E/C.12/2000/4
page 4
12.
The right to health in all its forms and at all levels contains the following interrelated and
essential elements, the precise application of which will depend on the conditions prevailing in a
particular State party:
(a)
Availability. Functioning public health and health-care facilities, goods and
services, as well as programmes, have to be available in sufficient quantity within the State
party. The precise nature of the facilities, goods and services will vary depending on numerous
factors, including the State party’s developmental level. They will include, however, the
underlying determinants of health, such as safe and potable drinking water and adequate
sanitation facilities, hospitals, clinics and other health-related buildings, trained medical and
professional personnel receiving domestically competitive salaries, and essential drugs, as
defined by the WHO Action Programme on Essential Drugs.5
(b)
Accessibility. Health facilities, goods and services6 have to be accessible to
everyone without discrimination, within the jurisdiction of the State party. Accessibility has four
overlapping dimensions:
(i)
Non-discrimination: health facilities, goods and services must be
accessible to all, especially the most vulnerable or marginalized sections
of the population, in law and in fact, without discrimination on any of the
prohibited grounds.7
(ii)
Physical accessibility: health facilities, goods and services must be within
safe physical reach for all sections of the population, especially vulnerable
or marginalized groups, such as ethnic minorities and indigenous
populations, women, children, adolescents, older persons, persons with
disabilities and persons with HIV/AIDS. Accessibility also implies that
medical services and underlying determinants of health, such as safe and
potable water and adequate sanitation facilities, are within safe physical
reach, including in rural areas. Accessibility further includes adequate
access to buildings for persons with disabilities.
(iii)
Economic accessibility (affordability): health facilities, goods and
services must be affordable for all. Payment for health-care services, as
well as services related to the underlying determinants of health, has to be
based on the principle of equity, ensuring that these services, whether
privately or publicly provided, are affordable for all, including socially
disadvantaged groups. Equity demands that poorer households should not
be disproportionately burdened with health expenses as compared to richer
households.
(iv)
Information accessibility: accessibility includes the right to seek, receive
and impart information and ideas8 concerning health issues. However,
accessibility of information should not impair the right to have personal
health data treated with confidentiality.