General comment No. 14: The right to the highest attainable

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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) 



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.



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,


 as well as in the Vienna 

Declaration and Programme of Action of 1993 and other international instruments.




  For example, the principle of non-discrimination in relation to health facilities, goods and services is 

legally enforceable in numerous national jurisdictions. 


  In its resolution 1989/11. 


  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; 








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. 


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. 


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. 


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 


1.  Normative content of article 12 


Article 12.1 provides a definition of the right to health, while article 12.2 

enumerates illustrative, non-exhaustive examples of States parties’ obligations. 


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, 


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