By Hon. Prof. Kariuki Muigua, OGW, PhD, C.Arb, FCIArb is a Professor of Environmental Law and Dispute Resolution at the University of Nairobi, Member of Permanent Court of Arbitration, Leading Environmental Law Scholar, Respected Sustainable Development Policy Advisor, Top Natural Resources Lawyer, Highly-Regarded Dispute Resolution Expert and Awardee of the Order of Grand Warrior (OGW) of Kenya by H.E. the President of Republic of Kenya. He is The African ADR Practitioner of the Year 2022, The African Arbitrator of the Year 2022, ADR Practitioner of the Year in Kenya 2021, CIArb (Kenya) Lifetime Achievement Award 2021 and ADR Publisher of the Year 2021 and Author of the Kenya’s First ESG Book: Embracing Environmental Social and Governance (ESG) tenets for Sustainable Development” (Glenwood, Nairobi, July 2023) and Kenya’s First Two Climate Change Law Book: Combating Climate Change for Sustainability (Glenwood, Nairobi, October 2023), Achieving Climate Justice for Development (Glenwood, Nairobi, October 2023) and Promoting Rule of Law for Sustainable Development (Glenwood, Nairobi, January 2024)*
The Corona Virus Disease Pandemic (COVID-19) exposed and brought to the attention of the whole world just how important health and well-being of the population is. Indeed, the fact that COVID-19 has affected all sectors of the global economy is evidence enough that human health and well-being form the backbone of the global economy. It is now clear that no matter how much governments invest in other areas of the economy, if the health sector is ailing, then all the other efforts come to naught. Indeed, it has been argued that ‘health care is not only a problem of healthcare but also a problem of a profound social nature, making it an integral part of all the social and economic development conditions’.
While Kenya has been investing and making efforts towards guaranteeing the realisation of the right to health care and well-being for all, there are still a lot of challenges facing the health sector. There is need for concerted efforts towards realisation of Sustainable Development Goal (SDG) 3 on ensuring healthy lives and well-being of all its citizens. SDG 3 seeks to “ensure healthy lives and promote well-being for all at all ages” and spells out the specific targets and end goals that countries should aspire to achieve. Notably, SDG 3 outlines targets that touch on various aspects of right to health for all groups of people, including men, women and children and their group-specific health needs.
The 1946 Constitution of the World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. The preamble further states that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” The CESCR General Comment No. 14 on The Right to the Highest Attainable Standard of Health, defines the right to health as a; “… a fundamental human right indispensable for the exercise of other human rights. Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity.
Arguably, the right to health is conditioned by the health system and the socio-economic factors, which are reflected in the health of the population. Notably, socioeconomic status underlies three major determinants of health: health care, environmental exposure, and health behaviour. The World Health Organization’s Commission has defined the Social Determinants of Health, that is, the factors apart from medical care that can be influenced by social policies and shape health in powerful ways, as “the conditions in which people are born, grow, live, work and age” and “the fundamental drivers of these conditions”. Related to this is the fact that ‘health-related behaviours are strongly shaped by social factors, including income, education, and employment’.
The scope, content and nature of State obligations under Article 12 of the ICESCR have been expounded by the Committee on Economic, Social and Cultural Rights (CESCR) under the General Comment No. 14: The Right to the Highest Attainable Standard of Health (Art. 12 of the Covenant). The General Comment No. 14: The Right to the Highest Attainable Standard of Health (Art. 12 of the Covenant) acknowledges that ‘the right to health is closely related to and dependent upon the realization of other human rights, as contained in the International Bill of Rights, including the rights to food, housing, work, education, human dignity, life, non-discrimination, equality, the prohibition against torture, privacy, access to information, and the freedoms of association, assembly and movement, all of which and other rights and freedoms address integral components of the right to health.
It has been observed that while it is difficult to pinpoint exactly what the right to health entails, there are specific elements that constitute the core content of the right to health and these include: a) access to maternal and child health care, including family planning; b) immunisation against the major infectious diseases; c) appropriate treatment of common diseases and injuries; d) essential drugs; e) adequate supply of safe water and basic sanitation; and f) freedom from serious environmental health threats. In addition to the scope of core content, a number of guidelines constitute the framework of the right to health: a) availability of health services; b) financial, geographic and cultural accessibility of health services; c) quality of health services; and d) equality in access to available health services.12 In addition to the foregoing, the right to health is also considered to be part of the broader right to an adequate standard of living.
Under Article 25(1) of the 1948 Universal Declaration of Human Rights, ‘everyone has the right to a standard of living adequate for the health and well-being of himself and his family’ and this includes the following elements: a) food; b) clothing; c) housing; d) medical care; and e) necessary social services. These elements are also all captured under Article 43 of the Constitution of Kenya 2010 on socio-economic rights. It is therefore evident that the right to health is not a standalone right but instead it is intertwined with many other rights.
*This is an extract from the Book: Promoting Rule of Law for Sustainable Development (Glenwood, Nairobi, January 2024) by Hon. Prof. Kariuki Muigua, OGW, PhD, Professor of Environmental Law and Dispute Resolution, Senior Advocate of Kenya, Chartered Arbitrator, Kenya’s ADR Practitioner of the Year 2021 (Nairobi Legal Awards), ADR Lifetime Achievement Award 2021 (CIArb Kenya), African Arbitrator of the Year 2022, Africa ADR Practitioner of the Year 2022, Member of National Environment Tribunal (NET) Emeritus (2017 to 2023) and Member of Permanent Court of Arbitration nominated by Republic of Kenya. Prof. Kariuki Muigua is a foremost Environmental Law and Natural Resources Lawyer and Scholar, Sustainable Development Advocate and Conflict Management Expert in Kenya. Prof. Kariuki Muigua teaches Environmental Law and Dispute resolution at the University of Nairobi School of Law, The Center for Advanced Studies in Environmental Law and Policy (CASELAP) and Wangari Maathai Institute for Peace and Environmental Studies. He has published numerous books and articles on Environmental Law, Environmental Justice Conflict Management, Alternative Dispute Resolution and Sustainable Development. Prof. Muigua is also a Chartered Arbitrator, an Accredited Mediator, the Managing Partner of Kariuki Muigua & Co. Advocates and Africa Trustee Emeritus of the Chartered Institute of Arbitrators 2019-2022. Prof. Muigua is a 2023 recipient of President of the Republic of Kenya Order of Grand Warrior (OGW) Award for his service to the Nation as a Distinguished Expert, Academic and Scholar in Dispute Resolution and recognized among the top 5 leading lawyers and dispute resolution experts in Band 1 in Kenya by the Chambers Global Guide 2024 and was listed in the Inaugural THE LAWYER AFRICA Litigation Hall of Fame 2023 as one of the Top 50 Most Distinguished Litigation Lawyers in Kenya and the Top Arbitrator in Kenya in 2023.
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