Statement by United Nations High Commissioner for Human Rights, Michelle Bachelet
25 March 2021
As United Nations High Commissioner for Human Rights – and as a doctor – I am pleased to join you in this Global Health Conference.
After this terrible past year, let me begin with some of the lessons of the COVID-19 pandemic, which I think can teach us a lot about the value of investing in human rights.
We can clearly see how the virus and its impacts feed off gaps in human rights protection.
In every region of the world, those who were already most vulnerable, including members of racial and ethnic minorities and indigenous peoples, are more likely to die of COVID-19, and have been hit the hardest by its socio-economic consequences.
The negative impact on individuals is horrifying – and could last for generations, as already poor and vulnerable people get pushed further back into poverty.
As the virus continues to spread in many places, there is also harm to development, because inequalities are deepening. More people are falling further behind, depriving society of the full contributions of everyone and harming us all.
Last month, I presented to the Human Rights Council my report on the global impact of the COVID-19 pandemic on human rights.
The health and socio-economic crisis we face is unparalleled.
The report demonstrates the importance of strong public universal healthcare systems, with quality care available, accessible and affordable to all -- without any discrimination, and regardless a person’s ability to pay.
The pandemic has made it clear that no one is safe until everyone is safe.
I am concerned to see how historical inequities, both within and between countries, are being repeated in vaccine distribution. We need global solidarity and concerted political action to ensure vaccines are available to everyone, everywhere.
The COVAX facility – and the EU’s support to this important initiative - is an inspiring example.
And Universal health coverage must be a fundamental priority.
The case for it has never been stronger nor the stakes higher.
Healthy societies are the key to unlocking sustainable development, and poor health outcomes severely restrict their capacity to flourish and build resilience; the 2030 Agenda for Sustainable Development clearly affirms this link. Moreover, target 3.8 specifically calls on us to achieve universal health. That includes “financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines.”
However, as we know, profound inequalities in access to and spending on health care have been a grave challenge even before COVID-19.
More than half the people alive today have little or no access to live-saving services such as prenatal care and basic treatment for malaria, tuberculosis or HIV-AIDS. Migrants and their families face a range of obstacles in accessing health services and for women and girls, sexual and reproductive health care remains a challenge, particularly for those in vulnerable situations.
This injustice undermines the future for entire countries and regions. Instead of thriving, individuals and communities are forced to struggle, simply to survive.
Socioeconomic determinants of health, such as poverty, inequality, discrimination, nationality and migration status have been major reasons why millions of people lack access to good quality health care and services. And in the past year, we have been painfully reminded of how outbreaks of communicable diseases can severely affect those in vulnerable situations.
There are also wide disparities between regions and rural and urban populations: 56 per cent of the global rural population, most of them in Africa, lack health coverage, compared to 22 per cent of the urban population.
Cost is also a very significant barrier. In 2019, the World Health Organization estimated that 930 million people spent more than 10% of their annual household income on health-care and about 210 million people spent more than 25%. This is a huge, virtually impossible burden. Extending coverage for health services, and ensuring that people are protected from financial risks can be the difference between life and death.
Although a broadly accepted definition of universal health coverage is yet to be developed, the right to health framework is an essential basis for its advancement. It should embrace both health services, including mental, sexual and reproductive health, and the underlying determinants of health
Moreover, the human rights standards pertaining to the rights to health and social protection are well-established. But, while we do have commitments and declarations, hundreds of millions of people still don’t have access to health coverage. What we lack -- and urgently need --- is political will.
Before the COVID-19 crisis, economic, social and cultural rights remained neglected, which was often justified on the basis of cost. Once the consequences of the crisis became clear, we saw governments passing substantial economic stimulus packages to mitigate their socio-economic impact. To me, that says that money can be found when the priority is recognized. In short, when there’s a will, there’s a way.
As a strong partner of the United Nations and supporter of multilateralism, the European Union can help lead the way and accelerate the process towards universal health coverage.
We count on you to mobilize technical cooperation to share knowledge, experiences and ensure the availability of adequate resources to advance the right to health everywhere.
International cooperation and solidarity must be central to our efforts to achieve the Sustainable Development Goals and recover better from the pandemic.
In that sense, I welcome the EU’s support for a human rights-based recovery as well as to the effective implementation of the United Nations Secretary-General’s Call to Action on Human Rights.
If anyone had any doubts, the pandemic has brought home that health-care and social protection are not only essential, but also pay high dividends in warding off devastating economic pain.
I commend the EU’s commitment to step up its engagement and investment in the area of health through ambitious programmes both internally and abroad.
I encourage you to consider focusing on deinstitutionalization. For instance, over-reliance on the institutional care of older people and people with disabilities can have a detrimental impact on the right to health.
It would be paramount to prioritize sustainable investments on health systems, comprising mental and sexual and reproductive health, to ensure access to care for those most vulnerable, including migrants, people deprived of their liberty and minorities. In that sense, I welcome the steps taken by local authorities in many countries to uphold the right to heath for migrants, regardless of status. Nevertheless, further steps are needed to ensure access to quality health care for all .
And I call on you to safeguard the involvement of all relevant actors in the design and implementation of these programmes.
It is essential that people can fully, and meaningfully, participate in setting priorities and policies that will affect their lives.
From my own experience and from the lessons of history, I am convinced that participation is not only a right; it is also key to recovering better from this crisis.
I welcome the EU’s call for recovery efforts that build more equal and inclusive, sustainable and greener societies, and I commend the Portuguese Presidency for making it one of its priorities.
Indeed, no recovery will be sustainable without a safe, clean and healthy environment.
The pandemic is a very powerful example of the threat to human well-being that results from environmental damage. Over-exploitation of our environment increases the risk of viruses, which cause infectious diseases like COVID-19, jumping from animal to human hosts.
And, as we strive to overcome this crisis, we have an opening to address the even more overwhelming threat of climate change. We can – and must -- steer our world onto a more sustainable path. We need to move fast.
In a way rarely seen before, COVID-19 provides us with a powerful demonstration of the value of universal health coverage.
It displays the importance of health and social protection systems that encompass the underlying determinants of health.
That is an investment rather than a cost. It is about the protection of us all and the resilience of our societies.
Human rights and public health go hand in hand.
Thank you for your partnership.