Towards a Framework Convention on Global Health (FCGH)

Towards our right to healthTowards a Framework Convention on Global Health (FCGH)

by Lawrence Gostin, Eric Friedman, Kent Buse, Attiya Waris, Moses Mulumba, Mayowa Joel, Lola Dare, Ames Dhaig & Devi Sridhar

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? The eyes of the global health community are focused on the post-2015 sustainable development goals, with the World Health Organization (WHO) advocating for universal health coverage. Adding healthy life expectancy as an overarching goal would capture the broader determinants of health and offer a richer integration of multiple sectors.1 Beyond improving health, the United Nations (UN) should focus on equity, human rights, inclusive participation and accountability.2  The stage is set for the post-2015 agenda to embrace global health with justice – improving healthy lives for everyone, with particular attention to marginalized communities.

The sustainable development agenda, however, cannot achieve global health with justice without robust global governance. We urge adoption of a legally binding global health treaty – a framework convention on global health grounded in the right to health. What are the purposes and content of a framework convention and how can such a treaty help to achieve global health with justice? And what steps need to be taken to galvanize support for its adoption and implementation? This perspectives paper seeks to spark international dialogue on a framework convention on global health and to explore the pathways to- wards a global health treaty.

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FCGH Background Briefing: The Right to Health

FCGHFramework Convention on Global Health Background Briefing: The Right to Health

August 2014
The Right to Health
Encompassing FCGH key principles

  1. o)  Define state responsibilities for the health of all its inhabitants on an equal basis, regardless of gender, race, nationality, ethnicity, religion, age, sexual orientation, gender identity and expression, or socioeconomic, migration, disability, disease, or other status, and to promote equality through equity, ensuring equal access to good quality and responsive health services, including by removing financial barriers and ensuring physical accessibility and dignified treatment.
  2. p)  Remove all discrimination and other barriers in law, policy, and practice that undermine the right to health.
    x) Strengthen global leadership on the right to health, including that of WHO.

The right to health is already codified through numerous global and regional treaties, most prominently the International Covenant on Economic, Social and Cultural Rights (ICESCR) (“the right of everyone to the enjoyment of the highest attainable standard of physical and mental health”) (article 12). An analysis of national constitutions adopted through 2011 found that 105 guaranteed everyone the right to health or specifically the right to medical care or public health.1 The right’s principles are detailed most prominently in General Comment 14 of the UN Committee on Economic, Social and Cultural Rights,2 as since elaborated upon through reports on the UN Special Rapporteurs on the right to health – and related rights such as those on food and on water and sanitation3 – along with general comments and recommendations from other treaty bodies4 and national and regional court cases.

Yet, major gaps and shortcomings exist in both international right to health law as it exists and in its implementation:
1. Clarity of key principles: General Comment 14 and other elucidations of the right to health have gone far towards developing its normative principles. Indeed, many of these – such as equality and non-discrimination, participation in health-related decisions, and accountability – are foundation elements of an FCGH.

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A FCGH – Would it Help Developing Countries to Fulfill their Duties on the Right to Health?

dutiesA FCGH – Would it Help Developing Countries to Fulfill their Duties on the Right to Health? A South African Perspective

Mark Heywood & John Shija, Section 27
September 29, 2010

It is arguable that the delivery of global health has reached an impasse. This is evident not only in unresolved debates that are raging about where to allocate health aid or how to sustain and expand funding for AIDS treatment,1 but also in challenges facing national health systems that are incapable of purely domestic resolution. But there is some irony and much opportunity in this situation. Not only have the last 20 years seen an unprecedented growth in funding for health, mainly through funding for AIDS, but there have also been a range of initiatives and ideas2 that have generated better knowledge not only of the determinants of health,3 but also of how to attain it.4 Scientists, public health experts and activists have created a store of intellectual knowledge, technology and ideas which, if properly and fairly deployed, might provide the opportunity to re-launch tangible progress towards the progressive realization of the right to health on a global scale.It is in this context that Professor Lawrence Gostin and now a growing band of fellow travelers have floated the idea of a Global Framework Convention on Health (FCGH)5. Gostin summarizes the FCGH as:
     A global health governance scheme that incorporates a bottom-up strategy that strives to do the following: build capacity, so that all countries have enduring and effective health systems; set priorities, so that international assistance is directed to meeting basic survival needs; engage stakeholders, so that a wide variety of state and non-state participants can contribute their resources and expertise; coordinate activities, so that programs among the proliferating number of participants operating around the world are harmonized; and evaluate and monitor progress, to ensure that goals are met and promises kept.6

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