An official website of the United States government

Statement at HRC Debate on Health and the Human Rights of Migrants
May 28, 2013

U.S. Statement Delivered by Ambassador Eileen Chamberlain Donahoe

Interactive Dialogue with the Special Rapporteurs on the
Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health
and on the Human Rights of Migrants

UN Human Rights Council – 23rd Session
May 27, 2014,


Thank you Mr. President.

For many years now the United States has joined other countries in supporting the right of everyone to the enjoyment of the highest attainable standard of health.  We thank the Special Rapporteur for using this year’s report to focus on access to medicines.

The United States agrees that access to affordable and high quality medicines and medical care in the event of sickness is an important component for the enjoyment of the highest attainable standard of physical and mental health.  However, research has shown that there exist multiple reasons why essential medicines are less widely available than they should be in some countries.  As the Special Rapporteur points out, often times these barriers are internal to a country, and would be best addressed by taking domestic action.  For example, states can place priority on putting in place strong regulatory systems.  A health system that incorporates transparent processes can help promote the availability, affordability, quality, safety and efficacy of medicines.

We take a different view from that presented by the Special Rapporteur in certain parts of the report.  The report recommends “a paradigm shift toward a rights-based approach on access to medicines.”  Considering how multi-faceted and complex this issue is, we believe such a one-sided paradigm is insufficient for the public health evidence-basis necessary for action in this area.  States must have the ability to determine how best to promote public health in a manner consistent with applicable human rights and other international obligations.

Similarly, the report promotes local production of medicines, yet offers no evidence to support the assertion that this measure would increase access.  We were especially surprised to see a recommendation that countries increase tariffs on imported medicines to protect local production.  Increasing tariffs is not effective as a health policy for the clear reason that it almost inevitably leads to diminished access to medicines, and higher prices for patients.

We also do not agree with the report’s characterization and definition of the enjoyment of the highest attainable standard of health.  The “right to health framework” is not well-defined, nor is it necessarily beneficial to the advancement of human rights and public health.  Furthermore, to the extent that it is implied throughout this report, the United States does not recognize creation of any new right which we have not previously recognized, the expansion of the content or coverage of existing rights, or any other change in the current state of treaty or customary international law.  In particular, we note the non-binding nature of the Special Rapporteur’s views and of many of the sources upon which he relies.

We appreciated the opportunity to meet informally with the Special Rapporteur during his visit to the United States last year.  Every government can and in fact should work to provide access to essential medicines for all.  The United States is committed to continuing to play an important, catalyzing role in promoting innovation and voluntary mechanisms that increase access to affordable health technologies to people around the world.

The United States also would like to recognize the report of the Special Rapporteur on the human rights of migrants, Mr. Francois Crépeau (Cray-poh).  We reaffirm the primary importance of protecting the human rights of migrants, irrespective of their immigration status, in line with domestic legislation.

We commend the report’s extensive efforts to document the EU’s evolving migration policy framework.  The report notes that while the EU has made strides in adopting and implementing policies to protect regular migrants, more must be done at the regional level to ensure the protection of human rights of irregular migrants – particularly those crossing international borders into the EU.  We appreciate observations on the risks migrants face in the informal sector, including exploitative working conditions.  We also support recommendations for increased protection training and capacity-building on EU borders, especially in EU Member States with an external border that acts as the first point of entry, and we applaud the EU for the efforts already undertaken.

We encourage the Special Rapporteur to build upon the theme of vulnerable migrants by examining third country nationals fleeing conflict zones; migrant victims of crime including those who are kidnapped and abused by smugglers and traffickers; stateless migrants and those facing barriers to obtaining nationality; unaccompanied children; and migrants crossing borders to seek assistance after natural disasters.

The United States thanks Special Rapporteur Crepeau for his efforts to promote human rights over the last year, and we look forward to continued updates on these mandates.