The right to health for vulnerable and marginalised groups: Russia as a case study

Abstract

The international human right to health seeks to deliver equal opportunity to enjoy the highest attainable standard of health for everyone and is specifically concerned with the health status of vulnerable and marginalised groups. To this aim it unequivocally prohibits discrimination and guarantees the equal access to health care for all. This contribution analyses the potential of the human rights framework to ensure equal health opportunities for women, children, indigenous peoples, prisoners, drug users and people with HIV by means of the Russian case study. This chapter will first establish the normative protection the right to health offers for disadvantaged groups via the principles of non-discrimination and equality, which are translated into the content of the right to health and the consequent states' obligations. Second, it undertakes a case study of the Russian public health system and assesses the health status of disadvantaged groups in the context of central government law and public health policy measures. From this empirical evidence, the systematic noncompliance of the State with its obligations in relation to the right to health of the vulnerable and marginalised groups is established: equal access to health care is particularly impeded for prisoners, drug users, indigenous people, women and adolescents; de facto discrimination is experienced by HIV-positive drug users despite the equality legislation available in Russia; and preventative measures, such as health information and education are not adequately provided to women, adolescents and indigenous groups. Based on the findings of the case study this carries out an analysis of the perspectives, challenges and dimensions of equal opportunity for disadvantaged communities to enjoy the highest attainable standard of health. It reaffirms that equal access to health care and non-discrimination are crucial conditions to combat health inequalities, and elaborates whether political willingness and purposeful rights-based action focusing on the specific health needs of vulnerable and disadvantaged people are capable of ensuring the much needed equal health opportunities for all.