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Global Politics: Engagement Activity

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Human Rights and Development in Healthcare
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In what ways does the access to and equity of resource

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distribution in healthcare impact human rights and sustainable

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development during COVID-19?

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Word Count: 2000

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Candidate ID: 027012-0046

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The Universal Declaration of Human Rights (1948) was the first international framework to

incorporate healthcare as a fundamental human right (WHO, 2022). It extends beyond medical

care to the foundational determinants of health, including equitable access to essential resources

like water, food, and well-being through education. Disproportionate attention to the right to

healthcare among other human rights not only exacerbates inequalities inherent in society,

manifesting in structural and cultural violence, but also undermines the development of structures

and frameworks that aim to establish positive peace and allow a state to prosper economically,

socially, and environmentally. The IB definition of a political issue is “any question that deals with

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how power is distributed and how it operates within social organizations” (International

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Baccalaureate Organization, 2016). In a rapidly globalizing world that is becoming increasingly

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concerned with material interests, especially amidst public health crises like the current COVID-
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19 pandemic, the distribution of natural and human resources is inherently significant in the
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analysis of power dynamics in the 21st century. This political issue incorporates concepts from all
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four units of the IB Global Politics course – Power & Sovereignty, Human Rights, Development,
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and Peace & Conflict – including poverty, states’ duty to preserve human rights, the effect of
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structural and cultural violence on positive peace, and how different factors affect sustainable
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development.

This issue is of interest to me due to my first-hand insight into the consequences of failing

healthcare systems concerning distribution of authority and resources within governmental

institutions in my home country, Kyrgyzstan. Especially among the pandemic, healthcare is

becoming increasingly relevant to state development and the preservation of human rights;

expenditure and attention to healthcare and expenditure defines health opportunities, which

directly contributes to economic performance and levels of poverty, that extends its effect on

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provisions of sustainable development and positive peace. This relates to various levels of analysis,

from legislative decisions made to influence the functioning of local healthcare systems, to the

implications of public health on international human rights and diplomatic relations. The

distribution of resources in healthcare has a complex causal nexus on a state’s long-term capacity

to participate in the international arena and power dynamics.

For my political engagement, I interacted with experts within the global public health sector and

explored the implications on sustainable development. I attended multiple online webinars and

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discussion panels, including ‘Protecting Human Rights During the Pandemic’ (Dornsife School of

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Public Health, 2020) with panelists from the Human Rights Watch and World Health

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Organization; ‘Vaccine Distribution: Ethics and Human Rights Considerations’ (Buissonnière,
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Faden, Mokdad, & Wilson, 2021) and ‘Structural Racism’s Exacerbating Impact on Health’
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(Corbie-Smith, Jiménez, & Ward, 2021) hosted by Physicians for Human Rights; and UNGA’s
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side event ‘Women, Health and Gender Equality’ (World Health Organization, 2021). I also
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undertook a Pilot Training in ‘Competencies in Public Health’ (Penn, Benken, & Watts, 2021),
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developed by the Centers for Disease Control and Prevention (CDC), in which explored the
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connections between health policy and sustainable development. Furthermore, I attended and aided

in an online WHO conference on ‘Priority Setting and Resource Allocation’ alongside a contact,

assisting in Russian to English written translation of documents and presentations, such as ‘Good

Practice Briefs’, regarding the WHO’s methodologies in healthcare resource. Additionally, I

assisted in organizing a Model United Nations (MUN) at my school, in which I also participated

as a representative delegate of the USA in the General Assembly of ‘Social, Humanitarian and

Cultural Approaches’. MUN, as a simulated political activity, not only allows exploration of

proceedings in the UN on a local level regarding issues of global significance, but also inculcates

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skills of negotiation, conflict resolution, and cooperation. Nevertheless, it poses limitations due to

its nature as a ‘simulation’, which means it doesn’t entirely abide by all provisions of an official

UN conference, as evident by the unique committees created for accessibility of this engagement

activity to students with varying goals. It also highlights the limitations inherent in the activities

of the international civil society and the UN itself, laying within challenges in their scale,

sustainability, coherence, and power dynamics. The nature of the political framework in the UAE

also poses a challenge – there is limited capacity to engage with civil society within the state, as it

is a federation of absolute monarchies. Interaction with NGO’s locally is limited by the age

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restrictions in the workforce and volunteer work. Nevertheless, the activities I undertook provided

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insight into the politics of healthcare and provided sufficient information that would allow me to

engage with and investigate my research question. gh

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Firstly, the engagements revealed how inequitable distribution of both human and material
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resources in healthcare undermines international human rights and perpetuates the poverty cycle.
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The concept of equality is especially relevant in the global health sphere and may be defined as all
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people seen as having the same intrinsic value, therefore also being entitled to the same rights.
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Article 25 of the UDHR outlines that “everyone has the right to a standard of living adequate for

the health …including… medical care and necessary social services” (United Nations, 1948),

which in itself implies that freedom from poverty is a human right. The negation of this right due

to inaccessible healthcare resources also undermines other rights, including Article 23 concerning

favorable work conditions, Article 26 concerning access to education, and Article 1 concerning

collective dignity. A WHO ‘Good Practice Brief’ I aided in translating, regarding health workforce

demand in England, outlined that “demand for workforce time is growing faster than the

population” (Edwards, 2017), thereby human resources are becoming scarce due to the availability

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of skills. Likewise, in the case of Kyrgyzstan’s shortage of health care workers, as outlined in

another brief by the WHO, access to healthcare services is threatened by unequal distribution of

resources, especially in “rural and remote areas” (Jakab, Akkazieva, & Habicht, 2018). This means

that the inequality extends to geographical factors, and therefore threatens the idea that human

rights are ‘universal’. However, the conference outlined the idea that “different societies have

different values, therefore priorities differ” and that an “understanding of other’s perspectives” is

required (Evetovits, 2017). This is especially relevant in the view of individual versus collective

rights, especially amidst humanitarian crises – for instance, in the case of COVID-19 vaccine

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access and individuals’ right to make decisions regarding its administration as per the right to

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liberty (ICCPR, Article 9). With vaccines becoming an essential resource in healthcare among the

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current humanitarian crises, the access to this resource is in itself an indicator of development: in
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the Vaccine Distribution: Ethics and Human Rights Considerations webinar, Marine Buissonnière
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had stated that: “Cutting off sources of supply [of vaccines] for low and middle-income countries
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less well positions [them] to negotiate … and exert power” (Buissonnière, Faden, Mokdad, &
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Wilson, 2021). Therefore, in the unequal distribution of healthcare resources, there is an unequal
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distribution of power, which in hindsight limits the capability of a state to protect human rights
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and facilitate sustainable development.

Furthermore, structural and cultural violence in the health sector’s resource distribution

approaches, specifically regarding gender and race, were determined to affect both development

and human rights. Structural violence refers to the functioning of a government in a way that

promotes inequalities and undermines the wellbeing of the population, whereas cultural violence

adheres to harmful attitudes and norms in society that permit violence. Regarding cultural violence

in gender, the pandemic had exacerbated inequalities in healthcare – as emphasized at the WHO

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& UNGA conference on ‘Women, Health and Gender Equality, it had a “disproportionate impact

on women” and caused “a spike in gender-based violence [and] disruption of … reproductive

health services” (Palm, 2021). In the webinar ‘Gender-based violence and COVID-19’, K. Naimer

stressed that “the right to physical and bodily integrity is a fundamental human right”, therefore

with the increase of gender-based violence and decrease in services to battle it, women are denied

essential rights. With priority being set on dealing with frontline consequences of humanitarian

crises, the distribution of secondary resources, like “hot-line shelters and rape crises centers”

(Garcia-Moreno, 2020), becomes inequitable and inefficient, thereby undermining human rights

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due to harmful societal attitudes that permit disregard of women’s reproductive and sexual rights.

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This was also highlighted in VISSMUN’s conference regarding female empowerment – cultural

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relativism as a justification to gender-based violence is often viewed as a legitimate claim, and
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therefore development in protecting female rights is often placed in the background of action in
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the civil society, especially in LEDC’s. This means that efforts to introduce gender equality into
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healthcare management and resources are undermined by attitudes in society and governance.
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Furthermore, as discussed in the webinar on ‘Structural Racism’s Exacerbating Impact on Health’,

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structural violence in the form of racism manifests in healthcare due to “healthcare deserts, lack of
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testing sites and employment of [people of color (POC)] in higher-risk jobs” (Ogedegbe, 2021).

These exposure factors, rooted in structural inequities regarding resource distribution, perpetuate

violence in POC communities and disallow development due to disparity inside states. Therefore,

inequitable resource distribution in healthcare is a product of structural and cultural violence, and

hence undermines human rights and disallows sustainable development.

Moreover, there is a clear link between the concept of equitable enforcement and power in

healthcare, which impacts the political and institutional development of states. Equitable

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enforcement in healthcare is “a process of ensuring compliance with policy that considers and

minimizes harm to people affected by health inequities” (Watts, Michel, Breslin, & Tobin-Tyler,

2021). In my Pilot Training for ‘Competencies in Public Health’, Matthew Penn, Director of Public

Health Law Services within CDC’s Center for State, Tribal, Local, and Territorial Support,

described systematic underenforcement and overenforcement as including selective enforcement

targeting marginalized groups, specifically with race, and chronic failure to enforce health and

safety regulations and facilitate equitable resource distribution (Penn, Benken, & Watts, 2021).

These aspects, therefore, are a form of indirect structural violence, as inequitable enforcement is

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rooted in invisible social forces that perpetuate inequality in health and manifest in ‘material and

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symbolic means of social exclusion’ (Dean, 2016). These means of exclusion link to power

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dynamics in the political arena: given that certain political systems have more power to enforce
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healthcare policies to protect population well-being, they possess greater legitimacy and can
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uphold equitable enforcement. As a result, equitable enforcement has a direct impact on political
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and institutional factors that may inhibit the development of a state. The political factor within
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equitable enforcement that most affects a state’s development is poor management as a result of a
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government’s failure to build and maintain infrastructure, equitably distribute finance, and
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minimize the red tape approach – all of which disallow efficient resource allocation and perpetuate

health inequalities. Furthermore, institutional factors consist of the efficacy of national and local

institutions, and their attempts made to influence regional, national, and local policies for

sustainable development within healthcare. This may be exemplified by a resolution adopted by

the Security Council in February of 2021 that was discussed in the VISSMUN conference: The

Security Council had “demand[ed] that parties to armed conflicts engage immediately in a …

humanitarian pause to facilitate … the equitable, safe and unhindered delivery and distribution of

COVID-19 vaccinations” (UN Security Council, 2021). The Security Council then affirms that

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these parties are to fully comply with “their obligations under international law, including

international human rights law”, which portrays how institutions like the UN may exert power

within a state, to the extent of interference within armed conflict. However, the power of the

Security Council may also threaten the ability of other states to take meaningful action – most

resolutions passed by the Security Council conclude with the phrase “Decides to remain seized of

the matter”, which precludes any recommendations within the matter from the General Assembly

(United Nations, 1945). Therefore, equitable enforcement impacts the political and institutional

development of a state by ensuring that bodies of authority may exert power to prioritize equitable

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resource distribution.

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Given the global humanitarian crisis of COVID-19, and the growing threat of others, there is
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greater emphasis placed on both human and material resources and greater inequalities within their
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distribution. The ways in which inequity of resource distribution in healthcare impacts

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international human rights and development are evident: it undermines human rights, which in
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turn perpetuates the poverty cycle, allows the charge of structural and cultural violence in public
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health systems, and permits political and institutional factors to limit the development of states.
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Therefore, to maintain the security of the public health system, both globally, and locally, it is of

utmost importance to confront the issue of resource distribution inequity.

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Bibliography
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