E/CN.4/2000/4
page 11
promotion and support of the establishment of institutions providing counselling and mental
health services, with due regard to equitable distribution throughout the country. Further
obligations include the provision of a public, private or mixed health insurance system which is
affordable for all, the promotion of medical research and health education, as well as information
campaigns, in particular with respect to HIV/AIDS, sexual and reproductive health, traditional
practices, domestic violence, the abuse of alcohol and the use of cigarettes, drugs and other
harmful substances. States are also required to adopt measures against environmental and
occupational health hazards and against any other threat as demonstrated by epidemiological
data. For this purpose they should formulate and implement national policies aimed at reducing
and eliminating pollution of air, water and soil, including pollution by heavy metals such as lead
from gasoline. Furthermore, States parties are required to formulate, implement and periodically
review a coherent national policy to minimize the risk of occupational accidents and diseases, as
well as to provide a coherent national policy on occupational safety and health services.25
37.
The obligation to fulfil (facilitate) requires States inter alia to take positive measures that
enable and assist individuals and communities to enjoy the right to health. States parties are also
obliged to fulfil (provide) a specific right contained in the Covenant when individuals or a group
are unable, for reasons beyond their control, to realize that right themselves by the means at their
disposal. The obligation to fulfil (promote) the right to health requires States to undertake
actions that create, maintain and restore the health of the population. Such obligations include:
(i) fostering recognition of factors favouring positive health results, e.g. research and provision
of information; (ii) ensuring that health services are culturally appropriate and that health care
staff are trained to recognize and respond to the specific needs of vulnerable or marginalized
groups; (iii) ensuring that the State meets its obligations in the dissemination of appropriate
information relating to healthy lifestyles and nutrition, harmful traditional practices and the
availability of services; (iv) supporting people in making informed choices about their health.
International obligations
38.
In its General Comment No. 3, the Committee drew attention to the obligation of all
States parties to take steps, individually and through international assistance and cooperation,
especially economic and technical, towards the full realization of the rights recognized in the
Covenant, such as the right to health. In the spirit of article 56 of the Charter of the
United Nations, the specific provisions of the Covenant (articles 12, 2.1, 22 and 23) and the
Alma-Ata Declaration on primary health care, States parties should recognize the essential role
of international cooperation and comply with their commitment to take joint and separate action
to achieve the full realization of the right to health. In this regard, States parties are referred to
the Alma-Ata Declaration which proclaims that the existing gross inequality in the health status
of the people, particularly between developed and developing countries, as well as within
countries, is politically, socially and economically unacceptable and is, therefore, of common
concern to all countries.26
39.
To comply with their international obligations in relation to article 12, States parties have
to respect the enjoyment of the right to health in other countries, and to prevent third parties from
violating the right in other countries, if they are able to influence these third parties by way of
legal or political means, in accordance with the Charter of the United Nations and applicable
international law. Depending on the availability of resources, States should facilitate access to