Author: Mercury Shitindo, Africa International University - Kenya, & Anahuac University-Mexico
How does one determine what are basic health needs in a global health crisis, particularly when resources are limited and priorities need to be set? I will utilize Thana C. de Campos’s ideas to discuss basic health needs and how they play out given the human right to health. The international law understanding of ‘health’, which De Campos refers to as the ‘well-being conception of health’, proposes a more differentiated understanding of ‘health’ based on the idea of basic health needs.
The ‘right to health’ can be viewed as a very broad term that could be summarized as the “right of everyone to the highest attainable standard of physical and mental health . Toebes argues that the full articulation of this statement is ‘best in line with the international treaty provisions that proclaim not only the right to health care services, but also the right to a number of underlying preconditions for health’.
Basic health needs and human rights
De Campos’s notion of the ‘well-being conception of health’ eludes to the right to health in relation to social determinants of health, which include any social-economic condition that may impact any aspect of a person’s overall well-being. He points out that this explanation focuses on only one aspect of a person’s well-being, whereas health is but one basic human good among many others that are equally important. When all these other aspects are put together, they translate into the integral well-being of a person. It is therefore critical that there is a clear distinction of what basic health needs are especially in global pandemics, emergencies and other dire global situations. This contributes towards making crucial and just decisions when called upon. When it comes to human rights and duties related to health, basic health needs satisfy two conditions: (1) they are indispensable to one’s survival, being vital to any human life because without them the basic human goods of life and health would be threatened and violated, and as a consequence (2) they impose prima facie strict duties on others.
Basic health needs and duties
People are responsible for the basic health needs of others in different ways, and to different degrees, depending on the nature of their relationships. Thus, although people universally share a responsibility for the basic health needs of others, and although basic health needs are necessary conditions to justify this universal responsibility, they alone are not sufficient conditions to justify and enforce duties on others.
Moreover, if each basic human need is the object of a human right, and if basic health needs are a type of basic human need, then basic human needs are the object of the right to health. All basic human needs, including basic health needs, have an equal moral value: they are equally valuable, irreducible, and incommensurable and cannot be simply and easily computed, traded, or weighed in moral deliberations. This special moral weight conferred on basic health needs justifies their protection under the right to health, which, in turn, justifies prima facie stringent universal duties placed on people through international instruments/treaties to safeguard the basic health needs of all human beings. Basic health needs are thus the very object of the basic human right to health.
Basic health needs have a distinct moral relevance, i.e., the moral value of health. Hence, the notion of basic health needs gives strong moral justification to create rights with corresponding duties for the legal protection of the basic health needs of all human beings. Different rights and duties are related to these different aspects of health, namely, the aspects that constitute basic health needs and the remaining aspects that relate to the overall well-being of a person. The rigorous moral force of basic health needs justifies the establishment of certain basic rights with corresponding duties for their satisfaction. Rights have a distinct moral force: they have preeminence over other considerations.
De Campos equates human rights as being synonymous to natural rights, that is, fundamental moral rights, inherent to all human beings simply by virtue of their humanity. While Finnis sums human or natural rights as being fundamental and are general moral rights. Considering these rights as a universal moral right, in the sense that it is a right possessed by all human beings, and owed to all human beings, simply by virtue of their shared humanity and vulnerabilities. Henry Shue asserts that “Basic rights are everyone’s minimum reasonable demands upon the rest of humanity. The right to health is also a recognized basic legal right, recognized and posited in various legal instruments, not only in the international realm (in both customary and codified International Law), but also in domestic jurisdictions (in various national constitutions and legislations)
Human rights are profoundly linked to global health and provide a universal framework for advancing global health with justice therefore forming the basic health needs which have to be prioritized across board and made accessible to all. An approach using ethical principles and distributive justice principles as a guide, to set priorities based partly on expected outcome is most suitable when setting priorities in a global crisis. For example, saving the most individual lives or saving the most life-years by giving priority to patients likely to survive longest after treatment, giving priority to those who can save others or giving priority to the worst off – this could be either the sickest or younger people who will have lived the shortest lives if they die untreated. This ensures that there is maximization of cumulative health benefits and basic human health needs are met.
Priority for limited resources should aim both at saving the most lives and at maximizing improvements in individuals’ post-treatment length of life. It must be emphasized that other social economic determinants to health, often reflected in other health-related human rights, must not be neglected in global health emergency measures. It is important to have a policy response that will ensure that basic health needs are prioritized so as to strengthen public health. Human rights should always be at the core of the global response.