he Pakistani government of Tehreek-i-Insaf (PTI) has taken a key step towards better delivery of health care to disadvantaged people by introducing health insurance cards and preparing a package of essential health services in some districts. Although experts see this as an important step towards improving access to health care, they demand that the government also make health care a fundamental constitutional right.
The national health card and the essential health services package are two of the government’s flagship policies to provide better health care to the poor. It is believed that over fifty percent of all Pakistanis live below the poverty line.
Since the late 1940s, more than 130 countries have enshrined the right to health in their national constitutions. Pakistan is not one of those countries. It contains a roundabout reference to “medical aid” but no explicit right to health.
The constitution recognizes the need for medical assistance for the population but does not recognize health as a fundamental right. The case requires the attention of the government. Article 24 of the constitution indirectly calls for the provision of education and medical assistance to all. The right to education is also recognized in article 37 of the constitution: “the State must promote, with particular care, the educational and economic interests of the backward classes or regions; and eradicate illiteracy and provide free and compulsory secondary education as quickly as possible. In 2010, article 25-A was introduced. He said, “The state will provide free and compulsory education to all children between the ages of five and sixteen, as determined by law.
“The right to health is one of the fundamental human rights. It is linked to the right to life, the right to education and the right to food and housing. The right to health is also the basis of universal health coverage as it establishes the right to health care and medical care. It is part of the Universal Declaration of Human Rights and the WHO constitution, ”said Dr Zafar Mirza, former Special Assistant to the Prime Minister for Health Affairs. He pointed out that Pakistan is a signatory to these two documents.
Globally, the first expression of the right to health was enshrined in the constitution of the World Health Organization in 1946. It reads as follows: “The States parties to this constitution declare, in accordance with the Charter United Nations, that the following principles are fundamental to the happiness, harmonious relations and security of all peoples. Health is a state of complete physical, mental and social well-being and not just the absence of disease or infirmity. WHO recognizes that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction as to race, religion, political belief, economic or social condition.
According to article 25.1 of the Universal Declaration of Human Rights (1948), “Everyone has the right to an adequate standard of living for his health and that of his family, including food, clothing, housing, necessary medical care and social services ”. Globally, a majority of countries have recognized health care as a constitutional and fundamental right.
“There is a need to amend our constitution to add the right to health and create a constitutional right to health care for Pakistani citizens regardless of economic status, creed, caste, color or age and location. Says Dr Mirza.s
The UN says the right to health is inclusive and goes beyond access to health care and the construction of hospitals. It includes a wide range of factors that can help people lead healthy lives.
The UN Committee on Economic, Social and Cultural Rights, the body responsible for monitoring the International Covenant on Economic, Social and Cultural Rights, declares: clean water and adequate sanitation; healthy food; adequate food and shelter; healthy working and environmental conditions; health education and information; gender equality are the main determinants of health. Universally, the right to health contains freedoms which include the right not to be subjected to non-consensual medical treatment, such as medical experiments and research or forced sterilization; and free from torture and other cruel, inhuman or degrading treatment or punishment.
The right to health also contains rights. These include the right to a health protection system offering everyone equal opportunities to enjoy the highest possible standard of health; the right to the prevention, treatment and control of disease; access to essential drugs; maternal, child and reproductive health; equal and timely access to basic health services; providing health-related education and information; participation of the population in health decision-making at national and community levels.
It urges that health services, goods and facilities be provided to all without discrimination. Non-discrimination is a key principle of human rights and is crucial for the exercise of the right to the highest attainable standard of health. All services, goods and facilities must be available, accessible, acceptable and of good quality. Public health and functional health care facilities, goods and services must be available in sufficient quantity in a state, and they must be physically accessible (within reach for all segments of the population, including children, adolescents, the elderly, the disabled and other vulnerable groups) as well as financially and on the basis of non-discrimination.
Accessibility also implies the right to seek, receive and communicate health-related information in an accessible format (for everyone, including people with disabilities), but does not infringe the right to have personal data processed by health in a confidential manner. Facilities, goods and services must also be ethical in medicine, be gender sensitive and culturally appropriate. In other words, they should be medically and culturally acceptable. These facilities must be scientifically and medically appropriate and of good quality. This requires, in particular, trained health professionals, scientifically approved and unexpired drugs and hospital equipment, adequate sanitation and safe drinking water.
Experts say the constitutionally enshrined right to health can also apply to and protect specific groups. These special groups include women, children, migrants, transgender people, and HIV / AIDS patients, among others.
“There is a need to add the right to health and create a constitutional right to health care for Pakistani citizens regardless of their social status, creed, caste, color, age and their location, ”says Dr Mirza. He says he hopes all political parties can agree on such a constitutional amendment. During his advisory role to the prime minister, he says, he campaigned to make the right to health a constitutional provision.
A number of health experts and health journalists at a recent workshop on the pandemic and health governance in Pakistan organized by Trust for Democratic Education and Accountability (TDEA) with support from the Foreign, Commonwealth and Development Office (FCDO) of the government of the United States United Kingdom, also urged the government to recognize health as a basic and fundamental right in the constitution.
There is an urgent need for lobbying and advocacy to highlight the importance of this topic and to put pressure on parliamentary parties to address this issue in parliament. Political parties should make the right to health a constitutional provision a priority agenda in their election manifestos.
The author is a staff reporter. He can be contacted at [email protected] Twitter: @waqargillani