Joint Action and Learning Initiative
services. The Campaign to Ban Landmines drove a process that culminated in a treaty banning this indiscriminate weapon.
JALI will draw inspiration from, and collaborate with, civil society movements, which are central to securing and ensuring adherence to a global health agreement. Such movements have spurred momentous transformations in health.
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Civil society campaigns for the right to health, such as those through the People’s Health Move- ment, are already underway. NGOs from the global South and North launched a Declaration of Solidarity for a Unified Movement for the Right to Health. Students and youth, with the passion for justice and belief that change is possible, grow- ing up in a world where human rights set soci- etal norms, will be central to this struggle. They have helped lead campaigns for AIDS treatment and funding and to end genocide. The complex- ity of global health requires that a broad range of sectors participate in this campaign for it to succeed – health workers and lawyers, environ- mentalists and unions, teachers and journalists, entrepreneurs and economists. Above all is the importance of full engagement of the commu- nities most impacted by global health inequities – among them: women, people living in poverty, people living with HIV/AIDS, people living with diabetes, people with disabilities, indigenous populations, men who have sex with men and intravenous drug users. The effort will have to be transnational, linking communities not only across national boundaries, but also between the global South and global North.
JALI is developing the partnerships required to undertake an inclusive process involving research, analysis, and extensive online and regional con- sultations to gain insight into and build consensus around answers to four foundational questions, and to stimulate coordinated action to reduce
health inequities. This bottom-up, research-fo- cused process will develop a detailed under- standing of health rights and state obligations, clear targets and benchmarks for success, and effective monitoring and accountability mecha- nisms. These will add precision to and enhance the effectiveness of international human rights law. By drawing on the voices of civil society and disadvantaged communities, JALI could have the legitimacy and the political support to transform global governance for health.
The four questions, and preliminary directions on answers, are:
1. What are the services and goods guaranteed to every person under the human right to health?
The World Health Organization (WHO) has placed universal health coverage high on the global health agenda, defining three dimensions of coverage: 1) the proportion of the population served; 2) the level of services; and 3) the proportion of health costs covered by prepaid pooled funds. WHO has defined universal coverage “as access to key promotive, preventive, curative and rehabilitative health interventions for all at an affordable cost.”3
The right to health provides critical insight into how states should work towards universal cover- age. Core obligations offer benchmarks to assess progress towards universal coverage such as non- discrimination, equitable distribution of health facilities, and essential services for all, including those addressing underlying determinants of health.
The core principle of equality requires states to prioritize covering 100% of their populations. Al- though 100% coverage of all health services will not be possible immediately, full coverage of “key” health interventions should be an initial benchmark towards universal coverage. The right to health framework militates against a narrow definition of “key” services. These should encompass strong health systems that are capable of delivering the services required to meet population needs and
ILSA Quarterly » volume 20 » issue 1 » October 2011
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