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Six US-Signed Treaties and Declarations Recognizing a Right to Health Care


Since 1946 the United States has signed at least six treaties and international declarations recognizing a right to health care, in whole, or in part. Two treaties were signed, ratified, and are considered legally binding (1, 2); two other treaties were signed but have never been ratified (3, 4); and two declarations were signed but are not considered legally binding (5, 6).

Where applicable, the treaties and declarations below list the date of adoption, date of signature, and date of ratification. According to the United Nations, adoption "is the formal act by which the form and content of a proposed treaty text are established." After adoption, a treaty or declaration may be signed by individual nations. The signing of a treaty does not legally bind a country; however it does create "an obligation to refrain, in good faith, from acts that would defeat the object and the purpose of the treaty." The third step in the treaty process is ratification. When a treaty is ratified, it becomes legally binding. In the United States a treaty must be approved by two-thirds of the Senate before it can be ratified. Declarations do not go through the ratification process and are not legally binding.

1. World Health Organization Constitution

Treaty signed, ratified, and legally binding as of 1948
2. International Convention on the Elimination of All Forms of Racial Discrimination

Treaty signed, ratified, and legally binding as of 1994
3.International Covenant on Economic, Social, and Cultural Rights

Treaty signed in 1977, not ratified
4. Convention on the Rights of the Child

Treaty signed in 1995, not ratified
5. Universal Declaration of Human Rights

Declaration signed in 1948, not legally binding
6. World Health Assembly Resolution 58.33

Resolution signed in 2005, not legally binding


1. World Health Organization Constitution
Date Adopted: July 22, 1946
Date Signed by United States: July 22, 1946
Date Ratified by United States: June 14, 1948
Relevant Section:

"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition...

Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures."

Sources:
Constitution of the World Health Organization (328 KB)

United Nations, "Chapter IX Health: 1. Constitution of the World Health Organization" (112 KB) , treaties.un.org (accessed Aug. 28, 2014)



2. International Convention on the Elimination of All Forms of Racial Discrimination
Date Adopted: Dec. 21, 1965
Date Signed by United States: Sep. 28, 1966
Date Ratified by United States: Oct. 21, 1994
Relevant Section:

"In compliance with the fundamental obligations laid down in article 2 of this Convention, States Parties undertake to prohibit and to eliminate racial discrimination in all its forms and to guarantee the right of everyone, without distinction as to race, colour, or national or ethnic origin, to equality before the law, notably in the enjoyment of the following rights...

The right to public health, medical care, social security and social services."

Sources:
International Convention on the Elimination of All Forms of Racial Discrimination (91 KB)

United Nations, "Chapter IV Human Rights: 2. International Convention on the Elimination of All Forms of Racial Discrimination" (330 KB) , treaties.un.org (accessed Aug. 28, 2014)



3. International Covenant on Economic, Social, and Cultural Rights
Date Adopted: Dec. 16, 1966
Date Signed by United States: Oct. 5, 1977 (signed by President Jimmy Carter)
Date Ratified by United States: As of 2014, the United States has not ratified this treaty
Relevant Section:

"Article 12

1. The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

2. The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for:

(a) The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child;

(b) The improvement of all aspects of environmental and industrial hygiene;

(c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases;

(d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness."

Sources:
International Covenant on Economic, Social, and Cultural Rights (80 KB)

Ann Piccard, "The United States' Failure to Ratify the International Covenant on Economic, Social and Cultural Rights: Must the Poor Always Be with Us?," The Scholar: St. Mary’s Law Review on Minority Issues, Winter 2010

United Nations, "Chapter IV Human Rights: 3. International Covenant on Economic, Social, and Cultural Rights" (295 KB) , treaties.un.org (accessed Aug. 28, 2014)



4. Convention on the Rights of the Child
Date Adopted: Nov. 20, 1989
Date Signed by United States: Feb. 16, 1995 (signed by UN Ambassador M. Albright on behalf of President Clinton)
Date Ratified by United States: As of 2014, the United States has not ratified this treaty
Relevant Section:

"Article 24

1. States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.

2. States Parties shall pursue full implementation of this right and, in particular, shall take appropriate measures:

(a) To diminish infant and child mortality;
(b) To ensure the provision of necessary medical assistance and health care to all children with emphasis on the development of primary health care."

Sources:
Convention on the Rights of the Child (113 KB)

Luisa Blanchfield, "The United Nations Convention on the Rights of the Child" (351KB) , crs.gov, Apr. 1, 2013

United Nations, "Chapter IV Human Rights: 11. Convention on the Rights of the Child" (341 KB) , treaties.un.org (accessed Aug. 28, 2014)



5. Universal Declaration of Human Rights
Date Adopted: Dec. 10, 1948
Date Signed by United States: Dec. 10, 1948
Date Ratified by United States: Not a treaty, no ratification necessary
Relevant Section:

"Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services."

Sources:
Universal Declaration of Human Rights (116 KB)

United Nations Office of the High Commissioner for Human Rights, "Fact Sheet No.2 (Rev.1), The International Bill of Human Rights" (55 KB) , ohcr.org (accessed Aug. 28, 2014)



6. World Health Assembly Resolution 58.33
Date Adopted: May 25, 2005
Date Signed by United States: May 25, 2005
Date Ratified by United States: Not a treaty, no ratification necessary
Relevant Section:

"Recognizing the important role of State legislative and executive bodies in further reform of health-financing systems with a view to achieving universal coverage,

1. URGES Member States:

(1) to ensure that health-financing systems include a method for prepayment of financial contributions for health care, with a view to sharing risk among the population and avoiding catastrophic health-care expenditure and impoverishment of individuals as a result of seeking care;

(2) to ensure adequate and equitable distribution of good-quality health care infrastructures and human resources for health so that the insurees will receive equitable and good-quality health services according to the benefits package;

(3) to ensure that external funds for specific health programmes or activities are managed and organized in a way that contributes to the development of sustainable financing mechanisms for the health system as a whole;

(4) to plan the transition to universal coverage of their citizens so as to contribute to meeting the needs of the population for health care and improving its quality, to reducing poverty, to attaining internationally agreed development goals, including those contained in the United Nations Millennium Declaration, and to achieving health for all;"

Sources:
World Health Assembly Resolution 58.33 (21 KB)

United Nations, "Fifty-Eighth World Health Assembly, Geneva, 16-25 May 2005," (868 KB) , apps.who.int (accessed Aug. 28, 2014)