“The concept of a […] human right to healthcare implies that the state should not be intrusive in matters of personal health. It should protect individuals from interference in their health, and should take proactive measures to ensure healthy living and working conditions. Above all, it should guarantee access to adequate healthcare.[1]“

The right to health is a fundamental human right enshrined in international law through various international treaties. According to the International Covenant on Economic, Social and Cultural Rights (ICESCR) of 1966,
still in force today, everyone has the right to the highest attainable standard of physical and mental health [2].

This means, among other things, that all states parties to the ICESCR commit to implementing these rights. In doing so, they guarantee ‘non-discriminatory access‘ [3] to an unrestricted right to health.

The World Health Organization (WHO) defines health in its 1946 Constitution as a state of complete well-being, not merely the absence of disease. This comprehensive approach emphasizes the importance of physical, mental and social aspects of health for an individual’s overall well-being. The right to health includes access to safe drinking water, adequate nutrition, healthy working conditions and medical care [4]. It also includes the autonomy to make decisions about one’s health and protection from interference. The realization of this right requires creating social conditions that enable people to lead healthy lives.

Other international human rights treaties, such as the UN Convention on the Rights of the Child [5], the UN Women’s Rights Convention [6] and the UN Convention on the Rights of Persons with Disabilities [7] also contain provisions on the right to health or specific aspects of it. These treaties aim to address the specific needs of particular populations.

The UN Committee on Economic, Social and Cultural Rights monitors the implementation of the ICESCR and issued a General Comment [8] on the right to health in 2000. This document emphasizes the importance of criteria such as availability, accessibility, acceptability* and equality in defining the right to health.
[* Explanation: In this context, ‘acceptability‘ means that health facilities, goods and services must be consistent with the cultural values and individual dignity of patients, be gender-sensitive and be appropriate to different living situations.]

In addition, according to the ICESCR, the primary responsibility for implementing the right to health lies with individual states. This responsibility includes the obligation of the state to respect, protect and fulfill this fundamental human right.

Thus, a state must ensure that its actions do not violate the right to health. Non-discriminatory access to healthcare is a central aspect of this obligation.

The duties to protect refer to safeguarding against interference by third parties, particularly private actors in the health sector.

Guarantee obligations, on the other hand, require active state intervention. These obligations are intended to ensure the full realization of the right to healthcare. This includes the provision of medical facilities and programs, as well as the improvement of socioeconomic conditions that affect health. An equitable distribution of resources and measures for the prevention and treatment of diseases are also necessary.

Healthcare is a human right. Yet it is common that instead of fulfilling their duty to make this right accessible to all, states are doing exactly the opposite. Through various regulations and laws, the human right to health is turning into a luxury good, no longer equally accessible to everyone.

So the isolationist stance of the EU starkly contrasts with this human right. Due to the absence of legal escape routes and the criminalization of refugees, they are systematically deprived of their human rights and have no access to healthcare. Instead, pushbacks at Europe‘s external borders are the order of the day [9].

This violent rejection of people seeking protection is not compliant with human rights. In our projects, bite wounds caused by police dogs were observed as well as cuts, loss of fingers and toes, and broken bones. These serious injuries, as well as minor wounds, can lead to severe infections due to poor hygiene and lack of medical care.

Even within Germany, refugees face restrictions on access to comprehensive medical care, for example, due to limitations in the Asylum Seekers‘ Benefits Act [10].

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Sources:
[1] Krennerich, Michael: Menschenrechte: Grundlagen, Kontroversen und Perspektiven. Wiesbaden: Springer (2016) S. 57.

[2] Deutsches Institut für Menschenrechte: Internationaler Pakt über wirtschaftliche, soziale und kulturelle Rechte (1966) [online]
https://www.institut-fuer-menschenrechte.de/fileadmin/Redaktion/PDF/DB_Menschenrechtsschutz/ICESCR/ICESCR_Pakt.pdf [accessed: 28.09.2024).

[3] Ausschuss für wirtschaftliche, soziale und kulturelle Rechte (CESCR). Allgemeiner Kommentar Nr. 14 (2000): Das Recht auf das für die Gesundheit erreichbare Höchstmaß (Artikel 12 des Internationalen Paktes über wirtschaftliche, soziale und kulturelle Rechte). UN-Dokument: E/C.12/2000/4.

[4] Weltgesundheitsorganisation (WHO). Verfassung der Weltgesundheits-organisation (1946) Präambel. Genf: WHO.

[5] Vereinte Nationen (UN). Übereinkommen über die Rechte des Kindes. Resolution 44/25 der Generalversammlung der Vereinten Nationen, 20. November 1989. UN-Dokument: A/RES/44/25.

[6] Vereinte Nationen (UN). Übereinkommen zur Beseitigung aller Formen von Diskriminierung der Frau. Resolution 34/180 der Generalversammlung der Vereinten Nationen, 18. Dezember 1979. UN-Dokument: A/RES/34/180.

[7] Vereinte Nationen (UN). Übereinkommen über die Rechte von Menschen mit Behinderungen (CRPD). Resolution 61/106 der Generalversammlung der Vereinten Nationen, 13. Dezember 2006. UN-Dokument: A/RES/61/106.

[8] Ausschuss für wirtschaftliche, soziale und kulturelle Rechte (CESCR). Allgemeiner Kommentar Nr. 14 (2000): Das Recht auf das für die Gesundheit erreichbare Höchstmaß (Artikel 12 des Internationalen Paktes über wirtschaftliche, soziale und kulturelle Rechte). UN-Dokument: E/C.12/2000/4.

[9] Border Violence Monitoring Network: Monthly Reports [online]
https://borderviolence.eu/databases/monthly-reports/ [accessed: 04.10.2024].

[10] Bundesweite Arbeitsgemeinschaft der psychosozialen Zentren für Flüchtlinge und Folteropfer: Welche Rechte auf Gesundheitsversorgung haben Geflüchtete? [online] https://www.baff-zentren.org/faq/welche-rechte-auf-gesundheitsversorgung-haben-gefluechtete/ [accessed: 24.09.2024].

Additional sources:
Krennerich, M. (2016). Menschenrechte: Grundlagen, Kontroversen und Perspektiven. Verlag Barbara Budrich.

Zenker, Heinz-Jochen 2011: Europäische Strukturen der Gesundheitsversorgung von irregulären Migrantinnen und Migranten, in: Mylius, Maren/Bornschlegl, Wiebke/Frewer, Andreas (Hrsg.): Medizin für „Menschen ohne Papiere“, Göttingen: V&R unipress, 83-99.
OHCHR. (1948). Universal Declaration of Human Rights. [online] https://www.ohchr.org/en/human-rights/universal-declaration/translations/german-deutsch [accessed: 24.09.2024].

Franke, A. (2006). Gesundheit und Menschenrechte: Grundlegende internationale Dokumente. 2. Auflage. Cambridge, MA: Harvard University Press.

Vereinte Nationen (UN). Allgemeiner Kommentar Nr. 20: Nichtdiskriminierung in wirtschaftlichen, sozialen und kulturellen Rechten (Artikel 2, Absatz 2 des Internationalen Pakts über wirtschaftliche, soziale und kulturelle Rechte). UN-Dokument: E/C.12/GC/20, 2009.Vereinte Nationen E/C.12/GC/20: General Comment No. 20 on the right to health.

European Center for Constitutional and Human Rights (ECCHR). Pushbacks an den EU-Außengrenzen. Januar 2024.
Verfügbar unter: [online] https://www.ecchr.eu [accessed: 24.09.2024].