Health & Human Rights: Is Access to Medicines All We Got?

1. Health & Human Rights: Is Access to Medicines All We Got? Benjamin Mason Meier, JD, LLM, PhD Assistant Professor of Global Health Policy University of North Carolina – Chapel Hill World AIDS Day November 30, 2009

2. Treatment for All ?

3. Outline • Background – Health and Human Rights • Theory – Limited Evolution of the Right to Health to Codify Prevention • Analysis – Human Rights for Prevention • Discussion – A Rights-Based Approach to HIV Prevention

4. International Law Human Rights Health & Human Rights Public Health

5. Human Right = Valid claim & Corresponding duty Rights holder Duty bearer • E.g.: “Awomanhas a valid claim to aright to health, which is realized through the duties of the national government to provideHIV Treatment.” • Goals – (1)Define duty-bearers and rights-holders, (2) Impose legal obligations on duty-bearers, (3) Inform rights-holders of their rights and how these rights can be claimed and enforced Human Rights-Based Approach Programs to Realize Rights Demand of Rights

6. Health & Human Rights • Human Rights Matter • Human Rights Evolve • Evolution of Rights in International Law • Disease Prevention through the Right to Health? Human Rights International Law Health & Human Rights Public Health The Health & Human Rights Movement

7. International Legal Framework for Health Second World War Four Freedoms UN Charter WHO Constitution UDHR The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

8. Universal Declaration of Human Rights • Article 25 • Medical care • Public health Second World War Four Freedoms UN Charter WHO Constitution UDHR “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services…”

9. Evolution of the Right to Health Declaration of Alma-Ata (1978) UDHR (1948) ICESCR (1966)

10. Legacy of Human Rights Neglect • From Legal Obligation to Non-Binding “Commitment” • Human Rightto Health Treatment • “Exceptional” Funding Distortions • Right to Health Does Not Address Underlying Determinants of Health • Dismantling Health Systems – Exacerbating Health Inequalities ✗ MDGs for Health

11. Human Rights for Prevention? Is a Right to Medicines All We’ve Got? From Public Health Discourses to Human Rights Obligations • From Collective to Individual Models • Structural determinants of health & Prevention • Primary health care • Curative medicine • Prevention as a Means to • Individual Health Capability • Collective Utility

12. Human Right = Valid claim & Corresponding duty Rights holder Duty bearer • E.g.: “Astatehas a valid claim to acollective health rights, whicharerealized through the duties of theinternational community to provideHIV Prevention.” Collective Rights-Based Approach Programs to Realize Rights Demand of Rights

13. Vaccine = Treatment + Prevention

14. Research Treatment Education Test + Social Measures Prevention Condoms PrEPs Microbicides Circumcision

15. Treatment for All (+ Prevention) Benjamin Mason Meier Assistant Professor of Global Health Policy University of North Carolina – Chapel Hill bmeier@unc.edu