What could human rights contribute to a global agenda for health equity?

In Europe and the U.S.A. over the past 15 years, the concepts and measurement of health disparities/inequalities and health equity have repeatedly been challenged in the form of proposals to substitute purely technical criteria for their definition. This approach in effect re-invents the concepts of health disparities/inequalities in a way that includes all epidemiologic differences and hence removes the social justice content that is at the core of these notions. This has direct implications for resource allocation, and indirect implications for measurement (and hence for accountability). In the face of these challenges, it has been important to ground the definition of health disparities/inequalities in concepts and principles with a degree of universality. International human rights laws, agreements, and principles provide such a basis. Although globally, human rights may be honored more in the breach than in the observance, nevertheless human rights laws, agreements, and principles were hewed out over many years through a process with global participation. Virtually all governments have at least signed (if not ratified) the major human rights instruments that provide a basis for defining and measuring health inequalities; given that being signatory implies agreeing in principle, these instruments therefore represent, at a minimum, a global consensus on values and aspirations. A rights-based approach to defining health disparities/inequalities and health equity does not address all challenges, which are inherently political, but it goes a long way to toward addressing some of the most fundamental conceptual and measurement challenges.