A/71/304
25. As a key precondition for the full realization of all human rights, including the
right to health, civil society actors working on health -related issues should be able
to carry out their work in a safe and enabling environment. The Special Rapporteur
is concerned about the limited space for civil society in many countries, including
those actors working on health-related rights.
D.
Obligations under the right to health
26. As previously stated, the Sustainable Development Goals are political
commitments. However, under the international human rights framework, in all their
efforts to meet the Goals, States should act in conformity with their obligations to
respect, protect and fulfil the right to health. The key elements of States’ obligations
under the right to health include progressive realization, obligations of immediate
effect, maximum available resources and international assistance and cooperation.
27. The right to health is subject to progressive realization, which means that
States have an obligation to move expeditiously and as effectively as possible,
through deliberate, concrete and targeted steps, towards the full realization of the
right (see E/CN.4/2003/53 and Corr.1 and 2). This requires adequate indicators and
benchmarks to properly monitor progress over time. Examining how Governments
create or miss opportunities to generate income, allocate budg ets and actually spend
allocated funds is useful to evaluate whether they are meeting their obligations to
progressively realize their health and other economic, social and cultural rights
obligations to the maximum of available resources (E/2009/90, paras. 44-54 and
74). Tracking how countries are investing resources in different Goals and targets is
essential to ensuring that efforts to meet them are channelled properly and that the
most marginalized populations get the attention that they deserve.
28. Certain health obligations are of immediate effect and are not subject to
progressive realization. This includes core obligations, such as non -discrimination.
The Sustainable Development Goals reflect a number of core obligations, such as
access to health facilities, goods and services on a non -discriminatory basis, access
to food, shelter, housing and sanitation, safe and potable water and essential
medicines, 9 and ensuring universal coverage of health-care services. 10 Other core
obligations that will be essential to realizing the Goals include the revision of the
national and subnational legal and policy environment and the amendment or
enactment of laws and policies when necessary; the adoption of a national health
strategy that addresses the right to health; and the equitable distribution of health
facilities, goods and services.
29. States must also devote maximum available resources to the right to health. 11 In
many countries, the health system is underfunded. The commitment in target 3.c to
substantially increase health financing is welcome and resonates with this obligation.
However, resources accumulated to finance health systems must be expended in the
context of good governance, transparency, participation and accountability. Civil
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10
11
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Committee on Economic, Social and Cultural Rights, general comment No. 14, para. 43.
Committee on the Rights of the Child, general comment No. 15, para. 73.
International Covenant on Economic Social and Cultural Rights, art. 2 (1).
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