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
15
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.
16
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.
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.
17
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.