The right to the highest attainable standard of health is incorporated in many international and regional human rights instruments.
This right contains both freedoms and entitlements, including freedom to control one’s own health and body and the right to
an accessible system of health care, goods and services.
Both aspects of the right to health - freedoms and entitlements
- have important cultural dimensions. The UN Committee on Economic, Social and Cultural Rights has for instance stated that
the right to health implies that health facilities, goods and services must be culturally appropriate, in other words respectful
of the culture of individuals and communities. At the same time, it should be noted that culture and health may have a problematic
relationship. Cultural patterns, attitudes or stereotypes may severely limit the health freedoms of people or may prevent
certain people from access to health care. Furthermore, there are cultural or traditional practices conducted and condoned
that are very harmful to the health of people.
It seems that international human rights law demands respect for the cultural
dimensions of the right to health, while at the same time requiring protection of the right to health against negative aspects
of cultures. How does this work out in practice? What does the concept of "culturally appropriate" health goods and services
mean at the national level? Who decides on what is or is not culturally appropriate? How have international supervisory elaborated
the freedoms and entitlements of the right to health of individuals and the obligations for States Parties to the treaties
in relation to the cultural dimensions of the right to health?
This article analyses several treaty provisions and the
interpretation of these provisions by the treaty monitoring bodies. Apart from several UN treaties several regional treaties
in Africa are dealt with, notably the African Charter on Human and Peoples’ Rights. The article concludes that various cultural
dimensions of the right to health are recognised and elaborated in recommendations by treaty monitoring bodies both at UN
and African level. These bodies have endorsed the idea that health facilities, goods and services must be respectful of the
culture of individuals, peoples and communities. At the same time, the right to health should be protected against the negative
impact that cultural values, patterns or practices may have, for instance on access to health goods and services and on the
health of people as such. The latter issue has received most attention at UN as well as at African level and there appears
to be a clear consensus on several practices that are considered harmful.
It is however also realised that identifying
a certain practice as harmful by an international body, even if agreed upon by the State Party, is not sufficient to eradicate
it. Cultural communities are crucial in promoting social and behavioural changes that may be needed to eradicate harmful practices.
It is therefore important to involve the cultural communities concerned in the drafting, implementation and evaluation of
health laws and policies. This could be more emphasised by the monitoring bodies. Involvement of the cultural community is
also crucial in respecting and promoting the more positive cultural dimensions of the right to health. By consulting cultural
communities and individuals concerned, States can implement the right to the highest attainable standard of health in a culturally
sensitive, appropriate and responsible way.