Using a right to health framework to assess cancer services in Samoa

Abstract

The right to the highest attainable standard of health (shortened as the ‘right to health’) is recognised in international human rights law, giving States duties to respect, protect and fulfil the right to health. As General Comment 14 informs, States have obligations to make conscious steps towards providing people with the full enjoyment of the right to health. The burden of non-communicable diseases is increasing and threatening the health and development of people globally, and thus is an important consideration when assessing States’ right to health obligations. The recognition of this global public health issue is evidenced by the United Nations High Level Meeting on the prevention and control of noncommunicable diseases, and by the indicators to reduce mortality due to non-communicable diseases in the Sustainable Development Goals. The burden of cancer, one of the four main non-communicable diseases, is also increasing globally, and more recently this growth has become particularly evident among low- and middle-income countries (LMICs). As such, cancer prevalence and mortality is becoming a major issue in the Pacific region, which is home to many LMICs. This thesis provides a case study of the Pacific nation Samoa, to examine whether the government is fulfilling the human rights entitlements of its people in respect to the prevention, diagnosis, treatment and palliative care of cancer. The six building blocks of the Samoan health system are analysed to determine whether the functions of each block meet minimum standards of cancer control as set by the World Health Organization. Areas of particular concern, including poor planning and lack of transparency, are identified. This leads to the conclusion that people’s human rights entitlements to the prevention, treatment and care of cancer are not being met by the government of Samoa despite its human rights obligation to do so.