Debate: Limitations on universality: the "right to health" and the necessity of legal nationality

Most discussions of the human right to health assume that every human being has legal nationality, but in reality there are at least 11 to 12 million stateless individuals worldwide who are often unable to access basic healthcare. The examples of the Roma in Europe, the hill tribes of Thailand, and many Palestinians in Israel highlight the negative health impacts associated with statelessness.Stateless individuals often face an inability to access the most basic healthcare, much less the "highest attainable standard of health" outlined by international agreements. Rather than presuming nationality, statelessness must be recognized by the medical community. Additionally, it is imperative that stateless populations be recognized, the health of these populations be tracked, and more research conducted to further elaborate upon the connection between statelessness and access to healthcare services, and hence a universal right to health.The "right to health" has been recognized as one of a set of basic human rights for at least the past half-century, since the adoption of the Universal Declaration of Human Rights in 1948. Currently, the "right to health" has been formally recognized by 56 national governments, in the form of constitutional or statutory provisions [1]. The scope and meaning of this right has been the subject of debate within the international community, however, and the means for achieving it remain similarly contested. The features of a healthcare system that is able to guarantee a comprehensive "right to the highest level of attainable health" for the citizenry of a given nation-state may be complicated by a variety of social and political obstacles. Backman and colleagues [1] recently reviewed the status of the right to health in 194 countries and found that much work still needs to be done before this right can legitimately be considered "universal."Despite a general awareness within the scholarly community that the right to health may not be availabl