Yet, more than 60 years later, millions of people, including children, still die
because they do not have access to health care. The Universal Declaration of Human
Rights itself is non-binding on states, which means, one would imagine, that it
would take binding human rights legislation to make a genuine impact. However,
such international legislation already exists, and was adopted several decades ago.
In 1966, the social security and welfare rights quoted above from the Universal
Declaration of Human Rights were affirmed by article 12 of the binding International
Covenant on Economic, Social and Cultural Rights, which requires that the
States Parties to the present Covenant recognize the right of everyone to the enjoyment of
the highest attainable standard of physical and mental health (ICESCR 1966 ).
Thus, the covenant commits states parties to strive for the highest attainable
standard of health for citizens within their borders - and state obligations do not stop
at the border. In article 2, the covenant affirms the responsibility of each state party
to take steps, individually and through international assistance and co-operation, espe-
cially economic and technical, to the maximum of its available resources, with a view
to achieving progressively the full realization of the rights recognized in the present
Covenant (ICESCR 1966 : article 2).
This covenant has been broadly adopted since 1966, 4 in addition to other trea-
ties and agreements. Table 9.1 summarizes the main international legal instru-
ments governing the human right to health.
While avoidable deaths of children have declined by around 35% in the past
20 years, 21,000 children under five still die every day. 5 Enshrining a human right in
law is clearly not enough; the right to health has not been realized in recent decades -
at least, not for everyone. Canadian research has confirmed that the ratification of
human rights treaties 'is not a good indicator of the realization of the right to health'
(Palmer et al. 2009 : 1,987):
Data for health (including HIV prevalence, and maternal, infant, and child [<5 years] mor-
talities) and social indicators (child labour, human development index, sex gap, and cor-
ruption index), gathered from 170 countries, showed no consistent associations between
ratification of human-rights treaties and health or social outcomes (Palmer et al. 2009 :
If, then, leaving undone what is right indicates a lack of courage, what might
Confucius expect us to do in these circumstances? To remain inactive about the
avoidable deaths of millions of people every year is clearly not an acceptable
option. But no single reform or tool can resolve problems of such magnitude as
the lack of access to health care worldwide. As the preamble to the Universal
Declaration of Human Rights states,
4 Only two major states are not parties to the covenant; the United States of America (see also