The Platform for a Framework Convention on Global Health: Realizing

the Universal Right to Health

June 2014

Why a global health treaty based in the right to health?

The Framework Convention on Global Health (FCGH)

The Platform for an FCGH The FCGH and the Sustainable Development

Goals Get involved: Join the Platform for an FCGH

Overview

Why a global health treaty based on the right to health?

• Health inequities• Life expectancy in high-income countries (2012): 79 years

Japan: 84 years

• Life expectancy in low-income countries (2012): 62 years• Sierra Leone: 46 years

• Domestic inequities Life expectancy in the United States (2012): 79 years Life expectancy of Native Americans on the Pine Ridge Reservation in South Dakota:

upper 40s

Under-5 mortality in India – top wealth quintile: 39/1,000 Under-5 mortality in India – bottom wealth quintile: 117/1,000

Under-5 mortality, global median – top wealth quintile: 50/1,000 Under 5 mortality, global median – bottom wealth quintile: 102/1,000

Global and national health inequity

Intellectual property regime impedes access to medicine Added danger of TRIPS-plus bilateral and regional agreements

Investment treaties enable corporations to challenge public health regulations

Trade treaties open foreign markets to cheap, unhealthy food displacing local, healthier produce

International narcotic regime impedes access to medicines necessary to control pain

The voluntary nature of the WHO Global Code of Practice on the International Recruitment of Health Personnel may not prevent recruitment from countries experiencing critical health worker shortages

International law outside the health sector: Undermining the right to health?

Despite international right to health commitments of all countries, implementation remains poor in many countries

Populations, particularly those marginalized, are often unable to participate in policy decisions affecting their health

Local health accountability mechanisms are frequently non-existent or poorly functioning

Discrimination against women, people with disabilities, sexual minorities, and others, in and out of the health sector, remains common, violating their right to health

Accountability and claiming the right to health

Most higher-income countries do not adhere to global commitment to international development assistance

International health financing is often insufficiently aligned with country strategies and systems

Few African countries meet their 2001 Abuja Declaration pledge of at least 15% of national budgets being allocated to the health sector

Accountability and health financing

Establish model for equitable, accountable global governance

Respond to growing demands of societies t0 reduce inequality

Contribute to economic productivity and growth

Build national public health capacities contributing to global health security

Further benefits

A Framework Convention on Global Health

Proposed global treaty based on the right to health and aimed at national and global health equity

Legally binding As framework convention, the initial treaty would be followed

by protocols (separately ratified) with greater detail on certain issues or responding to unaddressed or emerging issues Financing, research and development, health worker migration?

Could be adopted by the United Nations or World Health Organization

Would set forth a right to health for the 21st century Address right to health in a globalized world requiring

international responsibilities Respond to implementation shortcomings

Overview of the Framework Convention on Global Health

Robust universal health coverage Include universal coverage for public health (such as clean water, adequate sanitation,

healthy environments, nutritious food) Could set global standards with national adaption through inclusive process Move towards system where level of coverage does not depend on wealth or other

status Truly universal Domestic and international financing framework

Align with national health strategies and systems Address social determinants of health Ensure other legal regimes (e.g., trade, investment, intellectual property,

migration) respect and promote right to health Ensure other sectors respect and promote right to health (Health in All Policies) Enforceable norms on transparency, participation, and other aspects of

accountability to empower people and civil society to assert and secure the right to health and related rights

Clarify responsibilities for ensuring transnational corporations respect right to health

Strong mechanisms for monitoring compliance, including rigorous monitoring and reporting and innovative incentives and sanctions

Key elements of the FCGH

Right to health impact assessments to determine compliance with right for health in health and non-health sector policies and projects

Principles to enhance collaboration between health and other sectors to advance the social determinants of health

Health accountability strategies addressing community to global levels Standards on equitable financing and other measures to ensure equal access

to health care and public health interventions, including to overcome barriers for disadvantaged populations

Non-discrimination, including outside health sector in ways that undermine right to health

Requirements on transparency, public participation (including marginalized communities), and effective accountability policies and mechanisms

Ensure justiciability of right to health (can use courts to realize right to health) Right to health education for public, media, government, lawyers, judges,

health workers and other measures to enable people to claim their right to health

Empower WHO for global health leadership

More FCGH features

Right to health capacity-building funding mechanism to support NGOs, government institutions, and others building public understanding of and advocating for the right to health, and incorporating it into policies and institutions

Multi-sector forum with strong civil society participation to help integrate the right to health into various international legal regimes

National health equity strategies with action plans for equity for each marginalized community

Global Fund for Health for health care and public health interventions New accountability mechanisms such as increased number of regional

human rights special rapporteurs focused on equity, participation, and accountability

Establish clearer standards for key elements of right to health “maximum of…available resources,” progressive realization, “highest attainable

standard of physical and mental health” Make binding key elements (such as participation and emphasis on marginalized

populations) in authoritative General Comment 14 of Committee on Economic, Social and Cultural Rights

More FCGH possibilities

The Platform for a Framework Convention on Global Health

Global steering committee directs overall strategy and serves the needs of regions and national platforms Present interim steering committee

(http://www.globalhealthtreaty.org/about-us/who-we-are/)

Developing more democratic structure for future Possibility of future global advisory board National FCGH platforms Regional coordination

Overview of the Platform for an FCGH

National FCGH platforms Raise awareness about and advocacy for the FCGH at

national level Organize contributions to FCGH content at national level

Regional coordination Ensure national platform content contributions feed into

global content development Coordinate national advocacy possibilities and actions with

global advocacy strategy Develop and work with national platforms to execute

regional FCGH activities and actions

National FCGH platforms and regional coordination

The Framework Convention on Global Health and the

Sustainable Development Goals

Sustainable Development Goals (SDGs) will set health and development agenda 2015-2030

FCGH addresses multiple expected SDGs Health, clean water, adequate sanitation, nutritious food Themes of equity, participation, accountability, human rights

FCGH Platform seeking UN SDG declaration expected in September 2015 to include process to launch an FCGH Calling for UN Secretary-General and WHO Director-General

to form a multi-stakeholder working group to evaluate the value and benefits of, and propose the key principles, core content, and scope of, the FCGH

The FCGH and the Sustainable Development Goals

Legally binding agreement with treaty compliance and national accountability measures would provide stronger accountability in health-related areas than SDGs

Capacity building measures for the right to health that empower people to claim the right and governments to implement the right would advance health aspects of the SDGs

FCGH would fill in gaps in GGH governance in addition to accountability Intellectual property law and access to medicine and other medical

innovations Trade, such as in cheap and unhealthy foods that can displace healthier,

local alternatives Health worker migration Research and development Investment treaties and protecting national health regulations

Right to health assessments and other measures would protect and promote health outside health sector

Need for an FCGH in the context of the SDGs: Governance and accountability

Equity Ensuring universal health coverage is non-discriminatory with respect to

all populations, including frequently excluded (e.g., irregular migrants) Population-specific health equity strategies, participatory requirements,

and more to enhance health equity Universal health coverage that does not depend on level of a person’s

wealth Ensure equitable approach and special concern for marginalized groups

through health and related SDGs Financing

Develop binding domestic and international financing framework, ensuring funds to support health-related SDGs

Ensure equitable distribution of health financing Taxation, capital flight measures, innovative financing, capacity building

to increase resources for health and development

Need for an FCGH in the context of the SDGs: Equity and financing

Get involved: Join the Platform for a Framework Convention on

Global Health

www.globalhealthtreaty.org Endorse the FCGH Platform statement

http://www.globalhealthtreaty.org/actions/ Offer your views on the FCGH and the platform

statement Join or initiate your national FCGH platform Circulate national sign-on letter on SDGs and

FCGH For more information: info@globalhealthtreaty.org

Take action

“the right of everyone to the enjoyment of the highest

attainable standard of physical and mental health….”

Thank You