The International Covenant on Economic, Social and Cultural Rights
and the promotion of good health care. ( Committee on the Elimination of
Discrimination against Women, General Recommendation No. 24 (1999)
on article 12 of the Convention (women and health), para. 28)
Article 24 of the CRC also obliges States to combat disease and malnutrition,
including within the framework of primary health care, through, inter alia,
(…) the provision of adequate nutritious foods and clean drinking water
(…). The United Nations Committee on the Rights of the Child underlined
that under article 24, States have a responsibility to ensure access to clean
drinking water and that such access is particularly essential for young
children’s health. (Committee on the Rights of the Child, general comment
No. 7 (2006) on implementing child rights in early childhood, para. 27)
Article 28 of the CRPD and Article 5 of the ILO Convention No 169 have
also clearly enshrined water as a human right.
1.3 Right to Health
The right to the highest attainable standard of health (referred to as the
“right to health”) was first depicted in 1946 in the Constitution of the
WHO, and has since been included in several international treaties and
declarations. The most authoritative interpretation of the right to health
is outlined in Article 12 of the International Covenant on Economic, Social
and Cultural Rights (ICESCR).
In drafting article 12 of the Covenant on Economic, Social and Cultural
Rights, the Third Committee of the United Nations General Assembly did not
adopt the definition of health outlined in the preamble to the constitution
of the WHO, which conceptualizes health as “a state of physical, mental
and social wellbeing and not simply the absence of disease or infirmity.”
However, the reference in article 12.1 of the Covenant to “the highest
attainable standard of physical and mental health” is not confined to the
right to health care. On the contrary, the drafting history and the expressed
wording of article 12.2 acknowledge that the right to health embraces a
wide range of socio-economic factors that promote conditions in which
people can lead a healthy life, and extends to the underlying determinants
of health, such as food and nutrition, housing, access to safe and potable
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water and adequate sanitation, safe and healthy working conditions, and
a healthy environment.
Such a broad interpretation of the right to health implies that health is
more than a medical or scientific issue. Its content, delivery and outcomes
extend far beyond the confines of the ministry of health. This basic point
has been stressed as the true starting point for sustainable partnership for
health development in the 21st century.
The right to health contains both freedoms and entitlements. The freedoms
include the right to control one’s body, including reproductive health,
and the right to be free from interference, such as freedom from torture
and non-consensual medical treatment. General Comment No 14 (2000)
provides the normative content of the right to health. It says, the right to
health in all its forms and at all levels contains the following interrelated
and essential elements, the precise application of which will depend on
the conditions prevailing in a particular State Party:
(a) Availability: Functioning public health and health-care facilities, goods
and services, as well as programmes, have to be available in sufficient
quantity within the State party. The precise nature of the facilities,
goods and services will vary depending on numerous factors, including
the State Party’s developmental level. They will include, however, the
underlying determinants of health, such as safe and potable drinking
water and adequate sanitation facilities, hospitals, clinics and other healthrelated buildings, trained medical and professional personnel receiving
domestically competitive salaries, and essential drugs, as defined by the
WHO Action Programme on Essential Drugs.
(b) Accessibility: Health facilities, goods and services have to be accessible
to everyone without discrimination, within the jurisdiction of the State
party. Accessibility has four overlapping dimensions:
(i) Non-discrimination: health facilities, goods and services must be
accessible to all, especially the most vulnerable or marginalized sections
of the population, in law and in fact, without discrimination on any of the
prohibited grounds.
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