Health as Human Right

The idea of health as a human right presents a very complex, multi-

dimensional dilemma. One of the greatest problems that arises in the health
debate is that there is not a single, universal definition of health, nor a definite
means by which to attain it. The World Health Organization defines health as
“a state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity” but does little to explain what complete well-
being entails.[1] Taking this definition set forth by the leading international
health authority, it becomes obvious that the right to health is about more than
biomedical treatments of ailments; to fully examine health one must
incorporate an understanding of the social determinants that impact one’s
ability to attain the best possible care. In comparing the United States and
South Africa in their approaches toward healthcare, the historical contrast in
which these approaches are based, and the steps taken in response to the
debate of health as a human right, it becomes apparent that although the
United States is often considered to have a more advanced understanding of
health than South Africa, South Africa is on the forefront of the movement
toward the realization of healthcare as a human right.
When looking at a nation’s response to the debate of health as a human right,
it is necessary to examine the history and culture in which present day
perceptions and policies are based. In particular, it is important to focus on a
nation’s practices towards marginalized populations. As Paul Farmer posits,
“suffering is rarely separate from the actions of the politically powerful,” and
thus it is necessary to frame the political context that contributes to the
suffering that would naturally be associated with a violation of the right to
health.[2] In the case of South Africa, an analysis of the current political
climate in regards to health is not complete without examining the practices of
the Apartheid regime. To begin, the Apartheid system was not merely for the
segregation of the races. During Apartheid, whites were considered legally
superior to Blacks, Coloreds, and Indians, and the government made sure that
services that non-whites received, including medical care, were also inferior.
For example, hospitals were assigned to particular racial groups and most
were concentrated in white areas. With 14 different health departments, the
system was characterized by fragmentation and duplication.[3] But more than
the lack of access to care, the Apartheid system created many structural
barriers that limited access to both “named” resources such as education as
well as “unnamed” resources such as acceptance and power; these structural
barriers ultimately constrained the agency of the non-white population, leading
to ingrained feelings of inferiority.[4] However, on a more positive note, the
inspiring, thoughtful leadership of Nelson Mandela and his counterparts also
had a profound impact on the South African population. As William Gumede
writes in his introduction to Mandela’s No Easy Walk to Freedom, the African
National Congress’s success “turned the struggle against apartheid into a
moral struggle”.[5] The fight for liberation brought to the forefront the ideals of
equality and democracy, setting the stage for more recent battles for health
rights and equalities.