In 2012, the International Labour Organization (ILO) called on its 185 members to ensure that everyone in need has access to essential health care and basic income security.
Perhaps the most significant global social policy development in 2012 was approval of the International Labour Organization (ILO) recommendation on creation of social protection floors. Approved in June, the recommendation calls on the ILO’s 185 members to ensure that everyone in need has access to essential health care and basic income security.
The recommendation comprises at least four basic guarantees: (1) access to essential health care, including maternity care, that meets the criteria of availability, accessibility, acceptability and quality; (b) access to nutrition, education, care and any other necessary goods and services constituting basic income security for children; (c) basic income security for persons in active age who are unable to earn sufficient income, in particular in cases of sickness, unemployment, maternity and disability; and (d) basic income security for older persons.
Collectively, these guarantees will help to prevent or alleviate poverty, vulnerability and social exclusion, and allow a life in dignity. They can be achieved in different ways, such as through contributory or non-contributory social transfers. Examples include old-age pensions, disability benefits, child benefits, income support benefits and/or employment guarantees and services for the unemployed and working poor.
While the recommendation may appear unrealistically ambitious to some, especially for least developed countries, it actually builds on or complements commitments and aspirations contained in several other international agreements (e.g., the United Nations resolution on affordable universal healthcare, adopted on 12 December). Further, it is a nonbinding guideline that does not impose a deadline on governments, and clarifies that basic guarantees are to be nationally defined. These aspects provide flexibility for countries at all levels of development to progressively build up their social protection floors in accordance with local circumstances. Further, the recommendation reflects intentions of a growing set of countries that have already established goals for social security in their policies, laws, and budgets.
For example, Thailand established a universal healthcare scheme a decade ago, and Viet Nam has committed to putting one in place by 2014. The People’s Republic of China and the Philippines are among other developing Asian countries that have made great strides in extending access to basic healthcare. However, ensuring minimum quality healthcare standards, addressing out-of-pocket health expenditures that drive millions into poverty each year, engaging adequate numbers of properly trained healthcare professionals, and reaching migrant populations remain key challenges. Achieving other guarantees, such as providing income security for Asia’s growing elderly population, presents a host of other major challenges.
The global embrace of social protection floors comes at a time when planning for the post-2015 international development framework has begun in earnest. It thus seems likely that the guarantees included in the landmark ILO recommendation will become a part of the discussions around future targets to reduce poverty, improve human security, and provide access to essential services.