By: Louise Hallman

In November 2012, Fellows and faculty from 22 countries joined in a seminar that examined the question, "How can a rights-based approach best contribute to the strengthening, sustainability, and equity of access to medicines and health systems all over the world?"

The gathering was hosted by the Salzburg Global Seminar at its headquarters at Schloss Leopoldskron in Salzburg, Austria, and co-sponsored by the World Bank Institute and the Dartmouth Center for Health Care Delivery Science.

Over five days, world-renowned faculty presented on a range of issues relating to the challenges and potential solutions in realizing the right to health.

Repeatedly, the 75 Fellows heard that realizing the right to health is not just about the right to health care, but the right to other aspects that improve health, such as basics like food and shelter, as well as the right to information that helps individuals make better informed choices about their own health and that of their wider communities.

Resources are scarce in many countries, but they’re limited in all. Even in the richest countries, issues of fairness in the access to health care treatments arise: Who more deserves an expensive course of cancer drugs – a 75-year-old who has paid into national health insurance for many years but has only a few more years to live, or a 25-year-old who hasn’t worked or paid taxes for as long but who will have a much longer life ahead of him (in which to be a greater contributor to society) should he be cured?

"Fairness doesn’t ask you to treat everyone, it doesn’t ask you to give everything to everyone," said Leonardo Cubillos, senior health specialist at the World Bank Institute. "Fairness is not about charity. Fairness is about being responsible with your resources, in allocating them in such a manner that all parties agree—not on the decision, but on the process."

Over the course of the seminar, Fellows began outlining plans aimed at meeting so-far unmet needs — stopping corruption in Nepal, improving efficiency and coverage in Mexico, increasing affordability of medicines in East Africa — and detailing specific "next steps" and methodologies, with well-placed team-leaders in mind. The teams of Fellows made commitments to each other to carry their proposals forward, with many opting to use the newly launched Salzburg Global Fellowship Yammer Network – a social network platform exclusively for SGS Fellows – to help co-ordinate and implement their plans.

Only time will tell which of these projects eventually come to fruition, but as Reos facilitator Zaid Hassan said at the end of the week's presentations, "Ideas don’t happen because they’re good; they happen because people believe in them."

Louise Hallman is Editor — Salzburg Global Seminar. See her complete coverage of the November conference here.

Understanding Delivered

Health Rights: A Manifesto

Along with the seminar's formal questions (above) and informal sharing (bottom), a platform of sorts emerged that would help support the Fellows' work moving forward. Margot Skarpeteig, senior advisor at the Norwegian Agency for Development Co-operation, outlined the seven components to a rights-based approach to development, which could also be applied to health:

Participation – ensuring patients have a role in their own health care;

Accountability for both governments and doctors;

Non-discrimination  – ensuring the delivery of health care to all, including the vulnerable;

Transparency in the decision-making;

Human dignity – ensuring everyone is treated with respect of their cultural differences;

Empowerment – ensuring patients are informed about their health care systems;

Rule of law – ensuring all participants in the health care system deliver the right to health in accordance to legislation.