(a) To ensure the right of access to health facilities, goods and services on a nondiscriminatory basis, especially for vulnerable or marginalized groups;
(b) To ensure access to the minimum essential food which is nutritionally adequate and safe,
to ensure freedom from hunger to everyone;
(c) To ensure access to basic shelter, housing and sanitation, and an adequate supply of safe
and potable water;
(d) To provide essential drugs, as from time to time defined under the WHO Action
Programme on Essential Drugs;
(e) To ensure equitable distribution of all health facilities, goods and services;
(f)
To adopt and implement a national public health strategy and plan of action, on the
basis of epidemiological evidence, addressing the health concerns of the whole population; the
strategy and plan of action shall be devised, and periodically reviewed, on the basis of a
participatory and transparent process; they shall include methods, such as right to health
indicators and benchmarks, by which progress can be closely monitored; the process by which
the strategy and plan of action are devised, as well as their content, shall give particular
attention to all vulnerable or marginalized groups.59
A similar list is provided in the Committee's discussions of the right to water60 and of the right to
work, where it consists in an elaborate description of the requirements of non-discrimination and equal
protection of employment.61
The "core content" of the rights stipulated in the Covenant, it appears from these examples, includes
three components: (i) a basic needs requirement, ensuring that each individual is not deprived of
essential goods or services that keep him/her safe, physically and emotionally, and protect him from
permanent social exclusion: this would include basic shelter, adequate food, water and sanitation, and
essential drugs, but also access to primary education62; (ii) a non-discrimination requirement, ensuring
that any progress made in the realization of the right in question benefit all without discrimination, and
that where distribution issues arise, priority be given to the most disadvantaged and marginalized
groups63; and (iii) a procedural obligation, requiring from the State that, having identified the key
challenges associated with the realization of each right, it designs and implements a strategy that will
put it on track of moving towards the full realization of the right for all.64
It follows from these attempts at circumscribing the "core content" of rights that the fulfilment of the
corresponding obligations is neither costless -- particularly not the duties corresponding to the "basic
needs" component, which requires States, for instance, to set up primary health care centres and to
59
General Comment No. 14 (2000), cited above note 30, para. 43. In para. 44, the Committee adds a list of five obligations of
"comparable priority".
60
General Comment No. 15 (2002), cited above note 29, para. 37.
61
General Comment No. 18 (2005): The right to work (art. 6) (E/C.12/GC/18), para. 31.
62
In 1982, the International Labour Organisation identified as "basic needs" the following: "First, certain minimum
requirements of a family for private consumption: adequate food, shelter and clothing, as well as certain household
equipment and furniture. Second, they include essential services provided by and for the community at large, such as safe
drinking water, sanitation, public transport and health, educational and cultural facilities" (International Labour Organisation
(ILO), Target Setting for Basic Needs, Geneva: ILO, 1982, at 1). See also Trubek, "Economic, Social and Cultural Rights in
the Third World: Human Rights Law and Human Needs Programs", cited above note 12, at 206 (referring to the core rights
linked to subsistence as "what is most basic and universal... Behind all the specific rights enshrined in international
documents and supported by international activity lies a social view of individual welfare").
63
See above, text corresponding to notes 34-37.
64
Referring to the immediate obligations that would follow from a ratification of the Covenant by the United States, which
the Carter administration had transmitted to the Senate in 1978 accompanied by a statement according to which, in the
understanding of the U.S., the Covenant describes "goals to be achieved progressively rather than through immediate
implementation", Philip Alston, a member at the time of the Committee on Economic, Social and Cultural Rights, writes that
this view is incorrect, since there is an immediate requirement to take steps towards full realization of the right of the
Covenant: "The starting point for a program to implement economic and social rights is to ascertain, as precisely as possible,
the nature of the existing situation with respect to each right, so as to identify more clearly the problems that need to be
addressed and provide a basis for principled policy making" (Philip Alston, "U.S. Ratification of the Covenant on Economic,
Social and Cultural Rights: The Need for an entirely New Strategy", A.J.I.L., vol. 84 (1990): 365-393, at 379).
13
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