“Everyone has the right to a standard of living adequate for the health, and wellbeing of himself and his family…”.(Article 25 of the Universal Declaration of Human Rights 1948).World Health Orgnaisation (WHO) declares that it is one of the fundamental rights of every human being to enjoy “the highest attainable standard of health”. Inherent in the right to health is the right to the underlying conditions of health as well as medical care.

The United Nations further defined the right to health in Article 12 of the International Covenant on Economic, Social and Cultural Rights in 1966. The Covenant guarantees the “right of everyone to the enjoyment of the highest attainable standard of health”, and calls for the “provision for the reductions of . . . infant mortality and for the healthy development of the child; the improvement of all aspects of environmental and industrial hygiene; the prevention, treatment and control of epidemic, endemic, occupational, and other diseases; and the creation of conditions which could assure to all medical service and medical attention in the event of sickness.”

In 2000, the United Nations issued the General Comment No.14 “Right to Health” which expands upon the original ideas from 1966 by exploring the historical context of this right, further defining the meaning of an adequate health care system, detailing obligations of states and NGO’s, defining violations, and discussing the basics of implementation.

Since then, other international human rights treaties have recognized or referred to the right to health or to elements of it, such as the right to medical care. The right to health is relevant to all States: every State has ratified at least one international human rights treaty recognizing the right to health. Moreover, States have committed themselves to protecting this right through international declarations, domestic legislation and policies, and at international conferences.

Health expenditure has been increasing along with the increased rate of chronic and non-communicable diseases, making health-care less and less affordable for most people. In a country like Bangladesh, where per capita health expenditure is only $ 7.5 and 75 percent of it comes from the patients’ pockets, the government must think about alternative health expenditure.

If you visit the National Hospitals and talk to patients, you will find a significant number of poor patients having been forced to sell their land or property to pay for the accumulating bills for treatment. Alternative health financing, however, can bring a ray of hope for lower income and middle income groups.

According to the World Bank Report, 31 percent of people are poor accounting for around 5 crore of the total population. Every year an estimated 3 percent of the population is falling below the poverty line. Exorbitant health expenditure is considered as one of the main reasons behind this.

So though late, the government of Bangladesh has decided to implement health insurance by early next year. Under the programme, poor people will be provided with health cards. According to Health Minister Dr AFM RuhalHaque, if they show the cards to the concerned hospitals, they will get free treatment.

But the government is yet to confirm whether they will get treatment free of charge from only the public hospitals or from private hospitals too. Other important issues that are not quite clear are the ceiling on the insurance coverage and whether it would cover secondary and tertiary level healthcare or only primary care. The purpose of adopting health insurance is to reduce the burden of costs to the poor and also allow them to have access to appropriate medical care when they need it.

The Government of Bangladesh is responsible for the progressive realisation of the rights to health. We need progressive realisation right now.