Evolution of a human right to health: An incomplete success

The right to health was codified in the International Covenant of Economic, Social and Cultural Rights (ICESCR) as an individual right, focusing on individual health services at the expense of public health systems. Whereas public health and social medicine scholars have long understood the centrality of underlying structural determinants of health in predicting health status, the right to health—focusing on access to healthcare—has been ineffective in compelling states to address burgeoning inequalities in underlying determinants of health. The author's research assesses the ways in which the human right to health has evolved to meet threats to the public's health.

This research employs discourse analysis to examine the expanding scope of the right to health in various international documents subsequent to the ICESCR. Tracing this evolution in international discourse, the author finds that states have altered the right to health in accordance with disease threats, medical technologies, and public health knowledge. However, despite shifting meanings in these contingent discourses, the individual right to health remains normatively incapable of addressing injurious societal health determinants, advancing individual rights to meet collective threats.

By examining modern, globalized changes to underlying determinants of health, this research concludes that responding to societal health threats necessitates a collective right to public health. In creating a framework for discussing public health as a collective human right, obligating states to address the systematic and social conditions that underlie disease, this research finds that international legal bodies could hold states accountable for realizing the highest attainable standard of health.