China's Experience in Safeguarding the Right to Life and Health in Epidemic Response
The novel coronavirus is the most broadly impactful global contagion that humanity has faced in the last century, and it has posed a serious threat to the health and safety of people all over the world. Speaking at the 73rd World Health Assembly on May 18, 2020, UN Secretary-General António Guterres said that the Covid-19 pandemic is a tragedy, and that "both our response and our recovery must put human rights considerations at the center." Months earlier on January 20, President Xi Jinping delivered important instructions regarding the epidemic in which he stressed that the health and safety of the people should be the top priority. Throughout the crisis, China has acted according to the principle that life is invaluable, sharing its experience and solutions for firmly protecting human rights with the world, while also enriching and elevating theory on the right to life and health. These actions are of major practical significance for the development of a global community of health through joint efforts and for the protection of basic human rights around the world.
I. Safeguarding the right to life and health through a people-centered approach
The Covid-19 pandemic is a grave crisis that poses a serious test to the entire world, but it also serves as an opportunity to observe the state of human rights in different countries. What principles each country follows in its response, what actions they choose, and how effective these actions are all depend on whether or not they put the people first and make their health and safety the absolute priority. Putting the people first and recognizing that life is invaluable, China rapidly and effectively mustered resources and manpower throughout the country, and secured major strategic success in curbing the spread of the virus. We thus vigorously protected the people's right to life and health, and made important contributions for safeguarding public health security both regionally and globally.
China's efforts to treat patients and save lives on an equal and impartial basis and its commitment to protect the health and safety of the people at any cost are a reflection of both the essence of international law on the protection of universal human rights, and of the principle of putting the people above all else that China has followed in its response to Covid-19. With a commitment to equal protection of human rights, we conducted two rounds of blanket screening in Wuhan, implemented centralized supervision over four categories of people, namely confirmed cases, suspected cases, people with fevers, and close contacts of confirmed cases, and ensured that we addressed the needs of everyone who needed to be admitted to hospitals, to be treated, tested, or quarantined. We brought together the most experienced doctors, the most advanced equipment, and the most urgently needed resources, and made sure that all patients enjoyed equal rights to treatment regardless of factors such as their financial status, place of residence, level of education, gender, age, or ethnicity. On the basis of ensuring equal protection for all, we put stress on remedying shortcomings, focusing in particular on safeguarding the rights to life and health of special groups including the elderly, the disabled, children, the poor, and people living on low incomes. As of May 31, 2020, there had been a total of 83,017 confirmed cases reported in 31 provinces (autonomous regions, municipalities directly under the central government) and the Xinjiang Production and Construction Corps, with 78,307 recovered patients and 4,634 deaths. This represents a recovery rate of 94.3% and a mortality rate of 5.6%. Since the beginning of epidemic, Hubei Province has achieved the successful recovery of more than 3,000 Covid-19 patients aged 80 or above, and seven patients aged 100 or above. Many elderly patients with severe symptoms were brought back from death's door. This set of data fully demonstrates China's adherence to a people-centered approach to the protection of the right to life and health, which has elevated this right to a higher level.
Two doctors stanch an incision on the chest of Mr. Hu, a Covid-19 patient who had severe symptoms, after removing ECMO (artificial oxygenation) equipment at Wuhan Pulmonary Hospital, April 5, 2020. In the face of the sudden epidemic, China has spared no effort to save lives. The average cost to treat patients with severe symptoms is more than 150,000 yuan, while expenses for some critically ill patients reach a million yuan or more. All the expenses were underwritten by the government. PHOTO BY XINHUA REPORTER FEI MAOHUA
Human health is the foundation of social progress. Speaking at the 73rd World Health Assembly in May 2020, Xi Jinping said, "Let us make concerted efforts to protect the lives and health of people in all countries. Let us work together to safeguard planet Earth, our common home. Let us work together to build a global community of health for all!" China's outlook on health in the new area, its Healthy China initiative, and its strategic proposal to build a global community of health have provided direction and solid theoretical foundations for protecting the people's rights to life and health in this critical battle against Covid-19. Faced with this sudden outbreak that has seriously threatened the health and safety of the people, the CPC and the Chinese government have consistently made it clear that their foremost responsibility is to keep the people safe. Making the decisive choice to put life above all economic interests, they have spared no effort to save lives. They have also shown care and concern for Chinese citizens abroad, and mourned those who have died with the most solemn of national ceremonies. These actions fully demonstrate China's respect for the life and dignity of the individual. In an effort to safeguard the people's health benefits and right to life and health, China has established the largest legally defined network for the direct reporting of infectious disease outbreaks and public health emergencies, and formed a broad, multi-leveled medical insurance system based on basic medical insurance that features full coverage. All Covid-19 patients have been provided with the highest possible level of support. Out of pocket medical expenses incurred by Covid-19 patients (including confirmed cases and suspected cases) that were not covered by basic medical insurance, major illness insurance, medical assistance, etc., have been subsidized by the government. As of May 31, 2020, there have been a total of 58,000 admissions of confirmed patients to hospitals throughout China. Total medical expenses for these patients amounted to 1.35 billion yuan, or about 23,000 yuan per patient. Meanwhile, the average cost for each patient with serious symptoms was more than 150,000 yuan, with expenses for some critically ill patients even reaching a million yuan or more. The government assumed all of these expenses, in a true expression of its commitment to safeguard the people's right to life and health.
To win this people's war against the epidemic, it is imperative that we respect individual dignity, stimulate individual initiative, and bring together a vast pool of strength. In the fight against Covid-19, medical workers have charged bravely into battle like warriors clad in medical armor. Around 540,000 medical personnel from Hubei Province and its capital city of Wuhan took to the front lines, while more than 40,000 military and civilian medical workers from other parts of the country immediately rushed to their aid. Across the country, millions of medical workers fought against the epidemic on the front lines. The people of Hubei and Wuhan carried on tenaciously, and made tremendous sacrifices for the good of the nation. Four million community workers contributed to the fight in 650,000 urban and rural communities throughout the country, monitoring the epidemic, taking temperatures, screening people, standing guard, explaining policies, and constantly disinfecting. They earnestly and meticulously performed their duties, and effectively held the first line of defense in epidemic prevention and control. Our public security officers, customs officers, primary-level officials, and officials assigned from higher levels to communities made great sacrifices to keep the people safe, working around the clock to carry out disinfection and to detect people who were infected. Workers beyond count in all industries such as delivery people, sanitation workers, road and transport workers, media workers, and volunteers put hardship aside and performed their duties with dedication. All the 1.4 billion Chinese people, regardless of their age, gender, or job, made a conscientious effort to participate in the people's war against the epidemic. As a result, we were able to rapidly establish a powerful system for prevention and control featuring joint efforts and society-wide participation. This fully demonstrates the immense value and striking effects of the CPC's people-centered philosophy of governance, which truly serves as the foundation for protecting the people's right to life and health.
II. Treating the right to life and health as the most fundamental human right in epidemic prevention and control
In the fight against Covid-19, China chose without hesitation to put the lives of the people above fleeting economic interests. Around the globe, different values with respect to human rights have influenced how countries have chosen and applied prevention and control measures, and even determined the progress and outcome of their response.
In the extraordinary period when the Covid-19 outbreak began, taking decisive and law-based action to lock down cities and implement quarantine was the right decision to control the devastation of the virus, curb its spread, and protect the health and safety of the people. On January 25, 2020, during a meeting of the Standing Committee of the Political Bureau of the CPC Central Committee, Xi Jinping stressed the point that life is invaluable. In the critical stage of our epidemic response, China mobilized the strength of the entire nation and fought to protect the lives and health of the people at any cost, thus accumulating unique experience on how to safeguard human rights while responding to such a crisis.
The right to life and health is the most basic human rights due to the following main reasons. Firstly, the right to life and health are foundational in position and maternalistic in function. Life is the essential vehicle for human rights, and the mother that breeds all other human rights. Without life, the right to liberty, economic rights, and all other rights would not be able to exist. Therefore, the right to life and health is positioned at the foundation of human rights. Secondly, in normative terms, the position of the right to life and health as a fundamental human right accords with international human rights standards centered on the UN Charter. The Charter makes clear in its very first article that the purpose of the UN is "to maintain international peace and security," and the right to life is at the very essence of peace. The Universal Declaration of Human Rights states, "Everyone has the right to life, liberty, and security of person." Not only is the right to life and health a primary right, in a state of emergency, its overriding demands can be met by scaling back other rights such as the right to liberty and economic rights. Thirdly, assigning the right to life and health key importance is a vivid demonstration of Chinese socialist theory on human rights at work in epidemic response. By assigning primary importance to the rights of subsistence and development, China has pioneered a unique model and successful approach for respecting and protecting human rights. The right to life and health is the most elementary form of the rights to subsistence and development, and represents the backbone and premise of these rights. Finally, from the perspective of external factors, the fact that the people's right to life and health has been effectively protected in the course of our epidemic response is the inevitable outcome of China's persistent efforts since the launch of reform and opening up, and particularly since the 18th CPC National Congress in 2012, to promote the protection of human rights through development, to ensure that all of the people share in the fruits of development, and to safeguard the people's rights to subsistence and development.
III. Enriching the core meaning of the rights to life and health
Under the scope of traditional human rights law, the right to life only stipulates that no one shall be arbitrarily deprived of life. With a commitment to integrating the universal and practical aspects of human rights, China has fought a tough but effective battle against the epidemic. In the process, it has greatly expanded upon the meaning of the rights to life and health, and further enriched Chinese socialist theory on human rights.
A medical worker wheels an 81-year-old Covid-19 patient with severe symptoms to have a CT scan in an intensive care unit at Huoshenshan Hospital in Wuhan, Hubei Province, March 20, 2020. Since the beginning of the epidemic, Hubei has brought about the recovery of more than 3,000 patients over the age of 80, and seven patients over the age of 100. PHOTO BY XINHUA REPORTER WANG YUGUO
The traditional Western perspective on human rights equates these rights with personal and political freedom, while leaving out life and health. With the rise of the welfare state, Western scholars divided human rights into negative and positive rights. Negative rights refer to rights that can be automatically realized as long as the government does not act to negate them, restrict them, or obstruct them, and these take the form of personal rights and political rights on the basis of the concept of liberty. Positive rights refer to economic, social, and cultural rights based on equality, and require action and input on the part of the government to be realized. Some Western countries regard the right to health as a positive right, thereby stressing the responsibility of the state, but this overemphasizes the difference between health and life. Under normal conditions, the right to life is not completely equivalent to the right to health. The right to life stresses safeguarding the continuation of life, while the right to health stresses preserving the normal functioning of the organism that serves as the vessel of life. However, the novel coronavirus is contagious and deadly, and poses a serious threat to both people's lives and health. The only way to effectively guard against this threat is to keep people healthy by life and health are indivisibly connected in epidemic prevention and control. Combining the right to life and the right to health into a single unit is conducive to the protection of both. By protecting life from the harm posed by the virus, advancing the thorough and comprehensive development of human rights, and ensuring that everyone enjoys these rights, we have integrated the processes of respecting, protecting, and promoting human rights. As a result, we have combined components of the right to life and health such as safety, inviolability, a long life, and a sound mind and body into a single whole, and put in place rigorous protections for every link in this chain. This is the defining feature of China's efforts to protect human rights in the fight against the epidemic, and it has deepened and enriched theory and understanding with regard to the right to life and the right to health.
China has raised the bar for the protection of the right to life and health through its impressive actions to counter the epidemic. On standards for the protection of the right to health, Article 12 of the "International Covenant on Economic, Social, and Cultural Rights" stipulates: "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." Meanwhile, "General Comment No. 14" from the UN Committee on Economic, Social, and Cultural Rights states the essential elements of the right to health, namely that health facilities, goods, and services should be available, accessible, and acceptable and of good quality. However, there is still no clear consensus on what the "highest standard" is, or how these essential elements should be understood. In its response to the epidemic, China has not only actively fulfilled its obligations for protecting the right to life and health as set out in UN human rights agreements, but also adopted extremely comprehensive, rigorous, and thorough prevention and control measures. By doing so, it has kept its infection and mortality rates as low as possible, and achieved one of the highest recovery rates in the world, thus writing a new chapter on the protection of the right to life and health in humanity's history of struggle against epidemic disease.
China's vigorous efforts to safeguard the right to life and health in its response to the epidemic have fully demonstrated that the country respects and protects human rights.
After the outbreak began, China set up a unified and efficient command system, launched a prevention and control campaign featuring full mobilization, comprehensive planning, and augmented response measures, and took steps to ensure that resources for control and treatment were equally accessible and affordable to all. Everyone in both urban and rural areas could directly and rapidly procure anti-epidemic medical supplies and services, and no one was deprived of treatment because they could not afford it. The process of fighting the epidemic has in fact also been a process of ensuring that the rights and interests of all people related to life and health are protected. From initially only performing nucleic acid tests on suspected cases to implementing blanket testing over close to 10 million people in Wuhan, from requiring home isolation to providing designated isolation facilities, from giving aid to Wuhan and Hubei to assisting outbreak zones around the country, and from guaranteeing the provision of material resources to ensuring that mental health services are accessible to those who need them, China has not let a single case slip by undetected, and not given up on a single patient.
While respecting the general rules for prevention and control, China has upheld the principle of putting people first, taking steps to ensure that response measures are fully adapted to the unique characteristics of the Chinese people and the different needs of individual patients, and that treatment plans are acceptable and flexible. Used in conjunction with Western medicine, Chinese traditional medicine has played a constant and profound role in epidemic prevention and control, leveraged for its unique strengths in preventative treatment, differential diagnosis, and multi-targeted intervention. Out of respect for female patients, full consideration has been given to gender-specific sensitivities, and we have taken steps to foster harmonious social relations in order to protect the right to life and health through more acceptable methods.
A worker administers a nucleic acid test at a testing site on the grounds of Wujiashan No. 1 Elementary School in Dongxihu District, Wuhan, Hubei Province, May 15, 2020. Between the beginning of the day on May 14 and the end of the day on June 1, close to 9.9 million people were tested in Wuhan, with zero active cases discovered. Apart from children aged six or less, all of the city's residents were tested. PHOTO BY XINHUA REPORTER XIAO YIJIU
China has committed to consistently raising standards of quality for the protection of rights. Over the course of the response, we have formulated seven editions of Covid-19 diagnosis and treatment protocols, three editions of diagnosis and treatment protocols for seriously and critically ill patients, two editions of standards for managing mild and ordinary cases, two editions of plans for convalescent plasma therapy, and a recovery plan regarding the main functional impairments faced by Covid-19 patients that have been discharged from hospital. This has made treatment efforts more science- and standards-based.
The CPC Central Committee set up a group to lead the epidemic response and assembled a team of the best medical experts that applied professional, sophisticated, and precise protocols for medical work. Critically ill patients were examined by doctors of multiple medical disciplines and treated through the most advanced methods, with no effort spared to protect their right to life and health. WHO Director General Tedros Adhanom Ghebreyesus said that many of China's prevention and control measures went above and beyond relevant requirements for emergency response, setting a new benchmark for anti-epidemic work in other countries.
We have also strengthened solidarity and cooperation with the international community, and promoted a global community of health for all. China has provided active assistance to countries and regions with weak epidemic response capacity, enthusiastically participated in international cooperation on health and sanitation, promoted an effective and sustainable global public health system that benefits people around the world, and established firm lines of defense for protecting the health and safety of all humanity. We have thus made positive contributions toward safeguarding regional and global public health security and developing a global community of health.
In sum, under the strong leadership of the CPC, China has put the health and safety of the people first throughout its epidemic response. We have practiced good governance, leveraged our institutional strengths, and made effective use of our institutions to protect the right to life and health. Our contributions to the global human rights cause are thus clear for all to see.
Wang Xigen is Dean of the School of Law and Director of the Institute of Human Rights Law at Huazhong University of Science and Technology.
(Originally appeared in Qiushi Journal, Chinese edition, No. 12, 2020)