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The Health and Human Rights Journal launched 30 years ago at the dawn of the era of health and human rights. Health and human rights were more often viewed as being in tension than in harmony, and there was little guidance on the right to health itself. With the unabashed discrimination against people living with HIV/AIDS in the name of public health at the forefront of our minds, Jonathan Mann and one of us (LOG) sought to provide practical guidance on when and how human rights could be limited in the name of public health, developing the first health and human rights impact assessment. A singular lesson from the AIDS pandemic, amplified by the COVID-19 pandemic, is that equity must be at the core of health and human rights assessments.

Non-discrimination is at the core of human rights; without this principle, rights could practically be denied at will. Under human rights law, this is a far-reaching principle, encompassing not only intentional, facially discriminatory measures, but also substantive, indirect discrimination. Equity has also moved to the core of global health. Even with significant overall global health improvements during the Millennium Development Goals era, inequities within countries stubbornly persisted. And while the life expectancy gap between richer and poorer countries narrowed, the difference remains nearly a full generation. Meanwhile, the AIDS movement and an increasingly empowered health and human rights civil society forced the world's attention on marginalized and discriminated against populations.

Health and human rights assessments now regularly include equity as a core component, along with participation of affected populations. Several UN human rights special rapporteurs have encouraged human rights impact assessments’ use. With these assessments’ growing potential and this deepening legal recognition, it is time to recognize that as indispensable tools of governments and businesses to protect against human rights violations, and with relatively low resource requirements, conducting equity-focused, participatory health and human rights assessments is an immediate, core obligation of the right to health. UN human rights bodies should endorse this understanding, and along with the World Health Organization, offer guidance. Civil society organizations need not wait until this happens, though, to press governments to incorporate these assessments in their legal frameworks – an advance in health and human rights that could be transformative.


Copyright © 2024 Gostin and Friedman. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication Citation

Health and Human Rights Journal, Vol. 26, No. 1, Pp. 15-19.