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

 

 

 

 

 

                                                

States’ individual and joint efforts to, inter alia, make available relevant technologies, 

using and improving epidemiological surveillance and data collection on a 

disaggregated basis, the implementation or enhancement of immunization 

programmes and other strategies of infectious disease control. 

Article 12.2 (d):  The right to health facilities, goods and services

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17. 

“The creation of conditions which would assure to all medical service and 

medical attention in the event of sickness” (art. 12.2 (d)), both physical and mental, 

includes the provision of equal and timely access to basic preventive, curative, 

rehabilitative health services and health education; regular screening programmes; 

appropriate treatment of prevalent diseases, illnesses, injuries and disabilities, 

preferably at community level; the provision of essential drugs; and appropriate 

mental health treatment and care.  A further important aspect is the improvement and 

furtherance of participation of the population in the provision of preventive and 

curative health services, such as the organization of the health sector, the insurance 

system and, in particular, participation in political decisions relating to the right to 

health taken at both the community and national levels. 

Article 12:  Special topics of broad application 

Non-discrimination and equal treatment 

18. 

By virtue of article 2.2 and article 3, the Covenant proscribes any 

discrimination in access to health care and underlying determinants of health, as well 

as to means and entitlements for their procurement, on the grounds of race, colour, 

sex, language, religion, political or other opinion, national or social origin, property, 

birth, physical or mental disability, health status (including HIV/AIDS), sexual 

orientation and civil, political, social or other status, which has the intention or effect 

of nullifying or impairing the equal enjoyment or exercise of the right to health.  The 

Committee stresses that many measures, such as most strategies and programmes 

designed to eliminate health-related discrimination, can be pursued with minimum 

resource implications through the adoption, modification or abrogation of legislation 

or the dissemination of information.  The Committee recalls general comment No. 3, 

paragraph 12, which states that even in times of severe resource constraints, the 

vulnerable members of society must be protected by the adoption of relatively 

low-cost targeted programmes. 

19. 

With respect to the right to health, equality of access to health care and health 

services has to be emphasized.  States have a special obligation to provide those who 

do not have sufficient means with the necessary health insurance and health-care 

facilities, and to prevent any discrimination on internationally prohibited grounds in 

the provision of health care and health services, especially with respect to the core 

obligations of the right to health.

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  Inappropriate health resource allocation can lead 

 

15

  See paragraph 12 (b) and note 8 above. 

16

  For the core obligations, see paragraphs 43 and 44 of the present general comments. 

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to discrimination that may not be overt.  For example, investments should not 

disproportionately favour expensive curative health services which are often 

accessible only to a small, privileged fraction of the population, rather than primary 

and preventive health care benefiting a far larger part of the population. 

Gender perspective 

20. 

The Committee recommends that States integrate a gender perspective in their 

health-related policies, planning, programmes and research in order to promote better 

health for both women and men.  A gender-based approach recognizes that biological 

and sociocultural factors play a significant role in influencing the health of men and 

women.  The disaggregation of health and socio-economic data according to sex is 

essential for identifying and remedying inequalities in health. 

Women and the right to health 

21. 

To eliminate discrimination against women, there is a need to develop and 

implement a comprehensive national strategy for promoting women’s right to health 

throughout their life span.  Such a strategy should include interventions aimed at the 

prevention and treatment of diseases affecting women, as well as policies to provide 

access to a full range of high quality and affordable health care, including sexual and 

reproductive services.  A major goal should be reducing women’s health risks, 

particularly lowering rates of maternal mortality and protecting women from domestic 

violence.  The realization of women’s right to health requires the removal of all 

barriers interfering with access to health services, education and information, 

including in the area of sexual and reproductive health.  It is also important to 

undertake preventive, promotive and remedial action to shield women from the 

impact of harmful traditional cultural practices and norms that deny them their full 

reproductive rights. 

Children and adolescents 

22. 

Article 12.2 (a) outlines the need to take measures to reduce infant mortality 

and promote the healthy development of infants and children.  Subsequent 

international human rights instruments recognize that children and adolescents have 

the right to the enjoyment of the highest standard of health and access to facilities for 

the treatment of illness.

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  The Convention on the Rights of the Child directs States to 

ensure access to essential health services for the child and his or her family, including 

pre- and post-natal care for mothers.  The Convention links these goals with ensuring 

access to child-friendly information about preventive and health-promoting behaviour 

and support to families and communities in implementing these practices. 

 

Implementation of the principle of non-discrimination requires that girls, as well as 

boys, have equal access to adequate nutrition, safe environments, and physical as well 

as mental health services.  There is a need to adopt effective and appropriate measures 

to abolish harmful traditional practices affecting the health of children, particularly 

 

17

  Article 24.1 of the Convention on the Rights of the Child. 

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