November 11, 2025 • 54 mins
What do we mean when we say health is a human right? Dr. Benjamin Mason Meier is a Professor of Global Health Policy at the University of North Carolina (UNC) at Chapel Hill who has focused his research on the development, evolution, and application of human rights-based approaches to health.
In this episode, Dr. Meier joins Salma to explore the foundations of health as a human right—from its post-World War II origins to its development in international law. They discuss the obligations this framing creates for governments and international organizations, how rights must translate into tangible policies that improve health outcomes, and the tensions between advocacy and accountability. They also address the politics related to global health governance and human rights and consider what a human rights approach to health might look like in a future shaped by AI, climate change, and increased polarization.
Join this episode to learn about the difference between health as a human right as a slogan and health as a human right as a legal obligation—and why that distinction matters for global health's future.
Useful resources:
- Forman L, De Mesquita JB, Filho LB, Meier BM, Sirleaf M. How Did Human Rights Fare in Amendments to the International Health Regulations? J Law Med Ethics. 2024;52(4):907-921. doi:10.1017/jme.2024.172
- Gostin LO, Meier BM. Foundations of Global Health & Human Rights. Oxford University Press; 2020.
- Gostin LO, Meier BM, eds. Global Health Law and Policy: Ensuring Justice for a Healthier World. Oxford University Press; 2023.
- Robinson M. Human Rights in Global Health. Vol 1. (Mason Meier B, Gostin LO, eds.). Oxford University Press; 2018. doi:10.1093/oso/9780190672676.001.0001
Host: Dr. Salma Abdalla Editors: Catalina Melendez Contreras and Zachary Linhares Marketing: Kinkini Bhaduri Music: Eden Avery / Melting Glass from Epidemic Sound https://www.epidemicsound.com/track/2fqOXWpHab/
The views and opinions expressed by the guest in this episode do not necessarily reflect those of their institution, the funders, or the podcast team.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:05):
Welcome to Complicating the Narrative, a podcast that takes on the challenging questionsin public health by embracing complexity rather than avoiding it.
I'm your host Salma Abdalla Health as a human right, that's a phrase we hear constantly inglobal health, in conference keynotes, policy documents, and advocacy campaigns.
The idea seems straightforward.
Everyone everywhere has a right to health.
(00:27):
But what does mean in practice?
And does framing health as right help us achieve better health outcomes?
These are not theoretical questions.
We have seen rights-based frameworks invoked to demand vaccine equity during the COVID-19pandemic and at the same time used to resist public health restrictions.
We've seen human rights language shape access to HIV treatment and appear in many globalhealth declarations over the past half a century.
(00:52):
But we've also seen persistent critiques.
The rights frameworks can be too Western, too legalistic, or too disconnected from therealities on the ground.
There is also a deeper tension here.
Law operates both as a tool to advancing justice and as a reflection of power, revealingwho holds influence, who gets hurt, and whose health gets prioritized.
(01:12):
My guest today has spent decades thinking about these questions.
Professor Benjamin Mason Meier is a leading scholar of global health law, human rights,and governance structures.
He's a professor at the University of North Carolina at Chapel Hill, UNC,
with appointments both at the Gillings School of Global Public Health and the School ofLaw.
He's also the co-author of three foundational textbooks on global health governance, law,and human rights.
(01:38):
Ben has worked with the Health Organization and other global entities and has grappleddirectly with the challenges of making the case for a rights-based approach that is
meaningful across diverse political, legal, and cultural contexts.
So today,
we will explore what it means to frame health as a right, and what of rights-basedapproach might look like in a world marked by fragmentation and rapid technological
(02:03):
changes.
Ben, welcome to the podcast.
Thank you so much.
It's wonderful to join you during these challenging times for human rights and globalhealth.
first I really wanted to start just painting a picture for people who might notnecessarily know what is global health law and why would we think about law when it comes
to health and health outcomes.
(02:23):
And I know you are a lawyer by training, so maybe you would want to explain to ourlisteners what made you think that law could be a determinant of health.
You were studying law and then what was the moment that you thought, this makes sense forme to think of law as something that could shape the health outcomes of people.
I think your introduction really helped to frame why law is necessary.
How do we shift from saying health is a human right to making health a human right throughour policies and making it real in people's lives?
(02:52):
I began my career
not as a lawyer, but as a scientist, thinking that we could bring about access toessential scientific tools to advance health throughout the world.
But it became clear that we had many of these scientific tools, but we just didn't havethe policies in place in order to bring about access throughout the world to the people
(03:16):
who needed them most, to the scientific technologies that could improve health.
And so I went to study law and through that became
convinced that international law, law across nations, could help us to advance humanrights.
And so I started to study human rights under international law as a basis for publichealth, trying to understand the ways in which we've sought to take these ideas of justice
(03:42):
through human rights, to codify them under international law, and through that to shiftpolicies throughout the world that can make
the right to health real in people's lives.
That's interesting.
I didn't know that you were first trained as a scientist.
What type of scientist were you?
I was studying biochemistry.
(04:03):
These were exciting times.
We had just cloned a sheep and I had this vision that we would grow rice in the desert.
We would be able to feed the world and we would all hold hands and sing hallelujah.
But we never really got that opportunity.
And I became aware of science policy and the ways in which intellectual property patentswere stopping us from realizing access to health technologies.
(04:30):
in the most low income countries in the world.
And so I look to human rights as a way of shifting that narrative of thinking about healthtechnologies, not as intellectual property that could be monopolized and hoarded by the
wealthy, but as human rights that could be shared broadly across the world.
And that human rights understanding was what really brought me to thinking about the rightto health and the ways in which the World Health Organization exists
(04:58):
to ensure that health is a human right throughout the world.
So for those who are not familiar, what does it actually mean to think of health as ahuman right?
And I think as you mentioned, WHO in its general framing, it is based on the idea thathealth is a human right.
So maybe walk us through the history of how that understanding was codified in globalagreements.
(05:23):
It's really not possible to talk about health as a human right without beginning in thepost-war experience.
That the Second World War in some ways and the atrocities aligned with it highlightedchallenges to human rights and helped to establish a post-world order, post-World War
world order that would be shaped by human rights.
(05:46):
And that's not to say that human rights hadn't been invoked
throughout history in fights against slavery and fights for universal suffrage and fightsagainst colonization.
But the atrocities of the Second World War and the widespread immiseration and sufferingof the Great Depression that preceded it really clarified the need for a new world order
(06:07):
that would be grounded in human rights.
And as the United Nations was established at the end of the Second World War, human rightswould be one of the three pillars
of that new international organization.
With the charter of the United Nations in 1945, making clear not only that human rightswould be a central pillar, but that there would need to be the establishment of a new
(06:31):
international health organization to replace the League of Nations health office and tocreate an opportunity to bring the world together, to draw from the ashes of World War II,
to create a healthier world to come.
And the constitution of the World Health Organization developed in 1946 really becomes thefirst international agreement to lay out the idea that health is a fundamental human
(06:57):
right.
With the World Health Organization laying this out in its preamble and laying out a systemof global governance that would work to really rebuild the world in a way that would
realize health as a human right.
And we've seen over the course of the last 80 years now,
the evolution of that human right, not just as an idea, but as a concept of internationallaw, that through the Cold War, nations would come together to develop treaties to uphold
(07:26):
the right to health under the 1966 International Covenant on Economic, Social and CulturalRights, that we would expand it to cover a woman's right to health and the Convention on
the Elimination of Discrimination Against Women.
We would look to a child's right to health and the Convention on the Rights of the Child.
And at the end of the cold war, we would have a new opportunity to really shape what aright to health means under international law and how it can reflect understanding of
(07:56):
public health, understanding of public health that had arisen throughout the years withepidemiology, with understandings of social determinants of health.
And we would be able to shape the ways in which we think about health as a legalobligation and a contemporary understanding of a right to health.
really seeks not to just talk about health as a human right, but to lay out the conditionsthrough which governments bear an obligation to ensure that that right is respected, that
(08:26):
it is not violated by the government, that governments protect the right to health, toensure that third parties, private actors don't harm people's health, and that we fulfill
the right to health, that we lay out the underlying conditions in which health can berealized
in our societies and through our policies.
(08:46):
And as we look to health, we think about the ways in which we assess and monitor healthover time so that we can assess whether health is available in sufficient quantities, it's
accessible to all people, it's acceptable on the basis of race, religion, culture, gender,and that it's of sufficient quality.
(09:11):
And so we have both government obligations and attributes of a right to health that couldbe assessed at a government level to ensure that governments are making this promise of
health real.
I think, so this actually touches on maybe because I am an epidemiologist and a data nerd,but I do have questions later of then how do we measure all those items that you suggested
(09:33):
because I can argue with a different, with another epidemiologist about
whether something is accessible or not based on the data we have.
But I would love to talk about that later.
But before that, I wanted to maybe for people who are not necessarily familiar with all ofthe history that you talked about to ground everything that we're saying right now in real
world examples.
So thinking about one or two examples that you can give us that taking the rights basedframing over the past half of a century actually led to better health outcomes.
(10:01):
uh What was it that you think made the difference there?
Was it the moral force behind shaping health as a human right?
Was it the legal obligations?
it that it was used as a tool to advocate or empower advocacy or is it all the above?
So as the right to health is developed, we've developed a series of
(10:22):
different obligations that have been applied across a wide range of health issues.
And so it's one thing to say that human rights are developed under international law, butthe question that you're speaking to is how are human rights then implemented at the
national level through policies, through programs, through practices?
And there are a number of different issues that we can think about that highlight theapplication or the implementation of human rights and the ways in which we've sought to
(10:49):
ensure accountability
for the realization of rights throughout the world.
The most obvious one is possibly maternal mortality, that we begin to think aboutdisrespect leading up to childbirth, that women's rights, fundamental equality begins to
shape the motherhood experience.
We think about medical care at the time of delivery, and we think about the postpartumexperience, all of which implicate a series of policies.
(11:15):
And once we begin to assess, are they available?
are they accessible to all?
Are they acceptable and are they of sufficient quality?
We can begin to develop policies that have dramatically lowered the maternal mortalityrate, as WHO has found in a 2011 study.
Beyond the right to health, although I want to raise the idea that there are a number ofinterconnected rights that help to support health.
(11:40):
And one of the principal ones that I've worked on is around the right to water andsanitation.
The right to water and sanitation was never mentioned.
It wasn't mentioned in the Universal Declaration of Human Rights in 1948.
When the time came to codify economic and social rights and the international covenant oneconomic, social and cultural rights, no one discusses water, sanitation, hygiene.
(12:04):
It's only in the 1970s that we begin to see challenges, challenges to the quantity ofwater that's available during drought, challenges to the quality of water amid rising
concerns around pollution.
And so over the last
40 years, we've seen a dramatic development of a human right to water and sanitation,leading the Committee on Internet, the Committee on Economic, Social and Cultural Rights
(12:30):
in 2002 to shaping what it would mean to talk about water as a separate human right.
And in 2010, we would see the UN General Assembly declare water and sanitation as afundamental human right to be realized by all countries.
This has dramatically shifted the conversation around water and sanitation throughout theworld.
(12:52):
And over the past now 15 years, we've seen governments take steps to ensure that water isavailable, accessible, acceptable, also affordable and of sufficient quality.
But beyond that, we've seen the dramatic scaling up of rights-based water and sanitationsystems throughout the world and global funding agencies that have helped to
(13:16):
dramatically shift the conversation around funding for water, sanitation and hygiene.
And none of this would have been possible without thinking about water and sanitation as ahuman right.
And for that matter, no one discussing water and sanitation today would think of it as avolunteeristic action, as a charitable action.
They would begin by recognizing that access to water and sanitation is a fundamental humanright.
(13:42):
And the last thing I want to raise is around my work in tobacco control.
I think there's a concern right now that corporations have co-opted the language of humanrights, that they talk about a right to smoke, a right to drink, a right to put whatever
you want into your body.
And in some ways, this has shifted the conversation.
(14:04):
And I worry that this co-optation of rights around a negative vision of rights, a freedomfrom government intrusion,
takes us away from government responsibility to ensure the highest attainable standard ofhealth.
And so I've sought to shift the conversation, not as a freedom to smoke, but as a right tohealth that entails a freedom from addiction.
(14:25):
So how do we support people who use tobacco in order to free themselves from addiction?
How do we ensure the underlying environments in which children aren't exposed to tobaccoadvertising?
How do we make sure
that the conditions that shape non-communicable disease are most conducive to health.
(14:47):
And I think this is where we can think about examples of applications of human rightsthrough national policy that can make a real difference in people's lives.
I think this made me wonder, also, maybe this is an educational session for me.
Thinking about something as a human right does not necessarily, at least from what you'resaying, correct me if I'm wrong,
(15:07):
does not necessarily automatically mean we're thinking about it as a law.
Because I was thinking from what you were describing, the framing of a human right,freedom to or freedom from, that is really helpful in thinking about policies.
But then once you start thinking about it from a legal point of view or what type of lawyou write, I don't know where then we have a conversation about values more.
(15:32):
A value of, yes, it might be helpful to think about freedom from
having exposure to
tobacco or alcohol, but at the same time, you might be living in a context or a culturethat says, no, no, no, no, I actually prefer having the freedom to do something.
So I was just thinking about, is there a difference between creating a framing ofsomething as like, this is a framing of health as a human right versus thinking about what
(15:56):
a specific law would look like in a specific context?
Like I'm thinking about the US here.
I wonder if someone might argue a law that tells me I am prohibited from seeing those typeof
or corporations are prohibited from showing those type of advertisements to childrenactually infringes on my other rights.
This is why it's so important to talk about human rights under international laws as abasis for public health and the ways in which we need to create a generation of public
(16:24):
health scholars
who look at the right to health as more than just a slogan, but as a legal construct.
Because it's that legal construct that shifts us from advocacy to accountability.
That we can begin to think about accountability under law.
And there are lots of things that people can say are human rights.
I have a right to respect.
(16:45):
I have a right to love.
I have a right to donuts.
ah But saying that doesn't make it a right as a legal construct.
And so we look to international law as a way of understanding what governments themselveshave agreed to as human rights.
And then from that legal obligation, we can seek to hold governments accountable formeeting the obligations that they have set for themselves, whether those obligations are
(17:14):
to end gender discrimination, whether those obligations are to end ah tobacco use, whetherthose obligations are to end
cultural practices that may be harmful to health.
And It's been inspiring to see the ways in which human rights shifted the World HealthOrganization's policies around female genital cutting or female genital mutilation, where
(17:37):
what was once seen as a cultural practice through a series of in-depth culturalunderstandings alongside a series of international legal prohibitions shifted WHO's own
policies
from accepting cultural practices to now arguing, I think rightly based upon human rights,that this is a violation of the rights of women and girls.
(18:00):
and thus should be banned as a harmful practice for.
And this is interesting because I think it's also highlighting the tension in my own head.
And it's great that you use FGM or female genital mutilation or cutting because I workedon female genital mutilation and cutting in Sudan.
And it was always interesting.
We, for a long time, we worked on
going to cities, going to villages and talking to people about changing the practice.
(18:24):
But then ultimately, A few years ago, we actually criminalized FGM in Sudan.
And I think for a long time, we didn't think about it uh in a way that says, well, maybewe should ask the government to criminalize something versus just saying, we should just
always just go try and advocate or educate people about changing their practices.
I do think there is space for both, but it was really helpful after it was criminalized inSudan
(18:46):
it created more friction even when those practices continued to happen.
It just created more frictions in the system for whether someone can do this or not.
I think this challenge of cultural relativism has been with human rights from the verybeginning.
That as nations were declaring a universal declaration of human rights in 1948, there werethose who argued that there can be no universal rights, that all rights are relative to
(19:12):
space, to time.
But As the past 80 years have advanced, we've come to see that there are rights that canbe universal, that there are rights that can be eh adjusted for different national
contexts, but that they can still be respected throughout the world.
And that is in some ways the fundamental notion of human rights, that there are rightsthat no matter where you live, no matter what your government holds to, that
(19:42):
wherever rights violations take place throughout the world, they are a matter ofconsequence for everyone in the world.
uh I'm glad you mentioned cultural relativism.
It struck me as for a while, and maybe this is too strong of a feeling, when people say,but culturally this would not happen.
We shouldn't really infringe on the collective rights of maybe a culture to set guidelinesto what they want to do versus the individual rights of someone And honestly, for a long
(20:11):
time, especially when I started my studies in the US and I would bring up FGM, it
always felt weird and sometimes offensive for people to say, but we need to respectculture.
As someone who came from a country that had FGM and I was the first person in my familynot to undergo FGM to be told, but you need to respect the culture in the country.
Sometimes honestly, it's like the bigotry of low expectations.
(20:33):
It's like, oh, it's, it's for that place.
It's that culture.
That's okay.
We can, we can live with it.
And I felt like, but that does not respect the rights of
And that's what we've seen more often than not is that governments that purport to fightfor the importance of culture are more often using culture as a guise for power, that
(20:57):
they're using it as a way to oppress and using cultural relativism as a rationalizationfor systems of oppression at the national level.
But as an outsider,
human rights can provide the ability to criticize a government's practices, even if theysay that those practices are correct by their own cultural standards.
(21:18):
And not just me, the entire United Nations system.
Why should global governance have the ability to tell a government that what is happeningwithin its own country is wrong?
And that is what human rights provides, a set of universal norms that apply throughout theworld, that no matter what the government says,
can be recognized by international governance and protected by the United Nations system.
(21:44):
I'm pretty sure someone is listening out there to the two of us and fully disagreeing andthinking that their culture should reign.
And if that's the case, email us and maybe we'll have a different conversation.
But I fully agree with you on this.
And it's also interesting to me when we choose to say, oh, governance is important orsovereignty is important.
And when we choose to say, no, you need to actually implement international law, that alsoshows who's in power and which one of those uh
(22:19):
And so human rights has two different doctrines that apply in this context.
The first is called a margin of appreciation.
That we recognize that not all countries will realize rights in exactly the same ways.
And so there is a margin of appreciation for culture.
That doesn't mean that fundamental rights can be violated, but that there is flexibilitythere.
And that's really where governments say that they won't do something.
(22:42):
The second example is where governments can't do something, where they say we lack theresources in order to make this right real.
And in this context, we think not about a margin of appreciation, but a
principle of progressive realization, where not all rights, particularly economic andsocial rights, can be instantly realized.
(23:05):
We can't realize the highest attainable standard of health for all people throughout theworld instantly.
And so we began thinking about a principle of progressive realization to ask the question,over time, how are governments taking steps to progressively realize that right,
with the view to achieving the full realization of that right over time.
(23:29):
I think my question there for you is, are we thinking of a rights-based approach assomething that is aspirational or something that could be used for litigation or both
based on the two principles that you just laid out?
I'm thinking the case I know that is usually used, I think, as a good example of howhealth as a human right was used in South Africa, if I'm not mistaken, but you would know
(23:50):
the history more, during really the peak years of HIV AIDS in South Africa to providetreatment.
So do you think usually of principles as a way to encourage countries to move forward onsome rights?
I'm not saying when they're clearly violating a right, but when they're saying we can'treally do anything about this because of XYZ in our country.
(24:14):
So we're thinking about a progressive realization.
Versus no, this can be also a tool for someone in a country or a group as it happens withAfrica.
Maybe you can talk more about that example, that pushes the government then to achieve aright.
so let me take a step back and talk about the HIV AIDS pandemic in its historical contextand how it really is seen to have led to a health and human rights movement throughout the
(24:38):
world.
That leading into the HIV AIDS pandemic, we saw that human rights could be limited inorder to protect public health.
But what HIV AIDS made clear
within WHO and through advocates and across countries was that we need to see health andhuman rights as what WHO called inextricably linked.
(25:00):
That we need to see human rights protections as essential to health promotion.
And this became clear during the early years of the AIDS response where there wasdiscrimination against affected populations and that discrimination undermined public
health efforts.
Advocates made the case that they were human beings entitled to equal dignity and rights.
(25:21):
And WHO accepted this.
And through Jonathan Mann's work in the global program on AIDS, began to look to a humanrights-based approach to health, to thinking about the ways in which human rights could
lay a foundation to prevent disease and to promote health.
And as we developed therapies, antiretroviral therapies, medicines that could both
(25:45):
prevent and treat HIV, advocates look to these human rights and specifically the right tohealth in order to bring about access to essential medicines.
The South Africa case that you refer to is based upon the work of the Treatment ActionCampaign, which brought a case against the South African government to argue that there
(26:06):
was a right of access to maternal to child, to prevention of maternal to childtransmission of HIV,
and fought in the Supreme Court of South Africa in order to have the court guarantee themunder the post-apartheid constitution and its embodiment of a right to health, a right of
(26:29):
access to this essential medicine.
And we've seen this treatment action campaign case serving as a model for cases throughoutthe world where courts are able to find that there is a government obligation to ensure
access to an essential medicine.
as a matter of human rights.
Now that's a perfect example of what I said earlier about a principle of progressiverealization.
(26:52):
Not all governments have the ability to provide all medicines to all people at all times,but governments need to take steps expeditiously in order to promote the progressive
realization of a right to essential medicines.
And it's that right that has become a foundation for litigation throughout the world.
(27:13):
But having said that, I don't want to say that litigation is the only path toaccountability for human rights.
One of the things the Treatment Action Campaign case showed us was the ways in whichadvocacy in the streets was complemented by advocacy in the courtroom.
And we can look to the ways in which em advocacy can complement litigation as a basis foraccountability for global health.
(27:41):
And knowing that you're an epidemiologist,
data, data is a perfect source of accountability.
That if we say that rights need to be progressively realized, we can look to epidemiologicdata in order to assess whether things are moving in the right direction over time.
So we can compare.
(28:01):
We can compare across countries and we can compare over time to begin to assess whethergovernments are meeting their obligations uh to progressively realize the highest
attainable standard of health.
So then shifting gears, thinking more about global governance, which you've written a lotabout, especially when it comes to global governance and WHO.
(28:22):
And my first question is, do we think global government is too fragmented right now, or isit just stretched too thin?
Or do you think, oh no, the structure itself, the foundation is strong enough, but we havesome hiccups throughout the way that we just need to address.
So my early work studied the World Health Organization and the ways in which the WorldHealth Organization's historical work helped to shape a human right to health under
(28:52):
international law.
But one of the things that became clear through that was that WHO was not acting toimplement the right to health the way that other UN specialized agencies were working to
make human rights real through global governance.
And that led to our 2018 book on human rights and global health, rights-based governancefor a globalizing world, which looked across 20 different parts of the United Nations in
(29:21):
order to assess how they are advancing human rights through their work to address a widerange of underlying determinants of health.
So WHO obviously has the right to health as part of its core mission.
But UNAIDS is working to advance human rights in the HIV AIDS response.
UNICEF is working to advance children's rights in its own work on health.
(29:46):
UNESCO is working to advance health education as a human right.
The International Labor Organization is working to advance a human right to occupationalsafety and health.
And so that comparative study helped us to recognize fragmentations across the UnitedNations.
This raises an imperative to do what the UN calls mainstreaming human rights throughglobal governance.
(30:13):
One of Kofi Annan's initiatives as Secretary General of the United Nations in the 1990swas to help UN agencies understand that they too are responsible for realizing human
rights.
It's not just national governments that bear these obligations.
And in order to do this, he put forward an agenda for mainstreaming human rights acrossglobal governance, making it clear that, as he said, the era of declaration of human
(30:42):
rights, while not complete, must yield now to an era of implementation through globalgovernance.
And we've looked over the past 20 years now to try to understand the ways in which
as you say, there is a fragmented implementation of human rights across the United Nationssystem, and that we need to move toward more coordinated practices across the UN for
(31:08):
mainstreaming human rights to advance global health.
Whether it's in WHO's work, UNICEF's work, UNAIDS work, there are common practices thatcan be used in order to make human rights a central part of global governance and
advancing public health.
I've been reading some of the work that you've done on this and I think if I remembercorrectly, there was a 2024 paper.
(31:33):
So last year that looked to I think as was countries were discussing IHR.
And I think we must mention IHR because someone like me who's reading work on human rightsor global governance and law, we're always just going to find that term, so I would love
for you to explain more what is IHR, that makes the argument that WHO has trended, I thinkthat if I remember correctly, throughout
(31:56):
the years to focus more on the technical aspect of its work, just providing guidance andnot necessarily towards thinking more about the rights-based approach and that might be a
more helpful way of thinking about global governance.
But just, what you were saying around thinking about the fragmentation, thinking aboutdifferent entities working together,
or working in different areas that should be really leaning towards the same direction ofrealizing health as a human right.
(32:23):
The question then is, can we actually create accountability in a system like this?
I know that article that you wrote was part of thinking more about how do we create abetter IHR or thinking about, I think, about the pandemic treaty.
But just the system you described right now, that there are different entities in theglobal system working in different directions, can we create accountability in a system
like that?
(32:45):
I think WHO has long said wrongly that they are not a political organization
and that they don't engage with human rights because they are trying to remain apolitical.
And this has been a failure every time it's been said.
That Every time WHO says that it's not a political agency, it loses the political debateimmediately because it's not even participating in it.
(33:12):
Human rights have provided a way for WHO to advance health under international law.
And law is a foundational...
um
aspect of WHO's governance, the IHR, The International Health Regulations, have beencrucial to WHO governance over the years.
The Framework Convention on Tobacco Control, one of my first opportunities to work withthe World Health Organization, has been foundational to tobacco control.
(33:40):
And now we have a pandemic agreement, a third treaty that's been developed under the WorldHealth Organization in order to advance health throughout the world, not just as an
aspiration
but as a legal obligation.
And the IHR is crucial in dictating how governments will respond to public healthemergencies of international concern.
(34:03):
And when the World Health Organization's member states were revising the internationalhealth regulations in 2005, now 20 years ago, they made it clear that implementation of
the IHR should respect human rights.
And one of the challenges that we've seen through the years is what that means inpractice.
(34:25):
And WHO can play a crucial role in ensuring that governments implement what we call globalhealth law, international legal obligations under WHO in order to make human rights real
in public health.
But we saw this need for human rights in the IHR in 2005 based upon...
(34:48):
the experiences in the SARS epidemic, where the response to SARS, where it was notrights-based, undermined both national responses, but also global solidarity.
And so the 2005 revision of the IHR made clear that human rights is essential toimplementing the IHR.
(35:09):
And one of the fundamental challenges of the COVID-19 response is that governments onceagain turn to human rights violations.
that when faced with a novel threat, much as they did with HIV, they resorted to fear, todiscrimination.
Discrimination on the basis of national origin, discrimination against marginalizedgroups, divisions and travel bans that were unhelpful to the public health response.
(35:35):
Governments also violated the right to health, both in health system preparedness, butalso during extended lockdowns and making sure that people would have access to
underlying determinants of health.
And then finally, we saw violations of government responsibilities under human rights inthe IHR to ensure global solidarity, to ensure that governments are cooperating
(36:02):
internationally and providing assistance to ensure that the right to health is realthroughout the world.
These experiences undermined
the early pandemic response.
And when it came time to ensure access to vaccines for COVID-19, they made clear thatthere wouldn't be the solidarity, the global solidarity that was necessary in facing a
(36:24):
truly global threat.
And so human rights needed to play a greater role in amendments to the IHR in 2024.
And we developed a series of articles to make clear the human rights violations in thepandemic.
uh And to also make clear why human rights-based reforms were necessary in amendments ofthe IHR.
(36:47):
And I worry that amid rising international divisions, amid rising ah illiberal governmentsthroughout the world, we saw a pushback against human rights, both in the 2024 amendments
of the IHR and in the pandemic agreement.
And those human rights limitations will undermine our
(37:09):
public health response to future public health emergencies of international concern.
Two questions here, maybe two big questions that might take us into two differentdirections, but this is helpful for me to think about, how can we think of human rights as
we're drafting pandemic treaties?
(37:43):
you have people from WHO who say, well, when people like Ben they have not used the nameBen.
I'm just using you as an example.
uh They're forgetting when they say WHO, when it says it's apolitical, it loses itsability to have a conversation in a political world and it needs to take a stance from a
rights-based framework.
That they forget the real politic of the world, that we need to work with differentcountries that are very strong, and we don't necessarily have any way of pushing them to
enact anything that we implement.
And we're going to talk later about the US just maybe pulling out of some of the globalagreements that we have.
So one objection to what you're saying could be that, well, we just don't necessarilyunderstand how the world actually works.
(38:08):
We can push for your framing, but that doesn't necessarily get us anywhere that is useful.
maybe it's also linked to this because I was thinking, it is great to think about the lawand it's great to think about a rights-based approach to health.
But I also, I think you use like some of the things countries did during COVID, the earlydays of COVID, as a way of thinking about how countries violated human rights.
(38:31):
But if I remember correctly, you and I were, and Jude, we were working on a project and wehad a conversation of like, could countries close their border or not?
during a disease outbreak.
And the two of you came at it from different point of views and one of you had one viewabout could countries do this versus not?
I think that conversation for me, it was a few years ago, but still stuck in my head, it'ssimilar to epidemiology where we can have a governing principle, but even people who are
(38:55):
experts in the topic could come at it from different views and might not necessarily fullyagree on what is possible under that specific
And I think in this way, human rights provides a common language so that we can have thatconversation.
And one of the things coming out of our initial study of the UN that
(39:15):
was clear to us was that many people studying public health lack the ability to talk abouthuman rights beyond the slogan.
And so in 2020, we developed our first textbook on foundations of global health and humanrights.
And in 2023, coming after the COVID experience, we developed a second textbook on globalhealth law and policy to help to understand the foundations of global health law.
(39:42):
WHO in many ways,
shies away from human rights because it thinks that it's political.
But more importantly, it lacks the ability to engage with human rights as a legalconstruct because many WHO staff members went to school and studied public health at a
time before understanding of human rights was prevalent, at a time before understandingthe importance of public health law became so crucial to understanding public health
(40:10):
advancement.
And so
part of it is WHO's uh inability to have that conversation around human rights.
And you and I had the opportunity to work together as the IPPPR, the Independent uh Panelon Pandemic Preparedness and Response was considering some of the limitations of human
(40:31):
rights in the COVID-19 uh pandemic.
And uh Judith Bueno De Mesquita and I ah
were part of a team ah that was considering the human rights challenges that were faced.
And even when we're talking about human rights, as you point out, there can bedisagreements about what exactly it means to talk about proportional responses.
(40:57):
So if we think that human rights can be limited in order to prevent the spread of disease,
to what extent do we assess whether those public health limitations of human rights arenecessary, whether they're proportionate, whether they're time-limited, and whether
they're challengeable?
And so out of these experiences and our conversations in developing our report for theIPPPR, we worked with advocates across countries through the Global Health Law Consortium
(41:30):
that brings together legal academics in global health throughout the world.
We met over three years with over 150 different public health actors throughout the world.
And we developed what we call the principles and guidelines on human rights and publichealth emergencies, which seeks to clarify what human rights mean in the context of public
(41:53):
health emergencies that had never been done before, but also to try to elaborate thedifferent fundamental principles and norms
that should be considered in deciding, for example, whether travel restrictions areappropriate, in deciding how much vaccine inequity is too much vaccine inequity, how to
(42:17):
decide what role WHO should play in dictating health dictating, in setting guidelines forhealth standards throughout the world.
And so these principles and guidelines for human rights and public health emergencies,which we finalized in 2023,
really helped to clarify what it means to talk about human rights in the context ofpandemics and really sought to shape the development of the amendments of the
(42:45):
international health regulations and the development of a pandemic agreement.
Mentioning the pandemic agreement reminds me of the elephant in the room, which issomething you've written about a lot recently, is that the US has decided to step back
from being part of a global conversation about dealing with pandemics.
(43:06):
I know people have different feelings about the pandemic treaty, so I don't know where youstand on the final wording of the treaty.
But I think you've written with with Professor Lawrence Gostin about the importance of theUSA being part of the conversation.
So thinking a bit about what does it mean?
You're from the US for a country that has a lot of influence like the US to step back abit from being part of that conversation
(43:30):
For the last 80 years, the United States has been central to global governance in thecontext of public health.
The United States was instrumental in the founding of WHO and the development of the WHOconstitution, has been a leading member in guiding public health, but also human rights in
global governance.
(43:51):
And some of the challenges that we're seeing right now are part of a larger limitation
on human rights, on public health, and on global governance that have culminated in thewithdrawal from WHO.
And so we've seen the current administration really challenging this fundamental notionthat all persons are equal in dignity and rights, challenging the rights of migrant
(44:15):
populations, challenging the rights of minority populations, challenging the rights ofwomen and trans populations.
Beyond that, we've seen real attacks on public health science.
Attacks on data, attacks on public health officials, attacks on the idea that policyshould be evidence-based in its foundational development.
(44:38):
And then finally, we've really withdrawn from the idea that human rights and public healthbear a collective responsibility for the entire world.
We've stepped back from global governance.
We've done this before with the United States seeking to withdraw from the World HealthOrganization in the early days of the pandemic,
in ways that would prove catastrophic, both in the United States and throughout the world.
(45:02):
And we are seeking to withdraw from global governance again in ways that will undermineboth bilateral assistance to support the most vulnerable populations throughout the world
and the ways in which we come together to address common public health challenges in theglobalizing world through international cooperation.
(45:25):
It's these compounding violations of global health and human rights that leave the UnitedStates vulnerable to health threats, that leave the world increasingly divided and facing
our common challenges, and which really threatens in existential way the global governancesystem established at the end of the Second World War that has carried us through a series
(45:48):
of public health challenges over the last 80 years and now is under threat.
So Ben, I know this this is outside of, my area of expertise, and I know this is beyondwhat you work and think about, but a question that I'm increasingly thinking about these
days is where have we missed the opportunity to make it clear the importance of...
(46:13):
the work that is being done globally, global governance, have we just not communicated itwell enough we have a populist...
movement here in the US, but you have it in other countries, right?
Like there seems to be a global retreat on, as you said also, some illiberal governanceacross the globe of people just saying, we need to just be thinking about our own country.
We need to be thinking about our own sovereignty, and we're not engaging the globalconversation.
(46:37):
Is there something that we should do or could be doing that we just have not been doing
as a global public health community?
I would be interested to hear what you think about this.
So I think part of it is making sure that public health puts away this lie that publichealth is apolitical.
That in some ways we are doing a disservice to public health when we don't prepare publichealth actors for the political challenges that they will face.
(47:04):
So we're working with the Consortium of Universities for Global Health, CUGH, to help todevelop advocacy tools.
We developed a series of articles making clear the implications of the 2024 US electionson global health.
And following that election, we've developed a series of advocacy resources so that publichealth actors know how to engage in these political debates that will prove crucial to the
(47:31):
future of public health.
And secondly, we need to make sure that an understanding of political action, anunderstanding of human rights, an understanding of law is really foundational to public
health education.
And that's why even as we face many of the human rights challenges that we're facingtoday, we've continued to work to develop textbooks and to develop teaching resources so
(47:57):
that students who are studying public health in the United States and throughout the world
have the ability to learn about the foundational importance of human rights so that thatisn't questioned in future legal negotiations.
That future health policymakers not only understand public health, but they understandglobal health law so that they have the ability to shape agreements that can best prevent
(48:22):
disease and promote health.
I think in some ways, the present challenges make clear that this is really a generationalproject,
that we are not just responding to the exigencies of the moment, but we're beginning tothink about building a new generation of public health scholars, practitioners, and
(48:44):
advocates who at their foundation understand what it means to say that health is a humanright, not just as a slogan, but as a framework for public policy, and that they have the
law and policy skills to develop those policies
that can make the right to health real in people's lives in the world to come.
(49:06):
So then ending on the rapidly changing world we're living in, not just from governmentsacross the globe, but just technological changes.
We have climate change.
We have conversations about what does artificial intelligence, AI, or digital health datamean for thinking about law and health.
And I was wondering in this new era, that we're entering now, What does it mean to thinkabout a right to health?
(49:30):
And does the law or this framework of a rights-based approach change or remain the same aswe think about those really, complex challenges?
So when we talk historically about human rights, we're talking about a governmentobligation to provide for its people.
But once we start thinking about some of these
(49:51):
common challenges that we face today, climate change, for example, we're not talking aboutthe obligations of one government, we're talking about the obligations of all governments.
And we're not talking about just one person, but we're talking about all people.
So how do we shift human rights from the rights of individuals to the rights ofcollectives?
(50:13):
And in some ways, we're very good at this in public health because public health isalready thinking about population level health indicators.
Already thinking about public actions to protect the public.
How do we shift human rights in order to address threats of climate change and threats toplanetary health?
(50:33):
And this is one of the projects that we're developing now is how to talk about not justthe rights of individuals, but the rights of the entire world, the world itself um as a
rights holder so that we can best protect some of these new threats.
And this is the challenge going forward.
The human rights system was developed 80 years ago to really respond to a specific threatarising out of the second world war.
(51:02):
It's evolved over the last 80 years to address issues of decolonization and the rise ofthe global South, to address issues of inequitable economic development and neoliberal
attacks on health systems.
It's evolved to address threats
to the entire world coming from climate change.
(51:23):
We need to think about how human rights can evolve alongside global health going forwardso that public health law, human rights law, and global health law can align as we move
forward to address challenges that will require not just the global health system, butwill require partners in the UN's human rights system,
(51:47):
and will require advocacy at the intersection of public health and human rights in waysthat will be necessary to shape policies to address these real existential challenges.
then the last question I usually ask people, and I stopped asking what keeps you up atnight, because I realize if you're asking someone who cares about public health, maybe
(52:09):
that's a can of worms we don't want to open.
It's really, what is one narrative that you think people get wrong about?
And maybe in particular, people in public health get wrong about thinking about health andhuman rights and that should be more complicated.
Do we think we're oversimplifying using health as a human right,
as a slogan exactly what you just said, or is there more complex issues that we're missingin this conversation?
(52:33):
So I'll begin by saying that sleep is important and that people should get sleep at night.
One of the fundamental things that came out of the pandemic response and one of the thingsI try to instill in my students is that the best way that they can take care of the world
is to take care of themselves.
That personal wellness can become a foundation for global governance.
(52:54):
Now, shifting to global governance, we recognize that Dr.
Tedros, as the Director General of the WHO,
has been a crucial advocate for the right to health and will frequently proclaim thathealth is a human right as a political foundation for the statements that he's making.
One of the things we need to do is we need to be able to translate that commitment tohealth as a human right into an understanding of how policy can shape human rights in
(53:24):
public health practices throughout the world.
And that is what I see as my mission going forward.
Is to translate this commitment to health as a human right into policies that can makehuman rights real.
It doesn't matter that we say that health is a human right.
It's become a crucial rallying call for political advocacy.
(53:46):
But if we want human rights to be real, we need to understand the policies that can makehealth available, accessible, acceptable, and of sufficient quality.
Because without policies in place, we risk continuing backsliding
through illiberal governments, through challenges from corporate actors and commercialdeterminants of health, through backsliding that comes about because we've missed out on
(54:09):
some of the historical origins that led to the birth of human rights.
If we want human rights to be sustainable, to help guide our health policies goingforward, we need to recognize the importance of law in codifying, to establishing these
rights in law,
in a way that will make them real, not just for today or tomorrow, but through the healthcrises to come.
(54:34):
Thank you, Ben.
Thank you so much.
Welcome to Complicating the Narrative, a podcast that takes on the challenging questionsin public health by embracing complexity rather than avoiding it.
I'm your host Salma Abdalla Health as a human right, that's a phrase we hear constantly inglobal health, in conference keynotes, policy documents, and advocacy campaigns.
The idea seems straightforward.
Everyone everywhere has a right to health.
(00:27):
But what does mean in practice?
And does framing health as right help us achieve better health outcomes?
These are not theoretical questions.
We have seen rights-based frameworks invoked to demand vaccine equity during the COVID-19pandemic and at the same time used to resist public health restrictions.
We've seen human rights language shape access to HIV treatment and appear in many globalhealth declarations over the past half a century.
(00:52):
But we've also seen persistent critiques.
The rights frameworks can be too Western, too legalistic, or too disconnected from therealities on the ground.
There is also a deeper tension here.
Law operates both as a tool to advancing justice and as a reflection of power, revealingwho holds influence, who gets hurt, and whose health gets prioritized.
(01:12):
My guest today has spent decades thinking about these questions.
Professor Benjamin Mason Meier is a leading scholar of global health law, human rights,and governance structures.
He's a professor at the University of North Carolina at Chapel Hill, UNC,
with appointments both at the Gillings School of Global Public Health and the School ofLaw.
He's also the co-author of three foundational textbooks on global health governance, law,and human rights.
(01:38):
Ben has worked with the Health Organization and other global entities and has grappleddirectly with the challenges of making the case for a rights-based approach that is
meaningful across diverse political, legal, and cultural contexts.
So today,
we will explore what it means to frame health as a right, and what of rights-basedapproach might look like in a world marked by fragmentation and rapid technological
(02:03):
changes.
Ben, welcome to the podcast.
Thank you so much.
It's wonderful to join you during these challenging times for human rights and globalhealth.
first I really wanted to start just painting a picture for people who might notnecessarily know what is global health law and why would we think about law when it comes
to health and health outcomes.
(02:23):
And I know you are a lawyer by training, so maybe you would want to explain to ourlisteners what made you think that law could be a determinant of health.
You were studying law and then what was the moment that you thought, this makes sense forme to think of law as something that could shape the health outcomes of people.
I think your introduction really helped to frame why law is necessary.
How do we shift from saying health is a human right to making health a human right throughour policies and making it real in people's lives?
(02:52):
I began my career
not as a lawyer, but as a scientist, thinking that we could bring about access toessential scientific tools to advance health throughout the world.
But it became clear that we had many of these scientific tools, but we just didn't havethe policies in place in order to bring about access throughout the world to the people
(03:16):
who needed them most, to the scientific technologies that could improve health.
And so I went to study law and through that became
convinced that international law, law across nations, could help us to advance humanrights.
And so I started to study human rights under international law as a basis for publichealth, trying to understand the ways in which we've sought to take these ideas of justice
(03:42):
through human rights, to codify them under international law, and through that to shiftpolicies throughout the world that can make
the right to health real in people's lives.
That's interesting.
I didn't know that you were first trained as a scientist.
What type of scientist were you?
I was studying biochemistry.
(04:03):
These were exciting times.
We had just cloned a sheep and I had this vision that we would grow rice in the desert.
We would be able to feed the world and we would all hold hands and sing hallelujah.
But we never really got that opportunity.
And I became aware of science policy and the ways in which intellectual property patentswere stopping us from realizing access to health technologies.
(04:30):
in the most low income countries in the world.
And so I look to human rights as a way of shifting that narrative of thinking about healthtechnologies, not as intellectual property that could be monopolized and hoarded by the
wealthy, but as human rights that could be shared broadly across the world.
And that human rights understanding was what really brought me to thinking about the rightto health and the ways in which the World Health Organization exists
(04:58):
to ensure that health is a human right throughout the world.
So for those who are not familiar, what does it actually mean to think of health as ahuman right?
And I think as you mentioned, WHO in its general framing, it is based on the idea thathealth is a human right.
So maybe walk us through the history of how that understanding was codified in globalagreements.
(05:23):
It's really not possible to talk about health as a human right without beginning in thepost-war experience.
That the Second World War in some ways and the atrocities aligned with it highlightedchallenges to human rights and helped to establish a post-world order, post-World War
world order that would be shaped by human rights.
(05:46):
And that's not to say that human rights hadn't been invoked
throughout history in fights against slavery and fights for universal suffrage and fightsagainst colonization.
But the atrocities of the Second World War and the widespread immiseration and sufferingof the Great Depression that preceded it really clarified the need for a new world order
(06:07):
that would be grounded in human rights.
And as the United Nations was established at the end of the Second World War, human rightswould be one of the three pillars
of that new international organization.
With the charter of the United Nations in 1945, making clear not only that human rightswould be a central pillar, but that there would need to be the establishment of a new
(06:31):
international health organization to replace the League of Nations health office and tocreate an opportunity to bring the world together, to draw from the ashes of World War II,
to create a healthier world to come.
And the constitution of the World Health Organization developed in 1946 really becomes thefirst international agreement to lay out the idea that health is a fundamental human
(06:57):
right.
With the World Health Organization laying this out in its preamble and laying out a systemof global governance that would work to really rebuild the world in a way that would
realize health as a human right.
And we've seen over the course of the last 80 years now,
the evolution of that human right, not just as an idea, but as a concept of internationallaw, that through the Cold War, nations would come together to develop treaties to uphold
(07:26):
the right to health under the 1966 International Covenant on Economic, Social and CulturalRights, that we would expand it to cover a woman's right to health and the Convention on
the Elimination of Discrimination Against Women.
We would look to a child's right to health and the Convention on the Rights of the Child.
And at the end of the cold war, we would have a new opportunity to really shape what aright to health means under international law and how it can reflect understanding of
(07:56):
public health, understanding of public health that had arisen throughout the years withepidemiology, with understandings of social determinants of health.
And we would be able to shape the ways in which we think about health as a legalobligation and a contemporary understanding of a right to health.
really seeks not to just talk about health as a human right, but to lay out the conditionsthrough which governments bear an obligation to ensure that that right is respected, that
(08:26):
it is not violated by the government, that governments protect the right to health, toensure that third parties, private actors don't harm people's health, and that we fulfill
the right to health, that we lay out the underlying conditions in which health can berealized
in our societies and through our policies.
(08:46):
And as we look to health, we think about the ways in which we assess and monitor healthover time so that we can assess whether health is available in sufficient quantities, it's
accessible to all people, it's acceptable on the basis of race, religion, culture, gender,and that it's of sufficient quality.
(09:11):
And so we have both government obligations and attributes of a right to health that couldbe assessed at a government level to ensure that governments are making this promise of
health real.
I think, so this actually touches on maybe because I am an epidemiologist and a data nerd,but I do have questions later of then how do we measure all those items that you suggested
(09:33):
because I can argue with a different, with another epidemiologist about
whether something is accessible or not based on the data we have.
But I would love to talk about that later.
But before that, I wanted to maybe for people who are not necessarily familiar with all ofthe history that you talked about to ground everything that we're saying right now in real
world examples.
So thinking about one or two examples that you can give us that taking the rights basedframing over the past half of a century actually led to better health outcomes.
(10:01):
uh What was it that you think made the difference there?
Was it the moral force behind shaping health as a human right?
Was it the legal obligations?
it that it was used as a tool to advocate or empower advocacy or is it all the above?
So as the right to health is developed, we've developed a series of
(10:22):
different obligations that have been applied across a wide range of health issues.
And so it's one thing to say that human rights are developed under international law, butthe question that you're speaking to is how are human rights then implemented at the
national level through policies, through programs, through practices?
And there are a number of different issues that we can think about that highlight theapplication or the implementation of human rights and the ways in which we've sought to
(10:49):
ensure accountability
for the realization of rights throughout the world.
The most obvious one is possibly maternal mortality, that we begin to think aboutdisrespect leading up to childbirth, that women's rights, fundamental equality begins to
shape the motherhood experience.
We think about medical care at the time of delivery, and we think about the postpartumexperience, all of which implicate a series of policies.
(11:15):
And once we begin to assess, are they available?
are they accessible to all?
Are they acceptable and are they of sufficient quality?
We can begin to develop policies that have dramatically lowered the maternal mortalityrate, as WHO has found in a 2011 study.
Beyond the right to health, although I want to raise the idea that there are a number ofinterconnected rights that help to support health.
(11:40):
And one of the principal ones that I've worked on is around the right to water andsanitation.
The right to water and sanitation was never mentioned.
It wasn't mentioned in the Universal Declaration of Human Rights in 1948.
When the time came to codify economic and social rights and the international covenant oneconomic, social and cultural rights, no one discusses water, sanitation, hygiene.
(12:04):
It's only in the 1970s that we begin to see challenges, challenges to the quantity ofwater that's available during drought, challenges to the quality of water amid rising
concerns around pollution.
And so over the last
40 years, we've seen a dramatic development of a human right to water and sanitation,leading the Committee on Internet, the Committee on Economic, Social and Cultural Rights
(12:30):
in 2002 to shaping what it would mean to talk about water as a separate human right.
And in 2010, we would see the UN General Assembly declare water and sanitation as afundamental human right to be realized by all countries.
This has dramatically shifted the conversation around water and sanitation throughout theworld.
(12:52):
And over the past now 15 years, we've seen governments take steps to ensure that water isavailable, accessible, acceptable, also affordable and of sufficient quality.
But beyond that, we've seen the dramatic scaling up of rights-based water and sanitationsystems throughout the world and global funding agencies that have helped to
(13:16):
dramatically shift the conversation around funding for water, sanitation and hygiene.
And none of this would have been possible without thinking about water and sanitation as ahuman right.
And for that matter, no one discussing water and sanitation today would think of it as avolunteeristic action, as a charitable action.
They would begin by recognizing that access to water and sanitation is a fundamental humanright.
(13:42):
And the last thing I want to raise is around my work in tobacco control.
I think there's a concern right now that corporations have co-opted the language of humanrights, that they talk about a right to smoke, a right to drink, a right to put whatever
you want into your body.
And in some ways, this has shifted the conversation.
(14:04):
And I worry that this co-optation of rights around a negative vision of rights, a freedomfrom government intrusion,
takes us away from government responsibility to ensure the highest attainable standard ofhealth.
And so I've sought to shift the conversation, not as a freedom to smoke, but as a right tohealth that entails a freedom from addiction.
(14:25):
So how do we support people who use tobacco in order to free themselves from addiction?
How do we ensure the underlying environments in which children aren't exposed to tobaccoadvertising?
How do we make sure
that the conditions that shape non-communicable disease are most conducive to health.
(14:47):
And I think this is where we can think about examples of applications of human rightsthrough national policy that can make a real difference in people's lives.
I think this made me wonder, also, maybe this is an educational session for me.
Thinking about something as a human right does not necessarily, at least from what you'resaying, correct me if I'm wrong,
(15:07):
does not necessarily automatically mean we're thinking about it as a law.
Because I was thinking from what you were describing, the framing of a human right,freedom to or freedom from, that is really helpful in thinking about policies.
But then once you start thinking about it from a legal point of view or what type of lawyou write, I don't know where then we have a conversation about values more.
(15:32):
A value of, yes, it might be helpful to think about freedom from
having exposure to
tobacco or alcohol, but at the same time, you might be living in a context or a culturethat says, no, no, no, no, I actually prefer having the freedom to do something.
So I was just thinking about, is there a difference between creating a framing ofsomething as like, this is a framing of health as a human right versus thinking about what
(15:56):
a specific law would look like in a specific context?
Like I'm thinking about the US here.
I wonder if someone might argue a law that tells me I am prohibited from seeing those typeof
or corporations are prohibited from showing those type of advertisements to childrenactually infringes on my other rights.
This is why it's so important to talk about human rights under international laws as abasis for public health and the ways in which we need to create a generation of public
(16:24):
health scholars
who look at the right to health as more than just a slogan, but as a legal construct.
Because it's that legal construct that shifts us from advocacy to accountability.
That we can begin to think about accountability under law.
And there are lots of things that people can say are human rights.
I have a right to respect.
(16:45):
I have a right to love.
I have a right to donuts.
ah But saying that doesn't make it a right as a legal construct.
And so we look to international law as a way of understanding what governments themselveshave agreed to as human rights.
And then from that legal obligation, we can seek to hold governments accountable formeeting the obligations that they have set for themselves, whether those obligations are
(17:14):
to end gender discrimination, whether those obligations are to end ah tobacco use, whetherthose obligations are to end
cultural practices that may be harmful to health.
And It's been inspiring to see the ways in which human rights shifted the World HealthOrganization's policies around female genital cutting or female genital mutilation, where
(17:37):
what was once seen as a cultural practice through a series of in-depth culturalunderstandings alongside a series of international legal prohibitions shifted WHO's own
policies
from accepting cultural practices to now arguing, I think rightly based upon human rights,that this is a violation of the rights of women and girls.
(18:00):
and thus should be banned as a harmful practice for.
And this is interesting because I think it's also highlighting the tension in my own head.
And it's great that you use FGM or female genital mutilation or cutting because I workedon female genital mutilation and cutting in Sudan.
And it was always interesting.
We, for a long time, we worked on
going to cities, going to villages and talking to people about changing the practice.
(18:24):
But then ultimately, A few years ago, we actually criminalized FGM in Sudan.
And I think for a long time, we didn't think about it uh in a way that says, well, maybewe should ask the government to criminalize something versus just saying, we should just
always just go try and advocate or educate people about changing their practices.
I do think there is space for both, but it was really helpful after it was criminalized inSudan
(18:46):
it created more friction even when those practices continued to happen.
It just created more frictions in the system for whether someone can do this or not.
I think this challenge of cultural relativism has been with human rights from the verybeginning.
That as nations were declaring a universal declaration of human rights in 1948, there werethose who argued that there can be no universal rights, that all rights are relative to
(19:12):
space, to time.
But As the past 80 years have advanced, we've come to see that there are rights that canbe universal, that there are rights that can be eh adjusted for different national
contexts, but that they can still be respected throughout the world.
And that is in some ways the fundamental notion of human rights, that there are rightsthat no matter where you live, no matter what your government holds to, that
(19:42):
wherever rights violations take place throughout the world, they are a matter ofconsequence for everyone in the world.
uh I'm glad you mentioned cultural relativism.
It struck me as for a while, and maybe this is too strong of a feeling, when people say,but culturally this would not happen.
We shouldn't really infringe on the collective rights of maybe a culture to set guidelinesto what they want to do versus the individual rights of someone And honestly, for a long
(20:11):
time, especially when I started my studies in the US and I would bring up FGM, it
always felt weird and sometimes offensive for people to say, but we need to respectculture.
As someone who came from a country that had FGM and I was the first person in my familynot to undergo FGM to be told, but you need to respect the culture in the country.
Sometimes honestly, it's like the bigotry of low expectations.
(20:33):
It's like, oh, it's, it's for that place.
It's that culture.
That's okay.
We can, we can live with it.
And I felt like, but that does not respect the rights of
And that's what we've seen more often than not is that governments that purport to fightfor the importance of culture are more often using culture as a guise for power, that
(20:57):
they're using it as a way to oppress and using cultural relativism as a rationalizationfor systems of oppression at the national level.
But as an outsider,
human rights can provide the ability to criticize a government's practices, even if theysay that those practices are correct by their own cultural standards.
(21:18):
And not just me, the entire United Nations system.
Why should global governance have the ability to tell a government that what is happeningwithin its own country is wrong?
And that is what human rights provides, a set of universal norms that apply throughout theworld, that no matter what the government says,
can be recognized by international governance and protected by the United Nations system.
(21:44):
I'm pretty sure someone is listening out there to the two of us and fully disagreeing andthinking that their culture should reign.
And if that's the case, email us and maybe we'll have a different conversation.
But I fully agree with you on this.
And it's also interesting to me when we choose to say, oh, governance is important orsovereignty is important.
And when we choose to say, no, you need to actually implement international law, that alsoshows who's in power and which one of those uh
(22:19):
And so human rights has two different doctrines that apply in this context.
The first is called a margin of appreciation.
That we recognize that not all countries will realize rights in exactly the same ways.
And so there is a margin of appreciation for culture.
That doesn't mean that fundamental rights can be violated, but that there is flexibilitythere.
And that's really where governments say that they won't do something.
(22:42):
The second example is where governments can't do something, where they say we lack theresources in order to make this right real.
And in this context, we think not about a margin of appreciation, but a
principle of progressive realization, where not all rights, particularly economic andsocial rights, can be instantly realized.
(23:05):
We can't realize the highest attainable standard of health for all people throughout theworld instantly.
And so we began thinking about a principle of progressive realization to ask the question,over time, how are governments taking steps to progressively realize that right,
with the view to achieving the full realization of that right over time.
(23:29):
I think my question there for you is, are we thinking of a rights-based approach assomething that is aspirational or something that could be used for litigation or both
based on the two principles that you just laid out?
I'm thinking the case I know that is usually used, I think, as a good example of howhealth as a human right was used in South Africa, if I'm not mistaken, but you would know
(23:50):
the history more, during really the peak years of HIV AIDS in South Africa to providetreatment.
So do you think usually of principles as a way to encourage countries to move forward onsome rights?
I'm not saying when they're clearly violating a right, but when they're saying we can'treally do anything about this because of XYZ in our country.
(24:14):
So we're thinking about a progressive realization.
Versus no, this can be also a tool for someone in a country or a group as it happens withAfrica.
Maybe you can talk more about that example, that pushes the government then to achieve aright.
so let me take a step back and talk about the HIV AIDS pandemic in its historical contextand how it really is seen to have led to a health and human rights movement throughout the
(24:38):
world.
That leading into the HIV AIDS pandemic, we saw that human rights could be limited inorder to protect public health.
But what HIV AIDS made clear
within WHO and through advocates and across countries was that we need to see health andhuman rights as what WHO called inextricably linked.
(25:00):
That we need to see human rights protections as essential to health promotion.
And this became clear during the early years of the AIDS response where there wasdiscrimination against affected populations and that discrimination undermined public
health efforts.
Advocates made the case that they were human beings entitled to equal dignity and rights.
(25:21):
And WHO accepted this.
And through Jonathan Mann's work in the global program on AIDS, began to look to a humanrights-based approach to health, to thinking about the ways in which human rights could
lay a foundation to prevent disease and to promote health.
And as we developed therapies, antiretroviral therapies, medicines that could both
(25:45):
prevent and treat HIV, advocates look to these human rights and specifically the right tohealth in order to bring about access to essential medicines.
The South Africa case that you refer to is based upon the work of the Treatment ActionCampaign, which brought a case against the South African government to argue that there
(26:06):
was a right of access to maternal to child, to prevention of maternal to childtransmission of HIV,
and fought in the Supreme Court of South Africa in order to have the court guarantee themunder the post-apartheid constitution and its embodiment of a right to health, a right of
(26:29):
access to this essential medicine.
And we've seen this treatment action campaign case serving as a model for cases throughoutthe world where courts are able to find that there is a government obligation to ensure
access to an essential medicine.
as a matter of human rights.
Now that's a perfect example of what I said earlier about a principle of progressiverealization.
(26:52):
Not all governments have the ability to provide all medicines to all people at all times,but governments need to take steps expeditiously in order to promote the progressive
realization of a right to essential medicines.
And it's that right that has become a foundation for litigation throughout the world.
(27:13):
But having said that, I don't want to say that litigation is the only path toaccountability for human rights.
One of the things the Treatment Action Campaign case showed us was the ways in whichadvocacy in the streets was complemented by advocacy in the courtroom.
And we can look to the ways in which em advocacy can complement litigation as a basis foraccountability for global health.
(27:41):
And knowing that you're an epidemiologist,
data, data is a perfect source of accountability.
That if we say that rights need to be progressively realized, we can look to epidemiologicdata in order to assess whether things are moving in the right direction over time.
So we can compare.
(28:01):
We can compare across countries and we can compare over time to begin to assess whethergovernments are meeting their obligations uh to progressively realize the highest
attainable standard of health.
So then shifting gears, thinking more about global governance, which you've written a lotabout, especially when it comes to global governance and WHO.
(28:22):
And my first question is, do we think global government is too fragmented right now, or isit just stretched too thin?
Or do you think, oh no, the structure itself, the foundation is strong enough, but we havesome hiccups throughout the way that we just need to address.
So my early work studied the World Health Organization and the ways in which the WorldHealth Organization's historical work helped to shape a human right to health under
(28:52):
international law.
But one of the things that became clear through that was that WHO was not acting toimplement the right to health the way that other UN specialized agencies were working to
make human rights real through global governance.
And that led to our 2018 book on human rights and global health, rights-based governancefor a globalizing world, which looked across 20 different parts of the United Nations in
(29:21):
order to assess how they are advancing human rights through their work to address a widerange of underlying determinants of health.
So WHO obviously has the right to health as part of its core mission.
But UNAIDS is working to advance human rights in the HIV AIDS response.
UNICEF is working to advance children's rights in its own work on health.
(29:46):
UNESCO is working to advance health education as a human right.
The International Labor Organization is working to advance a human right to occupationalsafety and health.
And so that comparative study helped us to recognize fragmentations across the UnitedNations.
This raises an imperative to do what the UN calls mainstreaming human rights throughglobal governance.
(30:13):
One of Kofi Annan's initiatives as Secretary General of the United Nations in the 1990swas to help UN agencies understand that they too are responsible for realizing human
rights.
It's not just national governments that bear these obligations.
And in order to do this, he put forward an agenda for mainstreaming human rights acrossglobal governance, making it clear that, as he said, the era of declaration of human
(30:42):
rights, while not complete, must yield now to an era of implementation through globalgovernance.
And we've looked over the past 20 years now to try to understand the ways in which
as you say, there is a fragmented implementation of human rights across the United Nationssystem, and that we need to move toward more coordinated practices across the UN for
(31:08):
mainstreaming human rights to advance global health.
Whether it's in WHO's work, UNICEF's work, UNAIDS work, there are common practices thatcan be used in order to make human rights a central part of global governance and
advancing public health.
I've been reading some of the work that you've done on this and I think if I remembercorrectly, there was a 2024 paper.
(31:33):
So last year that looked to I think as was countries were discussing IHR.
And I think we must mention IHR because someone like me who's reading work on human rightsor global governance and law, we're always just going to find that term, so I would love
for you to explain more what is IHR, that makes the argument that WHO has trended, I thinkthat if I remember correctly, throughout
(31:56):
the years to focus more on the technical aspect of its work, just providing guidance andnot necessarily towards thinking more about the rights-based approach and that might be a
more helpful way of thinking about global governance.
But just, what you were saying around thinking about the fragmentation, thinking aboutdifferent entities working together,
or working in different areas that should be really leaning towards the same direction ofrealizing health as a human right.
(32:23):
The question then is, can we actually create accountability in a system like this?
I know that article that you wrote was part of thinking more about how do we create abetter IHR or thinking about, I think, about the pandemic treaty.
But just the system you described right now, that there are different entities in theglobal system working in different directions, can we create accountability in a system
like that?
(32:45):
I think WHO has long said wrongly that they are not a political organization
and that they don't engage with human rights because they are trying to remain apolitical.
And this has been a failure every time it's been said.
That Every time WHO says that it's not a political agency, it loses the political debateimmediately because it's not even participating in it.
(33:12):
Human rights have provided a way for WHO to advance health under international law.
And law is a foundational...
um
aspect of WHO's governance, the IHR, The International Health Regulations, have beencrucial to WHO governance over the years.
The Framework Convention on Tobacco Control, one of my first opportunities to work withthe World Health Organization, has been foundational to tobacco control.
(33:40):
And now we have a pandemic agreement, a third treaty that's been developed under the WorldHealth Organization in order to advance health throughout the world, not just as an
aspiration
but as a legal obligation.
And the IHR is crucial in dictating how governments will respond to public healthemergencies of international concern.
(34:03):
And when the World Health Organization's member states were revising the internationalhealth regulations in 2005, now 20 years ago, they made it clear that implementation of
the IHR should respect human rights.
And one of the challenges that we've seen through the years is what that means inpractice.
(34:25):
And WHO can play a crucial role in ensuring that governments implement what we call globalhealth law, international legal obligations under WHO in order to make human rights real
in public health.
But we saw this need for human rights in the IHR in 2005 based upon...
(34:48):
the experiences in the SARS epidemic, where the response to SARS, where it was notrights-based, undermined both national responses, but also global solidarity.
And so the 2005 revision of the IHR made clear that human rights is essential toimplementing the IHR.
(35:09):
And one of the fundamental challenges of the COVID-19 response is that governments onceagain turn to human rights violations.
that when faced with a novel threat, much as they did with HIV, they resorted to fear, todiscrimination.
Discrimination on the basis of national origin, discrimination against marginalizedgroups, divisions and travel bans that were unhelpful to the public health response.
(35:35):
Governments also violated the right to health, both in health system preparedness, butalso during extended lockdowns and making sure that people would have access to
underlying determinants of health.
And then finally, we saw violations of government responsibilities under human rights inthe IHR to ensure global solidarity, to ensure that governments are cooperating
(36:02):
internationally and providing assistance to ensure that the right to health is realthroughout the world.
These experiences undermined
the early pandemic response.
And when it came time to ensure access to vaccines for COVID-19, they made clear thatthere wouldn't be the solidarity, the global solidarity that was necessary in facing a
(36:24):
truly global threat.
And so human rights needed to play a greater role in amendments to the IHR in 2024.
And we developed a series of articles to make clear the human rights violations in thepandemic.
uh And to also make clear why human rights-based reforms were necessary in amendments ofthe IHR.
(36:47):
And I worry that amid rising international divisions, amid rising ah illiberal governmentsthroughout the world, we saw a pushback against human rights, both in the 2024 amendments
of the IHR and in the pandemic agreement.
And those human rights limitations will undermine our
(37:09):
public health response to future public health emergencies of international concern.
Two questions here, maybe two big questions that might take us into two differentdirections, but this is helpful for me to think about, how can we think of human rights as
we're drafting pandemic treaties?
(37:43):
you have people from WHO who say, well, when people like Ben they have not used the nameBen.
I'm just using you as an example.
uh They're forgetting when they say WHO, when it says it's apolitical, it loses itsability to have a conversation in a political world and it needs to take a stance from a
rights-based framework.
That they forget the real politic of the world, that we need to work with differentcountries that are very strong, and we don't necessarily have any way of pushing them to
enact anything that we implement.
And we're going to talk later about the US just maybe pulling out of some of the globalagreements that we have.
So one objection to what you're saying could be that, well, we just don't necessarilyunderstand how the world actually works.
(38:08):
We can push for your framing, but that doesn't necessarily get us anywhere that is useful.
maybe it's also linked to this because I was thinking, it is great to think about the lawand it's great to think about a rights-based approach to health.
But I also, I think you use like some of the things countries did during COVID, the earlydays of COVID, as a way of thinking about how countries violated human rights.
(38:31):
But if I remember correctly, you and I were, and Jude, we were working on a project and wehad a conversation of like, could countries close their border or not?
during a disease outbreak.
And the two of you came at it from different point of views and one of you had one viewabout could countries do this versus not?
I think that conversation for me, it was a few years ago, but still stuck in my head, it'ssimilar to epidemiology where we can have a governing principle, but even people who are
(38:55):
experts in the topic could come at it from different views and might not necessarily fullyagree on what is possible under that specific
And I think in this way, human rights provides a common language so that we can have thatconversation.
And one of the things coming out of our initial study of the UN that
(39:15):
was clear to us was that many people studying public health lack the ability to talk abouthuman rights beyond the slogan.
And so in 2020, we developed our first textbook on foundations of global health and humanrights.
And in 2023, coming after the COVID experience, we developed a second textbook on globalhealth law and policy to help to understand the foundations of global health law.
(39:42):
WHO in many ways,
shies away from human rights because it thinks that it's political.
But more importantly, it lacks the ability to engage with human rights as a legalconstruct because many WHO staff members went to school and studied public health at a
time before understanding of human rights was prevalent, at a time before understandingthe importance of public health law became so crucial to understanding public health
(40:10):
advancement.
And so
part of it is WHO's uh inability to have that conversation around human rights.
And you and I had the opportunity to work together as the IPPPR, the Independent uh Panelon Pandemic Preparedness and Response was considering some of the limitations of human
(40:31):
rights in the COVID-19 uh pandemic.
And uh Judith Bueno De Mesquita and I ah
were part of a team ah that was considering the human rights challenges that were faced.
And even when we're talking about human rights, as you point out, there can bedisagreements about what exactly it means to talk about proportional responses.
(40:57):
So if we think that human rights can be limited in order to prevent the spread of disease,
to what extent do we assess whether those public health limitations of human rights arenecessary, whether they're proportionate, whether they're time-limited, and whether
they're challengeable?
And so out of these experiences and our conversations in developing our report for theIPPPR, we worked with advocates across countries through the Global Health Law Consortium
(41:30):
that brings together legal academics in global health throughout the world.
We met over three years with over 150 different public health actors throughout the world.
And we developed what we call the principles and guidelines on human rights and publichealth emergencies, which seeks to clarify what human rights mean in the context of public
(41:53):
health emergencies that had never been done before, but also to try to elaborate thedifferent fundamental principles and norms
that should be considered in deciding, for example, whether travel restrictions areappropriate, in deciding how much vaccine inequity is too much vaccine inequity, how to
(42:17):
decide what role WHO should play in dictating health dictating, in setting guidelines forhealth standards throughout the world.
And so these principles and guidelines for human rights and public health emergencies,which we finalized in 2023,
really helped to clarify what it means to talk about human rights in the context ofpandemics and really sought to shape the development of the amendments of the
(42:45):
international health regulations and the development of a pandemic agreement.
Mentioning the pandemic agreement reminds me of the elephant in the room, which issomething you've written about a lot recently, is that the US has decided to step back
from being part of a global conversation about dealing with pandemics.
(43:06):
I know people have different feelings about the pandemic treaty, so I don't know where youstand on the final wording of the treaty.
But I think you've written with with Professor Lawrence Gostin about the importance of theUSA being part of the conversation.
So thinking a bit about what does it mean?
You're from the US for a country that has a lot of influence like the US to step back abit from being part of that conversation
(43:30):
For the last 80 years, the United States has been central to global governance in thecontext of public health.
The United States was instrumental in the founding of WHO and the development of the WHOconstitution, has been a leading member in guiding public health, but also human rights in
global governance.
(43:51):
And some of the challenges that we're seeing right now are part of a larger limitation
on human rights, on public health, and on global governance that have culminated in thewithdrawal from WHO.
And so we've seen the current administration really challenging this fundamental notionthat all persons are equal in dignity and rights, challenging the rights of migrant
(44:15):
populations, challenging the rights of minority populations, challenging the rights ofwomen and trans populations.
Beyond that, we've seen real attacks on public health science.
Attacks on data, attacks on public health officials, attacks on the idea that policyshould be evidence-based in its foundational development.
(44:38):
And then finally, we've really withdrawn from the idea that human rights and public healthbear a collective responsibility for the entire world.
We've stepped back from global governance.
We've done this before with the United States seeking to withdraw from the World HealthOrganization in the early days of the pandemic,
in ways that would prove catastrophic, both in the United States and throughout the world.
(45:02):
And we are seeking to withdraw from global governance again in ways that will undermineboth bilateral assistance to support the most vulnerable populations throughout the world
and the ways in which we come together to address common public health challenges in theglobalizing world through international cooperation.
(45:25):
It's these compounding violations of global health and human rights that leave the UnitedStates vulnerable to health threats, that leave the world increasingly divided and facing
our common challenges, and which really threatens in existential way the global governancesystem established at the end of the Second World War that has carried us through a series
(45:48):
of public health challenges over the last 80 years and now is under threat.
So Ben, I know this this is outside of, my area of expertise, and I know this is beyondwhat you work and think about, but a question that I'm increasingly thinking about these
days is where have we missed the opportunity to make it clear the importance of...
(46:13):
the work that is being done globally, global governance, have we just not communicated itwell enough we have a populist...
movement here in the US, but you have it in other countries, right?
Like there seems to be a global retreat on, as you said also, some illiberal governanceacross the globe of people just saying, we need to just be thinking about our own country.
We need to be thinking about our own sovereignty, and we're not engaging the globalconversation.
(46:37):
Is there something that we should do or could be doing that we just have not been doing
as a global public health community?
I would be interested to hear what you think about this.
So I think part of it is making sure that public health puts away this lie that publichealth is apolitical.
That in some ways we are doing a disservice to public health when we don't prepare publichealth actors for the political challenges that they will face.
(47:04):
So we're working with the Consortium of Universities for Global Health, CUGH, to help todevelop advocacy tools.
We developed a series of articles making clear the implications of the 2024 US electionson global health.
And following that election, we've developed a series of advocacy resources so that publichealth actors know how to engage in these political debates that will prove crucial to the
(47:31):
future of public health.
And secondly, we need to make sure that an understanding of political action, anunderstanding of human rights, an understanding of law is really foundational to public
health education.
And that's why even as we face many of the human rights challenges that we're facingtoday, we've continued to work to develop textbooks and to develop teaching resources so
(47:57):
that students who are studying public health in the United States and throughout the world
have the ability to learn about the foundational importance of human rights so that thatisn't questioned in future legal negotiations.
That future health policymakers not only understand public health, but they understandglobal health law so that they have the ability to shape agreements that can best prevent
(48:22):
disease and promote health.
I think in some ways, the present challenges make clear that this is really a generationalproject,
that we are not just responding to the exigencies of the moment, but we're beginning tothink about building a new generation of public health scholars, practitioners, and
(48:44):
advocates who at their foundation understand what it means to say that health is a humanright, not just as a slogan, but as a framework for public policy, and that they have the
law and policy skills to develop those policies
that can make the right to health real in people's lives in the world to come.
(49:06):
So then ending on the rapidly changing world we're living in, not just from governmentsacross the globe, but just technological changes.
We have climate change.
We have conversations about what does artificial intelligence, AI, or digital health datamean for thinking about law and health.
And I was wondering in this new era, that we're entering now, What does it mean to thinkabout a right to health?
(49:30):
And does the law or this framework of a rights-based approach change or remain the same aswe think about those really, complex challenges?
So when we talk historically about human rights, we're talking about a governmentobligation to provide for its people.
But once we start thinking about some of these
(49:51):
common challenges that we face today, climate change, for example, we're not talking aboutthe obligations of one government, we're talking about the obligations of all governments.
And we're not talking about just one person, but we're talking about all people.
So how do we shift human rights from the rights of individuals to the rights ofcollectives?
(50:13):
And in some ways, we're very good at this in public health because public health isalready thinking about population level health indicators.
Already thinking about public actions to protect the public.
How do we shift human rights in order to address threats of climate change and threats toplanetary health?
(50:33):
And this is one of the projects that we're developing now is how to talk about not justthe rights of individuals, but the rights of the entire world, the world itself um as a
rights holder so that we can best protect some of these new threats.
And this is the challenge going forward.
The human rights system was developed 80 years ago to really respond to a specific threatarising out of the second world war.
(51:02):
It's evolved over the last 80 years to address issues of decolonization and the rise ofthe global South, to address issues of inequitable economic development and neoliberal
attacks on health systems.
It's evolved to address threats
to the entire world coming from climate change.
(51:23):
We need to think about how human rights can evolve alongside global health going forwardso that public health law, human rights law, and global health law can align as we move
forward to address challenges that will require not just the global health system, butwill require partners in the UN's human rights system,
(51:47):
and will require advocacy at the intersection of public health and human rights in waysthat will be necessary to shape policies to address these real existential challenges.
then the last question I usually ask people, and I stopped asking what keeps you up atnight, because I realize if you're asking someone who cares about public health, maybe
(52:09):
that's a can of worms we don't want to open.
It's really, what is one narrative that you think people get wrong about?
And maybe in particular, people in public health get wrong about thinking about health andhuman rights and that should be more complicated.
Do we think we're oversimplifying using health as a human right,
as a slogan exactly what you just said, or is there more complex issues that we're missingin this conversation?
(52:33):
So I'll begin by saying that sleep is important and that people should get sleep at night.
One of the fundamental things that came out of the pandemic response and one of the thingsI try to instill in my students is that the best way that they can take care of the world
is to take care of themselves.
That personal wellness can become a foundation for global governance.
(52:54):
Now, shifting to global governance, we recognize that Dr.
Tedros, as the Director General of the WHO,
has been a crucial advocate for the right to health and will frequently proclaim thathealth is a human right as a political foundation for the statements that he's making.
One of the things we need to do is we need to be able to translate that commitment tohealth as a human right into an understanding of how policy can shape human rights in
(53:24):
public health practices throughout the world.
And that is what I see as my mission going forward.
Is to translate this commitment to health as a human right into policies that can makehuman rights real.
It doesn't matter that we say that health is a human right.
It's become a crucial rallying call for political advocacy.
(53:46):
But if we want human rights to be real, we need to understand the policies that can makehealth available, accessible, acceptable, and of sufficient quality.
Because without policies in place, we risk continuing backsliding
through illiberal governments, through challenges from corporate actors and commercialdeterminants of health, through backsliding that comes about because we've missed out on
(54:09):
some of the historical origins that led to the birth of human rights.
If we want human rights to be sustainable, to help guide our health policies goingforward, we need to recognize the importance of law in codifying, to establishing these
rights in law,
in a way that will make them real, not just for today or tomorrow, but through the healthcrises to come.
(54:34):
Thank you, Ben.
Thank you so much.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
The Male Room with Dr. Jesse Mills
As Director of The Men’s Clinic at UCLA, Dr. Jesse Mills has spent his career helping men understand their bodies, their hormones, and their health. Now he’s bringing that expertise to The Male Room — a podcast where data-driven medicine meets common sense. Each episode separates fact from hype, science from snake oil, and gives men the tools to live longer, stronger, and happier lives. With candor, humor, and real-world experience from the exam room and the operating room, Dr. Mills breaks down the latest health headlines, dissects trends, and explains what actually works — and what doesn’t. Smart, straightforward, and entertaining, The Male Room is the show that helps men take charge of their health without the jargon.