This year the BMA has chosen to mark World Health Day with the publication of our long-awaited and extensive report on global human rights in healthcare.
As doctors we recognise that our concern for our patients must extend beyond the immediacy of a clinical consultation, to a broad and holistic understanding of the impact that the world in which they inhabit has on their ability to live a life in which the opportunity for health is within their reach.
Our new report Human Rights in the New World (Dis)order builds on our decades-long commitment to these broader issues and realises the importance of human rights in medicine and healthcare. It outlines a shifting rights landscape in which new technologies, environmental change and geopolitical reconfigurations are putting renewed and at times intense stress on human rights in the practise of medicine and wider healthcare.
The report - compiled by BMA’s own Ethics and human rights department, with extensive input from the BMA medical ethics committee and external experts – reaffirms our commitment to global human rights standards in health and seeks to ensure the protection and promotion of informed global debate on health issues. It draws attention to and highlights the rapidly changing landscape in which we practise as clinicians and in which our patients live, shining a light on the challenges this presents to us in upholding, defending and promoting the health and health rights of the most vulnerable; both at home and abroad.
It identifies and offers recommendations for change on five key areas of human rights and healthcare globally:
- Neoliberalism, inequality and health
- Migration, ethnicity and health
- Climate change and environmental degradation
- The information age: new media and the assault on health expertise
- Conflict, human rights and health.
The COVID-19 effect
Our report was some two years in the making, and its preparation therefore coincided with the emergence of COVID-19, the biggest threat to public health since the global influenza outbreak of 1918-19. This served to highlight many of the issues addressed in the report, such as the effect of new communication technologies on the global health landscape.
The pandemic saw new media aiding the rapidity with which information about public health threats can be shared globally but also gave a platform to the spread of dangerous health misinformation, which is in itself is a fast-emerging threat to public health. This was typified by the way in which speculation and rumour were often touted as fact in relation to emerging treatments and vaccination.
It also notes the differential health outcomes from Covid infection and how this has shed light on persisting health and economic inequalities. Access to vaccines and personal protective equipment was too often dominated by those with the most power in the market, leaving resource-poor countries brutally exposed to the worst of the pandemic. Global co-operation was visibly at odds with forceful assertions of national self-interest.
The rapidly-growing effects of climate change on human rights and healthcare is given its most up-to-date overview here, building on previous reports in this area. Without rights-based global co-operation, including assistance for resource-poor countries to help them to mitigate against the effects of climate change, further conflict and displacement are inevitable.
The report argues that the recognition of a right to a healthy environment as a human right can provide the impetus for real and significant change going forward.
Conflict and health
The report details how recent decades have been characterised by conflict-driven displacement, forcing huge numbers of people to flee their homelands and seek asylum both in neighbouring countries and further afield. This has exposed this vulnerable section of our global population to severe health threats, especially on the migrant routes into Europe.
The mental and physical health consequences of displacement are profound and cause migrant people to face significant challenges in realising their health-related rights. We see this happening before our very eyes now in Ukraine and the resulting humanitarian crisis. Attacks on civilian targets in Ukraine – including healthcare facilities and personnel – makes the report’s final chapter on conflict and human rights tragically relevant.
We live in a time of rapidly increasing global change. It is essential that our basic rights to health and healthcare are reaffirmed, and that as doctors we recognise our role as advocates and defenders of these rights. The impact of rapid transformation on the health and health rights of the most vulnerable people, globally and in the UK, are issues that must be addressed.
Given concerning global developments putting human rights under attack in recent years, this ambitious report - which both builds on previous work and discusses new, emerging threats - is timely, urgent and brings the BMA’s commitment to fundamental health rights fully up to date.
Zoë Greaves is the BMA medical ethics committee chair