The South African Constitution minces no words regarding access to medical care.
“Everyone has the right to have access to health care services, including reproductive health care,” the document declares, adding that: “The state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realization of each of these rights.”
At a time when the United States is engaged in an archaic debate over whether to even try and provide universal access to health care, most other countries well understand the absurdity of conditioning access to basic human needs—including access to healthcare, housing and education—on the ability to pay.
That understanding was championed by Nelson Mandela, whose life and legacy is being honored this week by President Obama, members of Congress and leaders from around the world. Fittingly, the memorials for Mandela will coincide with this week’s sixty-fifth anniversary of the adoption (on December 10, 1948) by the United Nations General Assembly of the Universal Declaration of Human Rights—a document that the former South African president revered as a touchstone for nation building and governing.
Mandela, a lawyer by training and a student of constitutions, steered South Africa toward a broad understanding of human rights. When his country adopted its Constitution in 1996, he announced that “the new constitution obliges us to strive to improve the quality of life of the people. In this sense, our national consensus recognizes that there is nothing else that can justify the existence of government but to redress the centuries of unspeakable privations, by striving to eliminate poverty, illiteracy, homelessness and disease. It obliges us, too, to promote the development of independent civil society structures.”
There are many reasons to honor Mandela. And there is much to be borrowed from his legacy.
But it is absolutely vital, as we focus on this man, to recall his wise words with regard to human rights—and the role that government had in assuring access to those rights.
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Mandela embraced the great vision of the twentieth-century idealists who, at the end of World War II, recognized a responsibility to address the inequality that fostered fear, hatred and totalitarianism. It was an American, Eleanor Roosevelt, who reminded Americans seventy years ago that “at all times, day by day, we have to continue fighting for freedom of religion, freedom of speech, freedom from fear, and freedom from want—for these are things that must be gained in peace as well as in war.”
President Franklin Roosevelt, with his 1941 “Four Freedoms” speech, had begun to scope out the broader definition of human rights, speaking not just of First Amendment liberties but also of a “freedom from want – which, translated into world terms, means economic understandings which will secure to every nation a healthy peacetime life for its inhabitants—everywhere in the world.”
After her husband’s death in 1945, Eleanor Roosevelt carried the vision forward in her dynamic role as the first chairperson of the United Nations Commission on Human Rights. She oversaw the development of the Universal Declaration of Human Rights, a document that affirmed: “Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co-operation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality.”
The declaration also held out this promise: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”
When the fiftieth anniversary of the Universal Declaration of Human Rights was celebrated in 1998, Mandela addressed the UN General Assembly.
“Born in the aftermath of the defeat of the Nazi and fascist crime against humanity, this Declaration held high the hope that all our societies would, in future, be built on the foundations of the glorious vision spelt out in each of its clauses,” said Mandela, who had in the preceding decade made the transition from prisoner to president of South Africa. “For those who had to fight for their emancipation, such as ourselves who, with your help, had to free ourselves from the criminal apartheid system, the Universal Declaration of Human Rights served as the vindication of the justice of our cause. At the same time, it constituted a challenge to us that our freedom, once achieved, should be dedicated to the implementation of the perspectives contained in the Declaration.”
Mandela accepted that challenge, and explained that it remained unmet in much of the world.
“The very right to be human is denied everyday to hundreds of millions of people as a result of poverty, the unavailability of basic necessities such as food, jobs, water and shelter, education, health care and a healthy environment,” he said. “The failure to achieve the vision contained in the Universal Declaration of Human Rights finds dramatic expression in the contrast between wealth and poverty which characterizes the divide between the countries of the North and the countries of the South and within individual countries in all hemispheres.”
The president of South Africa was explicit in his criticism of leaders who failed—by “acts of commission and omission”—to address civil and economic injustice.
“What I am trying to say is that all these social ills which constitute an offence against the Universal Declaration of Human Rights are not a pre-ordained result of the forces of nature or the product of a curse of the deities. They are the consequence of decisions which men and women take or refuse to take, all of whom will not hesitate to pledge their devoted support for the vision conveyed in the Universal Declaration of Human Rights,” he explained.
Looking to the future, Mandela concluded, “The challenge posed by the next 50 years of the Universal Declaration of Human Rights, by the next century whose character it must help to fashion, consists in whether humanity, and especially those who will occupy positions of leadership, will have the courage to ensure that, at last, we build a human world consistent with the provisions of that historic Declaration and other human rights instruments that have been adopted since 1948.”
Douglas Foster on the meaning of Mandela.
