Government of Japan
    • F&C Management Limited
    • Henderson Global Investors
    • Catherine Royce
    • GlaxoSmithKline (GSK)

Impact Assessments and the Right to Health

UNESCO provided a grant for a short-term project to develop a methodology on human rights and impact assessments, using the right to health as a case study. Professor Paul Hunt and Gillian MacNaughton co-authored a report, entitled Impact Assessments, Poverty and Human Rights: A Case Study Using the Right to the Highest Attainable Standard of Health, which was submitted to UNESCO on 31 May 2006:

Medical Associations and the Right to Health

The British Medical Association, in collaboration with MedAct, provided a grant for a short-term project to research national medical association projects supporting the right to health and health-related Millennium Development Goals. The research focused particularly on support provided to national medical associations in developing countries by their counterparts in developed countries. The research findings were written up in a report by Dr Octavio Ferraz:

International Assistance and Cooperation for the Right to Health

The British Medical Association, in collaboration with Medact, provided a grant to support research on the duty of international assistance and cooperation, enshrined in the International Covenant on Economic, Social and Cultural Rights, and its relationship to the right to health. The research examined this legal duty, its relationship with the Millennium Goals, jurisprudence, and examples of its practical application by States. The research culminated in a report by Dr Octavio Ferraz and Judith Mesquita:

Guidelines for the Medical Investigation of Victims of Torture

This project of the Human Rights Centre was carried out in close cooperation with the Medical Foundation for the Care of Victims of Torture, and is funded by the UK Foreign and Commonwealth Office. Paul Hunt was on the advisory board of this project.

International Health Worker Migration and Human Rights

Commissioned by MedAct, a UK-based charity taking action on key global health issues, Judith Bueno de Mesquita wrote a paper on the human rights implications of international health worker migration, co-authoring with Matthew Gordon (London School of Hygiene and Tropical Medicine). This project was funded by the British Medical Association and Save the Children UK.

EU-China Human Rights Network Seminar: The rights to health and social security

In April 2004, the Human Rights Centre hosted a meeting of the EU-China Human Rights Network on the topics of the right to health and social security. The Right to Health Project coordinated the event and contributed three background papers and working papers for the meeting.

Judith Bueno de Mesquita also participated as Seminar Co-Rapporteur in a follow-up EU-China Human Rights Dialogue Seminar on the right to health and HIV/AIDS, held in the Hague, Netherlands, on 8-9 November 2004.

This project is coordinated by the Irish Centre for Human Rights and the Chinese Academy of Social Sciences. The Human Rights Centre, University of Essex, is a member of the Steering Group. The project is funded by the European Commission.

A Human Rights Approach to Health in the Context of Poverty Reduction Strategies

Building on recent conceptual advances focusing on the operationalisation of a human rights-based approach to health in the context of poverty reduction strategy papers and current experiences in developing and implementing poverty reduction strategies, this project identified and analyzed good practices for the delivery of pro-poor health policies through the prism of a human rights-based approach to health.

WHO was the lead institution in this project, and the Special Rapporteur was a member of the core project steering group. The project culminated in the publication of a handbook on a human rights approach to health in the context of poverty reduction strategies, which was published by WHO: