Philip Alston, the United Nations’ special rapporteur on extreme poverty and human rights, did not mince words when he issued his recent report on poverty in the United States.
Recent policies under the Trump administration “seem designed to remove basic protections from the poorest, punish the poor and make even basic health care a privilege to be earned rather than a right of citizenship.”
Alston’s damning assessment is a stark reminder of the consequences of the US government’s failure to recognize the right to health under international law. Articulated in the Universal Declaration of Human Rights in 1948, the right was then codified by the International Covenant for Economic, Social and Cultural Rights (ICESCR). 166 countries have ratified that treaty, including most developed nations of the world – but not the United States.
The right to health does not guarantee the right of everyone to be healthy. What it does do is oblige governments to enact policies that promote the availability and affordability of basic healthcare services, without discrimination against those most likely to face obstacles gaining access – the poor, minorities, persons with disabilities, women and children among others.
So far, many of the Trump administration’s signature policies have pulled in exactly the opposite direction. Most notably, it has embarked on an all-out effort to repeal the Affordable Care Act. That repeal failed in Congress, but many of the Affordable Care Act’s key components are still under attack.
Women, especially Black women, Indigenous women, and those living in rural areas, face particular challenges in accessing health care in the US. Black women die at higher rates than white women from preventable cervical cancer and maternal mortality. Reproductive healthcare is also under siege, from attempts to defund Planned Parenthood to the recently proposed domestic “gag rule” affecting all public family planning grantees that would prohibit even discussion or referral to other providers for abortion services.
Amid an epidemic of overdose deaths, the right to health for people who use drugs has been dealt crushing new blows by efforts, led by the Department of Justice, to return to punitive approaches that have proven disastrous and are incompatible with public health solutions to the crisis.
It is not enough to push back against the Trump administration’s harmful policies. It’s high time US political leaders realized that by failing to embrace the right to health under international law, they’ve made it easier for these terrible policies to take root.