Health Access

Health in 2013

United States views on international law [1] in relation to Health: The HRC adopted a resolution at its 23rd session on “Access to medicines in the context of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.” U.N. Doc. A/HRC/RES/23/14. On June 13, 2013, the U.S. provided the following explanation of its decision to call a vote and abstain on the resolution. The U.S. explanation of vote is excerpted below and available in full at (link resource) geneva.usmission.gov/2013/06/13/eov-on-the-resolution-on-access-tomedecines/.

Some Aspects of Health

The United States thanks Brazil for its continued dedication to an issue of tremendous importance to all countries. Regarding this resolution, however, my country has decided to call a vote and abstain. Some of our reasons follow. For many years now the United States has joined other countries in supporting the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. While we recognize the importance of access to medicine, we note that countries have a wide array of policies and actions that may be appropriate in promoting the progressive realization of the right to the enjoyment of the highest available standard of physical and mental health. Therefore, we think that this resolution should not try to define the content of the right. Furthermore, to the extent that it is implied in this resolution, the United States does not recognize creation of any new right which we have not previously recognized, the expansion of the content or coverage of existing rights, or any other change in the current state of treaty or customary international law.

Developments

The United States commitment in the arena of global health is unsurpassed. Through programs such as the Global Health Initiative, PEPFAR, and the President's Malaria Initiative, as well as through investments in medicines research led by our National Institutes of Health, and extensive technical engagement and financial contributions to multilateral health institutions, the United States plays an important, catalyzing role encouraging innovation and voluntary mechanisms that increase access to affordable health products and technologies to people around the world. At the same time, the United States has strong concerns about a number of the provisions of the resolution. The goal of greater access to medicines, and particularly to essential medicines, is, for each country, a multi-faceted and complex issue. States have to prioritize the access goal and promote public health policies in a manner best suited for their circumstances and consistent with their human rights and other international obligations.

Details

We regret that the resolution, in the context of human rights, has a select emphasis on issues of intellectual property and trade. There often exist multiple reasons why essential medicines are less widely available than they should be in some countries. Inappropriate tax and tariff policies, insufficient health systems, inadequate access to financing, or lack of essential medicines procurement systems in place to support health delivery, services, and access, can all serve as internal barriers. Many of these are best addressed by taking domestic action. In addition, the United States does not agree with the resolution's assertion that local production actually increases access or affordability. While it may have potential economic benefits unrelated to health, we would urge States only to undertake the promotion of local production when local circumstances and economic analysis make clear that doing so is likely to result in lower prices, comparable quality, and increased access.

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The United States reiterates its support for the Doha Declaration on TRIPS and Public Health and wishes to emphasize that nothing in this resolution is intended to or should be interpreted as altering the scope or meaning of that Declaration or any other part of the TRIPS Agreement. We would also like to encourage the Human Rights Council and the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health to consider and focus on other aspects of this issue, especially those that have been more neglected.

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Every government can and in fact should work to provide access to affordable, safe, efficacious and quality essential medicines for all. We look forward to continue working with our partners to address this and other critical issues facing our countries.

Resources

Notes

1. Health in the Digest of United States Practice in International Law