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Summaries – International Legal Instruments

The Global Compact on Health and Care Workers was developed on the basis of a scoping review of existing relevant international instruments. While the Compact is intended to provide technical guidance to WHO Member States and is itself not legally binding, it draws extensively from existing international legal instruments, which collectively contain both legally binding obligations and non-binding commitments to which states have agreed.

Below is a summary of these instruments. These range from binding ILO conventions, UN human rights treaties, the Geneva Conventions and their Additional Protocols, and other binding instruments to non-binding ILO recommendations, and UN General Assembly and World Health Assembly resolutions. They also include general comments from the UN treaty bodies, which are not directly binding but which comprise authoritative interpretations of human rights treaties that are legally binding.

Binding

  1. Collective Bargaining Convention, ILO No. C154 (1981) (link)
    1. This treaty sets out State obligations to realize the right to collectively bargain. The text also details measures that should be taken to promote collective bargaining. The Convention applies to all branches of economic activity and thus applies to health and care workers. 50 States have ratified this treaty as of June 12, 2023. See Arts. 1, 2, 5.
  2. Convention Concerning Decent Work for Domestic Workers Convention, ILO No. C189 (2011) (link)
    1. ILO Convention 189 sets out labor standards for all domestic workers and guarantees all domestic workers a right to a safe and healthy work environment. The Convention thus applies to all care workers that work in, or for, a household, such as home health assistants and home-based personal care workers. It also stipulates that domestic workers are to enjoy conditions of work that are no less favorable than those available to workers generally, including fair remuneration, social security protection, normal hours of work and overtime compensation, and measures for labor inspection and enforcement. 36 States have ratified ILO Convention 189 as of June 12, 2023. See Arts. 10, 11, 13(1), 14, 17.
  3. Convention Concerning Occupational Health Services ILO No. C161 (1985) (link)
    1. This ILO Convention provides for the establishment of an occupational health services entity/entities for all workers, in all branches of economic activities (and thus covers the health and care sector). In particular, occupational health service authorities are entrusted with preventative duties of preventing and protecting the health and safety of workers. They are also responsible for advising employers, workers, and their representatives on maintaining a safe and healthy working environment. As of June 12, 2023, 35 States have ratified ILO Convention 161. See Arts. 1-3, 5, 13-15.
  4. Convention on the Elimination of All Forms of Discrimination against Women (1979) (link)
    1. This Convention, often referred to as CEDAW, requires States to eliminate discrimination against women and girls in all areas and to promote women’s and girls’ equal rights. One of the enumerated provisions recognizes the right to work as inalienable and requires States to take measures to eliminate discrimination against women in employment. In addition, Article 12(1) states that “States Parties shall take all appropriate measures to eliminate discrimination against women in the field of health care”, which would encapsulate all women health and care workers. Article 11 of CEDAW further enumerates areas of labor rights that States must act upon. 189 States have ratified CEDAW as of February 21, 2023. See Art. 11.
  5. Convention on the Rights of Persons with Disabilities (2006) (link)
    1. The Convention on the Rights of Persons with Disabilities (CRPD) reaffirms that all persons with all types of disabilities must enjoy all human rights and fundamental freedoms. The treaty enumerates comprehensive obligations on how States can enable the full realization of all human rights for persons with disabilities. Among other obligations, States must protect with rights of persons with disabilities on an equal basis and prohibit discrimination based on disability with regard to all matters concerning all forms of employment. As such, these protections apply to all health and care workers. 186 States, as of February 21, 2023, have ratified the CRPD. See Art. 27 (1)(b).
  6. Discrimination (Employment and Occupation) Convention, ILO No. C111 (1958) (link)
    1. ILO Convention 111 sets international standards regarding non-discrimination in all forms employment and occupation, and as such applies to health and care workers. States must enact legislation that prohibits all discrimination and exclusion on any basis, including race, color, sex, religion, political opinion, nationality, or social origin within employment and occupation. States must also repeal legislation and modify administrative instructions or practices inconsistent with a policy of equal opportunity and treatment in respect of work. 175 States have ratified this Convention, as of June 12, 2023. See Art. 3.
  7. Employment Injuries Benefits Convention [Schedule 1 as Amended in 1980]. ILO No. C121 (1964) (link)
    1. This Convention, which modifies former ILO instruments on workplace compensation, outlines obligations on States to establish national legislation that provides benefits, such as medical care and cash benefits, for situations of employment injury or loss due to an industrial accident to occupational disease. The Convention covers morbid conditions, incapacity for work, invalidity, loss of faculty, and loss of support due to the death of a breadwinner. Schedule I of the Convention enumerates the minimum set of injuries or diseases that must be covered by national legislation on employment injuries. The Convention applies to all branches of economic activity, including the health and care sectors. 24 States have ratified ILO C121, as of June 12, 2023. See Arts. 4, 6, 9.
  8. Equal Remuneration Convention, ILO No. C100 (1951) (link)
    1. Under ILO Convention 100, each State must ensure the application of the principle of equal remuneration for men and women for work of equal value. This includes minimum wage, salary, and any additional emoluments arising from a worker’s employment. As applied to health and care workers, ensuring equal pay for work of equal value is recognized as an essential element in closing the health sector pay gap and addressing inadequate compensation for care workers, including community health workers. As of June 12, 2023, 174 States have ratified this instrument. See Art. 1-3.
  9. Freedom of Association and Protection of the Right to Organise Convention, ILO No. C87 (1948) (link)
    1. This Convention establishes the foundational principles and obligations to realize the universal rights to organize and enjoy the freedom of association. The treaty outlines the rights of both workers and employers to join independent organizations of their choosing. States must refrain from interfering with these rights. The Convention’s protection applies to all workers, with some limitations on armed and police forces. Thus, as applied under this treaty, all health and care workers have the right to freedom of association and the right to organize. 157 States have ratified ILO Convention 87 as of June 12, 2023. See Arts 1, 6.
  10. Geneva Conventions, and their Additional Protocols
    1. The four Geneva Conventions and their Additional Protocols form the core rules of international humanitarian law. They regulate the conduct of armed conflict and specifically seek to protect those not engaged in conflict, such as civilians or medical personnel, and those no longer participating in hostilities, such as the wounded or prisoners of war. Under these treaties, States Parties must respect and protect all medical and humanitarian personnel engaged in providing health and care services in conflict settings. As of April 06, 2023, 196 States have ratified all four Geneva Conventions, 174 have ratified Additional Protocol I, 169 have ratified Additional Protocol II, and 79 have ratified Additional Protocol III.
    2. The following articles govern obligations in situations of armed conflict concerning health and care work:
      1. Geneva Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field (1949) (link)
        1. See Arts. 19, 20, 24.
      2. Geneva Convention (II) for the Amelioration of the Condition, sick and Shipwrecked Members of Armed Forces at Sea (1949) (link)
      3. Geneva Convention (III) relative to the Treatment of Prisoners of War (1949) (link)
      4. Geneva Convention (IV) Relative to the Protection of Civilian Persons in Time of War (1949) (link)
        1. See Art. 20.
    3. Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol I) (1977) (link)
      1. See Art. 15.
      2. Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of Non‐International Armed Conflicts (Protocol II) (1977) (link)
        1. See Arts. 9, 10, 15.
      3. Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Adoption of an Additional Distinctive Emblem (Protocol III) (2005) (link)
  11. International Convention on the Elimination of All Forms of Racial Discrimination (1965) (link)
    1. Under the International Convention on the Elimination of All Forms of Racial Discrimination (CERD), States must prohibit and eliminate racial discrimination in all forms, including that based on race, descent, and national and ethnic origin. The treaty sets out specific obligations on States to guarantee the human rights of all people, and groups of people, without discrimination, and thus applies to all health and care workers. These rights include, but are not limited to, the rights to work, to free choice of employment, to equal and fair remuneration, to just conditions of work, and to form and join trade unions. CERD has been ratified by 182 States as of February 21, 2023. See Arts. 1, 2, 5(e)(i-ii), 6.
  12. International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families (1990) (link)
    1. This Convention establishes the minimum standards that States should apply to migrant workers and their family members, irrespective of their migratory status. A ‘migrant worker,’ per the treaty definition in Article 1 would include migrant health and care workers. It reinforces that all persons and their families are afforded basic human rights, without distinction, throughout the entire migration process. In particular, States may not treat migrant workers less favorably than their own nationals regarding remuneration, terms of employment, and work conditions. This Convention has been ratified by 58 States as of February 21, 2023. See Arts. 1-2, 25.
  13. International Covenant on Civil and Political Rights (1966) (link)
    1. The International Covenant on Civil and Political Rights (ICCPR) recognizes the inherent dignity of each individual and requires States to respect, protect, and fulfill enumerated human rights, without discrimination. Rights protected under the ICCPR that are of particular relevance to health and care workers include the right to life, the right to freedom of association with others, and equality before the law. 173 States have ratified the ICCPR as of February 21, 2023. See Arts. 6(1), 22.
  14. International Covenant on Economic, Social and Cultural Rights (1966) (link)
    1. The International Covenant on Economic, Social and Cultural Rights (ICESCR) requires states to ensure the human rights enumerated in the treaty, including the right to just and favorable work conditions, the right to social security, and the highest attainable standard of physical and mental health. All persons, including health and care workers, hold these rights themselves. States are also obligated to take steps, to the maximum of available resources, to progressively realize the rights within the Covenant and ensure rights are guaranteed to all, without discrimination. The ICESCR has been ratified by 171 States as of February 21, 2023. See Arts. 1, 2(1), 7, 8(1), 9, 12.
  15. International Health Regulations (2005) (link)
    1. The International Health Regulations (IHR) set out States’ obligations to prevent, protect against, control, and provide a public health response to the international spread of disease. The IHR stipulate that WHO, when evaluating a potential public health emergency of international concern, may rely on reports that follow established epidemiological principles, outside of official government notifications or consultations. In doing so, the IHR provide a significant degree of whistleblower protection, including the ability of health and care workers to act on behalf of the public, in accordance with medical ethics, in reporting information concerning unusual or unexpected public health events. The IHR enable WHO to protect the confidentiality of the source of the information when “duly justified.” WHO must seek to verify the information with the State concerned before sharing this information with other States. The IHR are binding on all WHO Member States. See Art. 9(1).
  16. Invalidity, Old-Age and Survivors’ Benefits Convention, ILO No. C128 (1967) (link)
    1. ILO Convention 128 articulates the requirements on how to protect employees through the provision of invalidity benefits, old age benefits, and survivor’s benefits. The text defines the contingencies covered, defines persons protected, and articulates how a specific benefit shall be calculated, provided, and secured. The scope of this Convention is broad applying to “employees” including health and/or care workers. 17 States have ratified this instrument, as of June 12, 2023. See Arts. 7-8, 14-15, 20-21.
  17. Labour Relations (Public Service) Convention, ILO No. C151 (1978) (link)
    1. Recognizing the differences between private and public employment, this instrument details the application of core labor rights to ‘public employees’, which would apply to health and/or care workers in it’s scope. In particular, the treaty affirms that public employees, just as other workers, have the right to freedom of association, to organize, and to collectively bargain. As of June 12, 2023, 58 States have ratified this Convention. See Arts. 1(1), 4.
  18. Maternity Protection Convention, ILO No. C183 (2000) (link)
    1. Per ILO Convention 183, all employed women, without discrimination, including those in atypical forms of dependent work, are entitled to social protection covering pregnancy, childbirth, and their complications. Persons protected under this instrument are to be provided health protections, including prenatal, childbirth, and post-natal care, as well as maternity benefits such as leave for a minimum period of 14 weeks (including six weeks’ compulsory leave after childbirth) with protected earnings. Further, the instrument sets out right-to-work protections for all pregnant or nursing women, including employment protection and non-discrimination. 43 States have ratified this ILO Convention 183 as of June 12, 2023. See Arts. 4-8.
  19. Medical Care and Sickness Benefits Convention, ILO No. C130 (1969) (link)
    1. This Convention further details States’ obligations for providing medical care and sickness benefits as part of their obligation to provide social security. The text sets out the contingencies that States must cover under medical care and sickness benefits and which categories of workers must receive such benefits. While the treaty applies to all health and care workers, States may exclude public servants from the application of this Convention so long as they are protected by special schemes that provide aggregate benefits at least equivalent to those in the Convention. 16 States have ratified this instrument as of June 12, 2023. See Arts. 4(1), 7-9.
  20. Migration for Employment Convention (Revised), ILO No. C97 (1949) (link)
    1. The Migration for Employment Convention sets out principles for equality and non-discrimination in the workplace. Specifically, it requires States to ensure equal treatment, without discrimination to nationality, race, religion, or sex, to immigrants and its own nationals in matters related to remuneration, membership in trade unions, accommodation, social security, employment taxes, and any employment-related legal proceedings. As applied to the Care Compact, migrant health and care workers are entitled to equal protection as nationals. As of June 12, 2023, 53 States have ratified this Convention. See Art. 6.
  21. Nursing Personnel Convention, ILO No. C149 (1977) (link)
    1. ILO Convention 149 recognizes the distinct work of nursing personnel. It sets out specific standards that States must address when developing laws and policies regulating the profession that supplement general ILO standards that apply to all workers. Specifically, the Convention ensures that nursing personnel enjoy equivalent benefits to other workers in the fields of hours of work, weekly rest, social security, maternity leave, and sick leave. In addition, States must establish requirements for the education and training of nursing personnel. 41 States have ratified ILO Convention 149, as of June 12, 2023. See Arts. 2(1-2), 6.
  22. Occupational Safety and Health Convention, ILO No. C155 (1981) (link)
    1. ILO Convention 155 provides for the formulation, implementation, and periodic review of a national policy on occupational health and safety that applies to all employed persons in all branches of economic activity. It also stipulates the areas of occupational health and safety that must be covered in such a policy, the measures to take at the national level to give effect to such a policy, and what requirements should be prescribed for employers. The Convention thus sets out critical protections for the health and safety of all health and care workers within an overall approach of prevention, risk assessment, training, and response. As of June 12, 2023, 77 States have ratified ILO Convention 155. See Arts. 4(1), 5(c), 9, 11(c), 11(e) 13, 14, 15, 19(b), 19(e).
  23. Promotional Framework for Occupational Safety and Health Convention, ILO No. C187 (2006) (link)
    1. Building on ILO Conventions 155 and 161, this instrument sets out a promotional framework to further inform a coherent and systematic treatment of occupational health and safety issues. The Framework details what national programs on occupational safety and health should address, encourages dialogue between government, workers’, and employers’ organizations, and sets out an obligation to progressively realize a safe and healthy working environment for all. 60 States have ratified ILO Convention 187 as of June 12, 2023. See Arts. 2-5.
  24. Right to Organise and Collective Bargaining Convention ILO No. C98 (1949) (link)
    1. Under ILO Convention 98, all workers are guaranteed the right to organize and collectively bargain. Under the agreement, and as applied to health and care workers, workers and their respective organizations shall enjoy protection against acts of anti-union discrimination and protection against acts of interference in the establishment, functioning, or administration of union activity. In addition, States are obligated to establish authorities to further protect the right to organize within their jurisdiction. As of June 12, 2023, 168 States have ratified this instrument. See Arts. 2-3.
  25. Social Security (Minimum Standards) Convention, ILO No. C102 (1952) (link)
    1. ILO Convention 102 articulates internationally accepted definitions and standards of the right to social security. It sets out minimum standards for social security, including medical care, sickness benefits, unemployment benefits, old-age benefits, employment injury benefits, family benefits, maternity benefits, invalidity benefits, and survivors’ benefits. States are required to provide such benefits through the proper administration of institutions and service delivery by the enumerated minimum standards and objectives. As of June 12, 2023, this Convention has been ratified by 65 states. See, e.g., Arts. 7-9, 13-14, 19-20, 25-26
  26. United Nations Convention against Corruption (2004) (link)
    1. The United Nations Convention against Corruption covers five areas of universal anti-corruption measures: preventive measures, criminalization and law enforcement, international cooperation, asset recovery, and technical assistance and information exchange. The Convention affirms that States should incorporate measures to protect any person who reports misconduct in good faith and on reasonable grounds from unjustified treatment or retaliation. The provisions of the Convention apply to any person, including health and care workers, who report and expose malfeasance in the workplace. As of November 18, 2021, 189 States have ratified this Convention. See Art. 33.
  27. United Nations Security Council Resolutions 2286 (2016) (link) and 2439 (2018) (link)
    1. United Nations Security Council Resolutions 2286 and 2439 strongly condemns attacks on medical personnel and medical facilities in conflict situations and demands States to end impunity for those responsible. The resolutions reaffirm the obligations States hold under international humanitarian law to ensure the safe and unimpeded passage and operation of medical and humanitarian personnel and to investigate any attacks on health and care workers in situations of conflict and fragility. UNSCR 2286, see Para 4, OP 2, OP 4; UNSCR 2439, see Para 6.
  28. Violence and Harassment Convention, ILO No. C190 (2019) (link)
    1. ILO Convention190 recognizes the right of everyone to a world of work free from violence and harassment for all workers and employees, irrespective of contractual status. As such, all health and care workers, in the formal and informal economy, are protected under this Convention. States must adopt laws, policies, and measures that prevent and eliminate violence and harassment in the world of work, including conduct that involves third parties. The Convention enumerates specific protections for gender equality, recognizes gender-based violence as a workplace issue, and requires States to implement an inclusive, integrated, and gender-responsive approach to preventing and eliminating violence and harassment. As of June 12, 2023, 27 States have ratified ILO C190. See Arts. 3, 4, 10, 11.
  29. Workers’ Representatives Convention ILO No. C135 (1971) (link)
    1. Under this Convention, obligations to further realize the right to freely associate and collectively bargain are enumerated with an emphasis on the rights of workers’ representatives. Trade union representatives or elected representatives of workers’ groups are to enjoy effective protection against any act prejudicial to them, including dismissal, based on their status or actions representing groups of employers. The protections proffered by this treaty apply to all workers’ representatives, including those of health and care workers. 85 States have ratified this instrument, as of June 12, 2023. See Art. 1.
  30. Workers with Family Responsibilities Convention, ILO No. C156 (1981) (link)
    1. Intending to create effective equality of opportunity between men and women workers, ILO Convention 156 articulates the States’ obligations to enact labor measures that consider the needs of workers with family responsibilities. This is inclusive of Care Workers, specifically those who hold responsibilities “in relation to their dependent children” and “other members of their immediate family who clearly need their care or support,” and “where such responsibilities restrict their [the workers] possibilities of preparing for, entering, participating in or advancing economic activity.” States must also enable workers with family responsibilities their right to free choice of employment and prevent family responsibilities from being a reason for termination. As of June 12, 2023, 45 States have ratified ILO C 156. See Arts. 3(1), 4, 5, 8.

Non-Binding

  1. Employment Injury Benefits Recommendation, ILO No. R.121 (1964) (link)
    1. ILO Recommendation 121 outlines how States can implement the Employment Injury Benefits Convention through legislation. It details that all employees, including those who are employed in the public and private sector, those who are self-employed, and those who are volunteer in health care settings should be covered, and sets standards for how employment injury benefits should be administered through national authorities for a range of occupational hazards and diseases. The recommendation applies to all health and care workers as a result. See Art. 3.
  2. Equal Remuneration Recommendation, ILO No. R90 (1951) (link)
    1. ILO Recommendation 90 supports the Equal Remuneration Convention by establishing measures and provisions States should implement in their national policies. The recommendation provides guidance on how to determine rates of equal remuneration and how States can promote equality of men and women workers in all workplace environments. See Arts. 5, 6.
  3. HIV and AIDS Recommendation, ILO No. R200 (2010) (link)
    1. This non-binding instrument sets out ILO guidelines and standards on regulating and addressing HIV and AIDS in the workplace. It touches on best practices for preventing the spread of HIV and AIDS while also preventing discrimination based on HIV status and upholding equality of opportunity and treatment. This recommendation applies to a broad set of workers, defined as “any person working under any form of arrangement” within “all sectors of economic activity, including the private and public sectors and the formal and informal economies.” Therefore, though not explicitly mentioned, this encapsulates all health and care workers. See Arts. 10-13
  4. ILO Declaration on Fundamental Principles and Rights at Work and its Follow–Up (2022) (link)
    1. The ILO Declaration and its follow-up mechanisms reflect commitments made by governments, employers, and workers’ organizations to uphold basic principles, rights, and values in the world of work. Although the Declaration is not a binding instrument in and of itself, the contents within it reflect binding obligations of ILO Member States concerning labor rights to all workers, including health and care workers. It also affirms that all ILO Members States (even if they have not ratified relevant ILO Conventions) have obligations that arise from joining the Organization. These obligations are in five categories including freedom of association, elimination of discrimination, and a safe and healthy working environment.
  5. ILO Social Protection Floors Recommendation, ILO No. R. 202 (2012) (link)
    1. The ILO Social Protection Floors Recommendation affirms the right to social security to all residents and children within a States’ jurisdiction, and thus applying to health and care workers, and provides guidance to States on how to establish and maintain social protection floors as a part of their national social security systems. It further articulates the minimum guarantees that a social protection floor should include, such as access to essential health and basic income security. See Art. 4.
  6. Labour Relations (Public Service) Recommendation, ILO No. R159 (1978) (link)
    1. ILO Recommendation 159 guides States on how to regulate public sector employees in light of international labor obligations. The recommendation focuses on laws and measures that uphold the right to freedom of association for public employees, including the recognition of public employees’ organizations and best practices for negotiations of terms and conditions of employment. Health and care workers employed in the private sector are captured under this recommendation
  7. Maternity Protection Recommendation, ILO No. R191 (2000) (link)
    1. These non-binding guidelines provide details on how principles found in the Maternity Protection Convention can be applied. It recommends minimum standards for maternity leave, discusses how to provide and extend benefits, and expresses standards of health protections that are important for pregnant or nursing women in the workplace. The recommendation thus applies to pregnant or nursing health and care workers. Recommendations of the ILO, while non-binding, function as guidelines orienting national policies and actions to fulfill binding legal obligations and represent the will of ILO Member States. See Arts. 1-2, 6.
  8. Medical Care and Sickness Benefits Recommendation, ILO No. R134 (1969) (link)
    1. ILO Recommendation 134 supplements the Medical Care and Sickness Benefits Convention by providing guidance on how States should implement their legal obligations under Articles 8 and 18 of the treaty. The recommendations highlight who is entitled to medical care and sickness benefits, including those whose work is “of a casual nature,” and what medical care should include. See Arts. 2, 11.
  9. Migrant Workers Recommendation, ILO No. R151 (1975) (link)
    1. Considering the interest in protecting workers employed in countries other than their own, and the binding obligations in the ILO Migration for Employment Convention, these ILO Recommendations set out provisions that States should include in their existing frameworks or policies governing migrant workers. The recommendation outlines the areas migrant workers are entitled to equal opportunity, non-discrimination, and treatment when it comes to conditions of employment. See Art. 2.
  10. Nursing Personnel Recommendation, ILO No. R157 (1977) (link)
    1. The Nursing Personnel Recommendation provides non-binding guidance to States on how to regulate the nursing profession in light of obligations under international labor law. The recommendation outlines the special conditions in which nursing is carried out and provides standards that States should implement in education, training, career development, remuneration, and other labor concerns related to the nursing sector. See Arts. 25, 27, 29.
  11. Occupational Health Services Recommendation, ILO No. R171 (1985) (link)
    1. ILO Recommendation 171 provides interpretive guidance on how States should design laws and measures around occupational health services to fulfill their obligations under the corresponding ILO Convention. The recommendation highlights the functions of the national occupational health services, including with respect to the working environment and workers’ health, describes how occupational health services should be organized, and outlines conditions for effective operations.
  12. Occupational Safety and Health Recommendation, ILO No. R164 (1981) (link)
    1. This non-binding instrument provides interpretive guidelines and standards on how States should implement the Occupational Safety and Health Convention. This includes guidance for regulatory measures necessary to realize legal obligations under the treaty. See, e.g., Para. 17.
  13. Promotional Framework for Occupational Safety and Health Recommendation, ILO No. R197 (2006) (link)
    1. Building on ILO Recommendation 171, this recommendation on a promotional framework for occupational safety and health outlines steps States should take through their national system for occupational health and safety to prevent occupational injuries, diseases, and death. It articulates best practices for a national program, details what a national profile for occupational safety and health should include and measures the ILO should take to facilitate international cooperation and information exchange.
  14. Protection of Worker’s Health Recommendation, ILO No. R97 (1953) (link)
    1. ILO Recommendation 97 provides non-binding policy guidelines for protecting the health of all workers, and thus encompassing health and care workers, in their place of employment. The recommendations include technical measures for risk mitigation, special measures for medical examinations for workers exposed to special health risks, and notifications of cases of occupational illness. See Sec. II, Paras 8-9.
  15. Report of the Special Rapporteur of the Human Rights Council on Extrajudicial, Summary or Arbitrary Executions, Saving Lives is Not a Crime, A/73/314 (link)
    1. “Saving Lives is Not a Crime” is a report authored by an independent human rights expert (“Special Rapporteur”) mandated by the United Nations Human Rights Council to advise on issues related to the right to life. The report addresses the criminalization and targeting of “humanitarian services and actors arising from activities to fight terrorism and deter migration and from the outlawing or stigmatization of sexual and reproductive rights”. In the report, the Rapporteur notes that the failure of States to provide access to health care, including through restrictions on health providers, such as the criminalization of healthcare in conflict settings, may violate the right to life. The report also highlights prosecution of humanitarian actors under anti-terrorism laws for providing aid to civilian populations, with the fear of such prosecution likely to result in greater harm to life and to civilian deaths. See paras. 21, 36-39.
  16. UN Committee on Economic, Social and Cultural Rights, General Comment 14, The Right to the Highest Attainable Standard of Health (2000) (link)
    1. This General Comment, published by the body of independent experts that monitors the implementation of the International Covenant on Economic, Social and Cultural Rights (ICESCR), provides additional guidance for and interpretation of the right to health. The General Comment provides that, to realize the highest attainable standard of health, health facilities, goods, and services must be readily available, accessible to everyone without discrimination, acceptable, and of good quality. General Comment 14 affirms that a protected, skilled, motivated, and supported health and care workforce is necessary to provide care that fulfills these four elements and the standards protected by the right to health. It also affirms the right to participate in health-related decision-making, and that public health strategies and plans of actions should be developed through participatory, transparent processes. See Paras. 11, 12, 15, 33, 36, 43(e), 44(e).
  17. UN Committee on Economic, Social and Cultural Rights, General Comment 20, Non-Discrimination in Economic, Social and Cultural Rights (2009) (link)
    1. This General Comment, published by the body of independent experts that monitors the implementation of the ICESCR, provides additional guidance on the realization of rights enumerated in the Covenant. Specifically, it affirms that discrimination undermines the fulfillment of economic, social, and cultural rights and that non-discrimination and equality are essential to exercising and enjoying such rights. It restates that the principle of non-discrimination is an immediate and cross-cutting obligation upon States, encompassing both formal and substantive discrimination. Among other rights, the obligations articulated by General Comment 20 apply to the realization of health rights and the right to just and favorable conditions of work for all persons including those who are health and care workers. The General Comment also details the meaning of the classes of people that the ICESCR specifies as being protected against discrimination vis-à-vis their rights, as well as examples of classes of people of “other status” who are to be protected against discrimination. See Paras. 15-35.
  18. UN Committee on Economic, Social and Cultural Rights, General Comment 23, The Right to Just and Favourable Conditions of Work (2016) (link)
    1. This General Comment, published by the body of independent experts that monitors the implementation of the ICESCR, provides additional guidance for and interpretation of the right to work. The General Comment provides that all workers have a right to a fair wage, that workers should receive equal remuneration for work of equal value, and that preventing occupational accidents and disease are fundamental aspects of the right to work. The comment further affirms that enabling working environments, rest and leisure, and paid leave are essential to the full realization of labor rights. See Paras. 10-12, 14-15, 18, 25, 28, 29, 30, 35-41, 44, 47, 48.
  19. United Nations General Assembly Resolution 69/132: Global Health and Foreign Policy (2015) (link)
    1. In Resolution 69/132, the United Nations General Assembly urges UN Member States to take actions that protect, promote, and respect the right to health, including by considering health issues in the formulation of foreign policy. The resolution specifically calls on countries to enhance and promote health and care workers’ safety and protection, in parallel with other actions to realize the right to health. See Para 13.
  20. United Nations General Assembly Resolution 74/2 (2019): Political Declaration of the High-Level Plenary Meeting on Universal Health Coverage (link)
    1. The United Nations General Assembly affirmed the importance of a protected, skilled, motivated, and supported health workforce by adopting a political declaration that recommits to achieving universal health coverage by 2030. The declaration calls on States to strengthen their national health workforces, develop and improve training for the full spectrum of health workers, scale up recruitment and retention efforts of health workers, to provide better opportunities and working environments to women in the health sector, and protect all such workers from violence and harassment. United Nations General Assembly resolutions, while not binding instruments, are formal expressions of the opinion or will of UN Member States. See Paras. 23, 57, 60, 61, 62, 64.
  21. United Nations General Assembly Resolution 75/156 (2020): Strengthening national and international rapid response to the impact of the coronavirus disease (COVID-19) on women and girls (link)
    1. In light of the threat to global health that COVID-19 posed, the United Nations General Assembly passed a resolution encouraging UN Member States to implement health response plans with a gender-sensitive lens. The Assembly further considered the specific physical, mental, and psychological needs of female front-line health workers and community health volunteers, along with the importance of creating a safe, enabling, and violence-free working environment for them. See Preamble, page 3.
  22. Workers with Family Responsibilities Recommendation, ILO No. R165 (1981) (link)
    1. This ILO Recommendation provides detailed guidance to States on how to establish national policies and measures that ensure equality of opportunity and treatment in the workplace for men and women workers with family responsibilities. Importantly, this encapsulates health and care workers who have “responsibilities in relation to other members of their immediate family who need their care or support.” The recommendation includes explanations of discrimination based on family responsibility, standards for conditions of employment that respect family responsibility, and guidelines for child-care and family services. See Arts. 6, 22(1), 25.
  23. World Health Assembly Resolution 29.43 (1976): International Women’s Year (link)
    1. Resolution 29.43 of the World Health Assembly encourages WHO Member States to increase participation by women at all levels in the health sector. The resolution emphasizes expanding training policies, recruiting and promoting women health workers, promoting active participation of women in WHO activities and its related bodies, and eliminating discrimination against women where it exists. World Health Assembly resolutions, while not binding instruments, are formal expressions of the opinion or will of WHO Member States. See Para 1(3).
  24. World Health Assembly Resolution 60.26 (2007): Workers’ Health: Global Plan of Action (link)
    1. Resolution 60.26 of the World Health Assembly endorses the Global Plan of Action on Workers’ Health 2008-2017 to strengthen WHO Member States’ action on occupational health policies and plans for workers, including healthcare workers. This Resolution urges Member States to take steps to strengthen occupational health coverage, guidelines, and services for all workers, including those in the informal economy. The resolution further recognizes that the health of workers is determined not only by occupational hazards but also by social and individual factors as well as access to health services.
  25. World Health Assembly Resolution 64.6 (2011): Health Workforce Strengthening (link)
    1. World Health Assembly Resolution 64.6 urges WHO Member States to continue bolstering the effective operation of domestic health systems by prioritizing human resources for health. The resolution articulates concern about the inadequate distribution of health workers and provides recommendations on how countries can increase the retention of health workers, especially in rural areas. The resolution does not explicitly mention care workers. See Para. 1(8).
  26. World Health Assembly Resolution 64.7 (2011): Strengthening Nursing and Midwifery (link)
    1. In Resolution 64.7, the World Health Assembly urges WHO Member States to translate into action their commitment to strengthening nursing and midwifery by, among other things, “implementing strategies for enhancement of interprofessional education and collaborative practice including community health nursing services”. See Para. 1(8).
  27. World Health Assembly Resolution 72.4 (2019): Preparation for the High-Level Meeting of the United Nations General Assembly on Universal Health Coverage (link)
    1. Resolution 72.4 of the World Health Assembly urges WHO Member States to continue strengthening national health and systems so that health workers have the necessary equipment and supplies to carry out their responsibilities effectively. The resolution also states that countries should invest in their health workforce, promote the recruitment, development, and training of such workers, and continue to implement the WHO Global Strategy on Human Resources for Health. See Paras. 1(7), 1(8).
  28. World Health Assembly Resolution 74.14 (2021): Protecting, Safeguarding and Investing in the Health and Care Workforce (link)
    1. In Resolution 74.14, the World Health Assembly affirms the essential role of health and, arguably given the resolutions’ application to ‘other relevant frontline workers, care workers, and calls upon WHO Member States to invest in, and implement, health workforce policies, prioritize investments and financing for recruitment and retention of health workers, and take the necessary steps to safeguard and protect health and care workers at all levels. In addition, the resolution urges Members to implement the WHO Global Strategy on Human Resources for Health.
  29. World Health Assembly Resolution 74.15 (2021): Strengthening nursing and midwifery: investments in education, jobs, leadership and service delivery (link)
    1. The World Health Assembly reaffirms the importance of establishing specific programs to strengthen the nursing and midwife workforce as a component of promoting a robust health and care workforce. The resolution urges WHO Member States to implement policy priorities on education, occupational health and safety, recruitment, training, and provision of services for the nursing and midwife sectors. See Paras. 2, 4.
  30. World Health Assembly Resolution 75.17 (2022): Human Resources for Health (link)
    1. In Resolution 75.17, the World Health Assembly adopts the Working for Health 2022-2030 Action Plan as a mechanism to accelerate investments in health and care worker education, skills, and jobs. The resolution urges countries to implement the Action plan, integrate workforce planning objectives, and utilize the Global Health and Care Worker Compact as guidance to inform national review.