Access to Heatlh

Inequalities with regard to health can, to a significant extent, be attributed to the circumstances in which people grow up, live and work. The choices of the government to do something about this
by means of socioeconomic and other policy measures have a significant effect on those circumstances. Poor health is a cause as well as a result of social exclusion, inequality, poverty
and vulnerability.

Every year, at least 20 million people die in developing countries as a result of a lack of adequate basic healthcare. According to the World Health Organisation (WHO), Africa accounts for almost half (42%) of all cases of child mortality before the age of five. However, two out of three cases could be avoided by simple means. In addition, about 536,000 women die of complications during childbirth every year, 99% of them in developing countries. A lack of drinking water and inadequate hygiene are also important risk factors determining the morbidity and mortality rates of the population in the South.

Health is a fundamental human right that is indispensable for the exercise of other human rights. It is enshrined in the Universal Declaration of Human Rights of 1948 (Art.25) and in the International Covenant on Economic, Social and Cultural Rights of 1966. For the World Health Organisation (WHO), the right to health contains both freedoms and rights: the right to control one’s own health and one’s own body (for example sexual and reproductive rights) and the right to physical integrity (for example the right not to be subject to torture and not to be subject to any medical experimentation without consent); the right to access a health protection system which guarantees equal possibilities to all to enjoy the best possible state of health. The key to health is a functional health care system i.e. one that is available, accessible and acceptable to all without any form of discrimination and of high quality.

In Asia, several members are active in the field of access to health care: some have developed their own mutual health scheme, by providing health services like GK in Bangladesh or AREDS in India. Another way to promote access to health is by organizing health workers and opposing privatization of health services, like the Alliance of Health Workers in the Philippines. The Asia Network on the right to Social protection also devoted one edition of the W-Connect newsletter in the September 2016 to the issue of access to health here, which also contains a joint position statement.

According to ILO Recommendation 202 on social protection floors, the minimum requirements in the area of social protection must include: 
• basic income security (especially in cases of sickness, unemployment, maternity or disability).
• access to a nationally defined set of goods and services, constituting essential health care and including maternity care, that meets the following criteria:

• Availability: the facilities, goods, public health programmes and health care services are functional and in sufficient supply.
• Accessibility: the facilities, goods and health care services are accessible to all without any form of discrimination. Accessibility is made up of four interdependent dimensions: non-discrimination, physical accessibility, economic accessibility or being sufficiently affordable, accessibility of information.
• Acceptability: all facilities, goods and services in the domain of health care must respect medical and appropriate ethics from a cultural point of view, in other words, should respect the culture of individuals, minorities, people and communities, be receptive to the specific requirements linked to sex and stages of life and must be designed so as to respect confidentiality and improve people’s state of health.
• Quality: as well as having to be acceptable from a cultural point of view, installations, goods and services in the domain of health care must also be scientifically and medically appropriate and of a high quality.

The Sustainable Development Goals refer to Health in Goal 3: “Ensure healthy lives and promote well-being for all at all ages”. Target 3.8 relates specifically to Universal Health Coverage and is: “Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”

The right to health nevertheless extends beyond the health care system. It includes an array of factors which may help individuals to live a healthy lifestyle and improve the way in which health is promoted. The general conditions in which people live and work have a major impact on health outcomes. These “social determinants of health” comprise, among others, socioeconomic development, working conditions, education, housing, sex and high-risk behaviour. Health care is just one of the factors to influence health and can therefore only constitute part of the solution.

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