Towards a framework convention on global health

Abstract

A global health treaty, a Framework Convention on Global Health (FCGH)–grounded in the right to health, with the central goal of reducing immense domestic and global health inequities–could serve as a robust global governance instrument to underpin the United Nations post-2015 Millennium Development Goals (MDGs). It would ensure for all people the three essential conditions for a healthy life–public health, health care, and the positive social determinants of health–while advancing good governance, responding to drivers of health disadvantages for marginalized populations, elevating health in other legal regimes, and enhancing people's ability to claim their rights. The legally binding nature of the FCGH would enhance accountability and compliance through rigorous monitoring and reporting, domestic human rights litigation, and international incentives. It would overcome the collection action problem of global health financing through a health financing framework with clear domestic and international obligations. Stakeholders have made thoughtful critiques of the FCGH, such as the opportunities costs of advocacy, the time and expense of treaty negotiations, and reporting burdens. Nevertheless, these costs could be turned into opportunities through civil society participation in negotiations, by taking advantage of extensive reporting and monitoring requirements to expand accountability around and strengthen strategies to respond to health inequities, and through non-binding frameworks on the way towards the treaty. The greatest challenge in achieving an FCGH is the political obstacles it will face. Social justice movements united behind an FCGH, to secure the treaty and to ensure its implementation, are vital to the success of an FCGH–and the right to health. With its aim of securing this right, the FCGH could unite disparate health-related movements, all of which should contribute to developing the treaty and taking ownership of its realization.

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