Achieving health globally requires a combination of a change in thinking and action as well as a financing of certain aspects; there are both fiscal and non-fiscal challenges to the achievement of health globally for all people whether they live in developed or developing countries. However, what will it take to eliminate the gross health inequities that continue to plague the world, the unconscionable health gaps between the rich and poor?
Today the world is focusing on two different processes in an attempt to achieve health as well as other important milestones in the well-being of all people. The Financing for Development process on the one hand is looking to encourage and crystallize fiscal commitments of states while the SDG discussions are focusing on the basic needs and rights of peoples that can be achieved in the post 2015 period.
The eyes of the global health community are similarly focused on the post-2015 sustainable development goals, with the World Health Organisation (WHO) is advocating for universal health coverage: global health with justice – improving healthy lives for everyone, with particular attention to marginalised communities worldwide and its fiscal implications. The sustainable development agenda, however, cannot achieve global health with justice without robust fiscal global, regional and national level governance. A proposal has been made for the adoption of a legally binding global health treaty – a framework convention on global health grounded in the right to health.
While many may argue that there is treaty fatigue and perhaps too many treaties there remains the need to crystallise one particular principle in human rights treaties: rights require resources. The continued reliance on the idealism of human rights without reference to the reality of the need to fund it can no longer be ignore and if for no other reason a framework convention on global health could allow for the clear recognition of this principle. The financing of health under the International Covenant on Economic Social and Cultural Rights places the responsibility of progressive realisation on both domestic states as well as through international co-operation and assistance and to date this has remained within the discretion of states as they choose to assist or not, health is a global issue: diseases cross borders as easily as the wind can blow and both these arms of realisation need further clarity within a treaty framework.
The understanding of the right to health remains partially clouded and this hinders both domestic and international accountability for international human rights obligations. To solve this problem, a framework convention on global health could bring clarity and precision to norms and standards surrounding the right to health, including states’ duties to “take steps…to the maximum of their available resources, with a view to achieving progressively the full realisation” of the right to health. Most importantly, the framework convention on global health could build on a progressive post-2015 development framework by putting specific standards and forceful accountability behind the post-2015 global commitments for both the SDGs as well as the FfD processes.