To determine if there is a correlation between ratification of human rights treaties and better health, Alexis Palmer and colleagues used statistical analyses to compare health and social indicators between countries that have ratified six key human rights treaties* and those that have not. In addition, they used the available data to determine if these same indicators improved within countries after ratification. In their analysis, they found no significant association between ratification of these treaties and an improvement in health indicators, a result that is disheartening but perhaps not unexpected by those who work in the global health field. The results for social indicators were no more reassuring; ratification was not significantly associated with improvements in social indicators, even though the treaties more directly target these indicators. The authors stress, however, that international human rights treaties are not without value in the pursuit of better global health. These treaties can be – and have been – used as the basis for legal cases focused on the right to health and can be used by NGOs as the basis for advocating policy changes.

This is not the first time researchers have employed quantitative analysis to evaluate the effectiveness of international human rights treaties. In a 2002 article in The Yale Law Journal, Oona A. Hathaway explored the relationship between treaty ratification and human rights ratings. She found “not a single treaty for which ratification seems to be reliably associated with better human rights practices and several for which it appears to be associated with worse practices,” a conclusion that is even more discouraging than that of the Palmer article. Emilie M. Hafner-Burton and Kiyoteru Tsutsui used the same six treaties as Palmer et al. to determine the impact of international treaties on human rights. Like Hathaway, they found evidence that ratification of treaties is correlated with an increase in human rights abuses in some cases. They also found that the higher the number of citizens involved in international NGOs, the more likely the country is to abide by human rights norms. Eric Neumayar echoes this conclusion in another recent paper. Again, we see evidence that human rights treaties are not themselves effective in reducing human rights abuses but do provide a platform upon which NGOs can work, giving NGOs legitimacy on the international stage.

The lack of any significant association between the ratification of human rights treaties and improvements in population health raises serious and often debated questions for human rights and global health practitioners: How can these treaties be used to make real progress in improving health indicators? What more can reasonably be done to enforce the treaties? And the big one: Would the time and resources spent on human rights treaties in their current form be more effective if used elsewhere, especially if widespread enforcement of treaties never becomes a reality?

Your comments and questions on this subject are welcome and encouraged – post a comment and let us know what you think.

*The six treaties examined in the study were the Convention on Rights of the Child; the Covenant on Economic, Social, and Cultural Rights; the Convention on Elimination of Discrimination against Women; the Convention against Torture; the Convention on Elimination of Racial Discrimination; and the Covenant on Civil and Political Rights.

Additional information:

Treaties used in legal arguments for improving public health
The Lancet: Do human rights matter to health?
The Lancet: Getting political: fighting for global health.

Compliance with international treaties
International Organization: Sticks and Stones: Naming and Shaming the Human Rights Enforcement Problem.

Why countries ratify international treaties
Sociological Forum: Global Human Rights and State Sovereignty: State Ratification of International Human Rights Treaties, 1965-2001
International Organization: Political Institutions and Human Rights: Why Dictatorships Enter into the United Nations Convention Against Torture
Journal of Conflict Resolution: Why Do Countries Commit to Human Rights Treaties?

Political systems and health
Epidemiologic Reviews: Epi + demos + cracy: Linking Political Systems and Priorities to the Magnitude of Health Inequities-Evidence, Gaps, and a Research Agenda