Autorentext:
Health is a valuable asset for every person and it is an individual aim to stay healthy. Whether and how it can be reached, however, depends not only on the individual. Especially when it comes to healthcare, certain conditions and arrange-ments are required. A market of any kind may be an answer how health services can be provided. However, in hardly any region of the world can one rely on that exclusively, rather the state actors influence on healthcare. The way healthcare services are then available in certain countries or regions, is various, ranging from a system of exclusively private providers to national health services.
But with all these different answers are always two main questions connected: Are health care ser-vices even offered, and are they sufficient? Are they affordable for everyone? Thus it addresses the central aspect of access to health care services. This is always a debate about social justice in socie-ties and at the same time, a debate about solidarity in societies. Hence, the access to health care ser-vices is a profoundly political debate and public health policy therefore revolves mainly around the issues of allocation and financing.
It was recognized early that the national state alone may not be able to cope with the social challen-ges of modern societies, especially with regard to health. So it is no surprise that already the first international agreement of worker protection, known as the Berne Convention of 1906, also had health dimensions as a subject of discussion. Later and also today international agreements, conven-tions and regulations contain numerous facts which focus on health. The right to health, especially the right to access to health care services is enshrined in many international, regional or national standards worldwide. In addition to the "European Social Charter", the "African Charter on Human and Peoples' Rights" and the "Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights”, it is particularly Art. 12 of the "International Covenant on Economic, Social and Cultural Rights", that guarantees a right to the highest attainable standard of physical and mental health.
But what is the use of such international agreements, conventions or regulations in the daily life of individuals? What is the use of such a right to health in practice? Wherever there is a enforceable, litigable and subjective right, every individual is able to enforce this position. But where it does not constitute an enforceable, liti-gable and subjective right, such arrangements are ineffective, so there is no guar-antee of access to healthcare services. Besides one should not misjudge that even with legally enforceable, litigable subjective rights, the question arises how they are to be implemented in their respective context.
Therefore, it is understandable and indispensable that in many regions of the world one cannot only bet on the way of juridification, but rather attempt by structural targets to force and grant a high level of healthcare and access to health care ser-vices. The best known are the so-called Millennium Development Goals. With those, a working group consisting of representatives of the UN, the World Bank, OECD and several NGOs implemented a list of eight goals to realize the provisions of the UN Millennium Declaration by the year 2015. Three of these Millennium De-velopment Goals (MDGs) direct to healthcare by creating specifications on the topics "Reduce of child mortality" (MDG 4), "Improving maternal health" (MDG 5) and "Combating HIV/AIDS, malaria and other major diseases" (MDG 6).
A final evaluation of the Millennium Development Goals is still awaited, but it is remarkable what these Millennium Development Goals initiated worldwide and ef-fected in some regions. It is there-fore not surprising that it is thought of a successor model. Thereby the attention will especially focus on the pursued goals and how they are, also financially, weighted. Besides it remains interesting to see if the desired Sustainable Development Goals will complement or even replace the Millennium Development Goals with respect to health care aspects.
