| CESCR/GC/14 CESCR_GC_14E.doc (English) | CESCR/GC/14 CESCR_GC_14C.doc (Chinese) |
| CESCR | CESCR |
| General comment No. 14: | 第14号一般性意见： |
| The right to the highest attainable standard of health (art. 12) | 享有能达到的最高健康标准的权利(第十二条) |
| Twenty-second session (2000) | 第二十二届会议(2000年) |
| 1. Health is a fundamental human right indispensable for the exercise of other human rights. | 1. 健康是行使其他人权不可或缺的一项基本人权。 |
| Every human being is entitled to the enjoyment of the
highest attainable standard of health conducive to living a life in
dignity. | 每个人都有权享有能够达到的、有益于体面生活的最高标准的健康。 |
| The realization of the right to health may be pursued
through numerous, complementary approaches, such as the formulation of
health policies, or the implementation of health programmes developed by
the World Health Organization (WHO), or the adoption of specific legal
instruments. | 实现健康权可通过很多办法，彼此互相补充，如制定卫生政策、执行世界卫生组织制定的卫生计划，或采用具体的法律手段。 |
| Moreover, the right to health includes certain components which are legally enforceable. | 而且，健康权还包括某些可以通过法律执行的内容。 |
| 2. The human right to health is recognized in numerous international instruments. | 2. 健康权在很多国际文书中得到承认。 |
| Article 25.1 of the Universal Declaration of Human
Rights affirms: "Everyone has the right to a standard of living adequate
for the health of himself and of his family, including food, clothing,
housing and medical care and necessary social services". | 《世界人权宣言》第二十五条第一款规定：“人人有权享受为维持他本人和家属的健康和福利所需的生活水准，包括食物、衣着、住房、医疗和必要的社会服务”。 |
| The International Covenant on Economic, Social and
Cultural Rights provides the most comprehensive article on the right to
health in international human rights law. | 《经济、社会、文化权利国际公约》在健康权上规定了国际人权法最全面的条款。 |
| In accordance with article 12.1 of the Covenant,
States parties recognize "the right of everyone to the enjoyment of the
highest attainable standard of physical and mental health", while
article 12.2 enumerates, by way of illustration, a number of "steps to
be taken by the States parties … to achieve the full realization of this
right". | 根据《公约》第十二条第一款，缔约国承认“人人有权享有能达到的最高的体质和心理健康的标准”，第十二条第二款又进一步列举了若干缔约国为实现这项权利应采取的步骤。 |
| Additionally, the right to health is recognized,
inter alia, in article 5 (e) (iv) of the International Convention on the
Elimination of All Forms of Racial Discrimination of 1965, in articles
11.1 (f) and 12 of the Convention on the Elimination of All Forms of
Discrimination against Women of 1979 and in article 24 of the Convention
on the Rights of the Child of 1989. | 此外，承认健康权的还有1956年的《消除一切形式种族歧视国际公约》第五条(辰)项(4)目，1979年的《消除对妇女一切形式歧视公约》的第十一条第1款(f)项和第十二条，和1989年的《儿童权利公约》第24条。 |
| Several regional human rights instruments also
recognize the right to health, such as the European Social Charter of
1961 as revised (art. 11), the African Charter on Human and Peoples'
Rights of 1981 (art. 16) and the Additional Protocol to the American
Convention on Human Rights in the Area of Economic, Social and Cultural
Rights of 1988 (art. 10). | 一些区域性人权文书也承认健康权，如修订的1961年《欧洲社会宪章》(第11条)、1981年的《非洲人权和人民权利宪章》(第16条)，和1988年的《美洲人权公约关于经济、社会和文化权利领域的附加议定书》(第10条)。 |
| Similarly, the right to health has been proclaimed by
the Commission on Human Rights, as well as in the Vienna Declaration
and Programme of Action of 1993 and other international instruments. | 同样，人权委员会、1993年的《维也纳宣言和行动纲领》和其他国际文书，也都提出过健康权。 |
| 3. The right to health is closely related to and
dependent upon the realization of other human rights, as contained in
the International Bill of Rights, including the rights to food, housing,
work, education, human dignity, life, non-discrimination, equality, the
prohibition against torture, privacy, access to information, and the
freedoms of association, assembly and movement. | 3. 健康权与实现国际人权宪章中所载的其他人权密切相关，又相互依赖，包括获得食物、住房、工作、教育和人的尊严的权利，以及生命权、不受歧视的权利、平等、禁止使用酷刑、隐私权、获得信息的权利，结社、集会和行动自由。 |
| These and other rights and freedoms address integral components of the right to health. | 所有这些权利和其他权利和自由都与健康权密不可分。 |
| 4. In drafting article 12 of the Covenant, the Third
Committee of the United Nations General Assembly did not adopt the
definition of health contained in the preamble to the Constitution of
WHO, which conceptualizes health as "a state of complete physical,
mental and social well-being and not merely the absence of disease or
infirmity". | 4. 在起草《公约》的第十二条时，联合国大会第三委员会没有采用世界卫生组织宪章序言中对健康的定义，该定义的健康概念是：“完全的身体、精神和社会安康，而不仅仅是没有疾病或衰弱”。 |
| However, the reference in article 12.1 of the
Covenant to "the highest attainable standard of physical and mental
health" is not confined to the right to health care. | 然而，《公约》第十二条第一款所述“享有能达到的最高的体质和心理健康的标准”，并不限于得到卫生保健的权利。 |
| On the contrary, the drafting history and the express
wording of article 12.2 acknowledge that the right to health embraces a
wide range of socio-economic factors that promote conditions in which
people can lead a healthy life, and extends to the underlying
determinants of health, such as food and nutrition, housing, access to
safe and potable water and adequate sanitation, safe and healthy working
conditions, and a healthy environment. | 相反，起草的过程和第十二条第二款明确的措词认为，健康权包括多方面的社会经济因素，促进使人民可以享有健康生活的条件，包括各种健康的基本决定因素，如食物和营养、住房、使用安全饮水和得到适当的卫生条件、安全而有益健康的工作条件，和有益健康的环境。 |
| 5. The Committee is aware that, for millions of
people throughout the world, the full enjoyment of the right to health
still remains a distant goal. | 5. 委员会清楚，对世界各地数以百万的人来说，充分享有健康权仍是一个遥远的目标。 |
| Moreover, in many cases, especially for those living in poverty, this goal is becoming increasingly remote. | 而且在很多情况下，特别是对那些生活贫困的人，这个目标正变得越来越遥远。 |
| The Committee recognizes the formidable structural
and other obstacles resulting from international and other factors
beyond the control of States that impede the full realization of article
12 in many States parties. | 委员会承认，因各种国际和其他因素造成的严重结构和其他障碍，超出了一些国家的控制能力，妨碍了很多缔约国充分实现第十二条。 |
| 6. With a view to assisting States parties'
implementation of the Covenant and the fulfilment of their reporting
obligations, this general comment focuses on the normative content of
article 12 (Part I), States parties' obligations (Part II), violations
(Part III) and implementation at the national level (Part IV), while the
obligations of actors other than States parties are addressed in Part
V. | 6. 为了帮助缔约国执行《公约》和履行它们的报告义务，这份一般性意见着重阐述第十二条的规范性内容(第一部分)、缔约国的义务(第二部分)、违反(第三部分)，和国家一级的执行(第四部分)，缔约国以外的其他行为者的义务在第五部分中阐述。 |
| The general comment is based on the Committee's experience in examining States parties' reports over many years. | 这份一般性意见是根据委员会多年来审查缔约国报告的经验提出的。 |
| 1. Normative content of article 12 | 1. 第十二条的规范性内容 |
| 7. Article 12.1 provides a definition of the right to
health, while article 12.2 enumerates illustrative, non-exhaustive
examples of States parties' obligations. | 7. 第十二条第一款提出了健康权的定义，第十二条第二款列举了缔约国的一些――但并非全部――义务。 |
| 8. The right to health is not to be understood as a right to be healthy. | 8. 享有健康权，不应理解为身体健康的权利。 |
| The right to health contains both freedoms and entitlements. | 健康权既包括自由，也包括权利。 |
| The freedoms include the right to control one's
health and body, including sexual and reproductive freedom, and the
right to be free from interference, such as the right to be free from
torture, non-consensual medical treatment and experimentation. | 自由包括掌握自己健康和身体的权利，包括性和生育上的自由，以及不受干扰的权利，如不受酷刑、未经同意强行治疗和试验的权利。 |
| By contrast, the entitlements include the right to a
system of health protection which provides equality of opportunity for
people to enjoy the highest attainable level of health. | 另一方面，应该享有的权利包括参加卫生保护制度的权利，该套制度能够为人民提供平等的机会，享有可达到的最高水平的健康。 |
| 9. The notion of "the highest attainable standard of
health" in article 12.1 takes into account both the individual's
biological and socio-economic preconditions and a State's available
resources. | 9. 第十二条第一款的“能达到的最高的健康标准”概念，既考虑进了个人的生理和社会经济先决条件，也考虑进了国家掌握的资源。 |
| There are a number of aspects which cannot be
addressed solely within the relationship between States and individuals;
in particular, good health cannot be ensured by a State, nor can States
provide protection against every possible cause of human ill health. | 有一些方面不可能完全在国家与个人之间的关系范围内解决，具体而言，国家不能保证健康，它也不能提供对所有可能造成人类疾病的原因提供保护。 |
| Thus, genetic factors, individual susceptibility to
ill health and the adoption of unhealthy or risky lifestyles may play an
important role with respect to an individual's health. | 因此，遗传因素、个人是否易患疾病，和追求不健康或危险的生活方式，都可能对个人的健康产生重要影响。 |
| Consequently, the right to health must be understood
as a right to the enjoyment of a variety of facilities, goods, services
and conditions necessary for the realization of the highest attainable
standard of health. | 因此，享有健康权必须理解为一项享有实现能够达到的最高健康标准所必须的各种设施、商品、服务和条件的权利。 |
| 10. Since the adoption of the two International
Covenants in 1966 the world health situation has changed dramatically
and the notion of health has undergone substantial changes and has also
widened in scope. | 10. 自1966年联合国通过国际人权两公约以来，世界的卫生状况发生了巨大变化，健康的概念也经历了重大改变，范围也拓宽了。 |
| More determinants of health are being taken into consideration, such as resource distribution and gender differences. | 更多的健康决定因素被增加进来，如资源分配和性别差异。 |
| A wider definition of health also takes into account such socially-related concerns as violence and armed conflict. | 较宽的健康定义，还考虑进了暴力和武装冲突等社会方面的关注。 |
| Moreover, formerly unknown diseases, such as human
immunodeficiency virus and acquired immunodeficiency syndrome
(HIV/AIDS), and others that have become more widespread, such as cancer,
as well as the rapid growth of the world population, have created new
obstacles for the realization of the right to health which need to be
taken into account when interpreting article 12. | 此外，一些原先不知道的疾病，如人类免疫缺陷病毒和艾滋病(艾滋病毒/艾滋病)，和其他一些传播较广的疾病，如癌症，以及世界人口的迅速增长，都造成了实现健康权的新的障碍，在解释第十二条时必须加以考虑。 |
| 11. The Committee interprets the right to health, as
defined in article 12.1, as an inclusive right extending not only to
timely and appropriate health care but also to the underlying
determinants of health, such as access to safe and potable water and
adequate sanitation, an adequate supply of safe food, nutrition and
housing, healthy occupational and environmental conditions, and access
to health-related education and information, including on sexual and
reproductive health. | 11.
委员会对健康权的解释，根据第十二条第一款的规定，是一项全部包括在内的权利，不仅包括及时和适当的卫生保健，而且也包括决定健康的基本因素，如使用安全
和洁净的饮水、享有适当的卫生条件、充足的安全食物、营养和住房供应、符合卫生的职业和环境条件，和获得卫生方面的教育和信息，包括性和生育卫生的教育和
信息。 |
| A further important aspect is the participation of
the population in all health-related decision-making at the community,
national and international levels. | 另一个重要方面，是人民能够在社区、国家和国际上参与所有卫生方面的决策。 |
| 12. The right to health in all its forms and at all
levels contains the following interrelated and essential elements, the
precise application of which will depend on the conditions prevailing in
a particular State party: | 12. 健康权的各种形式和层次，包括以下互相关联的基本要素，其具体实施将取决于具体缔约国的现实条件： |
| (a) Availability. | (a)可提供性。 |
| Functioning public health and health-care facilities,
goods and services, as well as programmes, have to be available in
sufficient quantity within the State party. | 缔约国境内必须有足够数量的、行之有效的公共卫生和卫生保健设施、商品和服务，以及卫生计划。 |
| The precise nature of the facilities, goods and
services will vary depending on numerous factors, including the State
party's developmental level. | 这些设施、商品和服务的具体性质，会因各种因素而有所不同，包括缔约国的发展水平。 |
| They will include, however, the underlying
determinants of health, such as safe and potable drinking water and
adequate sanitation facilities, hospitals, clinics and other
health-related buildings, trained medical and professional personnel
receiving domestically competitive salaries, and essential drugs, as
defined by the WHO Action Programme on Essential Drugs; | 但它们应包括一些基本的卫生要素，如安全和清洁的饮水、适当的卫生设施、医院、诊所和其他卫生方面的建筑、经过培训工资收入在国内具有竞争力的医务和专业人员，和世界卫生组织必需药品行动纲领规定的必需药品； |
| (b) Accessibility. | (b)可获取性。 |
| Health facilities, goods and serviceshave to be
accessible to everyone without discrimination, within the jurisdiction
of the State party. | 缔约国管辖范围内的卫生设施、物资和服务，必须面向所有人，不得歧视。 |
| Accessibility has four overlapping dimensions: | 获得条件有四个彼此之间相互重叠的方面： |
| Non-discrimination: health facilities, goods and
services must be accessible to all, especially the most vulnerable or
marginalized sections of the population, in law and in fact, without
discrimination on any of the prohibited grounds; | (一)不歧视：卫生设施、物资和服务必须在法律和实际上面向所有人，特别是人口中最脆弱的部分和边缘群体，不得以任何禁止的理由加以歧视。 |
| Physical accessibility: health facilities, goods and
services must be within safe physical reach for all sections of the
population, especially vulnerable or marginalized groups, such as ethnic
minorities and indigenous populations, women, children, adolescents,
older persons, persons with disabilities and persons with HIV/AIDS. | (二)实际获得的条件：卫生设施、物资和服务，必须是各部分人口能够安全、实际获得的，特别是脆弱群体和边缘群体，如少数民族和土著人、妇女、儿童、青少年、老年人、残疾人和患有艾滋病/携带病毒的人。 |
| Accessibility also implies that medical services and
underlying determinants of health, such as safe and potable water and
adequate sanitation facilities, are within safe physical reach,
including in rural areas. | 获得的条件还包括能够安全、切实得到医疗服务和基本的健康要素，如安全和洁净的饮水、适当的卫生设施等，包括农村地区。 |
| Accessibility further includes adequate access to buildings for persons with disabilities; | 获得的条件还包括建筑物为残疾人配备适当的进入条件。 |
| Economic accessibility (affordability): health facilities, goods and services must be affordable for all. | (三)经济上的获得条件(可承受)：卫生设施、物资和服务必须是所有人能够承担的。 |
| Payment for health-care services, as well as services
related to the underlying determinants of health, has to be based on
the principle of equity, ensuring that these services, whether privately
or publicly provided, are affordable for all, including socially
disadvantaged groups. | 卫生保健服务以及与基本健康要素有关的服务，收费必须建立在平等原则的基础上，保证这些服务不论是私人还是国家提供的，应是所有人都能承担得起的，包括社会处境不利的群体。 |
| Equity demands that poorer households should not be
disproportionately burdened with health expenses as compared to richer
households; | 公平要求较贫困的家庭与较富裕的家庭相比不应在卫生开支上负担过重。 |
| Information accessibility: accessibility includes the
right to seek, receive and impart information and ideasconcerning
health issues. | (四)获得信息的条件：获得条件包括查找、接受和传播有关卫生问题的信息和意见的权利。 |
| However, accessibility of information should not impair the right to have personal health data treated with confidentiality; | 然而，获得信息的条件不应损害个人健康资料保密的权利。 |
| (c) Acceptability. | (c)可接受性。 |
| All health facilities, goods and services must be
respectful of medical ethics and culturally appropriate, i.e. respectful
of the culture of individuals, minorities, peoples and communities,
sensitive to gender and life-cycle requirements, as well as being
designed to respect confidentiality and improve the health status of
those concerned; | 所有卫生设施、物资和服务，必须遵守医务职业道德，在文化上是适当的，即尊重个人、少数群体、人民和社区的文化，对性别和生活周期的需要敏感，遵守保密的规定，和改善有关个人和群体的健康状况。 |
| (d) Quality. | (d)质量。 |
| As well as being culturally acceptable, health
facilities, goods and services must also be scientifically and medically
appropriate and of good quality. | 卫生设施、物资和服务不仅应在文化上是可以接受的，而且必须在科学和医学上是适当和高质量的。 |
| This requires, inter alia, skilled medical personnel,
scientifically approved and unexpired drugs and hospital equipment,
safe and potable water, and adequate sanitation. | 这要求除其他外应有熟练的医务人员、在科学上经过批准、没有过期的药品，医院设备，安全和洁净的饮水，和适当的卫生条件。 |
| 13. The non-exhaustive catalogue of examples in article 12.2 provides guidance in defining the action to be taken by States. | 13. 第十二条第二款并不完全的举例，规定了各国采取行动的准则。 |
| It gives specific generic examples of measures
arising from the broad definition of the right to health contained in
article 12.1, thereby illustrating the content of that right, as
exemplified in the following paragraphs. | 它提出了一些属于第十二条第一款关于健康权的广泛定义范围内的具体措施的通用例子，从而说明了这项权利的内容，具体如以下各段所示。 |
| Article 12.2 (a): The right to maternal, child and reproductive health | 第十二条第二款(甲)项 产妇、儿童和生育卫生权 |
| 14. "The provision for the reduction of the
stillbirth rate and of infant mortality and for the healthy development
of the child" (art. 12.2 (a)) may be understood as requiring measures to
improve child and maternal health, sexual and reproductive health
services, including access to family planning, pre- and post-natal
care,emergency obstetric services and access to information, as well as
to resources necessary to act on that information. | 14. “减低死胎率和婴儿死亡率，和使儿童得到健康的发育”(第十二条第二款(甲)项，可理解为需采取措施，改善儿童和母亲的健康、性和生育卫生服务，包括实行计划生育、产前和前后保健、紧急产科服务和获得信息，以及根据获得的信息采取行动所需的资源。 |
| Article 12.2 (b): The right to healthy natural and
workplace environments 15. "The improvement of all aspects of
environmental and industrial hygiene" (art. | 第十二条第二款(乙)项 享有健康的自然和工作场所环境的权利 |
| 12.2 (b)) comprises, inter alia, preventive measures
in respect of occupational accidents and diseases; the requirement to
ensure an adequate supply of safe and potable water and basic
sanitation; the prevention and reduction of the population's exposure to
harmful substances such as radiation and harmful chemicals or other
detrimental environmental conditions that directly or indirectly impact
upon human health. | 15.
“改善环境卫生和工业卫生的各个方面”(第十二条第二款(乙)项)，主要包括在职业事故和疾病方面采取预防措施；必须保证充分供应安全和洁净的饮水和基本
卫生条件；防止和减少人民接触有害物质的危险，如放射性物质和有害化学物质，或其他直接或间接影响人类健康的有害环境条件。 |
| Furthermore, industrial hygiene refers to the
minimization, so far as is reasonably practicable, of the causes of
health hazards inherent in the working environment. | 此外，工业卫生指在合理可行的范围内，尽量减少在工作环境中危害健康的原因。 |
| Article 12.2 (b) also embraces adequate housing and
safe and hygienic working conditions, an adequate supply of food and
proper nutrition, and discourages the abuse of alcohol, and the use of
tobacco, drugs and other harmful substances. | 第十二条第二款(乙)项还包括适当的住房和安全、卫生和工作条件，充分供应食物和适当的营养，劝阻酗酒和吸烟、吸毒和使用其他有害药物。 |
| Article 12.2 (c): The right to prevention, treatment and control of diseases | 第十二条第二款(丙)项 预防、治疗和控制疾病的权利 |
| 16. "The prevention, treatment and control of
epidemic, endemic, occupational and other diseases" (art. 12.2 (c))
requires the establishment of prevention and education programmes for
behaviour-related health concerns such as sexually transmitted diseases,
in particular HIV/AIDS, and those adversely affecting sexual and
reproductive health, and the promotion of social determinants of good
health, such as environmental safety, education, economic development
and gender equity. | 16.
“预防、治疗和控制传染病、地方病、职业病和其他的疾病”(第十二条第二款(丙)项)，要求对行为方面的健康关注建立预防和教育计划，如性传播疾病，特别
是艾滋病/病毒，及有害于性卫生和生育卫生的行为，改善健康的社会要素，如安全的环境、教育、经济发展和性别平等。 |
| The right to treatment includes the creation of a
system of urgent medical care in cases of accidents, epidemics and
similar health hazards, and the provision of disaster relief and
humanitarian assistance in emergency situations. | 得到治疗的权利，包括在事故、流行病和类似健康危险的情况下，建立一套应急的医疗保健制度，及在紧急情况下提供救灾和人道主义援助。 |
| The control of diseases refers to States' individual
and joint efforts to, inter alia, make available relevant technologies,
using and improving epidemiological surveillance and data collection on a
disaggregated basis, the implementation or enhancement of immunization
programmes and other strategies of infectious disease control. | 控制疾病，指各国单独或共同努力，特别是提供相关技术、使用和改善分类的流行病监督和数据收集工作，执行和加强免疫计划，和其他传染病的控制计划。 |
| Article 12.2 (d): The right to health facilities, goods and services | 第十二条第二款(丁)项 享受卫生设施、物资和服务的权利 |
| 17. "The creation of conditions which would assure to
all medical service and medical attention in the event of sickness"
(art. 12.2 (d)), both physical and mental, includes the provision of
equal and timely access to basic preventive, curative, rehabilitative
health services and health education; regular screening programmes;
appropriate treatment of prevalent diseases, illnesses, injuries and
disabilities, preferably at community level; the provision of essential
drugs; and appropriate mental health treatment and care. | 17.
“创造保证人人在患病时能得到医疗照顾的条件”(第十二条第二款(丁)项)，包括身体和精神两个方面，要求平等和及时地提供基本预防、治疗、康复的卫生保
健服务，以及卫生教育；定期检查计划；对流行病、一般疾病、外伤和残疾给予适当治疗，最好是在社区一级；提供必需药品；和适当的精神保健治疗和护理。 |
| A further important aspect is the improvement and
furtherance of participation of the population in the provision of
preventive and curative health services, such as the organization of the
health sector, the insurance system and, in particular, participation
in political decisions relating to the right to health taken at both the
community and national levels. | 另一个重要的方面，是改善和进一步加强民众参与，提供预防和治疗保健服务。 如卫生部门的组织、保险系统等，特别是参与社区和国家一级的有关健康权的政治决定。 |
| Article 12: Special topics of broad application | 第十二条：广泛适用的专项议题 |
| Non-discrimination and equal treatment | 不歧视与平等待遇 |
| 18. By virtue of article 2.2 and article 3, the
Covenant proscribes any discrimination in access to health care and
underlying determinants of health, as well as to means and entitlements
for their procurement, on the grounds of race, colour, sex, language,
religion, political or other opinion, national or social origin,
property, birth, physical or mental disability, health status (including
HIV/AIDS), sexual orientation and civil, political, social or other
status, which has the intention or effect of nullifying or impairing the
equal enjoyment or exercise of the right to health. | 18.
根据第二条第二款和第三条，《公约》禁止在获得卫生保健和基本健康要素方面，以及在获得的手段和条件上，不得有任何种族、肤色、性别、语言、宗教、政治或
其他见解、国籍或社会出身、财产、出生、身体或精神残疾、健康状况(包括艾滋病/病毒)、性倾向，以及公民、政治、社会和其他地位上的任何歧视，可能或实
际上抵消或妨碍平等享有或行使健康权。 |
| The Committee stresses that many measures, such as
most strategies and programmes designed to eliminate health-related
discrimination, can be pursued with minimum resource implications
through the adoption, modification or abrogation of legislation or the
dissemination of information. | 委员会强调，可采取很多办法，如很多旨在消除健康方面歧视的计划和方案，并无须太多的资源，如通过、修订或废除某些法律，或开展宣传。 |
| The Committee recalls general comment No. 3,
paragraph 12, which states that even in times of severe resource
constraints, the vulnerable members of society must be protected by the
adoption of relatively low-cost targeted programmes. | 委员会忆及第3号一般性意见的第12段，该段指出，即使在资源严重困难的情况下，也必须通过采取费用相对较低的特别方案，保护社会脆弱群体的成员。 |
| 19. With respect to the right to health, equality of access to health care and health services has to be emphasized. | 19. 在健康权方面，必须强调公平获得卫生保健和卫生服务的条件。 |
| States have a special obligation to provide those who
do not have sufficient means with the necessary health insurance and
health-care facilities, and to prevent any discrimination on
internationally prohibited grounds in the provision of health care and
health services, especially with respect to the core obligations of the
right to health. | 国家负有特殊义务，为没有足够能力的人提供必要的卫生保险和卫生保健设施，在提供卫生保健和卫生服务方面防止出现任何国际上禁止的歧视现象，特别是在健康权的基本义务上。 |
| Inappropriate health resource allocation can lead to discrimination that may not be overt. | 卫生资源分配不当，可造成隐形的歧视。 |
| For example, investments should not
disproportionately favour expensive curative health services which are
often accessible only to a small, privileged fraction of the population,
rather than primary and preventive health care benefiting a far larger
part of the population. | 例如，投资不应过分偏重于昂贵的治疗保健服务，那方面的服务常常只有少数享有特权的人能够得到，而是应当偏重初级和预防卫生保健，使更大多数的人口受益。 |
| Gender perspective | 性别观点 |
| 20. The Committee recommends that States integrate a
gender perspective in their health-related policies, planning,
programmes and research in order to promote better health for both women
and men. | 20. 委员会建议，各国在它们有关卫生的政策、规划、方案和研究中，增加性别观点，促进改善妇女和男人的健康。 |
| A gender-based approach recognizes that biological
and sociocultural factors play a significant role in influencing the
health of men and women. | 基于性别的方针承认，生理和社会文化因素在影响男人和妇女的健康方面起着重要作用。 |
| The disaggregation of health and socio-economic data
according to sex is essential for identifying and remedying inequalities
in health. | 按性别对卫生和社会经济数据进行分类，对发现和纠正卫生方面的不平等现象十分重要。 |
| Women and the right to health | 妇女和健康权 |
| 21. To eliminate discrimination against women, there
is a need to develop and implement a comprehensive national strategy for
promoting women's right to health throughout their life span. | 21. 为了消除对妇女的歧视，必须制定和执行综合性国家战略，在妇女的整个一生中促进她们的健康权。 |
| Such a strategy should include interventions aimed at
the prevention and treatment of diseases affecting women, as well as
policies to provide access to a full range of high quality and
affordable health care, including sexual and reproductive services. | 该计划应包括采取行动，预防和治疗影响妇女的疾病，以及制定政策，提供全面的高质量且能够支付的卫生保健，包括性和生育服务。 |
| A major goal should be reducing women's health risks,
particularly lowering rates of maternal mortality and protecting women
from domestic violence. | 主要目标是减少妇女的健康危险，特别是降低产妇死亡率和保护妇女免受家庭暴力。 |
| The realization of women's right to health requires
the removal of all barriers interfering with access to health services,
education and information, including in the area of sexual and
reproductive health. | 实现妇女的健康权，必须清除所有影响获得卫生服务、教育和信息的障碍，包括在性和生育卫生方面。 |
| It is also important to undertake preventive,
promotive and remedial action to shield women from the impact of harmful
traditional cultural practices and norms that deny them their full
reproductive rights. | 另一个重要问题，是采取预防、促进和补救行动，保护妇女免受那些使她们不能充分享有生育权的有害传统文化习俗和规定的影响。 |
| Children and adolescents | 儿童和青少年 |
| 22. Article 12.2 (a) outlines the need to take
measures to reduce infant mortality and promote the healthy development
of infants and children. | 22. 第十二条第二款(甲)项规定，必须采取措施，降低婴儿死亡率，促进婴儿和儿童的健康发育。 |
| Subsequent international human rights instruments
recognize that children and adolescents have the right to the enjoyment
of the highest standard of health and access to facilities for the
treatment of illness. | 之后通过的国际人权文书承认，儿童和青少年有权享有最高标准的健康，和得到治疗疾病的设施。 |
| The Convention on the Rights of the Child directs
States to ensure access to essential health services for the child and
his or her family, including pre- and post-natal care for mothers. | 《儿童权利公约》要求各国保证，为儿童和他们的家庭提供基本卫生服务，包括对母亲的产前和产后护理。 |
| The Convention links these goals with ensuring access
to child-friendly information about preventive and health-promoting
behaviour and support to families and communities in implementing these
practices. | 该公约还在这些目标上要求确保能够获得对儿童有益的预防和增进健康行为的信息，支持家庭和社区将之付诸实施。 |
| Implementation of the principle of non-discrimination
requires that girls, as well as boys, have equal access to adequate
nutrition, safe environments, and physical as well as mental health
services. | 落实不歧视的原则，要求男孩子和女孩子一样，享有平等的机会，得到充分的营养、安全的环境，以及身体和精神的卫生服务。 |
| There is a need to adopt effective and appropriate
measures to abolish harmful traditional practices affecting the health
of children, particularly girls, including early marriage, female
genital mutilation, preferential feeding and care of male children. | 必须采取有效和适当的措施，废除影响儿童，特别是女童健康的有害传统习俗，包括早婚、女性生殖器残割、偏袒喂养和照顾男童。 |
| Children with disabilities should be given the
opportunity to enjoy a fulfilling and decent life and to participate
within their community. | 残疾儿童应给予机会，享受有意义和体面的生活，参与社区生活。 |
| 23. States parties should provide a safe and
supportive environment for adolescents, that ensures the opportunity to
participate in decisions affecting their health, to build life skills,
to acquire appropriate information, to receive counselling and to
negotiate the health-behaviour choices they make. | 23. 缔约国应为青少年提供安全和有帮助的环境，保证能够参与影响他们健康的决定，有机会学习生活技能、获得相关的信息、得到咨询，和争取他们自己作出的健康行为选择。 |
| The realization of the right to health of adolescents
is dependent on the development of youth-friendly health care, which
respects confidentiality and privacy and includes appropriate sexual and
reproductive health services. | 实现青少年的健康权。 取决于建立对青年有帮助的卫生保健，该套制度应尊重保密和隐私，并包括适当的性和生育卫生服务。 |
| 24. In all policies and programmes aimed at
guaranteeing the right to health of children and adolescents their best
interests shall be a primary consideration. | 24. 在所有保证儿童和青少年健康权的政策和方案上，儿童和青少年的最大利益应为首要考虑。 |
| Older persons | 老年人 |
| 25. With regard to the realization of the right to
health of older persons, the Committee, in accordance with paragraphs 34
and 35 of general comment No. 6 (1995), reaffirms the importance of an
integrated approach, combining elements of preventive, curative and
rehabilitative health treatment. | 25. 在实现老年人的健康权方面，委员会根据1995年的第6号一般性意见的第34和第35段，重申综合方针的重要性，结合预防、治疗和康复性保健治疗等要素。 |
| Such measures should be based on periodical check-ups
for both sexes; physical as well as psychological rehabilitative
measures aimed at maintaining the functionality and autonomy of older
persons; and attention and care for chronically and terminally ill
persons, sparing them avoidable pain and enabling them to die with
dignity. | 这方面的基本措施包括对男女老年人定期身体检查；身体和精神康复措施，保持老年人的活动能力和自主；治疗和照看患慢性病和不治之症的人，帮助他们免除可以避免的痛苦，和使他们能够体面的去世。 |
| Persons with disabilities | 残疾人 |
| 26. The Committee reaffirms paragraph 34 of its
general comment No. 5, which addresses the issue of persons with
disabilities in the context of the right to physical and mental health. | 26. 委员会重申第5号一般性意见的第34段，该段在身体和精神健康权方面讲到残疾人的问题。 |
| Moreover, the Committee stresses the need to ensure
that not only the public health sector but also private providers of
health services and facilities comply with the principle of
non-discrimination in relation to persons with disabilities. | 此外，委员会还强调，必须保证不仅公共卫生部门，而且私营提供卫生服务和设施的人也必须遵守对残疾人不歧视的原则。 |
| Indigenous peoples | 土著人 |
| 27. In the light of emerging international law and
practice and the recent measures taken by States in relation to
indigenous peoples,the Committee deems it useful to identify elements
that would help to define indigenous peoples' right to health in order
better to enable States with indigenous peoples to implement the
provisions contained in article 12 of the Covenant. | 27. 根据新产生的国际法和国际惯例，以及各国对土著人最近采取的措施，委员会认为需要确定一些有助于确定土著人健康权的主要问题，使有土著人的各国能够更好的执行《公约》第十二条的规定。 |
| The Committee considers that indigenous peoples have
the right to specific measures to improve their access to health
services and care. | 委员会认为，土著人有权享有具体措施，改善他们获得卫生服务和医疗的条件。 |
| These health services should be culturally
appropriate, taking into account traditional preventive care, healing
practices and medicines. | 这方面的卫生服务在文化上应当是适宜的，考虑进传统的预防护理、康复和传统医学。 |
| States should provide resources for indigenous
peoples to design, deliver and control such services so that they may
enjoy the highest attainable standard of physical and mental health. | 各国应为土著人提供资源，安排、提供和管理这方面的服务，使他们能够享有可以达到的最高水平的身体和心理健康。 |
| The vital medicinal plants, animals and minerals
necessary to the full enjoyment of health of indigenous peoples should
also be protected. | 土著人充分享有健康所需的重要医用植物、动物和矿物，也应给予保护。 |
| The Committee notes that, in indigenous communities,
the health of the individual is often linked to the health of the
society as a whole and has a collective dimension. | 委员会指出，在土著人社区，个人的健康常常与整个社会的健康连在一起，因此，有一个集体的影响。 |
| In this respect, the Committee considers that
development-related activities that lead to the displacement of
indigenous peoples against their will from their traditional territories
and environment, denying them their sources of nutrition and breaking
their symbiotic relationship with their lands, has a deleterious effect
on their health. | 在这方面，委员会认为，与发展有关的活动导致违反土著人的意愿，迫使他们离开传统的土地和环境，剥夺他们的营养来源，打破他们与土地的共生关系，将对他们的健康产生有害影响。 |
| Limitations | 限制 |
| 28. Issues of public health are sometimes used by States as grounds for limiting the exercise of other fundamental rights. | 28. 公共卫生问题时常被一些国家用来作为限制行使其他基本权利的理由。 |
| The Committee wishes to emphasize that the Covenant's
limitation clause, article 4, is primarily intended to protect the
rights of individuals rather than to permit the imposition of
limitations by States. | 委员会愿强调，公约的限制条款第四条，主要目的是保护个人的权利，而不是允许国家施加限制。 |
| Consequently a State party which, for example,
restricts the movement of, or incarcerates, persons with transmissible
diseases such as HIV/AIDS, refuses to allow doctors to treat persons
believed to be opposed to a Government, or fails to provide immunization
against the community's major infectious diseases, on grounds such as
national security or the preservation of public order, has the burden of
justifying such serious measures in relation to each of the elements
identified in article 4. | 因此，举例而言，以国家安全或维护公共秩序为借口，限制患有传染疾病的人，如艾滋病/病毒的人行动自由，或将之禁闭，拒绝让医生治疗被认为反对政府的人，或不给某个社区进行重要传染病的预防接种，有关缔约国均有责任对第四条中提出的每项内容说明此种严重措施的理由。 |
| Such restrictions must be in accordance with the law,
including international human rights standards, compatible with the
nature of the rights protected by the Covenant, in the interest of
legitimate aims pursued, and strictly necessary for the promotion of the
general welfare in a democratic society. | 这类限制必须符合法律，包括国际人权标准，符合公约保护的权利的性质，符合追求的合法目标，且必须是促进民主社会总体福祉所必须的。 |
| 29. In line with article 5.1, such limitations must
be proportional, i.e. the least restrictive alternative must be adopted
where several types of limitations are available. | 29. 根据第五条第一款，这类限制必须是适当的，即在有几种限制可作选择的情况下，必须选择限制性最小的办法。 |
| Even where such limitations on grounds of protecting
public health are basically permitted, they should be of limited
duration and subject to review. | 即使以保护公共健康为理由这种限制基本上是允许的，这些措施也应是短时间的，并需加以审查。 |
| 2. States parties' obligations | 2. 缔约国的义务 |
| General legal obligations | 一般法律义务 |
| 30. While the Covenant provides for progressive
realization and acknowledges the constraints due to the limits of
available resources, it also imposes on States parties various
obligations which are of immediate effect. | 30. 虽然公约提出了逐步实现，并且承认由于可资利用的资源有限造成了各种困难，但公约还是为缔约国规定了一些立即有效的义务。 |
| States parties have immediate obligations in relation
to the right to health, such as the guarantee that the right will be
exercised without discrimination of any kind (art. 2.2) and the
obligation to take steps (art. 2.1) towards the full realization of
article 12. | 缔约国在健康权方面即有一些立即生效的义务，如保证行使这项权利不得有任何歧视(第二条第二款)，和采取措施充分实现第十二条的义务(第二条第一款)。 |
| Such steps must be deliberate, concrete and targeted towards the full realization of the right to health. | 这些措施必须是深思熟虑的、具体的和目标明确的――充分实现健康权。 |
| 31. The progressive realization of the right to
health over a period of time should not be interpreted as depriving
States parties' obligations of all meaningful content. | 31. 在一段时间内逐步实现健康权，不应解释为缔约国的义务已失去一切有意义的内容。 |
| Rather, progressive realization means that States
parties have a specific and continuing obligation to move as
expeditiously and effectively as possible towards the full realization
of article 12. | 相反，逐步实现意味着缔约国有一项具体和始终存在的义务――尽可能迅速和切实地充分实现第十二条。 |
| 32. As with all other rights in the Covenant, there
is a strong presumption that retrogressive measures taken in relation to
the right to health are not permissible. | 32. 与《公约》中的所有其他权利一样，一个重要的假定是，不允许在健康权上采取倒退措施。 |
| If any deliberately retrogressive measures are taken,
the State party has the burden of proving that they have been
introduced after the most careful consideration of all alternatives and
that they are duly justified by reference to the totality of the rights
provided for in the Covenant in the context of the full use of the State
party's maximum available resources. | 如果蓄意采取了任何倒退措施，缔约国必须证明，有关措施是在认真权衡所有其他选择之后提出的，而且从公约规定的所有权利角度讲，为了充分利用缔约国最大限度可资利用的资源，采取这些措施是完全有理由的。 |
| 33. The right to health, like all human rights,
imposes three types or levels of obligations on States parties: the
obligations to respect, protect and fulfil. | 33. 健康权与各项人权一样，要求缔约国承担三类或三个层次的义务：尊重、保护和实现的义务。 |
| In turn, the obligation to fulfil contains obligations to facilitate, provide and promote. | 依次下来，实现的义务包括便利、提供和促进的义务。 |
| The obligation to respect requires States to refrain
from interfering directly or indirectly with the enjoyment of the right
to health. | 尊重的义务，要求缔约国不得直接或间接地干预享有健康权。 |
| The obligation to protect requires States to take
measures that prevent third parties from interfering with article 12
guarantees. | 保护的义务，要求缔约国采取措施，防止第三方干预第十二条规定的各项保证。 |
| Finally, the obligation to fulfil requires States to
adopt appropriate legislative, administrative, budgetary, judicial,
promotional and other measures towards the full realization of the right
to health. | 最后，实现的义务，要求缔约国为全面实现健康权采取适当的法律、行政、预算、司法、促进和其他措施。 |
| Specific legal obligations | 具体法律义务 |
| 34. In particular, States are under the obligation to
respect the right to health by, inter alia, refraining from denying or
limiting equal access for all persons, including prisoners or detainees,
minorities, asylum-seekers and illegal immigrants, to preventive,
curative and palliative health services; abstaining from enforcing
discriminatory practices as a State policy; and abstaining from imposing
discriminatory practices relating to women's health status and needs. | 34. 具体而言，各国有义务尊重健康权，特别是不能剥夺或限制所有人得到预防、治疗和减轻痛苦的卫生服务的平等机会，包括囚犯和被拘留者、少数群体、寻求庇护者和非法移民；不得作为一项国家政策采取歧视性做法；也不得对妇女的健康状况和需要推行歧视性做法。 |
| Furthermore, obligations to respect include a State's
obligation to refrain from prohibiting or impeding traditional
preventive care, healing practices and medicines, from marketing unsafe
drugs and from applying coercive medical treatments, unless on an
exceptional basis for the treatment of mental illness or the prevention
and control of communicable diseases. | 此外，尊重的义务还包括国家有义务不得禁止或阻挠传统的预防护理、治疗办法和医药，不得销售不安全的药品和采用带有威胁性的治疗办法，除非是在特殊情况下为治疗精神病，或预防和控制传染病。 |
| Such exceptional cases should be subject to specific
and restrictive conditions, respecting best practices and applicable
international standards, including the Principles for the Protection of
Persons with Mental Illness and the Improvement of Mental Health Care. | 这种特殊情况必须符合具体而限制性的条件，考虑到最佳做法和适用国际标准，包括“保护精神病患者和改进精神保健的整套原则”。 |
| In addition, States should refrain from limiting
access to contraceptives and other means of maintaining sexual and
reproductive health, from censoring, withholding or intentionally
misrepresenting health-related information, including sexual education
and information, as well as from preventing people's participation in
health-related matters. | 此外，各国不应限制得到避孕和其他保持性健康和生育卫生手段的途径，不应审查、扣押或故意提供错误的健康信息，包括性教育及有关信息，也不得阻止人民参与健康方面的事务。 |
| States should also refrain from unlawfully polluting
air, water and soil, e.g. through industrial waste from State-owned
facilities, from using or testing nuclear, biological or chemical
weapons if such testing results in the release of substances harmful to
human health, and from limiting access to health services as a punitive
measure, e.g. during armed conflicts in violation of international
humanitarian law. | 各国也不得违法污染空气、水和土壤等，如因国有设施的工业废料，不得在可造成释放有害人类健康物质的情况下使用或试验核武器、生物武器或化学武器，不得作为惩罚性措施限制得到卫生服务，如在武装冲突期间违反国际人道主义法。 |
| 35. Obligations to protect include, inter alia, the
duties of States to adopt legislation or to take other measures ensuring
equal access to health care and health-related services provided by
third parties; to ensure that privatization of the health sector does
not constitute a threat to the availability, accessibility,
acceptability and quality of health facilities, goods and services; to
control the marketing of medical equipment and medicines by third
parties; and to ensure that medical practitioners and other health
professionals meet appropriate standards of education, skill and ethical
codes of conduct. | 35.
保护的义务，主要包括各国有责任通过法律或采取其他措施，保障有平等的机会，得到第三方提供的卫生保健和卫生方面的服务；保证卫生部门的私营化不会威胁到
提供和得到卫生设施、物资和服务，以及这些设施、商品和服务的可接受程度和质量；控制第三方营销的医疗设备和药品；和保证开业医生和其他卫生专业人员满足
适当的教育、技能标准和职业道德准则。 |
| States are also obliged to ensure that harmful social
or traditional practices do not interfere with access to pre- and
post-natal care and family planning; to prevent third parties from
coercing women to undergo traditional practices, e.g. female genital
mutilation; and to take measures to protect all vulnerable or
marginalized groups of society, in particular women, children,
adolescents and older persons, in the light of gender-based expressions
of violence. | 各国还必须保证，有害的社会或传统习俗不能干预获得产前和前后护理和计划生育；阻止第三方胁迫妇女接受传统习俗，如女性生殖器残割；和采取措施，在性暴力表现上，保护社会中的各种脆弱和边缘群体，特别是妇女、儿童、青少年和老年人。 |
| States should also ensure that third parties do not limit people's access to health-related information and services. | 各国还应保证，第三方不得限制人民得到卫生方面的信息和服务。 |
| 36. The obligation to fulfil requires States parties,
inter alia, to give sufficient recognition to the right to health in
the national political and legal systems, preferably by way of
legislative implementation, and to adopt a national health policy with a
detailed plan for realizing the right to health. | 36. 实现的义务，要求缔约国除其他外在国家的政治和法律制度中充分承认健康权，最好是通过法律的实施，并通过国家的卫生政策，制定实现健康权的详细计划。 |
| States must ensure provision of health care,
including immunization programmes against the major infectious diseases,
and ensure equal access for all to the underlying determinants of
health, such as nutritiously safe food and potable drinking water, basic
sanitation and adequate housing and living conditions. | 各国必须保证提供卫生保健，包括对主要传染病的免疫计划，保证所有人都能平等地获得基本健康要素，如富于营养的安全食物和清洁饮水、基本的卫生条件和适当的住房和生活条件。 |
| Public health infrastructures should provide for
sexual and reproductive health services, including safe motherhood,
particularly in rural areas. | 公共卫生基础设施应提供性和生育卫生服务，包括母亲的安全知识，特别是在农村地区。 |
| States have to ensure the appropriate training of
doctors and other medical personnel, the provision of a sufficient
number of hospitals, clinics and other health-related facilities, and
the promotion and support of the establishment of institutions providing
counselling and mental health services, with due regard to equitable
distribution throughout the country. | 各国必须保证医生和其他医务人员经过适当培训，提供足够数量的医院、诊所和其他卫生设施，促进和支持建立提供咨询和精神卫生服务的机构，并充分注意到在全国的均衡分布。 |
| Further obligations include the provision of a
public, private or mixed health insurance system which is affordable for
all, the promotion of medical research and health education, as well as
information campaigns, in particular with respect to HIV/AIDS, sexual
and reproductive health, traditional practices, domestic violence, the
abuse of alcohol and the use of cigarettes, drugs and other harmful
substances. | 其他义务包括提供所有人都能支付得起的公共、私营或混合健康保险制度，促进医务研究和卫生教育，以及开展宣传运动，特别是在艾滋病/病毒、性和生育卫生、传统习俗、家庭暴力、酗酒和吸烟、使用毒品和其他有害药物等方面。 |
| States are also required to adopt measures against
environmental and occupational health hazards and against any other
threat as demonstrated by epidemiological data. | 各国还需采取措施，防止环境和职业健康危险，和流行病资料显示的任何其他威胁。 |
| For this purpose they should formulate and implement
national policies aimed at reducing and eliminating pollution of air,
water and soil, including pollution by heavy metals such as lead from
gasoline. | 为此，他们应制定和执行减少或消除空气、水和土壤污染的国家政策，包括重金属的污染，如汽油中的铅。 |
| Furthermore, States parties are required to
formulate, implement and periodically review a coherent national policy
to minimize the risk of occupational accidents and diseases, as well as
to provide a coherent national policy on occupational safety and health
services. | 此外，缔约国还应制定、执行和定期检查协调的国家政策，尽量减少职业事故和疾病的危险，并在职业安全和卫生服务方面制定协调的国家政策。 |
| 37. The obligation to fulfil (facilitate) requires
States inter alia to take positive measures that enable and assist
individuals and communities to enjoy the right to health. | 37. 实现(便利)的义务，要求各国除其他外采取积极措施，帮助个人和社区并使他们能够享有健康权。 |
| States parties are also obliged to fulfil (provide) a
specific right contained in the Covenant when individuals or a group
are unable, for reasons beyond their control, to realize that right
themselves by the means at their disposal. | 缔约国还必须在个人或群体由于他们无法控制的原因而不能依靠自身的力量实现这项权利的情况下，依靠国家掌握的手段，实现(提供)《公约》所载的一项具体权利。 |
| The obligation to fulfil (promote) the right to
health requires States to undertake actions that create, maintain and
restore the health of the population. | 实现(便利)健康权的义务，要求各国采取行动，创造、保持和恢复人民的健康。 |
| Such obligations include: (i) fostering recognition
of factors favouring positive health results, e.g. research and
provision of information; (ii) ensuring that health services are
culturally appropriate and that health-care staff are trained to
recognize and respond to the specific needs of vulnerable or
marginalized groups; (iii) ensuring that the State meets its obligations
in the dissemination of appropriate information relating to healthy
lifestyles and nutrition, harmful traditional practices and the
availability of services; (iv) supporting people in making informed
choices about their health. | 这方面的义务包括：(一)
促进了解有利健康的因素，如研究和提供信息；(二)
确保卫生服务在文化上是适当的，培训卫生保健工作人员，使他们了解和能够对脆弱群体或边缘群体的具体需要作出反应；(三)
确保国家在有益健康的生活方式和营养、有害的传统习俗和提供的服务方面，满足它在传播适当信息方面的义务；(四)
支持人民在他们的健康上作出了解情况的选择。 |
| International obligations | 国际义务 |
| 38. In its general comment No. 3, the Committee drew
attention to the obligation of all States parties to take steps,
individually and through international assistance and cooperation,
especially economic and technical, towards the full realization of the
rights recognized in the Covenant, such as the right to health. | 38. 委员会在第3号一般性意见中，提请注意各缔约国有义务采取措施，单独或通过国际援助和合作，特别是经济和技术合作，充分实现公约承认的各项权利，如健康权。 |
| In the spirit of Article 56 of the Charter of the
United Nations, the specific provisions of the Covenant (arts. 12, 2.1,
22 and 23) and the Alma-Ata Declaration on primary health care, States
parties should recognize the essential role of international cooperation
and comply with their commitment to take joint and separate action to
achieve the full realization of the right to health. | 本着《联合国宪章》第五十六条、公约的一些具体规定(第十二条、第二条、第一条、第二十二条和第二十三条)，和关于初级卫生保健的《阿拉木图宣言》的精神，缔约国应承认国际合作的重要作用，履行它们的承诺，共同和单独采取行动，充分实现健康权。 |
| In this regard, States parties are referred to the
Alma-Ata Declaration which proclaims that the existing gross inequality
in the health status of the people, particularly between developed and
developing countries, as well as within countries, is politically,
socially and economically unacceptable and is, therefore, of common
concern to all countries. | 在这方面，请缔约国注意《阿拉木图宣言》，宣言说在人民健康状况上存在的严重不平等情况，特别是发达国家与发展中国家之间，以及在各国内部，在政治、社会和经济上都是不能令人接受的，因此是各国的共同关注。 |
| 39. To comply with their international obligations in
relation to article 12, States parties have to respect the enjoyment of
the right to health in other countries, and to prevent third parties
from violating the right in other countries, if they are able to
influence these third parties by way of legal or political means, in
accordance with the Charter of the United Nations and applicable
international law. | 39. 缔约国遵守对第十二条承担的国际义务，必须尊重在其他国家享有健康权，并根据《联合国宪章》和适用的国际法，在能够通过法律或政治手段影响第三方的情况下阻止它们在第三国违反这项权利。 |
| Depending on the availability of resources, States
should facilitate access to essential health facilities, goods and
services in other countries, wherever possible, and provide the
necessary aid when required. | 缔约国应根据资源情况，在可能的情况下为在其他国家得到基本卫生服务、商品和服务提供便利，并在接到要求时提供必要的援助。 |
| States parties should ensure that the right to health
is given due attention in international agreements and, to that end,
should consider the development of further legal instruments. | 缔约国应保证，在国际协议中充分注意到健康权，并应为此考虑制定进一步的法律文书。 |
| In relation to the conclusion of other international
agreements, States parties should take steps to ensure that these
instruments do not adversely impact upon the right to health. | 在缔结其他国际协议方面，缔约国应采取措施，保证有关文书不会对健康权产生不利影响。 |
| Similarly, States parties have an obligation to
ensure that their actions as members of international organizations take
due account of the right to health. | 同样，缔约国还有义务保证，它们作为国际组织的成员采取的行动充分考虑到健康权。 |
| Accordingly, States parties which are members of
international financial institutions, notably the International Monetary
Fund, the World Bank, and regional development banks, should pay
greater attention to the protection of the right to health in
influencing the lending policies, credit agreements and international
measures of these institutions. | 作为国际金融机构成员的缔约国，如国际货币基金组织、世界银行、各区域开发银行等，也应在这些机构的借贷政策、信贷协议和国际性措施上发挥影响，加强对保护健康权的重视。 |
| 40. States parties have a joint and individual
responsibility, in accordance with the Charter of the United Nations and
relevant resolutions of the United Nations General Assembly and of the
World Health Assembly, to cooperate in providing disaster relief and
humanitarian assistance in times of emergency, including assistance to
refugees and internally displaced persons. | 40. 根据《联合国宪章》和联合国大会、世界卫生大会的有关决议，缔约国有共同和单独的责任，在发生紧急情况时，在提供救灾和人道主义援助方面进行合作，包括援助难民和国内流离失所者。 |
| Each State should contribute to this task to the maximum of its capacities. | 各国应尽其最大能力为这项工作作出贡献。 |
| Priority in the provision of international medical
aid, distribution and management of resources, such as safe and potable
water, food and medical supplies, and financial aid should be given to
the most vulnerable or marginalized groups of the population. | 在提供国际医疗援助、分配和管理资源等方面，如安全和洁净的饮水、食物和医疗物资，以及在财政援助中，应优先考虑人口中最脆弱和边缘的群体。 |
| Moreover, given that some diseases are easily
transmissible beyond the frontiers of a State, the international
community has a collective responsibility to address this problem. | 此外，鉴于有些疾病很容易跨过国家的边界传播，国际社会都有责任解决这个问题。 |
| The economically developed States parties have a
special responsibility and interest to assist the poorer developing
States in this regard. | 经济发达的缔约国有特殊的责任和利益，在这方面帮助较穷的发展中国家。 |
| 41. States parties should refrain at all times from
imposing embargoes or similar measures restricting the supply of another
State with adequate medicines and medical equipment. | 41. 缔约国在任何时候都不应实施禁运或采取类似措施，限制向另一个国家提供充足的药品和医疗设备。 |
| Restrictions on such goods should never be used as an instrument of political and economic pressure. | 对这类货物的限制绝不能用来作为施加政治和经济压力的手段。 |
| In this regard, the Committee recalls its position,
stated in general comment No. 8, on the relationship between economic
sanctions and respect for economic, social and cultural rights. | 在这方面，委员会提醒它在第8号一般性意见中在经济制裁和尊重经济、社会、文化权利之间的关系问题上阐明的立场。 |
| 42. While only States are parties to the Covenant and
thus ultimately accountable for compliance with it, all members of
society - individuals, including health professionals, families, local
communities, intergovernmental and non-governmental organizations, civil
society organizations, as well as the private business sector - have
responsibilities regarding the realization of the right to health. | 42. 虽然只有国家才能是《公约》的缔约国，从而对遵守《公约》负有最终责任，但社会的所有成员――个人，包括卫生专业人员、家庭、地方社区、政府间和非政府组织、公民社会组织，及私营企业部门――在实现健康权方面也都负有责任。 |
| States parties should therefore provide an environment which facilitates the discharge of these responsibilities. | 因此缔约国应为履行这方面的责任提供一个便利的环境。 |
| Core obligations | 核心义务 |
| 43. In general comment No. 3, the Committee confirms
that States parties have a core obligation to ensure the satisfaction
of, at the very least, minimum essential levels of each of the rights
enunciated in the Covenant, including essential primary health care. | 43. 委员会在第3号一般性意见中明确表示，缔约国有一项根本义务，即保证《公约》提出的每一项权利，至少要达到最低的基本水平，包括基本的初级卫生保健。 |
| Read in conjunction with more contemporary
instruments, such as the Programme of Action of the International
Conference on Population and Development, the Alma-Ata Declaration
provides compelling guidance on the core obligations arising from
article 12. | 结合更新的文书来看，如人口与发展国际会议的行动纲领，《阿拉木图宣言》在第十二条产生的核心义务上提供了明确的指导。 |
| Accordingly, in the Committee's view, these core obligations include at least the following obligations: | 因此，委员会认为，这些核心义务至少包括以下方面： |
| (a) To ensure the right of access to health
facilities, goods and services on a non-discriminatory basis, especially
for vulnerable or marginalized groups; | (a)保证在不歧视的基础上有权得到卫生设施、物资和服务，特别是脆弱和边缘群体； |
| (b) To ensure access to the minimum essential food
which is nutritionally adequate and safe, to ensure freedom from hunger
to everyone; | (b)保证能够得到最基本的、有充足营养和安全的食物，保证所有人免于饥饿； |
| (c) To ensure access to basic shelter, housing and sanitation, and an adequate supply of safe and potable water; | (c)保证能够得到基本住所、住房和卫生条件，及保证充分供应安全的饮用水； |
| (d) To provide essential drugs, as from time to time defined under the WHO Action Programme on Essential Drugs; | (d)根据世界卫生组织随时修订的《必需药品行动纲领》，提供必需药品； |
| (e) To ensure equitable distribution of all health facilities, goods and services; | (e)保证公平地分配一切卫生设施、物资和服务； |
| (f) To adopt and implement a national public health
strategy and plan of action, on the basis of epidemiological evidence,
addressing the health concerns of the whole population; the strategy and
plan of action shall be devised, and periodically reviewed, on the
basis of a participatory and transparent process; they shall include
methods, such as right to health indicators and benchmarks, by which
progress can be closely monitored; the process by which the strategy and
plan of action are devised, as well as their content, shall give
particular attention to all vulnerable or marginalized groups. | (f)
根据流行病学的实际情况，采取和实施国家公共卫生战略和行动计划，解决整个人口的卫生关注；该项战略和行动计划应在参与和透明的基础上制定，并定期审查；
在战略和计划应包括一些方法，如健康权的指标和标准，用以随时监测取得的进展；制定战略和行动计划的过程及其内容，都应特别注意各种脆弱和边缘群体。 |
| 44. The Committee also confirms that the following are obligations of comparable priority: | 44. 委员会还确认，以下是一些比较优先的义务： |
| (a) To ensure reproductive, maternal (prenatal as well as post-natal) and child health care; | (a)确保生育、产妇(产前和产后)和孩子的卫生保健； |
| (b) To provide immunization against the major infectious diseases occurring in the community; | (b)对社区出现的主要传染病进行免疫接种； |
| (c) To take measures to prevent, treat and control epidemic and endemic diseases; | (c)采取措施预防、治疗和控制流行病和地方病； |
| (d) To provide education and access to information
concerning the main health problems in the community, including methods
of preventing and controlling them; | (d)提供有关社区主要健康问题的教育和信息，包括预防和控制的方法； |
| (e) To provide appropriate training for health personnel, including education on health and human rights. | (e)为卫生工作人员提供适当的培训，包括卫生和人权教育。 |
| 45. For the avoidance of any doubt, the Committee
wishes to emphasize that it is particularly incumbent on States parties
and other actors in a position to assist, to provide "international
assistance and cooperation, especially economic and technical"which
enable developing countries to fulfil their core and other obligations
indicated in paragraphs 43 and 44 above. | 45. 为了避免有任何疑问，委员会愿强调，缔约国和其他能够给予帮助的角色尤其有责任提供“国际援助和合作，特别是经济和技术援助和合作”，使发展中国家能够履行以上第43和44段所述核心义务和其他义务。 |
| 3. Violations | 3. 违反 |
| 46. When the normative content of article 12 (Part I)
is applied to the obligations of States parties (Part II), a dynamic
process is set in motion which facilitates identification of violations
of the right to health. | 46. 将第十二条规范性内容(第一部分)应用于缔约国的义务(第二部分)，就启动了一个动态程序，据以确定违反健康权的情况。 |
| The following paragraphs provide illustrations of violations of article 12. | 以下各段说明了何为违反第十二条。 |
| 47. In determining which actions or omissions amount
to a violation of the right to health, it is important to distinguish
the inability from the unwillingness of a State party to comply with its
obligations under article 12. | 47. 在确定哪些行动或不行动违反了健康权时，重要的是必须区分缔约国没有能力和不愿遵守它对第十二条的义务。 |
| This follows from article 12.1, which speaks of the
highest attainable standard of health, as well as from article 2.1 of
the Covenant, which obliges each State party to take the necessary steps
to the maximum of its available resources. | 这要根据《公约》第十二条第一款，该款讲到能够达到的最高健康标准，和第二条第一款，该款要求各缔约国尽最大能力采取必要步骤。 |
| A State which is unwilling to use the maximum of its
available resources for the realization of the right to health is in
violation of its obligations under article 12. | 不愿最大限度地利用其现有资源实现健康权的国家，即违反了第十二条规定的义务。 |
| If resource constraints render it impossible for a
State to comply fully with its Covenant obligations, it has the burden
of justifying that every effort has nevertheless been made to use all
available resources at its disposal in order to satisfy, as a matter of
priority, the obligations outlined above. | 如果资源上的困难使得一国无法完全履行公约的义务，它必须证明，它已尽了一切努力，利用一切可资利用的资源作为优先问题满足上述义务。 |
| It should be stressed, however, that a State party
cannot, under any circumstances whatsoever, justify its non-compliance
with the core obligations set out in paragraph 43 above, which are
non-derogable. | 然而必须强调，在任何情况下缔约国均不能为没有遵守以上第43段提出的核心义务辩解，这些核心义务是不能减损的。 |
| 48. Violations of the right to health can occur
through the direct action of States or other entities insufficiently
regulated by States. | 48. 发生违反健康权的情况，可以是国家直接所为，也可能是国家管理不严的其他实体。 |
| The adoption of any retrogressive measures
incompatible with the core obligations under the right to health,
outlined in paragraph 43 above, constitutes a violation of the right to
health. | 以上第43段所述采取任何违背健康权核心义务的任何倒退措施，都是对健康权的违反。 |
| Violations through acts of commission include the
formal repeal or suspension of legislation necessary for the continued
enjoyment of the right to health or the adoption of legislation or
policies which are manifestly incompatible with pre-existing domestic or
international legal obligations in relation to the right to health. | 委任行为造成的违反，包括正式取缔或暂停继续享有健康权所必须的法律，或通过明显不符合在健康权方面原先存在的国内或国际法律义务的法律或政策。 |
| 49. Violations of the right to health can also occur
through the omission or failure of States to take necessary measures
arising from legal obligations. | 49. 违反健康权还可发生在国家不行为或没有采取法律义务要求的必要措施的情况下。 |
| Violations through acts of omission include the
failure to take appropriate steps towards the full realization of
everyone's right to the enjoyment of the highest attainable standard of
physical and mental health, the failure to have a national policy on
occupational safety and health as well as occupational health services,
and the failure to enforce relevant laws. | 不行为引起的违反，包括未采取适当措施，充分实现人人享有能达到的最高的体质和心理健康的标准的权利，没有制定关于职业安全和健康的国家政策及提供职业健康服务，和没有执行相关的法律。 |
| Violations of the obligation to respect | 违反遵守的义务 |
| 50. Violations of the obligation to respect are those
State actions, policies or laws that contravene the standards set out
in article 12 of the Covenant and are likely to result in bodily harm,
unnecessary morbidity and preventable mortality. | 50. 违反《公约》第十二条规定的标准，或有可能造成身体伤害、不必要的疾病和可预防的死亡，此类国家行为、政策或法律，即是违反遵守的义务。 |
| Examples include the denial of access to health
facilities, goods and services to particular individuals or groups as a
result of de jure or de facto discrimination; the deliberate withholding
or misrepresentation of information vital to health protection or
treatment; the suspension of legislation or the adoption of laws or
policies that interfere with the enjoyment of any of the components of
the right to health; and the failure of the State to take into account
its legal obligations regarding the right to health when entering into
bilateral or multilateral agreements with other States, international
organizations and other entities, such as multinational corporations. | 这
方面的例子包括由于法律上或事实上的歧视，拒绝某些个人或群体得到医疗设施、物资和服务；蓄意隐瞒或歪曲对保护健康或治疗极为重要的信息、中止法律或实行
妨碍享有一切健康权的法律或政策；或国家在与其他国家、国际组织和其他实体，如跨国公司，签订双边或多边协议时，未能在其法律义务中考虑到健康权。 |
| Violations of the obligation to protect | 违反保护的义务 |
| 51. Violations of the obligation to protect follow
from the failure of a State to take all necessary measures to safeguard
persons within their jurisdiction from infringements of the right to
health by third parties. | 51. 违反保护的义务，是国家未能采取一切必要措施，保护其管辖权内的人健康权不得受到第三方的侵犯。 |
| This category includes such omissions as the failure
to regulate the activities of individuals, groups or corporations so as
to prevent them from violating the right to health of others; the
failure to protect consumers and workers from practices detrimental to
health, e.g. by employers and manufacturers of medicines or food; the
failure to discourage production, marketing and consumption of tobacco,
narcotics and other harmful substances; the failure to protect women
against violence or to prosecute perpetrators; the failure to discourage
the continued observance of harmful traditional medical or cultural
practices; and the failure to enact or enforce laws to prevent the
pollution of water, air and soil by extractive and manufacturing
industries. | 这一类情况包括未能对个人、群体或公司的活动作出规定，使之不得侵犯他人的健康权；
未能保护消费者或工人的健康受到雇主、药品或食物的制造商行为的伤害；没有劝阻生产、销售和消费烟、毒品和其他有害药物；没有保护妇女免于暴力或没有起诉
施暴的人；没有劝阻继续遵守有害的传统医学或文化习俗；和没有颁布或实施法律，防止水、空气和土壤受到开采和制造业的污染。 |
| Violations of the obligation to fulfil | 违反实现的义务 |
| 52. Violations of the obligation to fulfil occur
through the failure of States parties to take all necessary steps to
ensure the realization of the right to health. | 52. 违反实现的义务，是缔约国未能采取一切必要措施，保证实现健康权。 |
| Examples include the failure to adopt or implement a
national health policy designed to ensure the right to health for
everyone; insufficient expenditure or misallocation of public resources
which results in the non-enjoyment of the right to health by individuals
or groups, particularly the vulnerable or marginalized; the failure to
monitor the realization of the right to health at the national level,
for example by identifying right to health indicators and benchmarks;
the failure to take measures to reduce the inequitable distribution of
health facilities, goods and services; the failure to adopt a
gender-sensitive approach to health; and the failure to reduce infant
and maternal mortality rates. | 这方面的例子包括没有采取或执行旨在保护所有
人健康权的国家卫生政策；公共资源的开支不足或分配不当，造成个人或群体不能享有健康权，特别是脆弱和边缘群体；没有在国家一级监督健康权的实现，例如通
过提出健康权的指标和基本标准；没有采取措施减少卫生设施、物资和服务分配不公平的现象；在卫生方面没有采取性别敏感的方针；和没有降低婴儿和产妇死亡
率。 |
| 4. Implementation at the national level | 4. 国家一级的执行 |
| Framework legislation | 框架立法 |
| 53. The most appropriate feasible measures to implement the right to health will vary significantly from one State to another. | 53. 落实健康权最适宜又可行的措施，因国而异，差别很大。 |
| Every State has a margin of discretion in assessing which measures are most suitable to meet its specific circumstances. | 每个国家在权衡哪些措施最适合它的具体情况上，都有一定斟酌处理的余地。 |
| The Covenant, however, clearly imposes a duty on each
State to take whatever steps are necessary to ensure that everyone has
access to health facilities, goods and services so that they can enjoy,
as soon as possible, the highest attainable standard of physical and
mental health. | 然而《公约》明确规定，每个国家都有责任采取一切必要措施，保证人人都能得到健康设施、商品和服务，使他们能够尽快的享有能够达到的最高标准的身心健康。 |
| This requires the adoption of a national strategy to
ensure to all the enjoyment of the right to health, based on human
rights principles which define the objectives of that strategy, and the
formulation of policies and corresponding right to health indicators and
benchmarks. | 这要求实行一项国家战略，在确定该项战略目标的人权原则基础上，确保所有人享有健康权，还要制定政策和相应的健康权指标和基准。 |
| The national health strategy should also identify the
resources available to attain defined objectives, as well as the most
cost-effective way of using those resources. | 国家卫生战略还应确定实现规定目标可以利用的资源，以及使用那些资源成本效益最高的办法。 |
| 54. The formulation and implementation of national
health strategies and plans of action should respect, inter alia, the
principles of non-discrimination and people's participation. | 54. 制定和执行国家卫生战略和行动计划，应特别遵守不歧视的原则和人民参与的原则。 |
| In particular, the right of individuals and groups to
participate in decision-making processes, which may affect their
development, must be an integral component of any policy, programme or
strategy developed to discharge governmental obligations under article
12. | 具体而言，个人和群体参与决策过程的权利，可能影响他们的发展，因此必须作为履行政府对第十二条义务所制定的一切政策、方案或战略的重要组成部分。 |
| Promoting health must involve effective community
action in setting priorities, making decisions, planning, implementing
and evaluating strategies to achieve better health. | 促进健康必须在确定优先问题、决策、计划、执行和评估改善健康的战略上，采取有效的社区行动。 |
| Effective provision of health services can only be assured if people's participation is secured by States. | 有效提供健康服务，只有在国家保证人民参与的情况下，才有可能得到保证。 |
| 55. The national health strategy and plan of action
should also be based on the principles of accountability, transparency
and independence of the judiciary, since good governance is essential to
the effective implementation of all human rights, including the
realization of the right to health. | 55. 国家卫生战略和行动计划还应建立在责任制、透明和司法独立的原则基础上，因为正确的管理是有效落实各项人权的关键，包括实现健康权。 |
| In order to create a favourable climate for the
realization of the right, States parties should take appropriate steps
to ensure that the private business sector and civil society are aware
of, and consider the importance of, the right to health in pursuing
their activities. | 为了创造有利于实现该项权利的气候，缔约国应采取适当措施，私营企业部门和公民社会在它们的活动中要想到健康权，认识到它的重要性。 |
| 56. States should consider adopting a framework law to operationalize their right to health national strategy. | 56. 各国应考虑通过一套法律纲要，实施它们的健康权国家战略。 |
| The framework law should establish national
mechanisms for monitoring the implementation of national health
strategies and plans of action. | 这套法律纲要法应建立监督执行国家健康战略和行动纲领的国家机制。 |
| It should include provisions on the targets to be
achieved and the time frame for their achievement; the means by which
right to health benchmarks could be achieved; the intended collaboration
with civil society, including health experts, the private sector and
international organizations; institutional responsibility for the
implementation of the right to health national strategy and plan of
action; and possible recourse procedures. | 该机制应包括规定实现的目标和时间；实现健康权的手段；准备如何与公民社会，包括卫生专家、私营部门和国际组织的合作；对执行健康权国家战略和行动纲领的体制责任；和可能的追索程序。 |
| In monitoring progress towards the realization of the
right to health, States parties should identify the factors and
difficulties affecting implementation of their obligations. | 在监督实现健康权取得的进展方面，缔约国应确定影响履行它们义务的各种因素和困难。 |
| Right to health indicators and benchmarks | 健康权的指标和基本要求 |
| 57. National health strategies should identify appropriate right to health indicators and benchmarks. | 57. 国家卫生战略应提出适当的卫生权指标和基本要求。 |
| The indicators should be designed to monitor, at the
national and international levels, the State party's obligations under
article 12. | 制定指标的目的，是在国家和国际上监督缔约国履行第十二条义务的情况。 |
| States may obtain guidance on appropriate right to
health indicators, which should address different aspects of the right
to health, from the ongoing work of WHO and the United Nations
Children's Fund (UNICEF) in this field. | 各国可从世界卫生组织和联合国儿童基金会在这个领域正在开展的工作中得到有关适当健康权指标的指导，解决健康权不同方面的问题。 |
| Right to health indicators require disaggregation on the prohibited grounds of discrimination. | 健康权指标要求对禁止的各种歧视分别列出。 |
| 58. Having identified appropriate right to health
indicators, States parties are invited to set appropriate national
benchmarks in relation to each indicator. | 58. 在提出适当的健康权指标后，缔约国应确定相对于每一指标的适当的国家基本水准。 |
| During the periodic reporting procedure the Committee will engage in a process of scoping with the State party. | 在提出定期报告过程中，委员会将与缔约国一道加以全面审查。 |
| Scoping involves the joint consideration by the State
party and the Committee of the indicators and national benchmarks which
will then provide the targets to be achieved during the next reporting
period. | 审查包括缔约国和委员会共同审议指标和国家基本水准，然后定出下一个报告期应实现的目标。 |
| In the following five years, the State party will use
these national benchmarks to help monitor its implementation of article
12. | 在以下的五年里，缔约国将采用新的国家基本水准，帮助监测第十二条的执行情况。 |
| Thereafter, in the subsequent reporting process, the
State party and the Committee will consider whether or not the
benchmarks have been achieved, and the reasons for any difficulties that
may have been encountered. | 之后，在下一个报告程序中，缔约国和委员会将审议基本水准是否已经达到，以及可能遇到的任何困难原因何在。 |
| Remedies and accountability | 补救与问责 |
| 59. Any person or group victim of a violation of the
right to health should have access to effective judicial or other
appropriate remedies at both national and international levels. | 59. 健康权受到侵犯的任何受害个人或群体，都应有机会在国家和国际上得到有效的司法或其他适当补救。 |
| All victims of such violations should be entitled to
adequate reparation, which may take the form of restitution,
compensation, satisfaction or guarantees of non-repetition. | 所有这方面违反行为的受害人，均应有权得到适当赔偿，赔偿可采取复原、赔偿、道歉或保证不再重犯等形式。 |
| National ombudsmen, human rights commissions,
consumer forums, patients' rights associations or similar institutions
should address violations of the right to health. | 国家意见调查官、人权委员会、消费者论坛、病人权利组织或类似机构，应解决侵犯健康权的问题。 |
| 60. The incorporation in the domestic legal order of
international instruments recognizing the right to health can
significantly enhance the scope and effectiveness of remedial measures
and should be encouraged in all cases. | 60. 本国法律制度中收入承认健康权的国际文书，可大大增加补救措施的范围和效果，因此在任何情况下均应给予鼓励。 |
| Incorporation enables courts to adjudicate violations
of the right to health, or at least its core obligations, by direct
reference to the Covenant. | 收入这方面的文书，可使法院能够直接引用公约，审判侵犯健康权的问题，或至少其基本义务。 |
| 61. Judges and members of the legal profession should
be encouraged by States parties to pay greater attention to violations
of the right to health in the exercise of their functions. | 61. 缔约国应鼓励法官和其他法律从业人员，在他们的工作中加强对侵犯健康权的重视。 |
| 62. States parties should respect, protect,
facilitate and promote the work of human rights advocates and other
members of civil society with a view to assisting vulnerable or
marginalized groups in the realization of their right to health. | 62. 缔约国应尊重、保护、便利和促进人权倡导者和公民社会其他成员的工作，帮助易受害或边缘群体实现它们的健康权。 |
| 5. Obligations of actors other than States parties | 5. 缔约国以外其他行为者的义务 |
| 63. The role of the United Nations agencies and
programmes, and in particular the key function assigned to WHO in
realizing the right to health at the international, regional and country
levels, is of particular importance, as is the function of UNICEF in
relation to the right to health of children. | 63. 联合国各机构和方案的作用，特别是世界卫生组织在国际、区域和各国实现健康权的主要职能，以及联合国儿童基金会在儿童健康权方面的作用，具有十分重要的意义。 |
| When formulating and implementing their right to
health national strategies, States parties should avail themselves of
technical assistance and cooperation of WHO. | 缔约国在制定和执行它们的健康权国家战略时，应利用世界卫生组织的技术援助和合作。 |
| Further, when preparing their reports, States parties
should utilize the extensive information and advisory services of WHO
with regard to data collection, disaggregation, and the development of
right to health indicators and benchmarks. | 此外，缔约国在编写它们的报告时应利用世界卫生组织在收集资料、分类，和制定健康权指标和基本要求等方面的广泛信息和咨询服务。 |
| 64. Moreover, coordinated efforts for the realization
of the right to health should be maintained to enhance the interaction
among all the actors concerned, including the various components of
civil society. | 64. 此外，应在实现健康权方面进行协调，加强所有有关方面的互动，包括公民社会的各个组成部分。 |
| In conformity with articles 22 and 23 of the
Covenant, WHO, the International Labour Organization, the United Nations
Development Programme, UNICEF, the United Nations Population Fund, the
World Bank, regional development banks, the International Monetary Fund,
the World Trade Organization and other relevant bodies within the
United Nations system, should cooperate effectively with States parties,
building on their respective expertise, in relation to the
implementation of the right to health at the national level, with due
respect to their individual mandates. | 根据《公约》第二十二条和第
二十三条，世界卫生组织、国际劳工组织、联合国开发计划署、联合国儿童基金会、联合国人口基金、世界银行、各区域开发银行、国际货币基金组织、世界贸易组
织和联合国系统内的其他有关机构，均应在国家一级落实健康权方面与各缔约国进行有效的合作，发挥它们各自的专长，同时适当注意到它们本身的职权范围。 |
| In particular, the international financial
institutions, notably the World Bank and the International Monetary
Fund, should pay greater attention to the protection of the right to
health in their lending policies, credit agreements and structural
adjustment programmes. | 具体而言，国际金融机构，特别是世界银行和国际货币基金组织，应在它们的借贷政策、信贷协议和结构调整方案中更加重视保护健康权。 |
| When examining the reports of States parties and
their ability to meet the obligations under article 12, the Committee
will consider the effects of the assistance provided by all other
actors. | 在审查缔约国的报告和它们履行第十二条义务的能力时，委员会将考虑所有其他方面提供援助的效果。 |
| The adoption of a human rights-based approach by
United Nations specialized agencies, programmes and bodies will greatly
facilitate implementation of the right to health. | 联合国各专门机构、方案和组织，采取以人权为基础的方针，将大大有利于健康权的落实。 |
| In the course of its examination of States parties'
reports, the Committee will also consider the role of health
professional associations and other non-governmental organizations in
relation to the States' obligations under article 12. | 委员会在审议缔约国的报告过程中，也将审议卫生专业组织和其他非政府组织在缔约国对第十二条义务方面的作用。 |
| 65. The role of WHO, the Office of the United Nations
High Commissioner for Refugees, the International Committee of the Red
Cross/Red Crescent and UNICEF, as well as non-governmental organizations
and national medical associations, is of particular importance in
relation to disaster relief and humanitarian assistance in times of
emergencies, including assistance to refugees and internally displaced
persons. | 65. 世界卫生组织、联合国难民事务高级专员办事处、国际红十字会/红新月会委员会和联合国儿童基金会，以及各种非政府组织和国家的医务界组织在紧急情况下救灾和人道主义援助方面的作用极为重要，包括对难民和国内流离失所者的援助。 |
| Priority in the provision of international medical
aid, distribution and management of resources, such as safe and potable
water, food and medical supplies, and financial aid should be given to
the most vulnerable or marginalized groups of the population. | 提供国际医疗援助、分配和管理资源，如安全和洁净的饮水、食物和医疗物资、财政援助等，应优先安排给人口中最脆弱和边缘的群体。 |
| Adopted on 11 May 2000. | 2000年5月11日通过。 |
| Notes | 注 |
| For example, the principle of non-discrimination in
relation to health facilities, goods and services is legally enforceable
in numerous national jurisdictions. | 例如，在卫生设施、物资和服务方面，不歧视的原则在很多国家的司法中都是可以通过法律执行的。 |
| In its resolution 1989/11. | 人权委员会第1989/11号决议。 |
| The Principles for the Protection of Persons with
Mental Illness and for the Improvement of Mental Health Care adopted by
the United Nations General Assembly in 1991 (resolution 46/119) and the
Committee's general comment No. 5 on persons with disabilities apply to
persons with mental illness; the Programme of Action of the
International Conference on Population and Development held at Cairo in
1994, as well as the Declaration and Programme for Action of the Fourth
World Conference on Women held in Beijing in 1995 contain definitions of
reproductive health and women's health, respectively. | 联
合国大会1991年通过的“保护精神病患者和改进精神保健的整套原则”(第46/119号决议)，和适用于精神病患者的委员会关于残疾人的第5号一般性意
见；1994年在开罗举行的人口与发展国际会议行动纲领；和1995年在北京举行的第四次世界妇女大会宣言和行动纲领，分别载有生育卫生和妇女健康的定
义。 |
| Common article 3 of the Geneva Conventions for the
protection of war victims (1949); Additional Protocol I (1977) relating
to the Protection of Victims of International Armed Conflicts, article
75 (2) (a); Additional Protocol II (1977) relating to the Protection of
Victims of Non-International Armed Conflicts, article 4 (a). | 关于战时保护平民之日内瓦四公约共同的第三条；《关于保护国际性武装冲突受难者的第一附加议定书》(1977年)第七十五条第二款(一)项；《关于保护非国际性武装冲突受难者的第二附加议定书》(1977年)第四条第一款。 |
| See WHO Model List of Essential Drugs, revised December 1999, WHO Drug Information, vol. 13, No. 4, 1999. | 见世界卫生组织的示范必需药品清单。 1999年12月修订，世界卫生组织药品信息第十三卷，1999年第4期。 |
| Unless expressly provided otherwise, any reference in
this general comment to health facilities, goods and services includes
the underlying determinants of health outlined in paragraphs 11 and 12
(a) of this general comment. | 除非另行说明，否则本一般性意见中所述卫生设施、物资和服务，均包括本一般性意见第11段和第12段(a)中所列的基本健康要素。 |
| See paragraphs 18 and 19 of this general comment. | 见本一般性意见，第18和第19段。 |
| See article 19.2 of the International Covenant on Civil and Political Rights. | 见《公民权利和政治权利国际公约》第十九条第2款。 |
| This general comment gives particular emphasis to
access to information because of the special importance of this issue in
relation to health. | 本一般性意见特别强调获得信息，因为这个问题对健康特别重要。 |
| In the literature and practice concerning the right
to health, three levels of health care are frequently referred to:
primary health care typically deals with common and relatively minor
illnesses and is provided by health professionals and/or generally
trained doctors working within the community at relatively low cost;
secondary health care is provided in centres, usually hospitals, and
typically deals with relatively common minor or serious illnesses that
cannot be managed at community level, using specialty-trained health
professionals and doctors, special equipment and sometimes inpatient
care at comparatively higher cost; tertiary health care is provided in
relatively few centres, typically deals with small numbers of minor or
serious illnesses requiring specialty-trained health professionals and
doctors and special equipment, and is often relatively expensive. | 在
有关健康权的复述和实践中，经常讲到三级卫生保健：初级卫生保健，主要指常见或较轻微的疾病，由社区内卫生专业人员或经过一般培训的医生提供，费用较低；
二级卫生保健由中心提供，通常是医院，主要处理社区一级无法医治的较为普通的轻微或严重疾病。
通常要靠经过专科培训的卫生专业人员和医生、特别设备，有时还要住院治疗，费用较高；三级卫生保健，只在较少的中心提供，主要治疗少量需要经过专科培训的
卫生专业人员和医生及特别设施的轻微或严重疾病，常常费用较高。 |
| Since forms of primary, secondary and tertiary health
care frequently overlap and often interact, the use of this typology
does not always provide sufficient distinguishing criteria to be helpful
for assessing which levels of health care States parties must provide,
and is therefore of limited assistance in relation to the normative
understanding of article 12. | 由于初级、二级和三级卫生保健的形式常常相互重叠和发生互动，因此采用这种分类办法并不总是能够提供充分的区分标准，帮助评估缔约国必须提供的卫生保健水平，因此，在对第十二条的规范理解上作用也很有限。 |
| According to WHO, the stillbirth rate is no longer commonly used, infant and under-5 mortality rates being measured instead. | 根据世界卫生组织的做法，死胎率已很少在使用，而采用了婴儿和5岁以下儿童死亡率作为衡量标准。 |
| Prenatal denotes existing or occurring before birth;
perinatal refers to the period shortly before and after birth (in
medical statistics the period begins with the completion of 28 weeks of
gestation and is variously defined as ending one to four weeks after
birth); neonatal, by contrast, covers the period pertaining to the first
four weeks after birth; while post-natal denotes occurrence after
birth. | 产前，指出生前或出生时；围产期，指出生前后的一小段时间(在医学统计学上，这段时间从怀孕28周起，结束的时间有不同规定，可从出生后一周到四周)；新生儿期，则指出生后的头四个星期；而出生后，即指出生之后。 |
| In this general comment, the more generic terms pre- and post-natal are exclusively employed. | 在本一般性意见中，只采用较普通的“出生前”和“出生后”这两个说法。 |
| Reproductive health means that women and men have the
freedom to decide if and when to reproduce and the right to be informed
and to have access to safe, effective, affordable and acceptable
methods of family planning of their choice as well as the right of
access to appropriate health-care services that will, for example,
enable women to go safely through pregnancy and childbirth. | 生育卫生，指男女有权自由决定是否和何时生育，以及有权了解情况和得到安全、有效、能够支付得起和可以接受的、由他们自己选择的计划生育方法，有权得到适当的卫生保健服务，例如可使妇女安全的渡过孕期和生产。 |
| The Committee takes note, in this regard, of
Principle 1 of the Stockholm Declaration of 1972 which states: "Man has
the fundamental right to freedom, equality and adequate conditions of
life, in an environment of a quality that permits a life of dignity and
well-being", as well as of recent developments in international law,
including General Assembly resolution 45/94 on the need to ensure a
healthy environment for the well-being of individuals; Principle 1 of
the Rio Declaration; and regional human rights instruments such as
article 10 of the San Salvador Protocol to the American Convention on
Human Rights. | 委员会在这个问题上注意到1972年斯德哥尔摩宣言的第一项原则，该原则规定：
“人人有权在高质量的环境中享有自由、平等和适当生活条件的基本权利，该环境应保证体面的生活和安康，并且符合国际法的最新发展，包括关于必须保证个人安
康的健康环境的大会第45/94号决议；《里约宣言》的第一项原则；和一些区域人权文书，如《美洲人权公约圣萨尔瓦多议定书》的第十条。 |
| ILO Convention No. 155, article 4.2. | 国际劳工组织第155号公约，第四条第2款。 |
| See paragraph 12 (b) and note 8 above. | 见以上第12段和注8。 |
| For the core obligations, see paragraphs 43 and 44 of the present general comments. | 关于各项基本义务，见本一般性意见，第43和第44段。 |
| Article 24.1 of the Convention on the Rights of the Child. | 《儿童权利公约》，第二十四条第1款。 |
| See World Health Assembly resolution WHA47.10, 1994,
entitled "Maternal and child health and family planning: traditional
practices harmful to the health of women and children". | 见1994年世界卫生大会决议WHA 47.10, 题为：“产妇和儿童健康和计划生育：有害妇女和儿童健康的传统习俗”。 |
| Recent emerging international norms relevant to
indigenous peoples include the ILO Convention No. 169 concerning
Indigenous and Tribal Peoples in Independent Countries (1989); articles
29 (c) and (d) and 30 of the Convention on the Rights of the Child
(1989); article 8 (j) of the Convention on Biological Diversity (1992),
recommending that States respect, preserve and maintain knowledge,
innovation and practices of indigenous communities; Agenda 21 of the
United Nations Conference on Environment and Development (1992), in
particular chapter 26; and Part I, paragraph 20, of the Vienna
Declaration and Programme of Action (1993), stating that States should
take concerted positive steps to ensure respect for all human rights of
indigenous people, on the basis of non-discrimination. | 有
关土著人的最新国际规范包括：国际劳工组织关于独立国家土著和部落居民的第169号公约(1989年)；《儿童权利公约》(1989年)第29条(c)和
(d)项，和第30条；《生物多样性公约》(1992年)第8条(j)项，建议各国尊重、保护和保留土著社区的知识、革新和习俗；联合国环境和发展会议
《21世纪议程》(1992年)，特别是第26章；和《维也纳宣言和行动纲领》(1993年)第一部分第20段，要求各国采取一致的积极措施，确保在不歧
视的基础上尊重土著人的各项人权。 |
| See also the preamble and article 3 of the United
Nations Framework Convention on Climate Change (1992); and article 10
(2) (e) of the United Nations Convention to Combat Desertification in
Countries Experiencing Serious Drought and/or Desertification,
Particularly in Africa (1994). | 另见联合国《气候变化框架公约》(1992年)序言和第三条；联合国《在发生严重干旱和/或荒漠化的国家特别是在非洲防止荒漠化的公约》(1994年)第10条第2款(e)项。 |
| During recent years an increasing number of States
have changed their constitutions and introduced legislation recognizing
specific rights of indigenous peoples. | 近年来，越来越多的国家修改了它们的宪法和提出立法，承认土著人的特别权利。 |
| See general comment No. 13, paragraph 43. | 见第13号一般性意见，第43段。 |
| See general comment No. 3, paragraph 9; general comment No. 13, paragraph 44. | 见第3号一般性意见，第9段；第13号一般性意见，第44段。 |
| See general comment No. 3, paragraph 9; general comment No. 13, paragraph 45. | 见第3号一般性意见，第9段；第13号一般性意见，第45段。 |
| According to general comments Nos. 12 and 13, the
obligation to fulfil incorporates an obligation to facilitate and an
obligation to provide. | 根据第12和第3号一般性意见，实现的义务包括提供便利的义务和提供的义务。 |
| In the present general comment, the obligation to
fulfil also incorporates an obligation to promote because of the
critical importance of health promotion in the work of WHO and
elsewhere. | 在本一般性意见中，由于促进健康在世界卫生组织和其他方面工作中的关键重要作用，实现的义务还包括促进的义务。 |
| General Assembly resolution 46/119 (1991). | 大会第46/119号决议(1991年)。 |
| Elements of such a policy are the identification,
determination, authorization and control of dangerous materials,
equipment, substances, agents and work processes; the provision of
health information to workers and the provision, if needed, of adequate
protective clothing and equipment; the enforcement of laws and
regulations through adequate inspection; the requirement of notification
of occupational accidents and diseases, the conduct of inquiries into
serious accidents and diseases, and the production of annual statistics;
the protection of workers and their representatives from disciplinary
measures for actions properly taken by them in conformity with such a
policy; and the provision of occupational health services with
essentially preventive functions. | 该项政策的主要内容包括发现、确定、
批准和控制危险材料、设备、物质、媒介和工作程序；向工人提供健康信息和在需要的情况下提供充分的保护服装和设备；通过适当检查执行法律和规定；要求通报
职业事故和疾病；对严重事故和疾病进行调查并提出年度统计数字；保护工人和他们的代表不因他们依此项政策而采取的正当行动而受到纪律处分；和提供职业卫生
服务，包括各种基本的预防职能。 |
| See ILO Occupational Safety and Health Convention, 1981 (No. 155) and Occupational Health Services Convention, 1985 (No. 161). | 见劳工组织的《职业安全和卫生公约》，1981年(第115号)，和《职业卫生服务公约》，1985年(第161号)。 |
| Article II, Alma-Ata Declaration, Report of the
International Conference on Primary Health Care, Alma-Ata, 6-12
September 1978, in: World Health Organization, "Health for All" Series,
No. 1, WHO, Geneva, 1978. | 《阿兰木图宣言》第2条，初级卫生保健国际会议的报告，阿兰木图，1978年9月6日至12日，载于世界卫生组织“全民健康”系列第一卷，世界卫生组织，1978年，日内瓦。 |
| See paragraph 45 of this general comment. | 见本一般性意见，第45段。 |
| Report of the International Conference on Population
and Development, Cairo, 5-13 September 1994 (United Nations publication,
Sales No. E.95.XIII.18), chap. I, resolution 1, annex, chaps. VII and
VIII. | 人口与发展国际会议报告，开罗，1994年9月5日至13日(联合国出版物出售品编号，E.95.XIII.18)，第一章，决议1附件，第七和第八章。 |
| Covenant, art. 2.1. | 《公约》第二条第一款。 |
| Regardless of whether groups as such can seek
remedies as distinct holders of rights, States parties are bound by both
the collective and individual dimensions of article 12. | 无论那些群体是否可以作为独特的权利持有人寻求补救，缔约国在集体和单独两个方面均受到第十二条的约束。 |
| Collective rights are critical in the field of
health; modern public health policy relies heavily on prevention and
promotion which are approaches directed primarily to groups. | 集体权利在卫生领域十分重要，现代公共卫生政策在很大程度上依赖预防和增进健康，主要都是针对集体的方针。 |
| See general comment No. 2, paragraph 9. | 见第2号一般性意见，第9段。 |
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