Richard Amenyah | Championing human rights for public health and sustainable development

Over the last two weeks, I’ve had several conversations with individuals from vulnerable and marginalised groups, including people living with HIV, which highlighted that the Caribbean not only needs investment, but it desperately needs to do more to incorporate human rights in the delivery of public health services.

Significant disparities in access to quality health services highlight the urgency of adopting a rights-based approach to public health, to close the inequity gaps to having good health. Health is a fundamental human right, and realising this right is essential for creating equitable and inclusive societies. Human rights are the cornerstone of robust public health systems and the achievement of the Sustainable Development Goals (SDGs) by 2030. Achieving universal health coverage and ensuring the well-being of everyone require dismantling barriers, such as discrimination, stigma, and outdated and punitive legal frameworks which prevent vulnerable and marginalised people from accessing the services they urgently need.

HUMAN RIGHTS AND PUBLIC HEALTH

Therefore, as we celebrate the 2024 International Human Rights Day on December 10 under the theme ‘Our rights, our future, right now’, the Caribbean is reminded of the critical intersection between human rights, public health, and sustainable development.

This means ensuring that laws and policies are not only designed to protect health, but are enforced in a manner that upholds dignity and non-discrimination. For instance, policies should guarantee that health services are available, accessible, affordable, of good quality and inclusive, particularly for marginalised groups such as migrants, indigenous people, people of Afro-descent, people living with disabilities, and people living with HIV.

The fight against the HIV epidemic in the Caribbean perfectly illustrates the nexus between human rights and public health. The 2024 World AIDS Day theme, ‘Take the rights path’, emphasised human rights as essential to ending AIDS as a public health threat by 2030. Discrimination against those living with HIV, sex workers, gay men and other men who have sex with men, and transgender and gender-diverse persons continues to drive new HIV infections and rights abuses. Stigma not only affects individuals’ rights to health, dignity, and privacy, but also their access to justice, education, employment, and other critical services. In 2022, these key populations accounted for nearly half of all new HIV cases in the region.

PREREQUISITE FOR SUSTAINABLE DEVELOPMENT

The Caribbean’s pledge to meet the SDGs, especially Goals 3 (Good Health and Well-being), 10 (Reduced Inequalities), and 16 (Peace, Justice and Strong Institutions), hinges on a commitment to human rights. The principle of ‘Leaving no one behind’ calls for dismantling systemic inequalities and fostering social justice. However, achieving sustainable development in this context means confronting the root causes of marginalisation and inequalities in society. When these issues remain unaddressed, their impact reverberates through families, communities, and the society.

The protection of fundamental rights and freedoms must therefore be at the forefront when devising public health strategies. Freedom from discrimination, the right to privacy, and the right to participate in decisions that affect one’s health are non-negotiable. These rights should be reflected in how health services are designed and delivered, from ensuring confidentiality to involving community voices in policymaking, to tailor interventions that are culturally sensitive, effective and person-centred.

Further, social justice principles are fundamental pillars in guiding public health policy and sustainable development which are people-centred. By focusing on social justice, we ensure that health and community systems are robust and resilient and address the overall social determinants of health – education, employment, housing, and environmental conditions, including climate change, etc. This tackles not only their negative outcomes, but the root causes of health inequities as well. For example, educational programmes that promote gender equality can lead to better health outcomes for women, reducing instances of gender-based violence, which is both a public health crisis and a human-rights violation. Similarly, using people-centred and rights-based approaches have resulted in the elimination of mother-to-child HIV transmission in 11 countries in the region.

A CALL TO ACTION

Human rights are not just a legal obligation, but a moral imperative for societal justice and health equity. They offer a transformative path to address and rectify systemic inequalities that perpetuate health crises and poverty. By shaping public health policies around human rights, we can dismantle the barriers to health, ensuring everyone can live with dignity and have good health and well-being, which are critical to achieving sustainable development.

It is important for us to remain committed to human rights as a core principle for public health interventions and community development strategies. Looking forward, governments must strengthen legal frameworks, foster community and stakeholder engagement, building capacity among healthcare workers, and strengthen collaboration. Legal reforms must align with international human-rights standards, ensuring that everyone, regardless of status, can access justice and health services.

The journey towards a sustainable, healthy Caribbean is deeply entwined with the commitment to human rights. Let us not only reflect on our commitments, but act to create a region where every individual can thrive, free from discrimination, and can enjoy their rights and access services that promote a dignified life. This isn’t just about achieving global goals; it’s about affirming the rights and dignity of every Caribbean citizen in our collective quest for a just, healthy, and sustainable future.

Dr Richard Amenyah is a medical doctor and public health specialist. He is the director for the UNAIDS multicountry office for the Caribbean. Follow him on X (formerly Twitter) at @RichardAmenyah or @UNAIDSCaribbean. Send feedback to jamaica@unaids.org.