5 Guide to the rights to healthcare and health protection in Aotearoa New Zealand A way forward Using a human rights-based approach to policy making which considers the above key features is vital to ensure the rights to healthcare and healthcare protection for all. As already discussed, the rights to healthcare and health protection are subject to progressive realisation and resource availability. However, there are some features of these human rights that are so important they must be addressed immediately. These are called core obligations. For example, the obligations of the government to adopt an equitable national public health strategy or to avoid direct discrimination against specific groups such as disabled people, are not subject to progressive realisation, both are core obligations of immediate effect. The United Nations human rights system provides some guidance on the core obligations arising from the rights to healthcare and health protection.3 However, the core obligations must be elaborated within the unique context of Aotearoa New Zealand. This is not an easy undertaking. More work needs to be done within the health and human rights community to clarify the contours and content of the core obligations of immediate effect arising from the rights to healthcare and health protection, grounded on Te Tiriti o Waitangi. How has this approach helped around the world? Case study – Italy4 Case study - Brazil5 The human rights to health care and health protection, protected in Italy’s Constitution, have explicitly shaped Italy’s national health service. The rights have been expressly included in national health plans, health interventions and community health schemes. For example, the guidelines for cancer screening remind health professionals that “access to screening is an application of a right”. A World Health Organisation study on Italy found that applying human rights to women’s and children’s health policies, programmes, and other interventions has not only helped the Italian government comply with its binding national and international obligations but has also contributed to improving the health of women and children. In Brazil, the values, and features of the rights to healthcare and health protection have been explicitly used to frame Brazil’s family health programmes. These reforms led to reduced health inequalities and improved health outcomes especially for Brazil’s poorest women and children. By the eighth year of the programme Brazil had seen a significant reduction of maternal mortality (53.1%) and infant and child mortality (34%). 3 See United Nations Committee on Economic, Social and Cultural Rights, General Comment 14. 4 See Chapter 3.3 “The right to health supports global public health” Carmel Williams et al. in Oxford Textbook of Global Public Health (7th edn) Roger Detels (ed.), Quarraisha Abdool Karim (ed.), Fran Baum (ed.), Liming Li (ed.), Alastair H Leyland (ed.). 5 Paul Hunt, Sonia Bhalotra, Carmel Williams, “The Role and Impact of the Right to Health: Evidence from Brazil’s Family Health Program”, Human Rights Quarterly, Volume 44, Number 1, February 2022, pp. 111-141