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World Law Now

For a Healthy Body Politic

By David Gallup

"Health is the organic binding within the created whole. This is true of a cell, a person, humanity, the galaxy and the universe."-Mattie L. Humphrey, nurse and lawyer
If we do not consider health as a basic human and ecological right, we will continue to pollute the earth and atmosphere and will continue to compete violently under the misconceived paradigm of Malthusian and Darwinian scarcity.

To reaffirm the organic bond within each human, among humans and with the earth, we must sanctify that bond through our law and governing institutions. In other words, world law and government must champion adequate standards of health and the fundamental right to health care.

Article 25 of the "Universal Declaration of Human Rights" affirms the right to health care: "Everyone has the right to a standard of living adequate for the health and well-being of himself [sic] and his [sic] family, including food, clothing, housing and medical care and necessary social services. . . ."

Among other international agreements, the 1979 Convention on the Elimination of All Forms of Discrimination Against Women, the 1989 Convention on the Rights of the Child, and the 1990 International Convention on the Protection of the Rights of Migrant Workers and Their Families all provide for the right to health care.

Intergovernmental organizations and national governments have held conferences to raise awareness about the global health crisis and the right to health care. In 1977, the United Nations' World Health Organization (WHO) drafted a resolution entitled "World Health for All" which reaffirmed that health is a fundamental human right. The resolution also called upon countries to collaborate with WHO to work toward the organization's constitutional mandate of "the attainment by all peoples of the highest possible level of health."

At the regional level, the European Community has attempted to create a cogent statement of rights and responsibilities regarding health care. The European Consultation on the Rights of Patients last year formulated "A Declaration on the Promotion of Patients' Rights in Europe." This declaration stresses the importance of viewing health care as a fundamental right rather than merely as a privilege.

At the national level, several constitutions provide for the right to health care. For example, the Constitution of the Republic of Surinam provides that "everyone shall have the right to good health. The State shall promote the general health care by systematic improvement of living and working conditions and shall give information on the protection of health." Another example is found in Egypt's Constitution which states in Articles 16 and 17, "The State shall guarantee cultural, social and health services, and work to ensure them for the villages in particular in an easy and regular manner in order to raise their standard. The State shall guarantee social and health insurance services, and all the citizens have the right to pensions in cases of incapacity, unemployment and old-age, in accordance with the law."

Many constitutions associate the right to work with the right to an adequate standard of living, encompassing health concerns.

Laws at the global and local levels must not only establish that we have a fundamental right to adequate standards of health care, but they must also define those standards and that care.

Some treaties and declarations attempt to do so. Under Article 12 of the International Covenant on Economic, Social, and Cultural Rights (ICESCR), health care is said to mean, "The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child; the improvement of all aspects of environmental and industrial hygiene; the prevention, treatment and control of epidemic, endemic, occupational and other diseases; [and] the creation of conditions which would assure to all medical service and medical attention in the event of sickness."

Other international resolutions, such as the "Declaration of Alma-Ata," refer to minimum standards for adequate care; specify the kinds of services that are health-related; define health as mental, physical and social well-being; and urge individual and collective responsibility in planning and implementing health care. Yet these standards are not being implemented.

"A basic standard of health care cannot be achieved, even in a more affluent society, apart from a commitment to health protection," according to Audrey R. Chapman, editor of Health Care Reform: A Human Rights Approach.

World health law must encompass education, research and development, universal accessibility to medical procedures, universal availability of current technologies, and safety and effectiveness regulations. To the individual, global health care means the ability to consult a health professional no matter where you are in the world and regardless of your financial means. Thus, world health law must devise standards of health for humanity and the earth as well as ensure that humans have the resources to implement those standards.

International concern for implementation of health care standards has been expressed through organizations such as WHO, the U.N.'s Environment and Development Programs and the International Red Cross. But like every international entity, these organizations are prevented by national governments from acting on behalf of humans living in impoverished, diseased, violent, and unsustainable environments. When these organizations do act, it is usually in response to crises and uncontrollable epidemics. They do not have a mandate to prevent health crises or to regulate health care infrastructures because nations have claimed this role, despite their inaction.

A Sept. 18 New York Times article reveals that WHO does not set its own budget priorities in conjunction with the actual need for funds for research, education and treatment. WHO's member-states establish its budget; consequently, the nation-states holding the purse strings can ignore preventable and curable diseases such as tuberculosis, because they choose not to intervene to counteract the pharmaceutical industry's stagnation.

By bringing the issue of health to the world level in conjunction with law, responsibility for the development of standards and the implementation of care will then belong to individuals and humanity, freeing health care from the constraints that national governments impose. Viewed from the perspectives of the patient and the health provider, health care should mean individuals helping individuals, without the constraints of the marketplace. But viewed from the perspectives of the pharmaceutical industry, the insurance companies, and governments, health care is a commodity to be bought and sold on the marketplace.

Due to the lack of global law regarding the right to health care, we have allowed these special interests to define the parameters of health care and to control, or limit, its dispersal. National laws, such as those proposed by the current United States administration, and various international resolutions further deepen reliance on economic factors, which determine how, when, where and for whom health care is provided.

This unhealthy process of implementing health care laws and standards based on nationalistic and corporate criteria cannot result in healthy persons or healthy social and natural environments. Indeed, governments and corporations claiming to resolve the global health crisis actually created the crisis and profited from it.

In her article "Planning to Heal the Nation" in Public Administration Review, Mattie Humphrey writes, "As long as institutions purporting to provide service to humanity excel only at securing budgets, status, and longevity for themselves, there will be no enlightened voluntary system of human [health] services!"

If we develop world health law through a process that accounts for the wholeness of humanity, the interdependence of humans and ecology, and individual sovereignty, this law can be a means to empower humans in their communities. The world health law process will allow humans to transcend concerns about physical needs and enable us to fulfill other needs, such as those involving mental and community health.

To expand upon Humphrey's metaphor, we can heal the world and ourselves if we look at the body politic, not as a fragmented Frankenstein's monster with no soul, but rather as an organic whole with a moral conscience aware of the bounty of humanity and the earth.

David Gallup is the General Counsel of the World Service Authority


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