Time for a human rights-based approach to refugee health

June 16th, 2014 will mark the 3rd National Day of Action to Stop Cuts to Refugee Health Care in Canada. Concerned members of the Canadian public and healthcare providers across the country will again join forces to protest the changes that were made to the Interim Federal Health Program (IFHP) in 2012.

The IFHP was originally implemented in 1957 to provide refugees and refugee claimants with health care access on par with Canadians on social assistance. For these newcomers arriving without the means to finance private health insurance, the IFHP was the only source of coverage until they qualified for provincial plans. But, on June 30th, 2012, the federal government made significant revisions to the IFHP without consulting health or immigration stakeholders. The policy that emerged is one that allots different levels of health care coverage to different categories of refugees. For refugee claimants arriving from specific countries, even the most basic health care is no longer insured.

The new IFHP quickly, and predictably, resulted in negative health outcomes for refugees and refugee claimants in Canada. Many have stated and shown that cuts to the IFHP make for bad public health policy as they put life-saving and cost-effective primary health care out-of-reach for many individuals. What’s more, the new IFHP runs counter to Canada’s humanitarian tradition and its obligation to respect, protect, and fulfill the right to health with equality and without discrimination within its jurisdiction.

As a signatory of all the core United Nations treaties, Canada explicitly supports human rights including the right to health. The Universal Declaration of Human Rights affirms that “[e]veryone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing, and medical care…” The Committee on Economic, Social, and Cultural rights (a committee to which Canada submits reports approximately every 5 years) has expanded upon the right to health by outlining its core contents. According to the Committee, everyone has the right to “equal and timely access to basic preventive, curative, and rehabilitative health services,” And, according to the Committee, every state has an immediate obligation to “guarantee that the right will be exercised without discrimination of any kind.” Furthermore, while the International Covenant on Economic, Social, and Cultural Rights makes room for progressive realization of the right to health, the Committee has stated that any retrogressive measures incompatible with the state’s obligations constitute a violation of the right to health.

The new IFHP is retrogressive, not progressive.

1. The new IFHP now makes preventive, curative, and rehabilitative health care less accessible for all refugees than it was before, leading many to delay seeking care until the need takes them to an emergency room
2. The new IFHP now discriminates among refugee claimants based on their nationality; denying life-saving health care for those arriving from a specific list of countries (discrimination that is prohibited by national and international law)
3. The new IFHP now links health policy with the enforcement of immigration policy when they ought to be separate processes; enforcement of Canada’s immigration policy should not prevent refugees in Canada from accessing their fundamental right to health

Having categorically backed international human rights instruments, Canada has a responsibility to formulate a refugee health policy that is consistent with its international human rights obligations and with its reputation for exemplary humanitarianism. The 2012 revision of the IFHP falls short of these obligations but 2014 is a new year. It is time for another revision, one that uses a human rights-based approach to health policy.

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Grace Belayneh


Grace Belayneh is a recent Global Health graduate living in the Greater Toronto Area.

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