Applying Human Rights Concepts In Public Health Social Science Paper Applying human rights concepts. There is a prompt that will help explain the situation
Applying Human Rights Concepts In Public Health Social Science Paper Applying human rights concepts. There is a prompt that will help explain the situation. Also a rubric and references attached. First page is Prompt and QuestionsSecond page about grading rubricOthers are the references.2 Pages, Single spaced, and APA format. Instructions: Please respond to each question following the prompt below in no more than
two paragraphs per question – which should take no more than one page double spaced for
each answer. That should be sufficient to enable you to provide complete and concise answers.
The prompt and questions are based on concepts we have discussed and read about; no outside
research is expected. You needn’t include references but if you think it helpful to refer to a
document or reading just name it in the text without a footnote or reference list (e.g. “Yamin
refers to this as…” or “UN General Comment #14 provides…”). Do not write the question
before providing your answer – just reference the question by number (i.e., 1, 2, 3, 4)
The prompt was written to provide you with all the relevant information you need to answer, so
please read it, including the elements of the proposed plan, carefully. If you are unclear about a
factual point in the scenario or think other facts may be relevant to write your answer, you should
state what you think is needed. If you assume certain facts, please state your assumptions.
The assignment is completely open book, but do not consult with other students or anyone else in
preparing your answer.
The answers will be graded on a 100 scale, with equal weight, 25 points, for each answer. As
noted in the syllabus, the assignment represents 20% of the course grade.
You have been hired by new the Minister of Health of Moonland to provide advice on a strategy
to address the health needs of its people. Moonland is a geographically large middle-income
country. It recently has had a more or less free election but its democratic institutions, such as a
free press and independent judiciary, are weak. Most of the country’s population lives in rural
areas, but most health institutions, health workers, and schools are concentrated in its three major
cities. In those cities, most health care is provided in private clinics on a fee for service basis.
There are public clinics in both urban and rural areas, but they are under-staffed and underresourced.
The health minister’s job has traditionally been institutionally weak within the government, and
historically health has not been a priority for the government’s resources.
The health minister tells you that her plan is based on the following assessment: (1) Moonland’s
aggregate health indicators are generally poor, with below average life expectancy for a middleincome country; (2) Under-5 child mortality, mostly a product of infectious diseases and diarrhea
(from unclean water and poor sanitation), is especially high for a country of its income; (3)
Literacy, especially among women and girls, is low.
The health minister presents you with her proposal for the following program, which she sees as
realistic given the resources she is likely to have:
1. Universal childhood vaccinations, which could be done without a lot of investments in
infrastructure and health personnel given resource constraints.
2. Subsidies to private clinics, which would enable them to expand services to provide free
care to low-income people who currently lack sufficient access to care, a strategy she
says takes best advantage of existing human and infrastructure resources.
3. An anticipation (but no commitments) of NGO-furnished services financed by donors,
which she expects to expand as a result of confidence in the new government.
4. Ongoing monitoring of the program by collecting data on vaccination rates, utilization of
the private clinics, and services offered by NGOs, if any.
As an expert in human rights and health you are asked to answer the following questions.
Remember, be specific and concise– two paragraphs for each.
1. Explain whether, from a human rights point of view, the minister has properly analyzed
the health situation and needs in the country, and if not, what additional steps she should
take to assess them.
2. Explain whether, from a human rights standpoint, the four key elements of the plan
suffice to meet human rights requirements for the health concerns she has identified. If
not, explain why not and what could be done to address those concerns.
3. The plan is based on her assessment of the resources she believes she is able to obtain.
Explain whether her approach is sound from a human rights standpoint.
4. Comment whether the process of developing, implementing and monitoring the plan is
consistent with human rights.
PAPER GRADING RUBRIC
Overall organization 12 points for overall clarity and organization
Each of the four parts: 22
Total Score Possible: 100 points
clear and well
mastery of the
reads as mere
22 points (for
idea to the
20 points (for
Omits or does
16 points (for
ignored or are
Int J Health Policy Manag 2016, 5(5), 337–339
Searching for the Right to Health in the Sustainable
Comment on “Rights Language in the Sustainable Development Agenda: Has Right to
Health Discourse and Norms Shaped Health Goals?”
Sarah Hawkes1*, Kent Buse2
The United Nations (UN) Sustainable Development Agenda offers an opportunity to realise the right to health
for all. The Agenda’s “interlinked and integrated” Sustainable Development Goals (SDGs) provide the prospect of
focusing attention and mobilising resources not just for the provision of health services through universal health
coverage (UHC), but also for addressing the underlying social, structural, and political determinants of illness and
health inequity. However, achieving the goals’ promises will require new mechanisms for inter-sectoral coordination
and action, enhanced instruments for rational priority-setting that involve affected population groups, and new
approaches to ensuring accountability. Rights-based approaches can inform developments in each of these areas.
Received: 6 January 2016
Accepted: 19 February 2016
ePublished: 24 February 2016
In this commentary, we build upon a paper by Forman et al and propose that the significance of the SDGs lies
in their ability to move beyond a biomedical approach to health and healthcare, and to seize the opportunity
for the realization of the right to health in its fullest, widest, most fundamental sense: the right to a healthpromoting and health protecting environment for each and every one of us. We argue that realizing the right
to health inherent in the SDG Agenda is possible but demands that we seize on a range of commitments,
not least those outlined in other goals, and pursue complementary openings in the Agenda – from inclusive
policy-making, to novel partnerships, to monitoring and review. It is critical that we do not risk losing the right
to health in the rhetoric of the SDGs and ensure that we make good on the promise of leaving no one behind.
Keywords: Human Rights, Sustainable Development Goals (SDGs), Accountability
Copyright: © 2016 by Kerman University of Medical Sciences
Citation: Hawkes S, Buse K. Searching for the right to health in the sustainable development agenda: Comment
on “Rights language in the sustainable development agenda: has right to health discourse and norms shaped health
goals?” Int J Health Policy Manag. 2016;5(5):337–339. doi:10.15171/ijhpm.2016.21
ast year (2015) the world set an agenda to guide and
influence universal sustainable development for the
next 15 years. Unconstrained by the narrow confines
of the predecessor Millennium Development Goal (MDG)
commitments, contributors to the SDGs agenda had the
opportunity to establish the parameters for an ambitious,
inclusive and progressive plan for a fairer world. The outcome
of the most comprehensive process of consultation that the
United Nations (UN) has ever undertaken, was a framework
of 17 goals and 169 targets – providing a veritable cornucopia
of aspirations. While described by some as ‘unremittingly
utopian,’1 according to the UN Secretary-General, with its
commitment to “leave no-one behind,” the SDG agenda
amounted to ‘blueprint for a better future.’2
It is to the process of goal and target development in the SDGs
that Forman and colleagues turn their attention.3 Applying a
human rights analysis to both the overall process and four
of the most important interim and outcome documents,
the authors recognise that the discourse surrounding
their formulation is likely to have played a major role in
the priorities set. Taking a constructivist lens to study the
activities of international organisations is not a new idea,4
including in global health,5,6 and the authors delve deeper into
constructivist methodologies by further applying an empirical
Full list of authors’ affiliations is available at the end of the article.
analysis to the use of human rights-focused language in the
SDG process and outcome documents. They find that while
the four major documents from the global goals process
are cognisant of human rights language, there is variation
in the construction and expression of the right to health.
This matters, they argue, since the language used in these
documents is likely to frame subsequent policy responses
both globally and nationally.
There can be no doubt that the language and discourse
associated with these documents reflect historical and current
concerns, reveals interests of actors, and may also have the
ability to shape future priorities, resource allocation decisions
and approaches to development challenges. An absence of any
human rights language in the texts would have been a source of
major concern, and it is, therefore, welcome that the opening
paragraphs of the final SDG outcome document state upfront
that the “17 SDGs and 169 targets … seek to realise the human
rights of all.”7 While the right to health is not spelled out per
se, the placing of human rights centre stage in the preamble
to the outcome document recognises them as fundamental
to achieving sustainable development for people, planet and
shared prosperity and acknowledges that transformative and
universal agendas can only be secured when human rights are
promoted, protected and realized.
Hawkes and Buse
What does the centrality of rights-based discourse mean
for health? Forman and colleagues express the view that the
concept of universal health coverage (UHC) is fundamental to
the right to health and a major step towards equity, including
in health financing. And it is, therefore, the reference to
UHC in the documents to which the authors attach greatest
significance as they search for mention of the right to health
in the agenda. There is little to argue with a concern for
UHC; indeed there is much to commend it. However, the
significance of the SDGs lies in their ability to move beyond a
biomedical approach to health and healthcare, and instead to
seize the opportunity for the realization of the right to health
in its fullest, widest, most fundamental sense: the right to a
health-promoting and health protecting environment for
each and every one of us.
The SDGs are presented as “interlinked and integrated”7–
which represents a major conceptual shift in thinking on
the foundations of development and health. The SDGs,
with their emphasis on intersectoral collaboration, offer
the most promising avenue yet to consider how we might
promote good health and well-being through ensuring that
the determinants of illness are addressed, rather than limiting
our vision to only ensuring access to illness-treatment or
management.8 Moreover, the SDGs are concerned with an
extremely wide range of structural drivers, risk factors and
diseases. Gone is the narrow focus of the MDGs with its
overwhelming emphasis on maternal and child health and
a small (but burdensome) number of infections. The SDGs,
in contrast, reflect more of the epidemiological transitions
that have occurred in the last 20 years and seek to address a
much broader range of conditions limiting human well-being,
including the non-communicable diseases, mental health,
violence and environmental risks which contribute the bulk
of the global burden of disease.9
Realizing the right to health within the SDG framework will
mean utilizing the full range of commitments, conventions
and covenants already in existence that promote, protect
and ultimately realize rights in relation to the determinants
of health. Take, for example, the International Covenant on
Economic, Social and Cultural Rights, which enshrines: the
right to work for fair wages and within a safe and healthy
working environment; to education; to safe potable water,
adequate sanitation, adequate and safe nutrition; the right to
non-discrimination and to gender equality in the enjoyment
of the rights.10 It is arguable that, as the Commission on Social
Determinants of Health concluded, realizing the rights to
healthy environments through addressing the underlying
determinants of illness and inequity, will have a substantial
and sustained impact on overall population levels of good
health and health equity.11 It is precisely the focus of the
sustainable development agenda on goals and targets for
poverty eradication, redressing inequality, promoting quality
education, food security, decent work, safe cities as well as on
inclusive institutions and access to justice which, if achieved,
will ultimately have the greatest impact on population health
levels – and hence determine whether the right to health is
realized or not for the majority of the population.
Nonetheless, if we are to get serious about the realization of
the right to health within the SDGs, we need to move beyond
the rhetoric of goals and targets and establish realistic,
feasible and responsible plans for action. Given the breadth
of conditions the SDGs aim to cover, this will include a
need to include plans for rational prioritization of resources
and activities – a process that is potentially divisive among
different health actors, but will be necessary to ensure that
resources are targeted where needed and where impact is
Critically, there can be little doubt that where progress was
achieved in the MDGs it was in part due to the monitoring
and reporting mechanisms which served to attract political
attention and resources and to generate accountability.13,14 In
the AIDS response, for example, National AIDS Commissions
were often placed in senior political bodies at national level
(eg, office of Prime Minister or President).15 Annual progress
on commitments are discussed annually by all stakeholders
from all sectors, formal monitoring mechanisms include nonstate actors and reporting is transparent and conveyed to the
the UN General Assembly. In the domain of women’s and
children’s health, the UN Commission on Information and
Accountability (COIA) was strengthened by the establishment
of an independent Expert Review Group which reported
directly to the UN Secretary General.13
While the SDG agenda refers to accountability, it does not
outline any explicit strategies for achieving and sustaining it.
Moreover, the SDG agenda provides flexibility for national
level decision-making around goals and targets – thus
leading to the possibility that countries may decide that
certain elements of a global framework are not appropriate
to their national context. For example, Goal 3 (health), sets
a target to “strengthen the implementation of the WHO
Framework Convention on Tobacco Control in all countries,
as appropriate.” The lack of binding commitments within
the Agenda, combined with the explicit assertion of national
sovereignty, leads to the possibility of so-called ‘discretionary
development’ occurring, with countries having the tractability
to pick and choose which elements of the agenda they deem
appropriate to them, or to set targets which lack the overall
ambition inherent in the SDG agenda. In this case, stronger
mechanisms for local priority-setting which is both rational
and inclusive of, and accountable to, relevant stakeholders,
need to be enhanced.11
What the SDG framework currently, and crucially, lacks is
a serious and explicit commitment to accountability for the
goals, targets and even the underlying principles (such as
the human rights principle). If we are to see human rights
promoted, protected and realized, and populations and people
achieving the highest attainable levels of health, then, as Paul
Hunt and others have noted, the health sector urgently needs
to establish a “web of accountability” with an independent
monitoring and review of the social determinants of health
in addition to accountability for the more narrow functions of
the health system itself.16
The significance and legacy of the sustainable development
agenda for the right to health lies in the possibility that the
ambition of the global goals reaches far beyond rolling out
of UHC to one that gives impetus to action on the range of
social determinants of health. The challenge and opportunity
for the international community is to advocate to ensure
that the commitment to health is matched by commensurate
levels of investment, to link the health sector to other sectors
International Journal of Health Policy and Management, 2016, 5(5), 337–339
Hawkes and Buse
to pursue shared goals, to articulate robust implementation
plans through inclusive processes and support resolute
action through new accountability structures that welcome
independent inputs, at global, national and subnational
levels—otherwise we risk losing the right to health in the
rhetoric of the SDGs.
Authors declare that they have no competing interests.
KB and SH co-conceived and co-authored all aspects of the paper. Both authors
read and approved the final manuscript. The views expressed in this paper do
not necessarily reflect those of UNAIDS, Geneva, Switzerland.
Faculty of Pop Health Sciences, Institute for Global Health (IGH), University
College London, London, UK. 2United Nations Programme on HIV/AIDS
(UNAIDS), Geneva, Switzerland.
1. Horton R. Offline 13/11 – the flames of war. Lancet.
2. Moon BK. Speaking at September 2015 United Nations General
Assembly, New York. http://www.un.org/apps/news/story.
asp?NewsID=51968#.VobEHcBkg_U. Accessed January 1,
3. Forman L, Ooms G, Brolan CE. Rights language in the
sustainable development agenda: has right to health discourse
and norms shaped health goals? Int J Health Policy Manag.
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