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5 Transnat'l Hum. Rts. Rev. 1 (2018)

handle is hein.journals/tranhurrv5 and id is 1 raw text is: A RIGHT TO UNIVERSAL HEALTH COVERAGE IN RESOURCE-CONSTRAINED NATIONS? TOWARDS A BLUEPRINT FOR BETTER HEALTH OUTCOMES UCHECHUKWU NGWABA* Abstract Universal health coverage, as conceived by the World Health Organization (WHO) and adopted in the programmatic framework of the Sustainable Development Goals (SDGs), is a clarion call for states to strengthen their health financing systems to avoid catastrophic and impoverishing health spending. However, the framing of the goals of universal health coverage fails to take account of underlying determinants of health and appears to abandon decades of health rights scholarship and jurisprudence. This scholarship and jurisprudence, although not entirely free from disagreements and shortcomings, is argued to offer a better framework for universal health coverage when strengthened with the paradigm of legal positions developed by Robert Alexy. Informed by the need to bolster universal health coverage to ensure better health outcomes in resource-constrained nations such as Brazil, India, Nigeria and South Africa, this paper argues for a strengthening of the framework of the right to health and its convergence with universal health coverage to achieve better health outcomes in resource-constrained nations. I. IN THIS PAPER, I advance the claim that if the right to health, understood as a set of legal positions to universal health coverage, is implemented in resource-constrained nations, better health outcomes are likely to result. The means I suggest for the implementation of the right is by engaging the tripartite framework of legal positions developed by Robert Alexy to clarify the beneficiaries, subject matter and addressees of the right to health. Alexy's idea bolsters the current framing of universal health coverage, linking it with the underlying determinants of health; and seeking a convergence of the right to health and universal health coverage to inform the attainment of better health outcomes in resource-constrained nations. The better health outcomes I envisage include significant reductions in the mortality rates, morbidity ratio and communicable and non- communicable diseases, and improvements in the underlying determinants of health. By putting forward these arguments, I invariably suggest that the current framing of the right to health in international law, and the domestic system of many resource-constrained nations, is inadequate to bring about the attainment of better health outcomes in those states. I further suggest that universal health coverage, as currently framed by the World Health Organization, * Sessional Lecturer, Macquarie University, Sydney, Australia; LLB (Jos), BL, LLM (Lagos), PhD (Sydney).

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