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

 

 

 

 

 

                                                                                                                                           

accessibility of information should not impair the right to have personal health 

data treated with confidentiality; 

(c) 

Acceptability.  All health facilities, goods and services must be respectful of 

medical ethics and culturally appropriate, i.e. respectful of the culture of individuals, 

minorities, peoples and communities, sensitive to gender and life-cycle requirements, 

as well as being designed to respect confidentiality and improve the health status of 

those concerned; 

(d) Quality. 

 

As well as being culturally acceptable, health facilities, goods and 

services must also be scientifically and medically appropriate and of good quality.  

This requires, inter alia, skilled medical personnel, scientifically approved and 

unexpired  drugs and hospital equipment, safe and potable water, and adequate 

sanitation. 

13. 

The non-exhaustive catalogue of examples in article 12.2 provides guidance in 

defining the action to be taken by States.  It gives specific generic examples of 

measures arising from the broad definition of the right to health contained in article 

12.1, thereby illustrating the content of that right, as exemplified in the following 

paragraphs.

9

Article 12.2 (a):  The right to maternal, child and reproductive health 

14. 

“The provision for the reduction of the stillbirth rate and of infant mortality 

and for the healthy development of the child” (art. 12.2 (a))

10

 may be understood as 

requiring measures to improve child and maternal health, sexual and reproductive 

health services, including access to family planning, pre- and post-natal care,

11

 

 

8

  See article 19.2 of the International Covenant on Civil and Political Rights.  This general comment 

gives particular emphasis to access to information because of the special importance of this issue in 

relation to health. 

9

  In the literature and practice concerning the right to health, three levels of health care are frequently 

referred to:  primary health care typically deals with common and relatively minor illnesses and is 

provided by health professionals and/or generally trained doctors working within the community at 

relatively low cost; secondary health care is provided in centres, usually hospitals, and typically deals 

with relatively common minor or serious illnesses that cannot be managed at community level, using 

specialty-trained health professionals and doctors, special equipment and sometimes inpatient care at 

comparatively higher cost; tertiary health care is provided in relatively few centres, typically deals 

with small numbers of minor or serious illnesses requiring specialty-trained health professionals and 

doctors and special equipment, and is often relatively expensive.  Since forms of primary, secondary 

and tertiary health care frequently overlap and often interact, the use of this typology does not always 

provide sufficient distinguishing criteria to be helpful for assessing which levels of health care States 

parties must provide, and is therefore of limited assistance in relation to the normative understanding 

of article 12. 

10

  According to WHO, the stillbirth rate is no longer commonly used, infant and under-5 mortality 

rates being measured instead. 

11

  Prenatal denotes existing or occurring before birth; perinatal refers to the period shortly before and 

after birth (in medical statistics the period begins with the completion of 28 weeks of gestation and is 

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emergency obstetric services and access to information, as well as to resources 

necessary to act on that information.

12

Article 12.2 (b):  The right to healthy natural and workplace environments 

15. 

“The improvement of all aspects of environmental and industrial hygiene” (art. 

12.2 (b)) comprises, inter alia, preventive measures in respect of occupational 

accidents and diseases; the requirement to ensure an adequate supply of safe and 

potable water and basic sanitation; the prevention and reduction of the population’s 

exposure to harmful substances such as radiation and harmful chemicals or other 

detrimental environmental conditions that directly or indirectly impact upon human 

health.

13

 Furthermore, industrial hygiene refers to the minimization, so far as is 

reasonably practicable, of the causes of health hazards inherent in the working 

environment.

14

  Article 12.2 (b) also embraces adequate housing and safe and 

hygienic working conditions, an adequate supply of food and proper nutrition, and 

discourages the abuse of alcohol, and the use of tobacco, drugs and other harmful 

substances. 

Article 12.2 (c):  The right to prevention, treatment and control of diseases 

16. 

“The prevention, treatment and control of epidemic, endemic, occupational 

and other diseases” (art. 12.2 (c)) requires the establishment of prevention and 

education programmes for behaviour-related health concerns such as sexually 

transmitted diseases, in particular HIV/AIDS, and those adversely affecting sexual 

and reproductive health, and the promotion of social determinants of good health, 

such as environmental safety, education, economic development and gender equity.  

The right to treatment includes the creation of a system of urgent medical care in 

cases of accidents, epidemics and similar health hazards, and the provision of disaster 

relief and humanitarian assistance in emergency situations.  The control of diseases 

refers to 

 

variously defined as ending one to four weeks after birth); neonatal, by contrast, covers the period 

pertaining to the first four weeks after birth; while post-natal denotes occurrence after birth.  In this 

general comment, the more generic terms pre- and post-natal are exclusively employed. 

12

  Reproductive health means that women and men have the freedom to decide if and when to 

reproduce and the right to be informed and to have access to safe, effective, affordable and acceptable 

methods of family planning of their choice as well as the right of access to appropriate health-care 

services that will, for example, enable women to go safely through pregnancy and childbirth. 

13

  The Committee takes note, in this regard, of Principle 1 of the Stockholm Declaration of 1972 

which states:  “Man has the fundamental right to freedom, equality and adequate conditions of life, in 

an environment of a quality that permits a life of dignity and well-being”, as well as of recent 

developments in international law, including General Assembly resolution 45/94 on the need to ensure 

a healthy environment for the well-being of individuals; Principle 1 of the Rio Declaration; and 

regional human rights instruments such as article 10 of the San Salvador Protocol to the American 

Convention on Human Rights. 

14

  ILO Convention No. 155, article 4.2. 

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