CERD’s Day of General Discussion on a Proposed General Recommendation on The Right to Health
Panel discussion: Racial discrimination in health as experienced by individuals and groups
Statement by the Sexual Rights Initiative
This statement is delivered by the Sexual Rights Initiative (SRI). SRI made a joint submission to the Committee with Her Rights Initiative, National Council of Women Leaders, International Dalit Solidarity Network, Dalit Human Rights Defenders Network, and the Association for Women’s Rights in Development (AWID).
A tripartite approach is necessary in order for states to meet their obligations under CERD Article 5 (e)(iv) concerning access to health and healthcare of all people. First, states must ensure that healthcare is publicly funded through progressive taxation; second, states must adopt a systems approach to fulfil the right to health; and, third, states must take an intersectional approach in all aspects of healthcare provision. The absence of any of these will compromise peoples’ rights to health, bodily autonomy and non-discriminatory services, especially among the marginalised. Racialised and gendered people everywhere will be excluded and oppressed unless they are actively included through such an approach.
The acceptance and normalisation of for-profit healthcare services by various Committees as a legitimate means for states to fulfil their human rights obligations without meaningful consideration of the gendered and racialised impacts of privatisation and austerity, is a key problem. Through CERD Article 5 (e)(iv), which specifies the right to public health, medical care, social security and social services, the Committee is uniquely positioned to articulate the impact of the privatisation of health services on communities and individuals subject to racial discrimination and also to provide clear guidance on state obligations to make use of maximum available resources to progressively realise the right to health. Privatisation of health services, often forced upon countries in the Global South through structural adjustment, ‘international assistance’ or other ‘good governance’ measures, inevitably benefits the elite few, both within the country and transnationally, and follows the colonial playbook in resource extraction, exploitation and forced underdevelopment.
Global South states are currently hampered in their ability to confront the ongoing COVID-19 pandemic due to a deeply racist intellectual property regime that is curtailing access to necessary medical commodities, medicines, and vaccines due to the capitalist logic of maximising profit. According to the Africa CDC, on average, only 21,2% of African people are fully vaccinated (defined as having received 2 doses). The failure to adopt a truly comprehensive, broad-based, and indefinite - open-ended TRIPS waiver that addresses all necessary health commodities for the ongoing COVID-19 pandemic and all future pandemics is an indictment of the international economic system and the structural racism inherent in it.
Further, the disregard of Indigenous peoples’ concepts of health and health knowledge in non-Indigenous health systems, combined with ongoing threats of colonial expansion and other legacies of colonialism, such as forced assimilation, political and economic marginalisation, poverty, and racial discrimination and prejudice, all contribute to indigenous peoples’ poorer health across the world. Indigenous conceptions of health all over the world understand individual health to be inextricably linked and, in fact, co-constitutive with collective and community health. Such a conception of health is more compatible with a systems approach and a human rights-based approach to health.
The Committee should encourage states to adopt a systems approach to the right to health, which encompasses all the rights and entitlements necessary to the fulfilment of the right to health, including its determinants. This is vital and it is a precondition for ensuring that individual sectors will deliver quality goods and services to all.
This approach ensures that health is treated as one piece of a larger mosaic instead of as a stand-alone right fractured away from other entitlements that determine people’s ability to live decent lives. Thus, good quality and publicly funded education, equitable access to adequate and nutritious food and clean water, supportive and sustainable physical and natural environments (including adequate sanitation), social security, community participation and decision-making that enhance self-worth and belonging for all people are all essential elements of a system in which people can thrive and come closest to realising their capabilities.