Sharing a Perspective from the Eastern Mediterranean Region

Three months ago, the world marked the 75th anniversary of the Universal Declaration of Human Rights (UDHR), a day that reminded all of us of our fundamental rights and freedoms, which include “the right to a standard of living adequate for…health and well-being.” Today, we are observing World Health Day in a similar spirit with a message that underscores health as indivisible human right entrenched not only in UDHR but in subsequent proclamations, international human rights law, treaties, and national constitutions around the world.

The world is in consensus on the recognition of health as a right. Beyond words on papers and fervent rhetoric, the reality is not as idealistic, however. The realization of the right to health is hindered by a range of social, economic, and environmental determinants. In many countries, the availability, accessibility, acceptability, and quality of health services are compromised by challenging surroundings. From the Eastern Mediterranean Region, a few instances can attest to this statement.

I’ll begin with extraordinary circumstances. Escalating violence and protracted conflict affecting nearly half of the region’s countries renders the right to health almost nonexistent: access to health services is disrupted, health workers are attacked, medical supply is depleted, and facilities are destroyed. There, health threats are imminent as people are exposed to contaminated water and are denied food. A similar situation faces other countries affected by unprecedented financial crises, where gains and progress of the past are now compromised as the state is unable to grant citizens life-saving treatment. Climate change is instigating more drought seasons, floods, and other environmental disasters, and is wreaking havoc on the health, lives, and livelihoods of people.

In times of normalcy, the situation is not as “normal” as we expect it to be. Social stigma still acts as a barrier to the fulfillment of the right to health. Patients fear isolation and choose not to seek help or treatment for life-threatening diseases. Misconceptions circulating widely through modern media are letting people make hurtful decisions about their own health.

In all situations, it is the vulnerable, women, children, and refugees, who bear the brunt of health rights deprivation.

The realization of the right to health is dependent on a myriad of factors that are beyond our control and scope of expertise. This entails the necessity for the adoption of multi-disciplinary approaches where collaborators can identify the surrounding circumstances hindering the realization of health as a right. At our disposal is a tested approach, a human rights-based approach (HRBA) to health, which has been impactful in improving health service quality and equity. HRBA must be the guide to ensure that our policies, programs, and interventions serve the health rights of all, especially the vulnerable and the marginalized.

We do need and must receive additional assistance from capable states and increased support from the private sector to aid countries facing challenging situations with few resources. However, such assistance and support must be channeled through the human rights lens, the HRBA.

And there is a clear formula for success. At the onset, the core elements of health rights and human rights principles are used as a starting point for discussions that later inform strategy, and more importantly program objectives and outcomes. Along the way, non-discrimination on any basis must be considered in the design of programs and so should the unique challenges of the vulnerable and the marginalized.

I am speaking here from experience rooted in collaborative efforts in the region under very tough situations where I worked with committed partners from around the globe to secure health rights (by making services available, accessible, acceptable, and of quality to all people) in many countries.

By considering human rights at the strategic and implementation level, we were able to create learning opportunities for health workers affected by movement constraints, to utilize technology and mass media to improve health literacy and accelerate knowledge sharing and generation, engage communities in health service design, delivery, and evaluation, and employ research to inform implementation of interventions especially in fragile contexts. Guided by a consideration of health rights, we were able to make contributions.

An HRBA to health must our focus so we can be able to deliver the tangible results we have all been aiming for. There is a compelling case for it, a case that will drive real change.