A Rights-Based Framework for the SDGs and Beyond: the FCGH

KEY SDG3A Rights-Based Framework for the SDGs and Beyond: A Framework Convention on Global Health

A growing movement is galvanizing around a proposed Framework Convention on Global Health (FCGH) – a global treaty based in human rights and aimed at national and global health equality. UN Secretary-General Ban Ki-moon issued the following call to action in his report in advance of the June 2016 High-Level Meeting on Ending AIDS: “I further encourage the international community to consider and recognize the value of a comprehensive framework convention on global health.”1 It is now time for the international community, from individual states to the Director-General of the World Health Organization – the organization mandated to lead the world on global health, and with the right to health as a core constitutional principle – to answer this call.

The FCGH Vision
All people, wherever they live, ought to be able to easily access comprehensive quality universal health coverage in a health system that does not discriminate, and that equally serves poor and rich. All should be able to readily access other universal needs for good health, such as clean water and nutritious food. The right to health, and the equality, accountability, and participation that are central to it, should be infused throughout the health system and integrated in other sectors and legal regimes, both domestically and internationally.

Filling in gaps in accountability, governance, financing, and human rights, the FCGH would help achieve the health goals and targets of the Sustainable Development Goals, while establishing a rights-based framework for health for the post-SDG era.

Read moreA Rights-Based Framework for the SDGs and Beyond: the FCGH

Boarding the FCGH Express

BoardingBoarding the FCGH Express

Sometimes the right to health provides a clear answer. Discriminatory laws must be abolished to ensure the right for all people, and not deny it because of someone’s “legal status” or nationality, for example. The right to health does not always provide a definitive answer, though. To borrow an example from my colleague Alicia Yamin’s book Power, Suffering, and the Struggle for Dignity, consider the right to health requirement of equitable distribution of health services. Providing maternal health services in remote areas may well cost more than in urban areas. For countries in the process of expanding access to care, and where sufficient additional resources are not available, shifting resources from urban to rural areas to enhance equity could well slow overall expansion of coverage, leading to more maternal deaths in the near term. How far should this reallocation to a more equitable distribution go? There is no right answer.

But there is a right process to figure out the answer, a process that will give that answer legitimacy. That is a process guided by the human right principle of participation, with a fully informed public discussion and meaningful participation in decision-making, including and especially by the people whose lives will be most affected; in this example, rural and urban women who rely on public health services.

Meaningful participation, then, should be a constant guide for those involved in health policymaking, whether in allocating health resources within a community, developing a national health strategy, or seeking to secure a global treaty based in the right to health – that is, in securing the Framework Convention on Global Health (FCGH).  And this is the most significant area where the initiative to establish an FCGH has fallen short. I write as someone who has been quite involved in FCGH efforts for the past six years, beginning when a small coalition in 2010 established what was known as JALI, which later evolved into the Platform for an FCGH, where we are today.

It is not that we do not recognize the critical importance of this participation. We do. I have myself written of the importance of having the FCGH reflect, above all, the voices and concern of the people who most experience health inequities and health injustice. We know that participation is vital. This is a matter of principle. The processes related to developing a treaty based on the right to health, including in the present more formative stages, should themselves follow human rights principles. Inclusive participation is also a strategic necessity. Without broad-based support, requiring genuine engagement and a shared sense of ownership, we won’t achieve the FCGH, much less an FCGH that countries will ratify and implement.

Read moreBoarding the FCGH Express