Ooms Gorik, Latif Laila A, Waris Attiya, Brolan Claire E, Hammonds Rachel, Friedman Eric A, Mulumba Moses, Forman Lisa
Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium.
BMC Int Health Hum Rights. 2014 Feb 24;14:3. doi: 10.1186/1472-698X-14-3.
The present Millennium Development Goals are set to expire in 2015 and their next iteration is now being discussed within the international community. With regards to health, the World Health Organization proposes universal health coverage as a 'single overarching health goal' for the next iteration of the Millennium Development Goals.The present Millennium Development Goals have been criticised for being 'duplicative' or even 'competing alternatives' to international human rights law. The question then arises, if universal health coverage would indeed become the single overarching health goal, replacing the present health-related Millennium Development Goals, would that be more consistent with the right to health? The World Health Organization seems to have anticipated the question, as it labels universal health coverage as "by definition, a practical expression of the concern for health equity and the right to health".Rather than waiting for the negotiations to unfold, we thought it would be useful to verify this contention, using a comparative normative analysis. We found that--to be a practical expression of the right to health--at least one element is missing in present authoritative definitions of universal health coverage: a straightforward confirmation that international assistance is essential, not optional.But universal health coverage is a 'work in progress'. A recent proposal by the United Nations Sustainable Development Solutions Network proposed universal health coverage with a set of targets, including a target for international assistance, which would turn universal health coverage into a practical expression of the right to health care.
当前的千年发展目标定于2015年到期,国际社会正在讨论其后续目标。在卫生方面,世界卫生组织提议将全民健康覆盖作为千年发展目标后续目标中的“首要总体卫生目标”。当前的千年发展目标因与国际人权法“重复”甚至是“相互竞争的替代方案”而受到批评。那么问题来了,如果全民健康覆盖真的成为首要总体卫生目标,取代当前与卫生相关的千年发展目标,这是否更符合健康权呢?世界卫生组织似乎已经预见到了这个问题,因为它将全民健康覆盖定义为“从定义上讲,是对卫生公平和健康权关注的实际体现”。
我们认为,与其等待谈判展开,不如通过比较规范性分析来验证这一论点。我们发现,作为健康权的实际体现,当前全民健康覆盖的权威定义中至少缺少一个要素:直接确认国际援助是必不可少的,而非可有可无。
但全民健康覆盖仍“尚在推进之中”。联合国可持续发展解决方案网络最近提出了一项带有一系列目标的全民健康覆盖提议,其中包括一项国际援助目标,这将使全民健康覆盖成为医疗保健权的实际体现。