key: cord-331422-288ryhc5
authors: Gostin, Lawrence O; Daniely, Tamira; Huffstetler, Hanna E; Williams, Caitlin R; Meier, Benjamin Mason
title: The shibboleth of human rights in public health
date: 2020-08-20
journal: Lancet Public Health
DOI: 10.1016/s2468-2667(20)30182-1
sha: 
doc_id: 331422
cord_uid: 288ryhc5

nan

Human rights discourse has greatly influenced advocacy for justice in public health. Yet, beyond rhetorical claims, how can we employ human rights to achieve the aspiration of health with justice? Without human rights education to support public health practice, human rights have become a shibboleth of public health-raised frequently to signal devotion to justice, but employed rarely in policy, programming, or practice. As advocates respond to the public health injustices of populist nationalism during an unprecedented pandemic, human rights education must be an essential foundation to hold governments accountable for implementing rights to safeguard public health. Human rights are based on the powerful idea of equal dignity for all people. By establishing international standards for health justice, human rights have been transformed from the rhetorical to the actionable, as legal obligations have been developed to realise the highest attainable standard of health. 1 Governments have established these universal rights under international law through the UN, beginning in the Universal Declaration of Human Rights and elaborated through an evolving range of health-related rights. 2 By structuring government responsibility for the promotion of health, international human rights law can translate calls for justice into public health action.

Human rights law thus defines what governments must, or must not, do to ensure the equitable enjoyment of health for all. International human rights law obligates governments to realise specific rights through health policies, programmes, and practices. 3 This national implementation of international law seeks to translate human rights law into public health realities, structuring fairness in health policy making and affording equal rights to health goods and services. Human rights empower civil society movements for health justice by proclaiming a global standard for physical, mental, and social wellbeing. Through this global standard, human rights require government action to respect human freedoms, protect individuals from harm, and fulfill basic needs.

Seeking to ensure government action, a range of policy mechanisms exist to facilitate accountability for national implementation. By providing an external check on government efforts, these accountability mechanisms require government officials to show how they have either realised, or taken progressive steps to realise, their human rights obligations. 4 This process not only identifies which aspects of health policy are insufficient or harmful, but also provides opportunities for redress of health grievances, with human rights advocacy holding governments to account for implementing international human rights law. 5 The current era-beset by a devastating pandemic and resurgent nationalism-has presented new challenges in facilitating government accountability to respect, protect, and fulfill human rights to advance public health. In response to the COVID-19 pandemic, some governments have violated human rights and undermined global governance, retrenching inward when global solidarity is needed most. 6 It is necessary for the next generation of leaders to reinvigorate the commitment to universal rights in public health, implement human rights through public health practice, and lead rights-based advocacy to ensure that governments are held accountable. 7 In preparing this next generation of leaders, human rights education provides a necessary foundation for public health engagement.

The academic discipline of health and human rights amplifies demands for justice in public health, reimagining claims for health-related rights through health policy reforms. Schools of public health have increasingly developed courses on human rights, combining rigorous understanding of international legal standards with public health science. Public health programmes have long embraced a focus on justice, but recent curricular reforms seek to strengthen student understanding of human rights under international law, examining how the realisation of rights shapes the lived reality of health. 8 These legal foundations provide an actionable basis for public health students to become human rights advocates, mainstreaming human rights norms and principles in public health policies, programmes, and practices.

As public health responds to rising challenges of health injustice, in the pandemic response and beyond, strengthening human rights training for the next generation is imperative. Through shared competencies for human rights education in public health, faculty can

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