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The Right to Health as the Right to Treatment: Shifting Conceptions of Public Health

This paper examines the implications of a legal and political discourse that frames the right to health as being mainly about access to medicines. Such a politics associated with the right to health is resulting in the provision of medicines to individuals that otherwise would have been marginalized within national health systems. However, while often empowering marginalized individuals and groups, litigation and mobilization around the right to health nevertheless facilitates access to only some medicines and for only some people. The right to health has not typically been interpreted as a general right to medicines, but rather, has had a narrower operative orientation. This has consequences on the understanding of the public commons, and the responsibilities of the state in the realm of public health. Moreover, by interpreting the right to health as the right to treatment, there is an implicit equating of health with health care. Such an orientation in effect deflects the understanding of health away from an emphasis on broader structural and contextual determinants. Health increasingly becomes about therapies and diagnostics, and not about social factors that contribute to well-being and illness. As such, much of the extant politics of the right to health might be contributing to a narrowing of the frameworks within which to address health of individuals and populations.