the ICESCR as requiring affluent States Parties and other actors to provide
“international assistance and cooperation, especially economic and
technical” in order to enable poor countries to fulfill their core obligations.172
The thrust of this provision is similar to the stipulation of MDG 8—to
develop a global partnership for development, through, inter alia, increase in
ODA—an issue discussed in Part II.173 They bear no repeating, except to note
that the response of the international community (governments and private
institutions) to prevailing developmental challenges in the third world,
particularly in the health sector, makes resource constraints a timid and lame
excuse. In 2012, ODA stood at $125.6 billion.174 Although this represents a
decline from a peak of $128.7 billion in 2010,175 one thing seems quite
glaring: add individual receipts to internally generated resources, however
austere, in each aid-receiving country and it becomes clear that failure to rise
to development challenges in many of these countries is not a product of
resource deficit. The UNFPA estimates that it would cost $300 to provide
fistula treatment—including surgery, post-operative care and rehabilitation
support,176 meaning that resource deficit is not an excuse.
The emphasis of this section on core obligations is driven by two
considerations. First, recalibrating national health systems in tandem with the
demands of the obligation is a surefire way not only to reduce the incidence
of fistula but also improve the entire health system. Second, and perhaps
more important, recalibration is possible immediately. The point is that
172. General Comment No. 14, supra note 143, ¶ 45; see also General Comment No. 3,
supra note 157, ¶ 14.
173. This idea has an antecedent in the U.N. Charter. Amongst the factors that propelled
the establishment of the U.N. was a need to “reaffirm faith in fundamental human rights, in
the dignity and worth of the human person, in the equal rights of men and women.” U.N.
Charter pmbl. A key objective of the Organization is to “achieve international co-operation in
solving international problems of an economic, social, cultural, or humanitarian character, and
in promoting and encouraging respect for human rights and for fundamental freedoms for all
without distinction as to race, sex, language, or religion.” U.N. Charter art. 1, para. 3. This
objective underscores the pledge by Member Nations pledge to “to take joint and separate
action in co-operation with the [UN]” in order to:
(a) attain higher standards of living, full employment, and conditions of economic and
social progress and development;
(b) develop and implement solutions to international economic, social, health, and
related problems; and international cultural and educational cooperation; and
(c) ensure universal respect for, and observance of, human rights and fundamental
freedoms for all without distinction as to race, sex, language, or religion.
See U.N. Charter art. 55, 56; see also ICESCR, supra note 129, at art. 11.
174. Aid to Poor Countries Slips Further as Governments Tighten Budgets, ORG. FOR
ECON. CO-OPERATION AND DEV. (Mar. 4, 2013), http://www.oecd.org/newsroom/
175. Development Aid Reaches an Historic High in 2010, ORG. FOR ECON. CO-OPERATION
AND DEV., http://www.oecd.org/dac/stats/developmentaidreachesanhistorichighin2010.htm
(last visited Oct. 11, 2015).