Statement to the OHCHR workshop on on promoting and protecting economic, social and cultural rights within the context of COVID-19: Session 4

Published on February 14, 2023

Action Canada for Population and Development

OHCHR workshop on promoting and protecting economic, social and cultural rights within the context of addressing inequalities in the recovery from the COVID-19 pandemic

Session 4: Investing in social spending, tackling inequalities and promoting economic policies that advance greater realization of economic, social and cultural rights



Around the world, health systems and health financing have been eroded, undermined and weakened by decades of neoliberalism, austerity, privatisation and structural adjustment programs and an emphasis on minimising State intervention and relying on a discourse of “personal responsibility.”[1]

Neoliberal approaches to health spending have disproportionate impacts along gender, race and class lines and are themselves a form of structural and economic violence that needs to be addressed to ensure that health systems are robust and equipped to stop reproducing and enacting structural violence onto the most marginalised, and to respond to survivors of interpersonal violence.

This privatisation is fuelled and exacerbated by persistent deficits, unavailability of public funds in absolute terms and low prioritisation of health by governments in their public expenditure.[2] None of these factors work alone; they feed into each other resulting in making health systems inaccessible for the people who most need them.[3] The violent impacts of neoliberal approaches to health are translated in numbers: recent Oxfam research estimates that for 5.6 million people per year in poor countries, lack of access to health care leads to death.[4]

Similarly, financialization transfers responsibility and risk, depending on the circumstances, to the individual instead of the state. This has two important consequences: it absolves the state from its obligations, and secondly, the structural oppressions, which created inequalities, continue to operate without any challenge. To put it simply, the rich get richer; the poor get poorer, the powerful gain more power and the marginalised are more disenfranchised. It also changes the relationship between the individual and the state, where holding states accountable is not only difficult but also inadequate. Accountability for International Financial Institutions, private investment firms, transnational corporation is urgent.


[1] Macassa G, McGrath C, Rashid M, Soares J. Structural Violence and Health-Related Outcomes in Europe: A Descriptive Systematic Review. International Journal of Environmental Research and Public Health. 2021; 18(13):6998., page 10.

[2] For instance, in Egypt the Constitution-mandated minimum spending of 3% of the GDP on health had been unachieved for several years until 2020, when it was reached not by increasing spending on underfunded aspects, but by broadening the scope of what constitutes “health spending” in the national budget. See, page 10.

[3] SRI submission to the Office of the High Commissioner on Human Rights for its report on maternal mortality and morbidity (2020).