Health is a Fundamental Human Right

(Written in the light of International Human Rights Day )

To have the highest attainable standard of physical and mental health is an intrinsic human right as recognized in major human rights instruments. Article 25 of the Universal Declaration of Human Rights, 1948 states that everyone has the right to a standard of living adequate for the health, and wellbeing of himself and his family. The preamble to the World Health Organization's (WHO) constitution also declares that it is one of the fundamental rights of every human being to enjoy the highest attainable standard of health.

Nepal formally emphasized health as a fundamental right only after the success of the pro-democracy movement of 2006 by issuing 10 point policy guidelines. Later Interim Constitution of 2007 enshrined for the first time, two health-related  fundamental rights of Nepali citizens stating that ‘every citizen shall have the right to receive basic health care services free of charge from the state as provided for in law’ (article 16.2) and ‘every women shall have the right to reproductive health and reproduction related rights’ (article 20.2). Although these instruments ensured “health for all” as a fundamental human right, the system’s definition of health and its segregation of even basic requirements of care have led to the flawed understanding of this right. Further, Nepalese health care delivery system is embarrassed by copious factors affecting the implementation of the free health services policy rolled out since December 2006, which is a key initiative towards securing the health rights of the citizens.

As one of the developing countries in the world, Nepal has a gross national income of US$440 per person and a population of more than 29 million. The quality of life and the health indictors are extremely unsatisfactory in this part of the world. Life expectancy at birth is 66 years. Though significant advances have been made in the improvements of maternal and infant morbidities and mortalities, they are yet to perk up. The maternal mortality ratio is 280 per 100000 live births and the infant mortality rate is 39 per 1000 live births. Poverty implications are widespread leaving many without even basic rights such as access to clean water, sanitation and medical care. Moreover, discrepancies in the availability, access and affordability of basic health care services has contributed to the extensive disparity in the health care indicators. The imbalances and mal-distribution in the various categories of human resources of health stands as major drawback to health service delivery. To secure health for the people in Nepal as a basic human right is therefore a challenging issue to confront.

Furthermore, abuses against women and girls are extremely common in Nepal. Limited access to adequate health care and nutrition, gendered norms and values which frontier women's ability to assess health care they need, forced trading of girls into prostitution and repression of freedom to decide self for the utilization of safe abortion services  has evidently been violating women’s rights to health care till the date. While there are continuing ample reported cases of infringement of the rights of children on one hand, the health rights of the elderly are still on shade on the other. The rights of the people suffering from mental health issues haven’t still gained a national concern and the health indicators yet do not reveal the improvements in the status of the under-privileged and disadvantaged populations. So it would be absolutely meaningless to argue that the citizen’s rights to health have been fulfilled based on exposition of few documented instruments that entitles health as the fundamental human right.

No doubt, Nepal is an area with stark contrasts in access to health care. Underdeveloped roads and fragile communication links, with remote mountainous terrain, poor infrastructure and lack of sufficient and competent health care personnel, particularly in the western Nepal has been limiting people access to health care. Therefore to dream for the fulfillment of the human rights to health care without significant changes in the current state of health service delivery patterns, technical capacity, medical infrastructures and staff expertise as per the health care demand of the country, would rather be vague and absurd.

Health is a privilege, and in developing countries like ours where particular determinants have constrained the delight of safe and stimulating health care, all the national and international instruments would be of no worth unless these commitments are achieved in realism. The state, humanitarian organizations, I/NGOs, voluntary organizations, professionals and even the general public have the key action to take upon. There is an undeniable fact that the right to the highest attainable standard of health for all cannot be realized overnight. Nevertheless the right to health imposes some obligations of immediate effect, such as non-discrimination, and the necessity that the state at least prepares a national plan for securing the health care rights of the citizen. It furthermore demands the active and informed partaking of individuals and communities in the health decision-making that affects them. The state ought to realize that right to health is something more than a slogan. The right must help to guarantee that health policies assign particular consideration to the vulnerable and marginalized, augment community involvement, and ensure that health interventions strengthen public health systems, and so on.