A/HRC/4/28 page 5 II. THE HEALTH AND HUMAN RIGHTS MOVEMENT: PROGRESS AND OBSTACLES 6. Thanks to the work of innumerable organizations and individuals, the health and human rights movement has made striking progress in the last decade. However, the movement cannot maintain its present momentum without confronting some major obstacles that now lie in its path. The present chapter briefly outlines recent progress and focuses on two key interrelated challenges facing the contemporary health and human rights movement. So long as these challenges are not adequately addressed, the health and human rights movement will be unable to realize its considerable potential. A. Recent progress 7. With a few exceptions, the relationship between health and human rights was not subject to close, serious examination until the 1990s. Of course, the World Health Organization (WHO) Constitution of 1946 affirms the right to health and so does the Declaration of Alma-Ata of 1978. Both represent very significant milestones in the journey of health and human rights. Also, some of those who were struggling against HIV/AIDS in the 1980s recognized the crucial importance of human rights. But, for the most part, these important developments were not accompanied by a detailed examination of the substantive relationship between health and human rights. That had to wait until the early 1990s, little more than a decade ago.2 A great debt is owed to the late Jonathan Mann and his colleagues at the Harvard School of Public Health and the Francois-Xavier Bagnoud Center for Health and Human Rights for their pioneering work on the relationship between health and human rights, especially in the context of HIV/AIDS. 8. In the 1990s, however, Dr. Mann and others suffered from a serious limitation that does not apply today. At that time, although there was a widespread and detailed understanding of many human rights, there was no comparable understanding of what must surely be a cornerstone of any consideration of health and human rights: the right to the highest attainable standard of health. Inevitably, this gap placed a significant constraint on all those working in the field of health and human rights during this period. It was not until 2000 that an authoritative understanding of the right to health emerged when the Committee on Economic, Social and Cultural Rights, working in close collaboration with WHO and many others, adopted general comment No. 14. 9. Although neither complete, nor perfect, nor binding, general comment No. 14 is compelling and groundbreaking. For the first time, here is a substantive understanding of the right to health that can be made operational and improved in the light of practical experience. The general comment makes the right to health - as set out in the WHO Constitution, affirmed in the Declaration of Alma-Ata and enshrined in numerous binding international human rights treaties - more than a slogan. In short, it represents another important milestone in the journey of health and human rights. 10. Since 2000, the development of the health and human rights movement has quickened. Some States, such as Peru, have begun to take the right to health seriously at the domestic level.3 Others, such as Sweden, are endeavouring to integrate the right to health, and other human rights, into their international policies.4 For many years, UNICEF, UNAIDS and some other