Health systems and the right to health: an assessment of 194 countries, G. Backman et al, The Lancet, 2008

The Lancet, Volume 372, Issue 9655, Pages 2047-2085
G. Backman, P. Hunt, R. Khosla, C. Jaramillo-Strouss, B. Fikre, C. Rumble, D. Pevalin, D. Páez, M. Pineda, A. Frisancho

This article is a ‘must read’ for thode interested in drug policies and the right to health.

Abstract

60 years ago, the Universal Declaration of Human Rights laid the foundations for the right to the highest attainable standard of health. This right is central to the creation of equitable health systems. We identify some of the right-to health features of health systems, such as a comprehensive national health plan, and propose 72 indicators that reflect some of these features. We collect globally processed data on these indicators for 194 countries and national data for Ecuador, Mozambique, Peru, Romania, and Sweden. Globally processed data were not available for 18 indicators for any country, suggesting that organisations that obtain such data give insuffi cient attention to the right-to-health features of health systems. Where they are available, the indicators show where health systems need to be improved to better realise the right to health. We provide recommendations for governments, international bodies, civil-society organisations, and other institutions and suggest that these indicators and data, although not perfect, provide a basis for the monitoring of health systems and the progressive realisation of the right to health. Right-to-health features are not just good management, justice, or humanitarianism, they are obligations under human-rights law.

Notably, one of the countries for which national data were received was Sweden. In that context the article deals specifically with harm reduction.

The test of availability can also be applied to harm-reduction initiatives. Provision of injecting drug users with comprehensive and integrated treatment, counselling, and clean needles and syringes is good for public health, reduces avoidable suff ering, saves lives, and is cost-effective. An appropriate harm-reduction initiative is also a right-to-health initiative. However, most countries do not provide harm-reduction services for people who use drugs, and those that do, such as Sweden, provide a limited and scattered service. The right to health requires all countries to have an effective, national, comprehensive harm-reduction policy and plan, delivering essential services. A high-income country such as Sweden is expected to provide more than the essential services.

The full article is available at http://www.who.int/pmnch/topics/health_systems/20081210_righttohealth/en/index.html