Poverty, malaria and the right to health: exploring the connections.

• Author: Hunt, Paul

Malaria is an extremely serious human rights issue. Six out of eight Millennium Development Goals (MDGs) cannot be achieved without tackling this disease. It is both a cause and a consequence of poverty. Its impact is especially ferocious on the poorest: those least able to afford preventive measures and medical treatment. Malaria kills well over 1 million people every year, claiming a child's life every 30 seconds. It impoverishes families, households and national economies, lowers worker productivity and discourages investment. It costs Africa $12 billion every year.

And yet, malaria is entirely preventable through an integrated package of interventions, such as properly maintained insecticide-treated nets, indoor residual spraying and information campaigns. If diagnosed and treated promptly and correctly, malaria is curable. New artemisinin-based combination therapies (ACTs), though effective, are expensive and beyond the reach of many in Africa, where the disease is most prevalent.

Recognizing malaria as a right-to-health issue does not provide a magic solution to an enormous complex problem. (1) But the right-to-health perspective--the human rights analysis--has a constructive contribution to make.

What is the right to health? The right to the highest attainable standard of health is codified in numerous legally binding international and regional human rights treaties. It is also enshrined in numerous national constitutions, over 100 of them comprising the right to health or health-related rights. (2) While the right to health includes the right to medical care, it also encompasses the underlying determinants of health, such as safe drinking water, adequate sanitation and access to health-related information.

The right to health also includes freedom, for example the right to be free from discrimination and involuntary medical treatment, as well as entitlements, such as the right to essential primary health care. The right has numerous elements, including child and maternal health and access to essential drugs. Like other human rights, it has a particular concern for the disadvantaged, the marginalized and those living in poverty. It requires an effective, inclusive health system of good quality.

International human rights law is realistic and recognizes that the right to the highest attainable standard of health for all cannot be realized overnight. Thus, the right is expressly subject to both progressive realization and resource availability. Although qualified in this way, nonetheless, the right to health imposes some obligations of immediate effect, such as non-discrimination, and the requirement that a State at least...