Ratification of human rights treaties makes no difference to health status

June 04, 2009

A paper in this week's edition of the Lancet concludes that whether or not a country has ratified UN human rights treaties has no effect on the health status of its population. This Health Policy paper is written by Dr Edward J Mills. British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, and colleagues.

The authors obtained data from 170 countries for their analysis, and looked at a range of health indicators including HIV prevalence, and maternal, infant (<1 year) and child (<5 years) mortalities. The six UN human rights treaties chosen were the Convention on rights of the child, Covenant on economic, social, and cultural rights, Convention on elimination of discrimination against women, Convention against torture, Convention on elimination of racial discrimination, and Covenant on civil and political rights.

Some 65% of countries had ratified all six treaties, but ratification of the treaties made no difference to the health indicators studied. There was also no difference in social indicators, such as child labour and corruption, between countries that had ratified treaties and those that had not. While high-income countries had made consistently greater health gains than poorer nations, this was independent of treaty ratification. Dr Mills says*: "These findings are extremely concerning, given the emphasis that the international community places upon consensus agreements and international law. Ours is not the first study to conclude that internationally legal documents are poorly related to population improvements, it is however, the first to examine health."

These findings have implications for the need for ratifying states to adequately monitor progress and track the success of their interventions. Until such time, the authors say* 'these symbolic gestures of improvement are empty and misleading to the populations that most need progress.'

They conclude: "Although the realisation of the highest attainable standard of health is a progressive obligation, the realisation of a minimum, essential health care is an immediate one. The fact that economic status was the greatest predictor of good health, but was not associated with likelihood of treaty ratification, emphasises the central role of financing in the realisation of the right to health."
Dr Edward J Mills. British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada T) +1 778 317 8530 E) emills@cfenet.ubc.ca

For full Health Policy, see: http://press.thelancet.com/hrts.pdf

Note to editors: *quotes direct from Dr Mills and cannot be found in the Health Policy paper

For this week's Editorials, see: http://press.thelancet.com/editorials0606.pdf


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