A/HRC/38/37
35.
The human rights framework helps to further clarify the responsibilities of States
regarding universal health coverage to: (a) ensure the participation of stakeholders in the
design of policies to implement universal health coverage; 54 (b) refrain from inappropriate
health resource allocation that would disproportionately favour expensive curative health
services, which are often accessible only to a small, privileged fraction of the population,
over primary and preventive health care benefiting a far larger part of the population; (c)
adopt legislative and other measures ensuring equal access to health care and health-related
services provided by third parties; 55 (d) ensure that availability, accessibility, acceptability
and quality of health facilities, goods and services are not undermined by health sector
privatization; 56 and (e) uphold and implement the right to social security, including the
implementation of social protection floors, as part of measures to ensure financial risk
protection.57
4.
Accountability for health
36.
In the 2030 Agenda, the General Assembly foresees a robust, voluntary, effective,
participatory, transparent and integrated follow-up and review framework to support
national implementation and to maximize and track progress to ensure that no one is left
behind. It aims to promote accountability, support effective international cooperation and
foster the exchange of best practices and mutual learning. 58 A global indicator framework,
including for the health-related Goals, has since been developed by the Inter-Agency and
Expert Group on Sustainable Development Goal Indicators, endorsed by the Statistical
Commission and adopted by the General Assembly. 59 It is to be complemented by
indicators at the regional and national levels. OHCHR has underscored the need for a robust
accountability mechanism at the global level under the high-level political forum on
sustainable development, and for the forum’s voluntary national reviews and thematic
reviews to draw systematically on information and recommendations from the United
Nations human rights mechanisms. Moreover, as recognized in the 2030 Agenda,
accountability in the private sector should be ensured based on the Guiding Principles on
Business and Human Rights.60
37.
Accountability is a complex, multidimensional concept. Human rights-based
accountability requires numerous forms of review and oversight and fostering of the
accountability of multiple actors at various levels, both within and beyond the health
sector. 61 Accountability comprises at least three fundamental components: monitoring,
independent review and remedial action.62 Effective monitoring is critical, not as an end in
itself, but as a tool for measuring progress and improving accountability. Each of these
components is indispensable and has a discrete role to play in strengthening
accountability.63
38.
Challenges around ensuring accountability for health include the failure to
differentiate between these components, with the result that one or more may be neglected,
54
55
56
57
58
59
60
61
62
63
12
Submission by Health Poverty Action, p. 4.
See Committee on Economic, Social and Cultural Rights, general comment No. 14, para. 35.
Ibid.
See International Covenant on Economic, Social and Cultural Rights, art. 9; ILO Social Security
(Minimum Standards) Convention, 1952 (No. 102); ILO Social Protection Floors Recommendation,
2012 (No. 202); ILO Medical Care Recommendation, 1944 (No. 69); and ILO Medical Care and
Sickness Benefits Convention, 1969 (No. 130).
See General Assembly resolution 70/1, paras. 72–73.
General Assembly resolution 71/313.
See General Assembly resolution 70/1, para. 67.
See A/HRC/21/22, paras. 74–75.
Commission on Information and Accountability for Women’s and Children’s Health, “Keeping
promises, measuring results”, p. 7; Independent Accountability Panel, 2016: Old Challenges, New
Hopes, Accountability for the Global Strategy for Women’s and Children’s and Adolescents’ Health,
pp. 9–11; and A/HRC/21/22.
Carmel Williams and Paul Hunt, “Neglecting human rights: accountability, data and Sustainable
Development Goal 3”, International Journal of Human Rights, vol. 21, No. 8 (2017), pp. 1118 and
1120.
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