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related sectors”.13 In 2007, WHO adopted a narrower definition: “A health system consists of all
organizations, people and actions whose primary intent is to promote, restore or maintain
health.”14 The literature reveals many other definitions, each with carefully nuanced differences.
35. For present purposes, there is no need to favour one definition over another because all the
features and measures identified in this report should be part of any health system, however
defined.
C. In general terms, a right-to-health approach
to strengthening health systems
36. International human rights law signals the content and contours of the right to the highest
attainable standard of health. In the last decade or so, States, international organizations,
international and national human rights mechanisms, courts, civil society organizations,
academics and many others have begun to explore what this human right means and how it can
be put into practice. Health workers are making the most decisive contribution to this process.
37. Drawing on this deepening experience, and informed by health good practices, this section
outlines the general approach of the right to the highest attainable standard of health towards the
strengthening of health systems. Because of space constraints, this outline can only be brief and
introductory.
1. At the centre: the well-being of individuals, communities and populations
38. A health system gives rise to numerous technical issues. Of course, experts have an
indispensable role to play in addressing these technical matters. But there is a risk that health
systems will become impersonal, “top-down” and dominated by experts. Additionally, as a
recent WHO publication observes, “health systems and services are mainly focused on disease
rather than on the person as a whole, whose body and mind are linked and who needs to be
treated with dignity and respect.”15 The publication concludes, “health care and health systems
must embrace a more holistic, people-centred approach”.16 This is also the approach required by
the right to the highest attainable standard of health. Because it places the well-being of
individuals, communities and populations at the centre of a health system, the right to health can
help to ensure that a health system is neither technocratic nor removed from those it is meant to
serve.
13
E. Tarimo, Towards a Healthy District. Organizing and Managing District Health Systems
Based on Primary Health Care, WHO, 1991, p. 4.
14
Everybody’s Business… (note 2 above), p. 2.
15
People at the Centre of Health Care: Harmonizing Mind and Body, Peoples and Systems,
WHO, 2007, p. v.
16
Ibid., p. vii.
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