Human Rights as a Framework for Accountabilty

A human rights approach to public health is a much stronger framework for accountability than that of social justice. Relying on social justice to provide such a framework is insufficient because of the challenges to defining social justice. Human rights, by their nature, change the power differential and impose a legal obligation on the government to fulfill the human rights of the whole of the population. Human rights also include an entitlement to people to monitor government implementation of rights and to have access to effective accountability mechanisms and remedies when government has failed to discharge its human rights obligations. Two case studies will be utilised to show how the process works. The first, the Action Group for Health, Human Rights and HIV/AIDS (AGHA) stock out survey is an example of a social accountability mechanism in action. The case explains how community representatives in two districts in Uganda tracked the health center supply of four key drugs over a six month period. The subsequent report was brought to the notice of the government who responded by increasing the health budget to ensure supply of the drugs. The Treatment Action Campaign (TAC) in South Africa is the second case study and explains how the judicial accountability mechanisms – the Constitutional Court action – emerged from and fed back into the social accountability mechanism – the TAC engaged in intensive public mobilization in the form of rallies, vigils and marches around the country, all of which attracted enormous support and media interest.