The environment for advancing human rights and human development and for foregrounding wellbeing, equity and justice has deteriorated significantly in recent times. Extreme inequality underpins increased antagonism against human rights, while democratic politics has become corroded by social polarization, racism, misogyny and violence. A ‘sinkhole’ effect threatens to collapse the collective ground that connects ‘first generation’ democratic human rights with ‘second generation’ socioeconomic rights and third generation solidarity rights.
This paper counters the erosion of collective health solidarity, offering public health as alternative grounding for human rights and human development. It uses new public goods theory and public health ethics to repair the democratic sinkhole and counter the hesitation to explicitly commit to advancing health rights. The new public goods approach applies a tripartite test of democratic participation, equity of access and publicness of benefit, supplementing rights-based approaches. A normative embedding of public health ethics further helps to restore ground and counter the erosion of health rights. The four main pillars of public health ethics (autonomy, beneficence, non-maleficence, justice) can be connected to four obligations for health programming: i) identifying and minimising burdens of collective programmes ii) fair procedures for dealing with burdens iii) reducing morbidity and mortality iv) reliable scientific evidence as an underpinning.
In view of current socio-political developments, a key concern is to protect the tripartite nature of public goods, the critical importance of scientific evidence and how public understandings of science connect to corrosive versus constructive collective or individual capabilities to attain future public health.