CESCR General Comment No. 14: The Right to the Highest Attainable
Standard of Health (Art. 12)
Adopted at the Twenty-second Session of the Committee on Economic,
Social and Cultural Rights, on 11 August 2000
(Contained in Document E/C.12/2000/4)
1.
Health is a fundamental human right indispensable for the exercise of other
human rights. Every human being is entitled to the enjoyment of the highest
attainable standard of health conducive to living a life in dignity. The realization of
the right to health may be pursued through numerous, complementary approaches,
such as the formulation of health policies, or the implementation of health
programmes developed by the World Health Organization (WHO), or the adoption of
specific legal instruments. Moreover, the right to health includes certain components
which are legally enforceable.
1
2.
The human right to health is recognized in numerous international instruments.
Article 25.1 of the Universal Declaration of Human Rights affirms: “Everyone has
the right to a standard of living adequate for the health of himself and of his family,
including food, clothing, housing and medical care and necessary social services”.
The International Covenant on Economic, Social and Cultural Rights provides the
most comprehensive article on the right to health in international human rights law.
In accordance with article 12.1 of the Covenant, States parties recognize “the right of
everyone to the enjoyment of the highest attainable standard of physical and mental
health”, while article 12.2 enumerates, by way of illustration, a number of “steps to be
taken by the States parties ... to achieve the full realization of this right”.
Additionally, the right to health is recognized, inter alia, in article 5 (e) (iv) of the
International Convention on the Elimination of All Forms of Racial Discrimination of
1965, in articles 11.1 (f) and 12 of the Convention on the Elimination of All Forms of
Discrimination against Women of 1979 and in article 24 of the Convention on the
Rights of the Child of 1989. Several regional human rights instruments also
recognize the right to health, such as the European Social Charter of 1961 as revised
(art. 11), the African Charter on Human and Peoples’ Rights of 1981 (art. 16) and the
Additional Protocol to the American Convention on Human Rights in the Area of
Economic, Social and Cultural Rights of 1988 (art. 10). Similarly, the right to health
has been proclaimed by the Commission on Human Rights,
2
as well as in the Vienna
Declaration and Programme of Action of 1993 and other international instruments.
3
1
For example, the principle of non-discrimination in relation to health facilities, goods and services is
legally enforceable in numerous national jurisdictions.
2
In its resolution 1989/11.
3
The Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental
Health Care adopted by the United Nations General Assembly in 1991 (resolution 46/119) and the
Committee’s general comment No. 5 on persons with disabilities apply to persons with mental illness;
3.
The right to health is closely related to and dependent upon the realization of
other human rights, as contained in the International Bill of Rights, including the
rights to food, housing, work, education, human dignity, life, non-discrimination,
equality, the prohibition against torture, privacy, access to information, and the
freedoms of association, assembly and movement. These and other rights and
freedoms address integral components of the right to health.
4.
In drafting article 12 of the Covenant, the Third Committee of the
United Nations General Assembly did not adopt the definition of health contained in
the preamble to the Constitution of WHO, which conceptualizes health as “a state of
complete physical, mental and social well-being and not merely the absence of disease
or infirmity”. However, the reference in article 12.1 of the Covenant to “the highest
attainable standard of physical and mental health” is not confined to the right to health
care. On the contrary, the drafting history and the express wording of article 12.2
acknowledge that the right to health embraces a wide range of socio-economic factors
that promote conditions in which people can lead a healthy life, and extends to the
underlying determinants of health, such as food and nutrition, housing, access to safe
and potable water and adequate sanitation, safe and healthy working conditions, and a
healthy environment.
5.
The Committee is aware that, for millions of people throughout the world, the
full enjoyment of the right to health still remains a distant goal. Moreover, in many
cases, especially for those living in poverty, this goal is becoming increasingly
remote. The Committee recognizes the formidable structural and other obstacles
resulting from international and other factors beyond the control of States that impede
the full realization of article 12 in many States parties.
6.
With a view to assisting States parties’ implementation of the Covenant and
the fulfilment of their reporting obligations, this general comment focuses on the
normative content of article 12 (Part I), States parties’ obligations (Part II), violations
(Part III) and implementation at the national level (Part IV), while the obligations of
actors other than States parties are addressed in Part V. The general comment is
based on the Committee’s experience in examining States parties’ reports over many
years.
1. Normative content of article 12
7.
Article 12.1 provides a definition of the right to health, while article 12.2
enumerates illustrative, non-exhaustive examples of States parties’ obligations.
8.
The right to health is not to be understood as a right to be healthy. The right to
health contains both freedoms and entitlements. The freedoms include the right to
the Programme of Action of the International Conference on Population and Development held at
Cairo in 1994, as well as the Declaration and Programme for Action of the
Fourth World Conference
on Women held in Beijing in 1995 contain definitions of reproductive health and women’s health,
respectively.