Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, ON, Canada, Canada.
Soc Sci Med. 2010 Oct;71(8):1520-6. doi: 10.1016/j.socscimed.2010.06.042. Epub 2010 Aug 13.
The WHO Commission on Social Determinants of Health (CSDH) ascribed health disparities within and between countries to "a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics." This article analyzes the relevance of the international human rights framework (IHRF) to the Commission's goal of reducing health disparities with reference to both social scientific and legal scholarship. We begin with an overview of the IHRF, demonstrating its potential as a challenge to the normative foundations of the emerging global economic order. We then survey the research literature on mechanisms to ensure accountability for realization of health-related rights, emphasizing the potential effectiveness of making human rights enforceable through the courts, and the special need for mechanisms to hold countries and international institutions accountable for obligations related to the human right to health. We conclude by identifying three key directions for further research, policy and advocacy: comparative human rights litigation, specifically the willingness of courts to address broad policy and budgetary issues; the conditions under which governments legislate or constitutionalize economic and social rights; and how rich, powerful countries affect economic and social rights outside their borders.
世界卫生组织(WHO)社会决定因素健康委员会(CSDH)将国家内部和国家之间的健康差距归因于“不良社会政策和方案、不公平的经济安排和糟糕的政治的有毒组合”。本文参考社会科学和法律学术文献,分析了国际人权框架(IHRF)与委员会减少健康差距目标的相关性。我们首先概述了 IHRF,展示了它作为对新兴全球经济秩序规范基础的挑战的潜力。然后,我们调查了确保实现与健康相关权利问责制的研究文献,强调了通过法院强制执行人权的潜在有效性,以及特别需要建立机制,使国家和国际机构对与健康权有关的义务负责。最后,我们确定了进一步研究、政策和宣传的三个关键方向:比较人权诉讼,特别是法院处理广泛的政策和预算问题的意愿;政府立法或使经济和社会权利宪法化的条件;以及富裕和强大的国家如何在其境外影响经济和社会权利。