According to the Universal Declaration of Human Rights, the right to health is a human right. But what this entails, and in what sense health can be a right, are still matters of controversy. In his latest book, published in the Amnesty International Global Ethics Series, political philosopher Jonathan Wolff sets out to study these and related questions.
Although it is written by a philosopher, this is not primarily a philosophical work and does not engage in lengthy discussions on the political philosophy or the moral basis of human rights. Using HIV/Aids as his main example, Wolff explains the origins of health as a human right, how it has developed during the past three decades, and what obstacles it has faced and continues to face.
Rather than providing straightforward answers to questions that he himself poses about the nature of health as a human right and how best to achieve it, Wolff introduces the reader to various sides of the argument with real-life examples. His overall conclusion seems to be that for individual questions, no one answer can be given. He does, however, maintain that promoting the idea of health as a human right is a worthy undertaking and that through international efforts it can be made a reality.
One criticism that can be levelled against the human right to health approach that Wolff mentions on several occasions is that it tends to concentrate on "vertical programmes". The problem is that when attention is paid to a particular health problem, it is often at the expense of others, which sometimes leads to counterproductive results in healthcare delivery more generally. By choosing to discuss the human right to health chiefly through the example of HIV/Aids and selected international organisations, Wolff's book seems to face a similar problem. It concentrates on the particulars of the chosen examples, with the more general and - some might argue - more crucial problems mentioned only in passing. For instance, if it is indeed the case that cost is no longer the main obstacle for treating HIV/Aids in sub-Saharan Africa, what, then, are the real problems and how can they be overcome? Corruption in the health sector and problems in governance are often mentioned in this context.
When health as a human right is discussed in relation to particular health problems, whatever is said about the rights of people in these cases should also apply to people in other, morally similar circumstances. If this is taken into account, practical solutions become even more difficult to come by. And what about health as a human right in the developed world? The scarcity of resources, together with an ageing population, are also contributing to making health as a human right a more difficult ideal to realise in these parts of the world.
Given the enormous size of this topic, it is no wonder that only a selection of issues is covered here, or that readers may be left wishing that arguments had gone further and deeper. Nevertheless, I would recommend this book to readers seeking to familiarise themselves with global health issues and human rights, and it will also be of value as an orientation for a course on ethics and global public health. The Human Right to Health is a worthy read, and a very good introduction to the complexities of taking seriously the idea of health as a human right on a global scale.
The Human Right to Health
By Jonathan Wolff. W.W. Norton, 144pp, £14.99. ISBN 9780393063356. Published 15 April 2012