A/HRC/17/25 example, an increase in the number of people undergoing HIV testing may be a good outcome, but if achieved through coercive testing rather than a voluntary campaign, it is clear that human rights have failed to be integrated into the strategy.61 Moreover, simply achieving a positive result in a given field, such as health, will not automatically promote respect for the corresponding right, and thus imbue rights-holders and duty-bearers with a long-term “guarantee [or] set of structural claims”.62 Put simply, more needs to be done to ensure that long-term realization of rights occurs as a result of any development interventions. In respect of health, this is best achieved through undertaking the process of identifying the relevant human rights laws, norms and standards that apply, as part of the right to health framework, and continuing on to identify rights-holders and duty-bearers in that context. It has been noted that the “quality, legitimacy and sustainability” of outcomes depend on the process used to achieve them, and human rights may help secure those desirable elements,63 as well as addressing structural problems that ultimately perpetuate the very conditions that development programming seeks to address. 51. Moreover, participation of those that development programming seeks to assist should be increased through adoption of human rights within existing approaches to development. Although it is certainly true that participation has been frequently utilized in development without adoption of a human rights-based approach – its benefits even being acknowledged by the World Bank during the 1970s64 – and thus “participation” as a concept is not exclusive to human rights or new to development, there is no doubt that sustainable, quality outcomes are clearly linked to ownership and empowerment by affected communities, and that those who have the greatest stake in development are those who form the subject of that development itself. Nevertheless, the substantial difference lies in the fact that the right to health views participation as an entitlement, rather than a privilege occasionally granted. Drawing further attention to the importance of participation throughout all stages of development can only be beneficial. Human rights-based frameworks and approaches address participation alongside other essential elements of accountability, capacity-building, and so forth; as such, mainstreaming of human rights in programming may not pioneer the use of participation, but has the potential to improve upon the ad-hoc use of such concepts. 52. Evidence of the positive effects of human rights at the practice level of development ultimately provides an additional impetus for reframing both human rights and development as described above. Ultimately, shifting the process through which development actions are implemented, even if goals and outcomes are only subtly altered, may prove the defining means through which the potential of human rights-based approaches become most apparent, even in the absence of rigorous empirical evidence. In fact, a relentless pursuit of evidence for human rights-based approaches has its own shortcomings, as will be discussed presently. E. Remaining challenges 53. Harmonizing the practical and operational aspects of human rights and development without compromising the essential values and philosophies of both domains is a challenge. 61 62 63 64 16 Sofia Gruskin et. al, “Rights-based approaches”, p. 139. Peter Uvin, Human Rights and Development (2004, Kumarian Press, Connecticut), pp. 52-53. Ghalib Galant and Michelle Parlevliet, “Using rights to address conflict – a valuable synergy” in Reinventing Development?: Translating rights-based approaches from theory into practice, Paul Gready and Jonathan Ensor, eds. (London, Zed Books, 2005), p. 111. Andrea Cornwall, “Historical Perspectives on Participation in Development” Commonwealth & Comparative Politics, vol. 44, No. 1 (March 2006) pp. 63-65.