Mechanisms of Accountability for the Realization of the Right to Health in China

Qiu, Shengnan; Macnaughton, Gillian

Accountability for the right to health Accountability is a key component of human rights, including the right to health. In General Comment 9 on the domestic application of the covenant, the UN Committee on Economic, Social and Cultural Rights, the body responsible for monitoring implementation of the covenant, stressed that the central obligation of states parties in relation to the ICESCR is to ensure that the rights recognized by the covenant are fulfilled. 10 Although the ICESCR adopts a flexible approach that enables governments to take into account the particularities of their own legal and administrative systems, governments must nonetheless use all the means at their disposal to realize the rights recognized in the covenant. 11 Accountability is crucial to ensuring that states parties meet their obligations under the covenant. Governments are required to provide appropriate means of redress to aggrieved rights-holders. 12 There are many types of accountability mechanisms, including judicial, quasi-judicial, administrative, political, and social mechanisms. 13 While the type may vary, the purpose of each mechanism is to ensure that governments are answerable for their actions or inactions regarding the right to health and that rights-holders have effective remedies when their rights have been violated. 14 There are a number of potential remedies for violations of the right to health. Restitution, compensation, and rehabilitation focus on addressing impacts of rights violations on individual right-holders or groups of rights-holders. 15 Satisfaction and guarantees of non-repetition are remedies aimed at addressing rights violations at the systemic level. 16 Importantly, accountability is "sometimes narrowly understood to mean blame and punishment, whereas it is more accurately regarded as a process to determine what is working (so it can be repeated) and what is not (so it can be adjusted)." 17 In this sense, accountability for human rights also hinges on the notion of participation of people and groups in all health-related decision making. Governments ensure one kind of participation through the creation of accountability mechanisms and effective remedies. 18 In addition, individuals and groups are entitled to participate in meaningful ways in the development and design of health policies and in monitoring and evaluating the implementation of these policies. 19 In order to ensure avenues for meaningful participation, governments must create fair and transparent processes that are accessible to and inclusive of diverse groups. 20 Participation methods vary but could include regional or national conferences, local health committees, focus groups, budgetary oversight, and public meetings. 21 Effective monitoring and evaluation by government, civil society, and rights-holders also requires transparency. Governments have an obligation to provide the public with information about their efforts to realize the right to health. 22 Continuous monitoring of efforts and outcomes serves a number of purposes. First, it provides governments with valuable information about the impact of their efforts. 23 Second, it provides rights-holders with information they need to participate meaningfully in health-related decision making and to hold their government accountable for realizing the right to health. 24 Accountability mechanisms for the right to health in China The exact term "accountability" (wen ze) was first introduced into the Chinese polit