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

 

 

 

 

 

                                                

detailed plan for realizing the right to health.  States must ensure provision of health 

care, including immunization programmes against the major infectious diseases, and 

ensure equal access for all to the underlying determinants of health, such as 

nutritiously safe food and potable drinking water, basic sanitation and adequate 

housing and living conditions.  Public health infrastructures should provide for sexual 

and reproductive health services, including safe motherhood, particularly in rural 

areas.  States have to ensure the appropriate training of doctors and other medical 

personnel, the provision of a sufficient number of hospitals, clinics and other 

health-related facilities, and the promotion and support of the establishment of 

institutions providing counselling and mental health services, with due regard to 

equitable distribution throughout the country.  Further obligations include the 

provision of a public, private or mixed health insurance system which is affordable for 

all, the promotion of medical research and health education, as well as information 

campaigns, in particular with respect to HIV/AIDS, sexual and reproductive health, 

traditional practices, domestic violence, the abuse of alcohol and the use of cigarettes, 

drugs and other harmful substances.  States are also required to adopt measures 

against environmental and occupational health hazards and against any other threat as 

demonstrated by epidemiological data.  For this purpose they should formulate and 

implement national policies aimed at reducing and eliminating pollution of air, water 

and soil, including pollution by heavy metals such as lead from gasoline. 

 

Furthermore, States parties are required to formulate, implement and periodically 

review a coherent national policy to minimize the risk of occupational accidents and 

diseases, as well as to provide a coherent national policy on occupational safety and 

health services.

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37. 

The obligation to fulfil  (facilitate) requires States inter alia to take positive 

measures that enable and assist individuals and communities to enjoy the right to 

health.  States parties are also obliged to fulfil (provide) a specific right contained in 

the Covenant when individuals or a group are unable, for reasons beyond their 

control, to realize that right themselves by the means at their disposal.  The obligation 

to fulfil (promote) the right to health requires States to undertake actions that create, 

maintain and restore the health of the population.  Such obligations include:  

(i) fostering recognition of factors favouring positive health results, e.g. research and 

provision of information; (ii) ensuring that health services are culturally appropriate 

and that health-care staff are trained to recognize and respond to the specific needs of 

vulnerable or marginalized groups; (iii) ensuring that the State meets its obligations in 

the dissemination of appropriate information relating to healthy lifestyles and 

 

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  Elements of such a policy are the identification, determination, authorization and control of 

dangerous materials, equipment, substances, agents and work processes; the provision of health 

information to workers and the provision, if needed, of adequate protective clothing and equipment; the 

enforcement of laws and regulations through adequate inspection; the requirement of notification of 

occupational accidents and diseases, the conduct of inquiries into serious accidents and diseases, and 

the production of annual statistics; the protection of workers and their representatives from disciplinary 

measures for actions properly taken by them in conformity with such a policy; and the provision of 

occupational health services with essentially preventive functions.  See ILO Occupational Safety and 

Health Convention, 1981 (No. 155) and Occupational Health Services Convention, 1985 (No. 161). 

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nutrition, harmful traditional practices and the availability of services; (iv) supporting 

people in making informed choices about their health. 

International obligations 

38. 

In its general comment No. 3, the Committee drew attention to the obligation 

of all States parties to take steps, individually and through international assistance and 

cooperation, especially economic and technical, towards the full realization of the 

rights recognized in the Covenant, such as the right to health.  In the spirit of Article 

56 of the Charter of the United Nations, the specific provisions of the Covenant (arts. 

12, 2.1, 22 and 23) and the Alma-Ata Declaration on primary health care, States 

parties should recognize the essential role of international cooperation and comply 

with their commitment to take joint and separate action to achieve the full realization 

of the right to health.  In this regard, States parties are referred to the Alma-Ata 

Declaration which proclaims that the existing gross inequality in the health status of 

the people, particularly between developed and developing countries, as well as 

within countries, is politically, socially and economically unacceptable and is, 

therefore, of common concern to all countries.

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39. 

To comply with their international obligations in relation to article 12, States 

parties have to respect the enjoyment of the right to health in other countries, and to 

prevent third parties from violating the right in other countries, if they are able to 

influence these third parties by way of legal or political means, in accordance with the 

Charter of the United Nations and applicable international law.  Depending on the 

availability of resources, States should facilitate access to essential health facilities, 

goods and services in other countries, wherever possible, and provide the necessary 

aid when required.

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  States parties should ensure that the right to health is given due 

attention in international agreements and, to that end, should consider the 

development of further legal instruments.  In relation to the conclusion of other 

international agreements, States parties should take steps to ensure that these 

instruments do not adversely impact upon the right to health.  Similarly, States parties 

have an obligation to ensure that their actions as members of international 

organizations take due account of the right to health.  Accordingly, States parties 

which are members of international financial institutions, notably the International 

Monetary Fund, the World Bank, and regional development banks, should pay greater 

attention to the protection of the right to health in influencing the lending policies, 

credit agreements and international measures of these institutions. 

40. 

States parties have a joint and individual responsibility, in accordance with the 

Charter of the United Nations and relevant resolutions of the United 

Nations 

General Assembly and of the World Health Assembly, to cooperate in providing 

 

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  Article II, Alma-Ata Declaration, Report of the International Conference on Primary Health Care, 

Alma-Ata, 6-12 September 1978, in:  World Health Organization, “Health for All” Series, No. 1, 

WHO, Geneva, 1978. 

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  See paragraph 45 of this general comment. 

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