World Health Organization: The Right to Health Care

World Health Organization: The Right to Health Care JPHMUN 2013 Background Guide Background/Significant Events Organized health care has been around for centuries, even before the scientific discoveries during the Renaissance. In earlier times, there was a reliance on herbs and natural remedies to care for patients. As technology advanced and diseases become more resistant to drugs, changes had to be made in treatment and the delivery of health care, which has resulted in the modern hospitals, medications and procedures that are available today. However, these advancements did not happen instantly- they were a result of centuries of research and discovery. During the Renaissance, artists took an interest in creating more life-like figures and sculptures which led them to studying anatomy (Bambach). Artists like Antonio Pollaiolo, Michelangelo, and Leonardo DaVinci were known for their studies on the human body- usually performed on corpses. They wanted to understand the muscles, organs, and all of their functions (Bambach). These artists formed the base on which our understanding of the human body was built. Through understanding the human body, there was more opportunity to better treat and care for it. Late in the 18th Century and early in the 19th century, the Industrial Revolution changed the way that the world worked. Innovations in technology and the growth of large industries led to the beginnings of modern health care. With the influx of people moving to cities from rural communities, cities became overcrowded. This overcrowding, combined with poor sanitation and a lack health care, led to the rapid spread of various diseases. Sir Edwin Chadwick was concerned about the poor sanitation in urban Britain. He believed that doing things like ensuring proper ventilation in homes and having clean living areas would encourage better health which, in turn, would help to alleviate financial strain on the government. His findings inspired the JPHMUN 2013-1

Public Health Act of 1848 in Great Britain which established the first Board of Health ( Edwin Chadwick (1800-90) ). In 1905, Robert Koch received the Nobel Prize for his discoveries in medicine (Olser). Koch discovered the bacterial causes of disease through isolating and reproducing the biological roots of some diseases. This led to the study of bacteriology. Government-provided health started to increase and improve in the 19th Century. In 1911, the British parliament passed a universal health care law (Light). While it was limited to just workers and not their dependents, it did ensure that they were able to afford necessary medicine and primary care and were covered in the case of disability or illness (Light). After World War I, the British wanted health care to be expanded and reformed but there was a lack of political unity around the issue. It was during World War II that people realized how critical health care was. The devastation of the war caused the British government to ask Sir William Beveridge to draw up an economic rebuilding plan in June of 1941 (Light). Beveridge proposed the idea of having a national health service that was funded through taxation (Light). In 1948, the National Health Service was established. Similar to the impact of the Industrial Revolution, the World Wars caused massive social disruption, widespread devastation and major health problems on a massive scale. The wars left many people wounded and caused world governments to once again look at their national health care systems. New Zealand led the way for national health care systems in 1938. Other countries followed suit and adopted national health care systems. These systems have undergone considerable technological and medicinal advancement over the past century as the fields of medicine and public health have become more complicated and advanced. According to the United States Department of Labor, ten of the 20 fastest growing occupations in the US are in the medical industry. The industry is expected to produce 3.2 million new jobs by 2018. In France, 11.2% of the gross domestic production (GDP) was spent on health care in 2009. Many advanced industrial countries provide universal healthcare systems. Nonetheless, there is a widespread perception that the provision of healthcare services in many countries needs reform, in order to be economically sustainable and accessible in the 21st century. Health Care Reform JPHMUN 2013-2

The World Health Organization (WHO) is at the forefront of reform. The WHO is attempting to restructure its financing and management to be able to address health concerns in a timely manner while staying current on health issues that affect countries worldwide. The WHO believes that by staying current on the health challenges in the world, it will be able to better advise national health systems in how to deal with health risks and with health care ( WHO Reform for a Healthy Future ). There is an ever-widening gap in health care. This basic right is not being provided in some poorer countries because they don t have the resources to meet an adequate standard of care. Reform is needed. By finding the methods and resources to help these developing countries, we can ensure a better life for millions. Healthcare in developing nations is usually provided jointly by private institutions and the government, but it isn t necessarily universal (Thomas). These countries are burdened by malnutrition, HIV/AIDS, illness and poor living conditions. While charities, NGOs, and the WHO do what they can to address global healthcare needs, it often is not enough to make a substantial or lasting difference to millions of people. These organizations try to provide some basic level of treatment but the faulty implementation of programs hinders further development (Thomas). The issue moves beyond finding medication because there are not enough doctors to deliver them. For example, only about 5,000 doctors graduate in Africa every year, and of that 5,000 many end up moving to developed nations that are seeking to take care of their own healthcare shortages. In fact, the world needs about 4 million more health care workers, and at least 1 million of those are needed in Sub-Saharan Africa (Doctors dilemma). Developed nations generally have more accessible health care. Due to greater access to resources, they are able to provide better services to their citizens. An issue that needs attention in developed countries is technology. With medical research making new discoveries and creating new medications and treatment regimes on a regular basis, some medical systems find it difficult to provide the most up-to-date care for their patients. Moreover, it is often unclear whether or not the most modern (and expensive) treatments are always the best. With the financial crisis of 2008 in the back of our minds, consumers are looking for cost-effective health care. The medical industry is taking this into consideration. Historically, there have been changes in health care. Various summits and declarations, like the Declaration of Alma-Ata (1978) brought the issue to the attention of countries and JPHMUN 2013-3

international organizations. The Declaration of Alma-Ata focused on health care as a right and addressed the need for international action on primary care ( Declaration of Alma-Ata ). Health care reform is ongoing and it will likely continue on this path of constant change, with the goal of providing every person the basic right to healthcare. However, this goal could take decades to achieve, or even centuries, and perhaps may never be accomplished. Health Care as a Human Right We have to differentiate between having a right to health care and governments having an obligation to provide health care (Light). Some observers believe that governments should not have to provide health care for their citizens but that people should have to find it themselves. Those who oppose the idea of health care as a right often see it as impractical and immoral (Peikoff). To them, government- provided healthcare, which is paid for through taxation, is taking money from someone who has worked hard to earn that money to provide a service to someone else. They see this as immoral, and believe that access to medicine and treatment is a privilege (Peikoff). Article 25 of the Universal Declaration of Human Rights rejects this perspective. It states that: (1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control (The Universal Declaration of Human Rights). It proclaims that everyone has the same right to health care. The United Nations holds countries accountable for the safety of their citizens. They must ensure that basic rights are protected. The sustainability of a country is directly related to the health of its citizens. By preventing and treating diseases, citizens stay healthy; this allows the country to prosper economically and politically. Past Action from the UN The United Nations Population Fund (UNFPA): Established in 1967, the UNPF seeks to ensure that every woman, man and child enjoy(s) a life of health and equal opportunity ( About UNFPA ). Working with both JPHMUN 2013-4

governmental bodies and non-governmental organizations, the UNFPA develops the framework established by the 1994 International Conference on Population and Development and the Millennium Development Goals ( About UNFPA ). The UNFPA emphasizes human rights as it seeks to ensure that everyone worldwide has access to proper health care. It has ongoing projects to help in areas that need it most. For example, the UNFPA is helping to alleviate an ongoing food shortage in the Horn of Africa; it is active in Haiti, which is still experiencing the social and political disruptions caused by the earthquake that struck in 2010; and it is implementing various campaigns that address HIV/AIDS, female genital mutilation, gender equality, and human rights ( About UNFPA ). World Health Organization (WHO): The WHO deals directly with health issues worldwide through setting the standards and guiding ongoing research ( About WHO ). It is responsible for many of the programs and summits on health care and reform. The Millennium Development Goals: The Millennium Development Goals were initiated in 2002 and have an end date of 2015. There are eight MDGs. Altogether, the goals attempt to further a coherent program to help reverse extreme poverty in the world ( Background ). The 11th General Programme of Work: The 11th General Programme of Work set out a plan for 2006-2015 and is more comprehensive than the Millennium Development Goals. It looks at what diseases are afflicting human populations, what the effects are, and how the international community needs to respond ( 11 th General Programme of Study: Executive Summary ). The Current Situation Different Health Care Systems There are different kinds of health care systems. There is universal health care, as found in the United Kingdom, as well as privatized health care, as found in the United States. Both have benefits and downfalls. Those who see health care as a privilege and not as right tend to favor privatization. Those who can afford health care receive it and those who cannot afford it, do not get it. In this view, governments have minimal responsibilities to their citizens and privatized health care does not infringe on any rights. For those who see health care as a right, JPHMUN 2013-5

universal health care has many benefits. Everyone has equal access to treatment. One downfall to universal healthcare is the wait times that are often associated with it. Patients sometimes have to wait hours to receive treatment and months to access surgical procedures. Another viable system would be one similar to that found in France, a pluralistic system. In this system, there is a privatized structure and also a public one. This would allow those who needed public (government funded) health care to use it, and those who could afford to pay for their own care would be able to do so. There are potential dangers with this kind of system, in that it could cause the private system to prosper at the expense of the public. Still, many observers believe that France has the best medical system in the world. The Obama Administration s effort to reform privatized health care in the US was one of the big news stories of 2010-2011. The health care reform law, nicknamed Obamacare, was passed on March 22, 2010. The bill requires every citizen to purchase health care (federal subsidies are available). In exchange, the bill provides citizens with various rights and protections. People with pre-existing conditions cannot be turned down by insurance companies and people who become ill cannot be denied insurance coverage, as often happens in the US. Children can stay on their parent s coverage until age 26, should they meet the requirements. Even with these reforms, the US is the only industrialized country that does not have a universal health care system (Light). The United Kingdom boasts universal national health care managed by the British National Health Services, which was established in 1948 (Light). Ideologically, the British system is tax-based and seeks to provide adequate health care to all citizens (Light). In 2010, some changes were proposed that would improve the health care system by making sure that patients were involved in decisions that affect them while ensuring that the clinicians and doctors had final say on decisions that affected patients ( Liberating the NHS: Legislative framework and next step ). France has been rated as the having one of the best health care systems in the world by the World Health Organization (WHO). The French have universal health care that works on a pluralistic system where both public and private practitioners coexist and work side by side ( Health in France ). While the quality is comparable in both sectors, the public system caters to ongoing care as well as education, whereas the private sector is more driven by profit and JPHMUN 2013-6

focuses on surgical procedures ( The French Health Care System ). French citizens have the choice between the two structures. While these examples illustrate various health care options, they also remind us that there are some countries that cannot afford to provide healthcare to their citizens. Drugs Are Not Aids While the HIV/AIDS crisis is declining slightly, there are still approximately 33 million people living with HIV in the world today ( Strengthening Efforts to Prevent HIV ). HIV/AIDS affects millions of people in the world today. The Joint United Nations Programme on HIV/AIDS (UNAIDS) released a report in 2010 that indicated about 20% fewer new infections in 2010 than in 1999. While this is reassuring in suggesting the possibility of an AIDS free generation, the disease continues to spread and there are many infected persons who cannot afford treatment ( UNAIDS Press Release ). UNAIDS was formed in hopes of bringing awareness to the disease and providing treatment. It is working towards the possibility of an AIDS free generation. Regional Stances Western Europe and the United States of America Western Europe and the US are in a category of countries that are providing adequate health care. They are providing for the basic rights of their citizens. At the same time, there is always room for improvement. While these countries do provide good care, they could do even better. Countries that can afford basic health care sometimes see issues from governmental corruption or from poor accessibility in rural areas. The US is currently reforming its system because it saw that there was room for improvement. 49.9 million Americans remain without health care coverage and millions more have health care insurance policies that denies them treatment when they need it ( Highlights 2010 ). The US health care reforms are meant to address these considerable deficiencies. Other Developed Countries: South Africa In South Africa there is a pluralistic system that allows private and public health care. The public system is the primary health care system and is government funded, but the private system is growing ( Health Care in South Africa ). The public system is free to the public but JPHMUN 2013-7

provides the most basic of care whereas the private health care system provides more advanced care for anyone who can afford to pay for it ( Health Care in South Africa ). Developing Nations Many developing nations rely on NGOs, charities, and international organizations to provide basic care for their citizens. Medical systems in developing countries vary in categorization. There are privatized systems, public systems, pluralistic and others. While some countries have pledged to rebuild their systems in the past, they often fall victim to lack of money to do so. Many of these countries are already in considerable debt to developed countries. Non-Governmental Organizations (NGOs) NGOS are major actors when it comes to health care. From Doctors without Borders to World Vision and Red Cross, NGOs play a crucial role in providing health care, particularly in poorer, undeveloped countries that cannot afford medical treatment on their own. While governments and international organizations may be more interested in building lasting institutions to help solve health care issues, NGOs focus on dealing with the immediate health problems of individuals in need of medical attention. JPHMUN 2013-8

Works Cited 11th General Programme of Study: Executive Summary. World Health Organization. Accessed 12 January 2012. http://whqlibdoc.who.int/hq/2006/gpw_es_2006-2015_eng.pdf. About the NHS. NHS. Last Modified 24 October 2011. http://www.nhs.uk/nhsengland/thenhs/about/pages/overview.aspx About UNFPA. UNFPA. Accessed 12 January 2012. http://www.unfpa.org/public/cache/offonce/home/about;jsessionid=dc70617d886755c DAFC5A57E025B0019.jahia01. About WHO. World Health Organization. Accessed 12 January 2012. http://www.who.int/about/en/. Background. We Can End Poverty 2015: Millennium Development Goals. Accessed 11 January 2012. http://www.un.org/millenniumgoals/bkgd.shtml. Bambach, Carmen. "Anatomy in the Renaissance." Heilbrunn Timeline of Art History. The Metropolitan Museum of Art, October 2002. http://www.metmuseum.org/toah/hd/anat/hd_anat.htm. 9 January 2012. Declaration of Alma-Ata. International Conference on Primary Health Care. Last Modified September 1978. http://www.who.int/hpr/nph/docs/declaration_almaata.pdf. Doctors' dilemma. The Economist. Last Modified 6 November 2004. http://www.economist.com/node/3423186. Edwin Chadwick (1800-90). Science Museum. Accessed 12 January 2012. JPHMUN 2013-9

http://www.sciencemuseum.org.uk/broughttolife/people/edwinchadwick.aspx. Global Health Observatory. World Health Organization. Accessed 11 January 2012. http://www.who.int/gho/governance_aid_effectiveness/en/index.html. Health in France. French Embassy. Accessed 9 January 2012. http://www.ambafrance-uk.org/health-in-france.html. Healthcare. United States Department of Labor. Last Modified 2 February 2010. http://www.bls.gov/oco/cg/cgs035.htm. Health Care in South Africa. South Africa Info: Gateway to the Nation. Accessed 13 January 2012. http://www.safrica.info/about/health/health.htm. Highlights: 2010. US Census Bureau. Accessed 19 January 2012. http://www.census.gov/hhes/www/hlthins/data/incpovhlth/2010/highlig hts.html. Economic and Social Council UN Human Right Council - 9 Liberating the NHS: Legislative framework and next steps. Department of Health. Last Modified 28 February 2011. http://www.dh.gov.uk/en/healthcare/liberatingthenhs/dh_122624. Light, Donald W. Universal Health Care: Lessons from the British Experience. American Journal of Public Health. Last Modified 1 January 2003. http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=32cfba9f-dae1-44c1-9251- b3429064a4eb%40sessionmgr112&vid=4&hid=126. Osler, Sir William. The Evolution of Modern Medicine. Accessed 13 January 2012. http://etext.virginia.edu/etcbin/toccernew2?id=oslevol.sgm&images=images/modeng&data=/texts/english/modeng/parsed&ta g=public&part=24&division=div2. JPHMUN 2013-10

Peikoff, Leonard. Health Care is Not a Right. Last Modified 11 December 1993. http://www.bdt.com/pages/peikoff.html. Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. United Nations Human Rights. Accessed 13 January 2012. http://www.ohchr.org/en/issues/health/pages/srrighthealthindex.aspx. Strengthening Efforts to Prevent HIV. UNFPA. 9 January 2012. http://www.unfpa.org/hiv/. The French Health Care System. Medical News Today. Last Modified 8 June 2009. http://www.medicalnewstoday.com/articles/9994.php. The Universal Declaration of Human Rights. The United Nations. Accessed 14 January 2012. http://www.un.org/en/documents/udhr/index.shtml#atop. Thomas, Varghese. Health care in developing countries- Need for finance, education or both? Calicut Medical Journal, no 7.1 (2009). http://calicutmedicaljournal.org/2009/1/e1.pdf. UNAIDS Press Release. Last Modified 23 November 2010. http://www.unaids.org/documents/20101123_pr_globalreport_en.pdf. UNFPA. UNFPA. Accessed 12 January 2012. https://www.unfpa.org/public/. What is in the 2010 US Health Reform Bill. Insurance Providers. Accessed 9 January 2012. http://www.insuranceproviders.com/what-is-in-the-2010-us-health-carereform-bill/. JPHMUN 2013-11

WHO reform for a Healthy Future. World Health Organization. Accessed 11 January 2012. http://www.who.int/dg/reform/en/index.html JPHMUN 2013-12