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Examining the Right to Health's Status in the Pacific

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Examining the Right to Health's Status in the Pacific asia-pacific journal on human rights and the law 17 (2016) 257-277 brill.com/aphu Article ∵ Searching for the Elusive? Examining the Right to Health’s Status in the Pacific Jennifer Y Kallie School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland [email protected] Claire E Brolan School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland; Dalla Lana School of Public Health, University of Toronto [email protected] Nicola C Richards School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland Abstract Integrating the right to health is pivotal in progressing health and development in the Pacific. The Sustainable Development Goal (sdg) agenda provides an opportunity for this, given the relationship between health, human rights, climate change and sustain- able development. The right to health’s content can be utilised to progress country obligations in various ways: through facilitating implementation of Universal Health * CEB acknowledges this research was part of Work Package 2 (wp2) of the Go4Health Project. Funding for Go4Health from the European Union’s 7th Framework Programme (HEALTH- F1-2012-305240) and the Australian Government’s NH&MRC European Union Collaborative Research Grants (1055138). © koninklijke brill nv, leiden, 2016 | doi 10.1163/15718158-01702007 <UN> 258 Kallie, Brolan and Richards Coverage, supporting the development of health metrics, and assisting in equitable health policies. Cumulatively, such measures can act as process and outcome indica- tors of a state’s progressive realisation toward achieving the right to health. In analysing the status of the law and policy relating to the right to health, this study has established a right to health baseline for the Pacific region at sdg commencement, contributing both to monitoring and evaluation, and promoting visibility of this often overlooked region. Methods included a systematic review of the literature on the right to health, and review of six structural rights indicators in existing law and policy relating to the right to health in the 16 Pacific Island Forum countries and territories, 14 of which are recognised as small island developing states. Findings confirm the right to health’s marginalisation in the region. The ratification of United Nations (un) treaties, integra- tion of international human rights obligations into domestic law and policy, and com- pliance with reporting requirements were found to be piecemeal and ad hoc at best. We argue that while legal recognition is only one step in the process of realising the right to health, the existence of right to health law and policy is a pivotal start if there is to be equitable implementation of the sdg health agenda. We also recommend Pacific nations develop one reporting framework, which can double to meet their reporting requirements under un treaty bodies and sdg 3 global health commitments. Keywords right to health (rth) – Pacific Island Forum countries – Sustainable Development Goal agenda – rth scorecard – status of rth in the Pacific 1 Introduction In 2009, the Secretary-General of the Pacific Island Forum (pif) Secretariat ac- knowledged integrating the right to health is pivotal in progressing the region’s health and development: All rights are fundamental to human development; the right to health is just as critical as the right to freedom of speech; and the right to livelihood is inexorably linked to freedom of movement. These are the essential un- derpinnings of the right to development. Without support for all human rights, I do not believe we can have real prospect for communities and for Forum Member States to achieve [the] sustainable development goals.1 1 Tuiloma Neroni Slade, ‘Ratification of International Human Rights Treaties: Added Value for the Pacific Region’ (Office of the United Nations High Commissioner for Human Rights asia-pacific journal on human rights and the law 17 (2016) 257-277 <UN> Searching for the Elusive? 259 There is crucial need for the post-2015 Sustainable Development Goal (sdg) agenda to advance health and development in the Pacific, especially given the relationship between health, human rights, climate change and sustainable development.2 Indeed, heads of government of the 16-member pif actively shaped formulation of the post-2015 sdgs,3 unsurprising as this region is al- ready highly affected by climate change.4 In 2014 Pacific leaders voiced this concern at the un Climate Summit and at the un International Conference on Small Island Developing States (sids). In adopting the post-2015 sdgs at the un General Assembly in September 2015, the world’s governments implic- itly acknowledged the need to redress the Pacific’s unique health and devel- opment challenges.5 For example, in the post-2015 global health goal, sdg 3 (“Ensure healthy lives and promote well-being for all, at all ages”), which contains 9 Targets and 4 Means of Implementation, Means of Implementa- tion 3c draws specific focus onto the world’s sids (that includes numerous Pacific Island nations) in terms of achieving a “substantial” increase in “health financing and the recruitment, development, training and retention of health workforces”.6 Certainly challenges around human resources for health and (ohchr) – Regional Office for the Pacific, Suva, Republic of the Fiji Islands qnd Pacific Islands Forum Secretariat (pifs), Suva, Republic if the Fiji Islands, 2009) <http://pacific .ohchr.org/docs/RatificationBook.pdf> accessed 4 September 2014. 2 Peter S Hill and others, ‘How Can Health Remain Central Post-2015 in a Sustainable Devel- opment Paradigm?’ (2014) 10 Globalization and Health; ‘Transforming our world: The 2030 Agenda for Sustainable Development’ (United Nations) <https://sustainabledevelopment. un.org/content/documents/7891Transforming%20Our%20World.pdf> accessed 6 October 2015; ‘Thematic Session – Climate, Health and Jobs: Session Notes’ (un Climate Summit, 23 September 2014) <http://www.un.org/climatechange/summit/wp-content/uploads/ sites/2/2014/08/Climate-Health-and-Jobs-Session-Notes1.pdf> accessed 6 October 2015. 3 ‘Forty-Fifth Pacific Islands Forum, Koror, Republic of Palau’ (Pacific Islands Forum Sec- retariat, 29–31 July 2014) <http://www.forumsec.org/resources/uploads/attachments/ documents/2014_Forum_Communique_31Jul2014.pdf> accessed October 6, 2015. 4 Rokho Kim and others, ‘Climate change and health in Pacific Island States’ (2015) 93(12) Bul- letin of the World Health Organization 817; T Weir and others, ‘Social and cultural issues raised by climate change in Pacific Island countries: an overview’ (2016) 1 Regional Environ- mental Change; S Taylor and L Kumar, ‘Global climate change impacts on Pacific Islands terrestrial biodiversity: A review’ (2016) 9(1) Tropical Conservation Science. 5 ‘Draft resolution submitted by the President of the un General Assembly. Draft outcome document of the United Nations summit for the adoption of the post-2015 development agenda’ (un General Assembly, 12 August 2015) <http://www.un.org/ga/search/view_doc .asp?symbol=A/69/L.85&Lang=E> accessed 6 October 2015. 6 Ibid. asia-pacific journal on human rights and the law 17 (2016) 257-277 <UN> 260 Kallie, Brolan and Richards health financing have been acute and longstanding in remote Pacific Island nations.7 The post-2015 sdgs are pivotal for the Pacific’s environmental well-being, human health and survival, and integration of the right to health into sdg health policy and planning by Pacific nations and their partners cannot be understated. The purpose of this article is to establish a right to health base- line for the Pacific region at sdg commencement. This will occur through two means: systematic review of the literature on the right to health and the Pa- cific, and by reviewing international and domestic laws and policy on the right to health (the structural indicators) in pif countries. This article contributes to the region’s visibility in global health and human rights affairs, which have been long-overlooked. 2 Background 2.1 Health in the Pacific Australia, New Zealand, and the 14 Pacific Island countries (pics) – Polynesia (Cook Islands, Niue, Samoa, Tonga, Tuvalu), Melanesia (Fiji, Papua New Guinea, Solomon Islands, Vanuatu), and Micronesia (Federated States of Mi- cronesia, Kiribati, Marshall Islands, Nauru, Palau) – comprising the pif, are in one of the world’s most natural-disaster prone regions (Figure 18). Many pif communities are vulnerable to the impacts of climate change,9 which 7 Lyn N Henderson and Jim Tulloch, ‘Incentives for retaining and motivating health workers in Pacific and Asian countries’ (2008) 6(18) Human Resources for Health; Azmat Gani, ‘Health care financing and health outcomes in Pacific Island countries’ (2009) 24 Health Policy and Planning; ‘who Country Cooperation Strategy for the South Pacific 2006–2011’ (World Health Organization, 2010) <http://www.wpro.who.int/entity/country_focus/country_offices/ccs_ pic_2006_2011.pdf> accessed August 18, 2016; ‘Recruiting and Retaining Health Workers in Remote Areas: Pacific Island Case-Studies’ (World Health Organization, 2011) <http://apps .who.int/iris/bitstream/10665/44547/1/9789241501255_eng.pdf> accessed August 18, 2016); ‘who Country Cooperation Strategy for the South Pacific 2006–2011’ (World Health Or- ganization, 2010) <http://www.wpro.who.int/entity/country_focus/country_offices/ccs_ pic_2006_2011.pdf> accessed August 18, 2016; ‘Recruiting and Retaining Health Workers
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