When people, especially vulnerable populations such as the elderly and minorities, are denied health care because of overstrained hospital systems...When insurance companies provide unequal coverage of reproductive health-related prescriptions for men and women...When teenagers are enticed into alcohol and tobacco addiction...These can be considered human rights issues, said Massachusetts Public Health Commissioner Howard Koh at a recent dinner organized by the François-Xavier Bagnoud (FXB) Center for Health and Human Rights at HSPH and the APHA International Human Rights Committee (IHRC) at the Harvard Faculty Club in Cambridge. Koh gave these examples as ways in which human rights impact public health in this country, and he pledged to collaborate with the FXB Center and the IHRC.

The dinner is part of a project of the FXB Center and IHRC to develop curricula that combines human rights principles with public health training and practice. The dinner kicked off a two-day workshop at HSPH attended by more than 30 public health and human rights specialists from across the country, including two former APHA presidents, the current APHA president and the president-elect. HSPH Dean for Academic Affairs James Ware welcomed Koh and the participants, noting the importance that HSPH attaches to the efforts of the FXB Center and APHA to develop health and human rights curricula.

Koh spoke eloquently about the impact of international human rights on his childhood. In the 1960s, Koh’s father served as ambassador to the US for South Korea’s first democratically-elected government. That government was short-lived. Within a few months, the military overthrew the government, tossing the newly-elected president into jail. Koh’s family remained in the US, but the upheaval strongly impacted Koh, who became a physician recognized for his commitment to equity and diversity in public health practice.

Koh then recounted a lecture given by workshop participant and Boston University professor George Annas last year at the Massachusetts Department of Public Health in which Annas observed, "Public health is human rights."

Remembered Koh, "I almost fell out of my chair. I had an epiphany, and that was: I need to talk to my brother more!" Koh’s brother Harold served as US Assistant Secretary of State for Democracy, Human Rights and Labor in the Clinton administration.

Indeed, the Massachusetts commissioner called his brother and had what Koh described as a highly productive conversation about life goals. They realized that both of them were engaged in prevention–Koh to prevent illness and his brother to prevent human rights abuses.

Koh described several topics in which human rights issues and public health overlap: access to health care, family planning, HIV/AIDS and bioterrorism control, for example. He cited the tobacco industry in particular as a menace, saying that it addicts its customers to a lethal product and adding that the alcohol industry also creates addictions. Both addictions produce poor health consequences. How best should the industries be held accountable, he asked?

He briefly discussed the public health needs of prisoners, describing opportunities to help both inmates and the communities to which the prisoners are eventually released. As an example, Koh talked about one initiative that offers AIDS-related services to HIV-infected prisoners before and after they are freed.

"One of the big unknowns to us was to what extent leaders in public health practice would want to ensure that the public health workforce learns about and applies human rights," said Stephen Marks, director of the FXB Center and François-Xavier Bagnoud Professor of Health and Human Rights in the Department of Population and International Health, in a later interview. "During his talk, Commissioner Koh made a formal commitment that his department really wants to participate in a human rights and public health curriculum. Other workshop attendees made similar commitments."

Marks said the workshop was successful in building bridges between academics with considerable experience teaching human rights and practitioners who may have little knowledge of the subject. Workshop attendees are now undertaking a variety of projects to help develop the human rights curricula, which Marks sees as an area of expansion for the FXB Center.

"The FXB Center exists because of a vision that human rights provides a framework for how public health can be more responsive to human needs," said Marks. "It’s an effort to build public health on the understanding that human rights violations have public health consequences and, conversely, that public health and medical practice may produce human rights violations, such as discrimination, harming human dignity or failing to obtain informed consent before testing. The integration of human rights into public health programs and policies is known to contribute to bettering people’s chances for a healthy life. That’s why it is important to include human rights principles in public health practice."