Towards a Framework Convention on Global Health : A Transformative Agenda for Global Health Justice

International law has responded weakly to the inequities in health care, public health, and the broader determinates of health that collectively cause the greatest loss of lives and human potential every year. Approximately one-third of global deaths can be attributed to enduring and unconscionable inequities. Despite significant progress in improving global health over the past several decades, these inequities persist. Current global governance for health is inadequate to the task of resolving these inequities, from lack of accountability and enforcement to inadequate funding and the absence of leadership required to respond to the threats to health that arise from other sectors. The risk of a persisting global health underclass looms large. Human rights law, with its universally accepted right to health, can underpin new norms and structures to dramatically reduce health inequities and ameliorate the factors that give rise to them. Four fundamental questions can clarify national and international responsibilities under the right to health and offer guidance to new legal instruments to resolve these health inequities: 1. What are the health services and goods guaranteed to every human being under the right to health? 2. What do states owe for the health of their own populations? 3. What responsibility do states have for improving the health of people beyond their borders? 4. What kind of global governance mechanisms are required to guarantee that all states live up to their mutual responsibilities to provide health goods and services to all people? To capture the answers to these questions, we offer ideas for the contents and structure of a new global treaty grounded in the right to health and with the principal purpose of ameliorating health disparities among the world’s rich and poor. This Framework Convention on Global Health (FCGH) would set global health norms and priorities, with a robust vision of making available and accessible to all: universal health care, public health measures, and the social determinants required for good health. The FCGH would embed equity as a key principle in binding international law; establish targets and benchmarks, tailored to individual countries through inclusive and flexible processes, including the critical involvement of civil society and communities; ensure sustainable funding backed by clear national and international responsibilities; strengthen global governance for health including by responding to health threats in other sectors and strengthening the World Health Organization; and establish a robust regime of accountability at local and national levels along with effective enforcement and compliance mechanisms for the FCGH itself. The path towards an FCGH will be arduous, with multiple barriers posed by politics and special interests. However, the treaty offers an innovative path we should forge, propelled by social mobilization. An inclusive process will be central in establishing the treaty, with a campaign driven by social movements committed to the right to health