Guardian columnist Wolff (Philosophy/University College London; Ethics and Public Policy, 2011 etc.) poses a challenging but essential question: “How can there be a human right to health if the resources are just not there to satisfy it?”
Before addressing the current global health crisis, the author looks back at Franklin Roosevelt's 1941 speech in which he asserted that the “four freedoms”—freedom of speech and worship, and freedom from fear and want—are basic human rights. In 1945, the first UN Charter included provisions for human rights, in 1948 the Universal Declaration of Human Rights was passed and during the same period the World Health Organization came into existence. The protection of human rights became international law in 1976. This is the context for the definition of “right to health” as a human right protected under international law, although its implications are still under debate. Does it include free access to condoms and abortion, or the right of developing nations to produce affordable pharmaceuticals in violation of patents? Wolff uses the HIV/AIDS epidemic as a case study—from its discovery in 1981 to the fight over funding to support research and guarantee that sufferers have access to treatment. He writes about how international efforts to deal with the spread of AIDS to Haiti and Africa were derailed by a “catastrophic” change in World Bank policies in the 1980s, when the Bank, and the IMF, insisted that developing countries seeking aid cut back public-sector expenditures. Just as these constraints were being reversed, the World Trade Organization demanded that members cease violating patents by producing low-cost generic pharmaceuticals. While the author describes the struggle to establish the right to universal health as a work in progress, he is cautiously optimistic.
A broad-ranging, insightful analysis of the complex practical and ethical issues involved in global health.