A/HRC/29/33
which are not necessarily used in an ethical and cost-effective way; (b) there are increased
incentives for corruptive practices when expensive specialized health-care interventions in
public sector do not serve those in most need; (c) the filters (tiers) in health-care systems do
not properly function, and mild cases flow into specialized care, placing the entire healthcare system at risk of poor management of the principles of medical ethics and health
economics. That has negative impact on the full realization of right to health and generates
negative public health outcomes.
72.
The sustainable implementation of a modern public health approach is not only in
line with human rights, but is also a powerful way to develop and strengthen social justice
and social cohesion. In that regard, the importance of universal health coverage cannot be
overestimated. Since the International Conference on Primary Health Care, there have been
many achievements, but also failures. Universal coverage is a central component of healthy
public policies and its global achievement should be seen as one of the main goals for the
post-2015 agenda. However, the Special Rapporteur thinks that a broader holistic approach
is needed so that none, in particular those in vulnerable situations and in most need of
health care, are not excluded neither de jure nor de facto from access to quality services.
73.
All international and national actors should be mobilized to reaffirm and revitalize
the decisions of the historic International Conference on Primary Health Care and
International Conference on Health Promotion. The full enjoyment of the right to health can
only be operationalized through human rights-friendly and culturally relevant health
promotion policies that empower people to increase control over their lives and improve
their health and well-being.
C.
Mental health and emotional well-being
74.
The historical divide, both in policies and practices, between mental and physical
health has unfortunately resulted in political, professional and geographical isolation,
marginalization and stigmatization of mental health care.
75.
The modern public mental health approach, which emerged in the global scene in
the end of twentieth century with a critical mass of new evidence on the importance of
mental health and the effectiveness of integrated approaches, still faces enormous
challenges. It is regrettable that, in many countries and regions of the world, modern mental
health care is still not available. Moreover, in countries which can afford to give resources
to mental-health services, those resources are often used to support segregated psychiatric
institutions where stigmatizing and human rights-unfriendly services are provided.
76.
The Special Rapporteur would like to highlight two key messages of the modern
public mental-health approach. Firstly, there is no health without mental health. Secondly,
good mental health means much more than absence of a mental impairment.
77.
The modern understanding of mental health includes good emotional and social
well-being, healthy non-violent relations between individuals and groups, with mutual trust
of, tolerance of and respect for the dignity of every person. In that regard, promoting good
mental health should be a cross-cutting priority relevant to the sustainable development
agenda, as it is of concern to many of its elements, including the protection of dignity and
people in order to ensure healthy lives and strong inclusive economies; promote safe and
peaceful societies and strong institutions; and catalyse global solidarity for sustainable
development (see A/69/700).
78.
By investing in the good mental health of children and youth, a substantial
contribution is made not only to the sustainable development of our economies, for which
good emotional and cognitive abilities are needed, but also the root causes of intolerance
and social exclusion are addressed and healthy and cohesive societies promoted.
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