1. Transcending Available Resources: Improving Public Health Through the Right to Development Ashley M. Fox, MA & Benjamin Mason Meier, JD, LLM, MPhil IGERT-International Development & Globalization Fellows, PhD Candidates, Department of Sociomedical Sciences, Columbia University Introduction  The International Covenant on Economic, Social and Cultural Rights (ICESCR) codified into international law an individual human right to health but limited this right only to the maximum of a state’s available resources, with a view to achieving progressively full realization of the right.  Without development, states will be unable to increase their available resources to realize progressively the right to health; however, neoliberal development policies have led to increasing poverty and inequality within and among states.  Although the United Nations adopted the Declaration on the Right to Development, this collective human right was not initially linked to health outcomes, stymieing attempts to protect public health during structural adjustment. The Globalization of Disease  Modernization has markedly improved health throughout the world, including increased life expectancies at birth and decreased infant and maternal mortality.  Despite this, contemporary neoliberal economic policies (e.g., trade liberalization and state privatization) have led to insalubrious development and exacerbated inequality.  Increased poverty and inequality is responsible for injurious health consequences, resulting in the rise of non-communicable and communicable diseases.  Structural adjustment programs have reduced the capacity of states to provide medical care and diminished state public health systems.  Rights-based economic development has failed to improve public health.  Working through “rights-based approaches to health,” public health advocates have employed the individual human right to health in development discourses.  However, this individual right—burdened by the principle of progressive realization—has been ineffective in addressing underlying determinants of health, marginalizing public health actors in development.  A right to health, if framed as part of a right to development, would allow states to challenge harmful development conditionalities. Methods  Through legal and political analyses, this research examines whether modern processes of globalization necessitate incorporation of health rights in the right to development. An Evolving Right to Development  The adverse impact of neoliberal policies on public health in the developing world necessitates state responses through collective human rights.  This collective human right—a right to development, inhering in developing states themselves—obligates states and international organizations to address underlying determinants of health and the public health systems that structure them. Objectives  To assess the human right to health as a means of ameliorating global disparities in public health outcomes.  To compare the human rights implications of targeted health interventions with socio-economic interventions that influence underlying determinants of health.  To analyze the role of the right to health in development discourses and the right to development in public health systems. Conclusions  Acknowledging this synergy of rights would ensure that policies implemented to enhance development will not do so at the expense of public health.  By creating a framework for discussing health within development discourses, international legal bodies could operationalize the right to development through concrete, measurable public health indicators for development policies. The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health… - International Covenant on Economic, Social and Cultural Rights, Art. 12(1) (1966). A Synergy of Rights  The collective right to development, as a vector of rights, should be viewed as both encompassing and incorporating an individual right to health.  Without a right to development, less developed countries will be unable to progressively realize the “highest attainable standard” of health.  Without health rights, the public health needs of the state will not be prioritized.  This enhanced right to development could empower states and public health advocates to promote public health systems during development processes. States have the right and the duty to formulate appropriate national development policies that aim at the constant improvement of the well-being of the entire population and of all individuals… - Declaration on the Right to Development, Art. 2(3) (1986).