State Responsibility for Ensuring the Right to Health in Mass Gatherings

Abstract

Context: Mass gatherings (MGs), defined as concentrations of people assembled for a specific purpose, have major cultural, religious, and economic significance but also pose substantial public health risks, including communicable disease outbreaks, crush injuries, and environmental hazards. Evidence Acquisition: This review examines states’ responsibilities to protect health at MGs by analysing international human rights law, particularly Article 12 of the International Covenant on Economic, Social and Cultural Rights. It also considers obligations related to religious pilgrimages, international cooperation, accountability, climate change, and digital health governance. Results: States bear the primary and nondelegable responsibility for safeguarding the right to health of all MG participants. Fulfilling this obligation requires a comprehensive, multisectoral approach that includes proactive planning, robust risk assessment, adequate on-site health services, and effective surveillance and response systems. Conclusions: Failure to implement appropriate public health protections at MGs may constitute a breach of states’ legal duties to respect, protect, and fulfill the right to the highest attainable standard of health. Effective governance must also address emerging risks and ensure international cooperation and accountability.