A/62/214
46. In some quarters, the right to the highest attainable standard of health is
narrowly understood to mean a right to medical care. However, this view is
inconsistent with international human rights law, which encompasses both medicine
and public health. The International Covenant on Economic, Social and Cultural
Rights, for example, and the Convention on the Rights of the Child clearly affirm
that the right to health is more than access to medical care. Specifically, article 24 of
the Convention on the Rights of the Child states that the right to health includes
access to nutritious food, clean drinking water, environmental sanitation and so on,
as well as medical care. Equating the right to health with a right to medical care is a
misinterpretation of international human rights law.
47. The right to the highest attainable standard of health is an inclusive right
extending not only to timely and appropriate medical care but also to the underlying
determinants of health, such as access to safe water and adequate sanitation, an
adequate supply of safe food, nutrition and housing, healthy occupational and
environmental conditions, access to health-related education and information,
including on sexual and reproductive health, and freedom from discrimination. 16 In
short, the right to health includes both medical care and the underlying determinants
of health.
48. In his reports, the Special Rapporteur has consistently looked at medical care
and the underlying determinants of health, including the impact of poverty and
discrimination on health. However, he has noticed a definite tendency in some
Governments, international organizations and elsewhere to devote a
disproportionate amount of attention and resources to medical care at the expense of
the underlying determinants of health. This is deeply regrettable because both are
fundamental elements of the right to the highest attainable standard of health.
49. Although space constraints do not permit a detailed examination of all relevant
issues, the present section focuses on two underlying determinants of health: access
to safe water and adequate sanitation. 17 It adopts the right-to-health analytical
framework that the Special Rapporteur has used in previous reports in relation to
other health issues. Although confined to only two essential conditions of health,
namely water and sanitation, the analysis is illustrative and relevant to other
underlying determinants of health.
Water, sanitation and human rights
Water, sanitation and the right to health
50. Safe water and adequate sanitation are two integral and closely related
underlying determinants which are essential for the realization of the right to the
highest attainable standard of health. Inadequate access to water and sanitation can
threaten life, devastate health, destroy opportunities, undermine human dignity and
cause deprivation. 18
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16
17
18
07-45379
E/2001/22-E/C.12/2000/21, annex IV, general comment 14, para. 11.
In this regard, similar but different terms are sometimes used, such as “safe and potable water
and adequate sanitation” and “safe drinking water and basic sanitation”. For the purposes of the
present section, “safe water and adequate sanitation” is used for the underlying health
determinants of water and sanitation.
See UNDP, Human Development Report 2006 (http://hdr.undp.org/hdr2006/report.cfm).
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