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

 

 

 

 

 

                                                

disaster relief and humanitarian assistance in times of emergency, including assistance 

to refugees and internally displaced persons.  Each State should contribute to this task 

to the maximum of its capacities.  Priority in the provision of international medical 

aid, distribution and management of resources, such as safe and potable water, food 

and medical supplies, and financial aid should be given to the most vulnerable or 

marginalized groups of the population.  Moreover, given that some diseases are easily 

transmissible beyond the frontiers of a State, the international community has a 

collective responsibility to address this problem.  The economically developed States 

parties have a special responsibility and interest to assist the poorer developing States 

in this regard. 

41. 

States parties should refrain at all times from imposing embargoes or similar 

measures restricting the supply of another State with adequate medicines and medical 

equipment.  Restrictions on such goods should never be used as an instrument of 

political and economic pressure.  In this regard, the Committee recalls its position, 

stated in general comment No. 8, on the relationship between economic sanctions and 

respect for economic, social and cultural rights. 

42. 

While only States are parties to the Covenant and thus ultimately accountable 

for compliance with it, all members of society - individuals, including health 

professionals, families, local communities, intergovernmental and non-governmental 

organizations, civil society organizations, as well as the private business sector - have 

responsibilities regarding the realization of the right to health.  States parties should 

therefore provide an environment which facilitates the discharge of these 

responsibilities. 

Core obligations 

43. 

In general comment No. 3, the Committee confirms that States parties have a 

core obligation to ensure the satisfaction of, at the very least, minimum essential 

levels of each of the rights enunciated in the Covenant, including essential primary 

health care.  Read in conjunction with more contemporary instruments, such as the 

Programme of Action of the International Conference on Population and 

Development,

28

 the Alma-Ata Declaration provides compelling guidance on the core 

obligations arising from article 12.  Accordingly, in the Committee’s view, these core 

obligations include at least the following obligations: 

(a) 

To ensure the right of access to health facilities, goods and services on a 

non-discriminatory basis, especially for vulnerable or marginalized groups; 

(b) 

To ensure access to the minimum essential food which is nutritionally 

adequate and safe, to ensure freedom from hunger to everyone; 

 

28

    Report of the International Conference on Population and Development, Cairo, 5-13 September 

1994 (United Nations publication, Sales No. E.95.XIII.18), chap. I, resolution 1, annex, chaps. VII and 

VIII. 

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(c) 

To ensure access to basic shelter, housing and sanitation, and an adequate 

supply of safe and potable water; 

(d) To 

provide 

essential 

drugs, as from time to time defined under the WHO 

Action Programme on Essential Drugs; 

(e) 

To ensure equitable distribution of all health facilities, goods and services; 

(f) 

To adopt and implement a national public health strategy and plan of action, 

on the basis of epidemiological evidence, addressing the health concerns of the whole 

population; the strategy and plan of action shall be devised, and periodically 

reviewed, on the basis of a participatory and transparent process; they shall include 

methods, such as right to health indicators and benchmarks, by which progress can be 

closely monitored; the process by which the strategy and plan of action are devised, as 

well as their content, shall give particular attention to all vulnerable or marginalized 

groups. 

44. 

The Committee also confirms that the following are obligations of comparable 

priority: 

(a) 

To ensure reproductive, maternal (prenatal as well as post-natal) and child 

health care; 

(b) 

To provide immunization against the major infectious diseases occurring in 

the community; 

(c) 

To take measures to prevent, treat and control epidemic and endemic diseases; 

(d) 

To provide education and access to information concerning the main health 

problems in the community, including methods of preventing and controlling them; 

(e) 

To provide appropriate training for health personnel, including education on 

health and human rights. 

45. 

For the avoidance of any doubt, the Committee wishes to emphasize that it is 

particularly incumbent on States parties and other actors in a position to assist, to 

provide “international assistance and cooperation, especially economic and 

technical”

29

 which enable developing countries to fulfil their core and other 

obligations indicated in paragraphs 43 and 44 above. 

3.  Violations 

46. 

When the normative content of article 12 (Part I) is applied to the obligations 

of States parties (Part II), a dynamic process is set in motion which facilitates 

identification of violations of the right to health.  The following paragraphs provide 

illustrations of violations of article 12. 

 

29

  Covenant, art. 2.1. 

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