Human Rights Issues: The State, Non-State Institutions, and the Individual

October 25 - 29, 2008, San Diego, California

Dabney P. Evans, MPH, CHES


February 25, 2009


2008 marked the 60th anniversary of the Universal Declaration of Human Rights (UDHR).[1] This international document, which lays out the fundamental rights and freedom of all persons, is seen as the cornerstone of modern human rights. Faced with a large-scale humanitarian crisis and more than 6 million displaced persons at the end of World War II, the international community responded via various measures, including the establishment of the Office of the United Nations High Commissioner for Refugees (UNHCR) in 1950 and the drafting of the 1951 Convention Relating to the Status of Refugees.[2] Today the UNHCR estimates that there are just under 33 million refugees worldwide. Another 24.5 million people are internally displaced persons, who are distinguished from refugees by the fact that they have not crossed an international border.[3] The fact that there are more than 50 million refugees and internally displaced persons clearly demonstrates how far we are from yet realizing the human rights outlined in these documents. The American Public Health Association (APHA)-International Human Rights Committee organized several sessions[4] at the 2008 annual meeting of the AHPA to highlight some of the issues faced by both State and non-State actors as well as the individuals who are members of refugee, immigrant, and noncitizen populations in the effort to realize human rights.


The State, Individuals, and Human Rights


The expression denoting something "without borders" has come into common parlance as professionals and organizations, such as doctors, lawyers, and journalists, express their support for the principle of universality, a doctrine also widely espoused in the field of human rights. However, why are borders so important that we must express that public health or any other cause must be promoted regardless of them? The answer to this question lies in another tenet in the field of human rights, that of State sovereignty. In fact, the entire United Nations system is based on the premise that the State is a positively engaged participant willing to promote and protect human rights. States are responsible for the ratification of international treaties and for the legislative measures to enact such treaties. States are viewed as the duty bearers of human rights and are responsible to respect, protect, and fulfill the rights of their citizens.

Many times, of course, the reality is just the opposite. As in the case of World War II and countless conflicts since then, individuals find themselves in situations in which their rights are violated directly by the primary institution, the State, endowed with rights obligations. When these individuals leave the "protection" of their country of origin either by force or by choice to become refugees, asylum seekers, or migrants, their vulnerability for human rights violations increases. International human rights and humanitarian law exist for the protection of refugee populations in the forms of the 1951 Refugee Convention and the subsequent 1967 Refugee Protocol.[5] Likewise, migrant worker populations fall under the International Convention on the Protection of the Rights of all Migrant Workers and Members of Their Families.[6] Although these international treaties are designed to protect vulnerable populations, States may not recognize a vested interest in protecting the rights of noncitizen populations, such as refugees and migrant workers, compounding the vulnerability of such populations.

At the APHA meeting, Ben Achtenberg[7] discussed the fact that many asylum seekers are often survivors of torture. After fleeing their home countries, they may be detained as a part of the asylum process. Such an experience can further exacerbate prior traumatic experiences. Similarly, Andrea Guerrero[8] discussed migrant populations who may experience human rights violations after being placed in detention centers during the immigration process. Fundamentally, human rights are about individuals. For the asylum seekers, refugees, or migrants who find themselves crossing a border, the relationship between the individual and the State is paramount. All States should be encouraged to ratify the international human rights and humanitarian law treaties that provide protections to vulnerable noncitizen populations. The ratification of such treaties creates legal obligations for host States toward these populations, just as other human rights treaties create protections for populations of vulnerable populations of citizens within States.


Non-State Institutions and Human Rights


At the time of the initial development of the modern human rights system, States were the dominant actors in the international arena. However, today we see the growing role that non-State actors -- including transnational corporations, terrorist organizations, and nongovernmental/civil society organizations (NGOs) -- may play on the world stage. Transnational corporations (TNCs) are often portrayed as the "bad guys," whereas the NGOs are the "good guys." However, this analysis is an oversimplification. All kinds of non-State actors may potentially violate and/or protect human rights. Oftentimes they both respect and violate rights within the same act. Enrique Davalos[9] provided an example of a TNC operating a maquiladora on the US-Mexico border. Although TNCs may be providing an opportunity for the right to work, they may also be violating the right to association if that same company refuses to allow its workers to participate in trade unions. Likewise, health-based NGOs working to fulfill the right to health may undermine State efforts to achieve the same goal by recruiting skilled health professionals away from the public sector with higher-paying NGO jobs.[10]

Fundamentally, non-State actors have the same human rights duties or obligations as individuals, namely, to respect or refrain from the direct human rights violations of others. Even at the level of individuals, this is of course easier said than done, and is only complicated further by the complex actions taken by non-State actors. However, clarifying the duties of non-State actors may be a useful first step in raising awareness about human rights obligations among the individuals that compose non-State institutions.




This report has discussed human rights both in regard to the rights of vulnerable individuals, such as refugees and migrant populations, and the moral and legal obligations of various structural entities, including governmental and non-State actors. Although there have been many advances in human rights over the 60 years since the inception of the Universal Declaration of Human Rights, there is still much work to be done. This work must take place at the level of the individual rights holder as well as the institutional level of the duty bearers. From a historical perspective, human rights is still a very new paradigm. The modern system of human rights is based on a State-centric model. As the forces of globalization continue to rise, the challenges facing those engaged with human rights will relate to the interactions between individuals, States, and non-State actors. The rights and obligations of these various players must be evaluated and evolve as necessary in order to fulfill the vision set forth in the Universal Declaration of Human Rights of dignity and human rights for all.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.