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Food for revitalizing a thought


Human Rights Reader 334

  1. An examination of the history of almost any type of social movement, including human rights (HR) movements, shows that there are great spurts of action, of organization followed by periods of relatively slower growth, perhaps to be followed by new spurts, generally of a variant kind of organization in the same realm. It may well be, that the original spurt of the HR movement is at a lull right now (the SDGs only pay lip service to them!) and that a next spurt with a renewed moral* and political spirit is ‘in the air’ (A. Stinchcombe) —meaning fear and fright are being overcome

*: Within the scientific community, there has been almost a code of honor that you will never transgress the red line between pure analysis and moral issues. But we are now in times where we have to think about the moral and HR consequences of our stance towards society. (H. J. Schellnhuber) For instance, economic development, to be morally good –i.e., fair and just– must take into account people’s need for things like freedom, education, health and meaningful work: all HR attributes. Furthermore, Pope Francis rejects the belief that technology and the ‘current economic outlook’ will solve environmental problems, or “that the problems of global hunger and poverty will be resolved simply by market growth.”


  1. So, what are the challenges that a renewed push will have to face? First, it will have to develop a clear, renewed vision of where it wants to go post 2015. Revitalization will require espousing convincing policy proposals that clearly express solidarity between the different segments of the population whose rights are being violated within and between countries and continents. New forms of bringing together these groups to coalesce into a veritable movement must simply be pursued. The newly established active groups of claim holders must no longer be dominated by white male leaders from the North, but by women, people of color, minorities, many of those who are subsisting through hidden, underpaid wage-labor or in otherwise precarious jobs, or live under a debt bondage –frightened. A broadened definition of these groups will necessarily lead to a drastic change in the HR movement’s operations. It will assist these groups to further their claiming and demanding interests effectively. An additional final change needed concerns changing organizational structures and cultures not only adapted to local realities, but also to the structure and culture of the growing international HR network. Probably, the best option will be a new democratic, unitary structure facilitating the inclusion of the newly joining groups in the same international network guaranteeing a democratic approach, i.e., a greater participation of the rank-and-file members. The possibilities offered by the internet are a positive contribution to a renewed structure of this kind.


  1. Moreover, and most importantly, new methods of collective action, away from fear, and especially across borders, have to be adopted. While lobbying governments and transnational organizations has to date been the principal activity of international HR activists –and efforts are made to cultivate the ‘good will’ of states– effective action requires much greater effort engaging in active measures such as boycotts, mass demonstrations, people’s tribunals, and so on (which in turn demands a substantial strengthening of the internal structures).


  1. The HR movement cannot afford to simply be a sleeping giant or a weak inter-societal federation of frightened people. The question is whether the existing international HR movement can meet the challenges outlined here. It is likely that a new spurt in our development will be a difficult process, interspersed with failed experiments and moments of crisis. For our HR movement, organizational structures and patterns of behavior have existed for over two decades and are not easily changed. But change we must –and some inklings of it can already be seen. We are aware that it is highly unlikely that new structures and patterns will be shaped through reforms from above, through the central leadership. If there is one thing that history has taught us, it is that movements, for instance trade union structures, almost never develop smoothly by means of piecemeal engineering. They are generally the outcome of conflicts and the willingness to embark in ‘risky’ experiments. Pressure from below through citizen claim holders paying attention to alternative action models will be a highly important factor in deciding the outcome. (HR Learning playing a key role here).*** What forms those pressures will take, and whether they will be sufficient to bring about major changes, no one can say yet with any certainty. The chances that a successful new push will materialize soon will depend on all of us awakening the sleepy (but not sleeping, not frightened) giant. (M. van der Linden)

***: If by citizen claim holders exerting pressure from below we mean their using the HR framework to demand their rights by bringing governments to account and, for instance, decide how tax funds are used, then, beware, we will still be far from being active in global citizenship. At he global level, way too much attention is being given to ‘multistakeholderism’ these days. The notion of ‘stakeholder’, as opposed to ‘shareholder’, was originally a way to make corporations purportedly more accountable to the people affected by their actions. But now, multistakeholder governance in the Internet, in public-private partnerships (PPPs) within the United Nations or elsewhere means that corporations are moving into taking up a role in global governance –without necessarily becoming more accountable in the process. This means less rights for citizens, not more. (R. Bissio)


Although unrelated to the above, I have to cover an important HR topic in this Reader. So here are some words on Human Rights Impact Assessments.


  1. Although other types of impact assessments, particularly health impact assessments, may also involve participation by the people likely to be affected and concerned about the inequality of the health consequences on different populations, Human Rights Impact Assessments (HRIA) are distinctive in that the principles and norms used are elaborated based on a body of existing international and domestic laws and recommendations. Therefore, what is required for the fulfillment of the rights to non-discrimination and to equality, for example, is not decided by the assessment team, but rather by bodies authorized to establish standards that apply to all levels of government and across all sectors, as well as apply to the monitoring of compliance with them. Human rights (HR) thereby provide greater coherence and stronger mechanisms of accountability than other forms of impact assessment.


  1. Human Rights Impact Assessments intend to contribute to the capacity of claim-holders to claim their rights and duty-bearers to meet their obligations. This invariably means that HR Learning for both claim-holders and duty-bearers must be part of the assessment process. HR Learning empowers claim-holders by giving them knowledge of their rights, this encouraging participation in the assessment, as well as in future HR struggles. HR Learning for duty-bearers is centered around the standards they are responsible for meeting and the processes they need to put in place to inform the public. By encouraging their participation, at the same time they are promoting equality and nondiscrimination, and are integrating accountability mechanisms into government decision-making. In this way, HRIA processes serve as a model and an opportunity for claim-holders and duty-bearers to practice HR-based governance. It is key that the people most likely to be affected are included in this process from early on, rather than simply as sources of information at more advanced steps. They must have a meaningful opportunity to influence the decisions on which alternatives, if any, are explored before adoption. HR principles and standards provide the framework for this discussion. All alternatives must be evaluated in terms of their HR impacts.


  1. The main difference here is that human rights standards are integrated into each step of the HRIA. Therefore, the initial screening requires determining the HR obligations of the State; scoping requires informing claim-holders about their HR entitlements and how the proposal under review may impact on them; data collection must thus be done in response to established HR-based indicators. In later steps, HRIA requires a HR-based analysis of the options and a HR-based justification for the policy under consideration for adoption. It is this use of the HR framework that makes the HRIA unique.


  1. Repeated recommendations of the Committee on ESCR (CESR), over several years now, urge States to employ HRIA so that HRIA must now be considered the appropriate means to make progress in realizing economic, social and cultural rights.** The Convention of the Rights f the Child (CRC) has also recommended child rights impact assessments be carried out on investments in the health sector. Human Rights Impact Assessments are clearly an aid to equitable, inclusive and sustainable policy making –and from a right-to-health perspective, are a key feature of a health system.

**: As an aside here, consider: There is nothing like ‘fundamental human rights’. This comes from the US-favored position that only civil and political rights are real or ‘fundamental rights’ while economic, social and cultural rights are ‘aspirational rights’. (U. Jonsson) There is nothing like ‘basic human rights’ either; all rights are equal, i.e., indivisible, interdependent and interrelated. Actually, over and over, we have to reaffirm the interdependence and indivisibility of civil and political (CP) rights with economic, social and cultural (ESC) rights in the context of their correct connotation, that is that both categories of rights are equally justiciable and subject to effective remedies.


  1. In sum, so far, HRIAs are necessary to determine whether a proposal is consistent with any State’s existing national and international legal obligations, including obligations for the right to health. It is also an important means of informing public debate and thereby enhancing the right to take part in the conduct of public affairs.


  1. HRIAs require: broad-based consultations with international agencies, non-profit organizations, public health or other professional associations, community-based or advocacy groups, and community leaders who can provide invaluable perspectives regarding how health policies affect human rights in their communities. Today, HRIA is widely recognized as a key tool in the HR toolkit.


  1. As part of the policymaking process, impact assessment has become a method to engage claim-holders and duty-bearers, to provide an evidence base upon which to predict the potential impacts of a variety of options, to openly debate alternatives and to select the policy option that will lead to the greatest positive impacts. This approach correlates well with the obligation of governments to progressively realize the right to health and other rights. Therefore, today the aim of a HRIA related to health is to identify the policy option that will lead to the greatest enjoyment of the right to health. HRIA is necessary for governments to know whether proposed policies conflict with their pre-existing HR obligations, including to progressively realize the right to health. Guidelines do exist.


  1. The proliferation of soft law aspects on HRIA so far has the potential, with time and further development, to turn into hard international law. There is no doubt that the entrenchment of HRIA in domestic law will be necessary before HRIA is carried out routinely as part of the policy making process. It is time for governments to routinely carry out HRIAs of proposals that have the potential to impact on the right to health and other rights, as recommended by the pertinent UN HR mechanisms. In this regard, HR Learning in more public health schools will be helpful. Finally, there is a huge need for funding to carry out HRIA. Governments can no longer claim that the right to health is too vague to implement, nor can they maintain that the methods and tools for monitoring and assessment of the right to health are not available. A wide range of methods and tools are now available for governments and NGOs to carry out HRIA, including those related to health. HRIA for healthy policy making is now a feasible endeavor at the local, national, and international levels. Moreover, HRIA is now highly recommended, perhaps even legally required, by the CESCR and the CRC, as well as the UN Special Rapporteurs on the right to education, the right to health, and the right to food. Even if not yet legally required by HR bodies or by domestic legislation, HRIA simply makes sense as it leads to improved decision-making processes, healthier policies, and greater respect for human rights. (G. MacNaughton)


Claudio Schuftan, Ho Chi Minh City


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Food for a disparity reducing thought


Human Rights Reader 373


  1. The reduction of extreme poverty is undeniable in some regions, but the reduction worldwide remains limited.* Just consider: 75% of the world’s people today have no access to basic social protection, a key human right (HR). Are we thus talking of clearly redistributive and thus HR-relevant mechanisms being put in place? (CETIM)

*: Take, for example, increasingly popular direct transfer programs implemented the world over; they transfer modest allocations to the poorest households. True. But its members are still too often excluded from the formal job market.


  1. Let us look at China: With the opening of its markets, China has seen a spectacular growth and a reduction in poverty.** But has it seen disparity reduction? No. One cannot actually pass over the fact that this growth was planned by first eliminating extreme poverty and establishing of a ‘poverty-with-dignity’ regime (debatable from the HR perspective…!) that assured the majority of Chinese access to essential goods and services: Only building on such a base, could the adoption of market mechanisms indeed bring about the rapid economic growth realized. (As we all know, the controversy is still ongoing today though whether the long-term social and environmental effects of this growth are sustainable).

**: Mind you, the global average poverty reduction that the United Nations celebrates is almost exclusively due to China –and most of it happened before the MDGs.


  1. The MDGs are credited with reducing poverty (not disparity though) but, as aid, some of this reduction happened before the MDGs existed, i.e, before the year 2000. (R. Bissio)


  1. No, we do not yet have much to show for disparity reduction; on the contrary. Does this mean we must consider poverty reduction efforts a failure? I think yes. [Ask yourself: How less poor are people barely above the 1.25 USD/capita/day threshold?]. So, what did-the-world-do/is-the-world-doing wrong? The answer is: a lot. Do we just need to do more of the same? No. What has been wrong all along is that efforts have simply not tackled the shortcomings of how capitalism functions. Capitalism promoting the fiction of personal choice misdirects people masterfully. Capitalism has perfected the art of making things appear different from what and how they are. The liberal emphasis on personal choice hides the impact of capitalism on our social system and deflects workers and the unemployed from their common HR-linked class interests. There is simply no profit in providing social services and thus mitigating HR abuses –and the working class has not been strong and united enough to organize and forcefully demand the provision of these services and of fair employment. Just as capitalism required African slavery, it requires, to take just one example, sexism to deny social support for women’s sexual and reproductive health, for adequate maternity leave, for women’s job security after pregnancy, for higher wages; all this, to keep most women financially dependent on higher-waged men. For the majority of the working class, obedience is demanded, questioning is forbidden and defiance is punished.*** (S. Rosenthal)

***: Moreover, children present a special problem for capitalism, because children are natural scientists; they want to know “Why?” about everything. And when they do not like the answer, they keep asking “Why?” …Nothing can be more subversive.


  1. The same failure is true for the whole poverty reduction narrative. It has nothing to do with poverty or with ‘the poor’ (yak!). It is about strengthening the macro-economic and institutional reforms, and about doing away with welfare states, with public social services and with social insurance. ‘Anti-poverty’ policies (yak!) never aim to help those rendered poor in the first place. They have other objectives, such as economic programs, or achieving the ‘political legitimacy’ that make governments look good. Poverty reduction is the ‘social label’ of the Washington Consensus policies. They give neoliberal globalization a purported human face. (F. Maestrum) And after all, as this Reader has incessantly repeated, the most pressing problem is not poverty per-se, but inequality as linked to HR.




  1. The issue of wealth redistribution remains mostly untouched and thus keeps relentlessly feeding ever growing social inequalities at all levels, including in governance –since wealth buys power. The world has tried all sorts of ‘pro-poor’ policies (yak! terribly paternalistic concept!). But these cannot succeed without addressing the following crucial aspects (not an inclusive list): cross-subsidization between rich and poor people; a balancing of the use of non-renewable resources; global wealth redistribution schemes; regulation of a basically exploitative system that tramples HR; global social policies that redistribute not only access opportunities, but results; and proactive promotion and defense of HR. Targeting may be (may be!) a useful adjunct to universal policies in order to ensure equity and equality, but cannot become a substitute for overall disparity reduction measures. (Globalism and Social Policy Programme at STAKES)


  1. For the above to materialize, global, regional and national social policies are needed to secure the ‘Three Rs’ of Redistribution, Regulation and Rights that are nothing less than fundamental to the much wider social vision of HR.**** These policies should provide for:
  • systematic resource redistribution between countries and within regions and countries to enable poorer countries to meet human needs,
  • effective supranational regulation (for sure including of TNCs) to ensure that there is a social purpose in the global economy, and
  • enforceable economic, social and cultural rights that enable citizens and residents to, where necessary, seek legal redress against unjust or ineffective governments at whatever level.

****: The Three Rs are mutually dependent, each upon the others, i.e., each necessary but not sufficient.

  1. Bottom line, to secure economic, social and cultural rights in poor countries, at least resources must be redistributed between and within countries and international business activities everywhere must be effectively regulated.


Claudio Schuftan, Ho Chi Minh City



Mahatma Gandhi said that the ultimate solution for fighting poverty was not mass production, but production by the masses. We have to trust and believe in ordinary people to offer their own simple sustainable solutions. The view that the millions of families living in marginalized, neglected, poor or exploited communities and who cannot read or write, are unable to think clearly for themselves or act responsibly in their self-interest is terribly pejorative, paternalistic and derogatory. What we definitely do not need are $800/day consultants from the World Bank and international donor agencies producing voluminous unreadable reports telling developing countries the infinite advantages of Western models to ‘combat’ poverty (yak! a term borrowed from war academies?).


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Food for an indeed enforceable thought


Human Rights Reader 372


The Universal Declaration of Human Rights recognizes human rights as the most important of the four ‘pillars’ in the UN Charter, when stating: “The recognition of the inherent dignity and the equal and inalienable rights of all members of the human family is the foundation of freedom, justice, and peace in the world.” [The original Pillars of the United Nations are: Peace, Justice, Freedom and Human Rights.  Democracy is not mentioned in the UN Charter, although ‘freedom’ is seen as a substitute for ‘democracy’]. (U. Jonsson)


We do not need to demonize, but to democratize the SDGs process


Had you ever pondered? The human rights framework offers solutions that closest resemble the way humanity survived and operated prior to the establishment of theocratic, monarchic, colonial or oligarquic states.


  1. We cannot but look at the challenges being brought about by the sustainable development goals (SDGs) as a collection of separate morsels (goals) in a shish-kebab held together by a skewer. The mother of all challenges is the shish-kebab’s (neoliberal) skewer that holds together and binds all the morsels. Why? Because it (the skewer) has deliberately been made human rights (HR) deaf. We badly need a critical post-approval hearing about the post 2015 development agenda kebab –or perhaps that is not enough and some of its elements actually need some radical excision or graft surgery…


  1. For a long time, optimism that HR treaties could improve the lives of people coexisted with what can only be called cynicism about the willingness of countries to comply with them. In recent years, political scientists have found little evidence that countries that ratify HR treaties improve their HR performance. Instead, governments prefer to selectively complain about the HR violations in adversary or looked-down-on countries ignoring their own and their friends’ HR violations. Actually, human rights-violating countries do not admit that they violate HR and sometimes go to great lengths to conceal their violations. Sadly, international HR institutions have not been able to effectively step in, because they have been deprived of the needed legal power and have been starved of funds. (E. Posner)


  1. As a reminder, there are two essential approaches to translating international HR treaties into national law and thereby allowing individuals a recourse to invoke HR treaty provisions before national courts. This will be crucial in the SDGs era. One approach is the system of automatic incorporation where after the ratification of a HR treaty by the State, it automatically becomes part of national law. The other approach is the dualistic system in which provisions of international HR treaties only become a part of the national legal framework once they are enacted through ad-hoc national legislation. In both cases, parliaments and parliamentarians can and do have a prominent role in ensuring the application of international HR law, but they have a more active part to play in the dualistic system where further legislation must be adopted or adapted.


  1. Moreover, parliamentarians can and should be active in developing HR Universal Periodic Review (UPR) Follow-up Action Plans (UPRs are submitted by all countries every four years to pertinent UN HR bodies), as well as in advocating for a Mid-term UPR Review to better monitor the implementation of UPR bodies’ recommendations. The UPR actually provides useful entry points for parliamentarians to engage in more closely follow-up UPR recommendations.


  1. You may wonder what happens with enforcing the different categories of HR. Although enforcing civil and political rights does not carry monetary costs, it is to be noted here that there are other costs to implementing them (prominently, political costs). There are various costs involved in implementing economic, social and cultural rights (ESCR) especially to effectively promote, protect and prevent their violation. As the primary actors in approving national budgets and thus shaping national priorities, parliamentarians are indeed the critical actors in ensuring that sufficient funding is provided to implement ESCR and that the recommendations of the UPR are enacted. Better late than never, in the post 2015 era, parliamentarians should thus consider the recommendations of the UPR (in addition to other pertinent comments and recommendations emanating from specific HR treaty bodies –children’s rights, women’s rights…) before passing the national budget every year. Similarly and crucially, appropriate measures and resources should be allocated and made available to raise the public awareness of HR and to ensure that HR Learning becomes a part of the regular curriculum in schools and elsewhere. Awareness-raising programs and regular training of parliamentarians and judges on the work the UN Human Rights Council and the UPR do must be absolutely supported. Parliaments can further establish permanent HR committees and sub-committees that will oversee the follow-up to the UPR recommendations.


It is man’s humanity that makes him so inhuman (Erich Fromm)


-No government has the right to hide behind national sovereignty in order to violate the human rights or fundamental freedoms of its peoples. (Kofi Annan)

-International law –including international HR law– cannot be enforced against great powers. There simply are no enforcement mechanisms. (Noam Chomsky)


  1. Apologies used by the perpetrators of HR violations include justifying these violations by distorting them or even negating them altogether and then uniting with other perpetrators far-and-near in persistently holding the same line of justifications. We have all seen (and are tired of) critics of HR using subtle apologetic nudges praising things purportedly slowly going ‘in desirable directions’. However that may be true, these purported achievements fall way short and are overshadowed by many regrettable omissions. These soft critics miss the chance to really throw weight behind key and overarching (and politically crucial) priorities and to truly frame the discussion unambiguously from a human rights-based perspective; there are no “a little pregnant” options here.*

*: Note that this is not the case of genuine progressive realization of HR plans.


  1. ‘Intentional ignorance’ and bogus apologies thus pertain to the inconvenient truth about the suffering of those whose rights are being violated, because they are deemed ‘inconvenient to be acknowledged’. Such an attitude leads to saying: “Yes, bad things happened in the past, but let us put all of that behind us and march on to a glorious future, all sharing equally in the rights and opportunities of citizenry.” Nice deception, isn’t it?**

**: Take for instance racist hatred in the US (and Europe); what do people see as some of the necessary requirements for ending it? There are many responses thrown at this question; many answers are or have been right, and some have achieved results. But racism is far from eradicated; it is not what it was not very long ago despite such efforts. It’s a long, hard road: No magic wand to address intentional ignorance. (N. Chomsky)


  1. Carrying out justice on HR issues requires not only caring, but commitment. The realization of HR in general depends on caring. Nice agreements can be adopted in United Nations meetings and governments can vocally proclaim the centrality of HR. But, if there is no commitment, no amount of these formal engagements means much. They are just promises. It is time to look inwards into the way HR work is done so as to put HR principles really to work –beyond promises.*** (G. Kent)

***: The fulfillment of basic needs generates promises; the fulfillment of HR carries correlative duties by the state.


Human rights accountability work encompasses assessing responsibility, answerability and enforceability.


  1. We must make the monitoring of HR-oriented processes and mechanisms meaningful, mandatory and not miss looking at cross-border impacts. National accountability processes presuppose a ‘conducive environment’; this invariably calls for broad public interest civil society and social movements participation. But, in reality, we know that, in many countries, public interest civil society organizations and movements are faced with diminishing resources and restricted political freedoms –a burden, but not an insurmountable one. In our search for accountability, ex-ante HR assessments of potential private sector partners must play an important role so as to flag the potential risks of undue influence that will call for extra vigilance and preemptive protective measures. (K. Donald, CESR)


We are neither right nor left, we are coming from the bottom and going for the top. (Spain’s Indignados slogan)


  1. As the late Tarzi Vittachi from UNICEF once said, the debate about the future (of the SDGs and of HR in our case) is always conveniently ‘about something else’. What has grown is the disconnect between the perception of many about HR and the world that we want to change. The disasters created by neoliberal globalization are now evident for everybody to see. The loss of legitimacy of the political system is deeper every day. The inability of the system to resolve even problems for the survival of the planet, like climate change, have become common knowledge. The unprecedented growth of social injustice is now even denounced by international organizations like the IMF and the World Bank. However, on all those issues, these organizations do not take any proactive position. Can anybody remain frozen in their vision of what HR work must be, if they/we do not relate it to what is happening in the real world out there? HR activists are just facilitators who only help us taking strong positions; they propose a vision and now, more and more, propose concrete plans of action. We cannot allow activists and just a handful of the converted to meet, debate among themselves and act by themselves. If the debate is left to activists and some representatives of selected organizations alone, the level of combativity will go on the decline. We have to further ask: Can those whose rights are being violated free themselves using the same instruments as the violators? Are we (and them) wrongly adopting the verticality that characterizes the ills of the violators’ political system? Horizontality is very difficult; true. But that is where we must go. We thus need to start acting by taking strong positions on global issues. Are participants in the post 2105 debate ready to adopt the needed mechanisms of organization and action, albeit limited at the beginning? I do not know about you, but I am ready. As said, international law –including international HR law– cannot be enforced against great powers. There are no enforcement mechanisms. A counter-power has to emerge… (N. Chomsky)


  1. So, activists must ready themselves to accept this, i.e., to fight the system, proposing some kind of counter-system and acting-upon it. Food for thought for you here. Without that clear decision, everything will always be ‘about something else’, and we will continue debating issues that are not really central. (R. Savio)


  1. It is participatory monitoring that will eventually lead to new commitments about what requires corrective action. Why? Because it makes the HR movement ultimately answerable to the people and communities whose lives are affected; it fosters the ‘leave-no-one-behind’ principle. Participatory monitoring is, therefore, not an optional add-on in our work. (CESR)


  1. In recent years, governments around the world have been implementing policies across sectors that impact negatively on the realization of economic, social and cultural rights. These retrogressive measures include, for example, privatization of the provision of public goods, unequal revenue raising and austerity measures. Plenty to monitor here! Government laws and regulations across policy areas negatively affect the realization (or the retrogression) of these rights. Sometimes the influence of policies on HR is direct and at other times it is indirect –there is always an impact though. But, on the other hand, we are witnessing a new era. Recent jurisprudence on economic, social and cultural rights demonstrates the willingness of some courts to decide individual and collective claims of violations and in some instances to require structural remedies to redress mass violations. More to monitor here…


From aspirational to operational


– People must be able actually to do or be, rather than be what they are prevented by others from doing or being. (Amartya Sen)

-Only a world movement will bring human rights to the world. The best of words can keep us going, but… (C. Mokhiber and S. Koenig)

-Revolutionizing our HR work will only succeed when you realize it starts with you. (R. Popovic) There is no alternative unless we come up with a better one.


  1. It is fair to note that many national and international civil society organizations are still searching for a new HR-based institutional path which will allow for continuous true popular participation –without delegating decision-making space to anybody else. They continue to search and the search will go on until genuine citizens movements find the power and the right pathways and structures to enable them to add HR contents and to impinge on the legislative process in each country. Without this happening, the negotiating capacity for a better world in pertinent political institutions is severely limited. (R. Bissio) In short, the public policy space needs to respond to claim holders. (Stop this nonsense of rather saying: “must respond to stakeholders”).


  1. Therefore, the challenge that remains for HR work is organizing and mobilizing claim holders to demand states bridge the gap between the sphere of international legally binding obligations on HR and concrete actions on the ground.


  1. Bottom line, we need to be bold and find the courage to speak up among friends, colleagues and claim holder, as well as duty bearers groups on vital public matters especially on HR. This will require fighting against all kinds of falsehoods and lack of transparency. Ultimately, it is claim holders who need to appreciate their individual and collective power. The only choice we do not have is pondering whether we ought to change the world; it turns out that every act we do carry out, or don’t, changes the world. (F.M. Lappe)


Claudio Schuftan, Ho Chi Minh City



I see many colleagues trying to introduce yet another right, the right of the commons which is to substitute the right to property by the right of use and the right of free access. They argue that the commons is the result of a social process of democracy and solidarity by civil society organizations that try to organize society in a different way. For them, it is not about opposing the commons and public services, but rather to build on the achievements of public services and to democratize their management and their orientation. Their ultimate aim is to change the right of property by the right of the commons, thereby creating a ‘commons based alternative’. (WSF TUNIS 2015) I remain yet unconvinced of how this supersedes or improves on applying the HR framework.

Social Medicine and Human Rights in Health Professional Training

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All are welcome to join for upcoming workshop at the University of Chicago on teaching social medicine & human rights in medical education.   This workshop is in preparation for a larger event at the University of Minnesota on teaching social medicine that will take place April 28-30th, 2015.

Workshop Website

Social Medicine and Human Rights Conference Flyer


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Food for a subversive thought


Human Rights Reader 371


In the words of a Dean of Johns Hopkins University, work in the health sector requires the flexibility of an earthworm, the ability of a locksmith and the capability of mounting a grand indignation of a lawyer. (…in Philadelphia in the original quote).


  1. The veritable crisis in health systems failure we see the world over should lead us to a re-think of the triumphalism that has marked some of the global health debate in recent years as the MDGs are evaluated. Some even project a ‘grand convergence within a generation’ between North and South –rich and poor countries– based upon predictions of ‘an end of preventable mortality, including that from infectious diseases’. The truth though is that health systems in too many countries are and have been dysfunctional –way before Ebola hit.* Health facilities are often a place where people, especially women and children, experience first-hand their poverty and marginalization. (A.Yamin)

*: Is ebola the terrorism of the poor…? (P. Farmer)


The greatest attribute of health (and of the right to health) is to desire it. (L. Weinstein)


Yes, we desire universal health coverage. But what must we do when UHC means different things to different people? …and is not in line with human rights?


  1. A question that remains ever unasked is whether the ‘communitization’ of health services in diverse contexts is the real desirable alternative to their privatization; it certainly is the mean to heighten and boost the ‘publicness’ of health services. (A. Shukla)


  1. However, it is more. Not only do we not ask the preceding question but, as a corollary, we actually do not actively enough identify and use effective means to tackle the ‘commercial determinants’ of preventable ill-health, malnutrition and deaths. This, despite the fact that it is now increasingly recognized that the key political debates in public health revolve around countering the primacy of economic over social policies as a consequence of the reign of neoliberalism. (I. Kickbusch)


  1. Current health systems, with their data collection and (little) use, their practices and their tools cannot just result-in and be satisfied-with coming up with yet more technical ‘recommendations’, ‘guidelines’ and ‘model programs’. Why? Because the subjects of health care delivery systems are people and communities with real every day problems, with needs and with desires anchored in very concrete contexts. Their problems cannot be dealt with numero-statistics used in tables and elegant figures that ‘describe’ and perhaps monitor trends in health situations. These statistics often only mask or scratch the surface of the real problems at hand. Little is done to ‘take charge’ of the latter to really address them in a truly disaggregated, participatory and human rights-based way. (G. Tognoni)


  1. National health services said to be centered on primary health care have been ‘reorganized’ through waves of liberalization, privatization and disease-focused verticalization, as well as through performance-based financing and many other reforms. As a result, people have come to services to find new rules for what is free and what is charged, for what medicines and supplies are present and which are not. Furthermore, community health activities and community health workers have appeared, disappeared and appeared again. The problem lies in the application of biased forms of knowledge that subdue others, in practice excluding and disempowering these others from the creative processes that have a much better chance to transform society.


  1. What is really scary is that this also fosters the tendency for ordinary people to be the last to know and care about the waves upon waves of reforms transforming their health systems. Action cannot grow out of knowledge and options conceived in distant corridors.** Those affected by the problem are the primary source of information and thus the primary actors that can truly generate, validate and use the knowledge needed for lasting, sustainable action(s). It is rather a problem when the knowledge used to guide this change does not draw on the experience, knowledge and wisdom of those directly involved, through methods that build their sovereign power to inform, to learn-from and to shape the needed changes.*** (R. Loewenson) This is why some of us are now speaking of health sovereignty (as in food sovereignty).

**: Knowledge tends to drive out wisdom.

***: Authoritarianism and obedience go together with an a-critic and rigid thinking; they also go together with disqualifying the weak and minorities; with stereotyping and prejudice; with a lack of tolerance that brings about permanent conflict between a spirit of service and the currently predominant mercantile mentality of so many health planners. (L.Weinstein)


Human rights applied to health aim at personalizing subjects that are actively being made to be impersonal, i.e., at personalizing a population-level intervention. (M. Debartolo)


  1. Many of you have heard the call for Health in all Policies (HiaP) as a purported vehicle to fulfill the right to health and to achieve greater equality. It is centered in calling for greater ‘policy coherence’ –just otherwise defined. HiaP has a ring of the ancient call among us for a multisectoral approach only now insisting to give health a greater deserved attention.**** The question, of course, is which kind of health are we to more aggressively promote. It is no secret that in the world we are divided on this issue. There is a clear North/South gap; there is a gap between what we in public interest civil society want and what charter-based UN agencies want; a gap between what international NGOs and public interest CSOs and social movements want. Worrisome is the fact that each group will continue pushing their vision of which health and HiaP to promote. I am afraid we cannot sweep the politics of it all under the rug anymore. We cannot make progress when different breaks are on; we need full speed.

****: Being skeptical, I ask coherence for and between what? Public interest CSOs and social movements will continue to fight such coherence when just understood as multisectoral coordination without a call for structural reforms; they will lean towards approaches closer to those made in Brazil.


  1. The collective social action needed for the right to health to be respected and fulfilled shows us that there are three types of mobilization: (i) the rejection of the imposition of health policies related to a neoliberal health system model that commoditizes health and privatizes the social security and health systems (e.g., Mexico, Colombia and Peru); (ii) the active defense of public social security systems and of universal health care systems under threat by a commoditization and privatization drive (e.g., Brazil and Costa Rica) and (iii) the autonomous proposition of communities resisting and generating their own forms of health care and of the protection of life (e.g., Chiapas in Mexico, Chimaltenango in Guatemala and Cochabamba in Bolivia). (M. Torres)


The challenge we face in health care reform thus is to set up a universal health system based on the human right to health. (M. Rios)


  1. Health sector reform has for long been a citizens demand because, in so many places, the current system has for practical purposes collapsed. The way the system is organized does not respond to the needs of people and, therefore, violates their rights. The challenge thus is to come up with a health system that, by building on human rights principles, addresses solemn international obligations and national promises, agreements and even constitutional mandates. Therefore, in the debates about health sector reform, it is no longer postponable to incorporate the following measures to unequivocally strengthen the role of the state:
    • in its health governance function (as relates to stricter and enforced health regulations);
    • in public health care financing (increasing the state’s share in the financial protection of the most vulnerable, increasing health expenditure to at least reach the average of the countries in the region);
    • in the delivery of health care services (improving health infrastructure networks including physical, personnel and equipment needs);
    • in truly implementing comprehensive primary health care services and securing referrals to secondary and tertiary care facilities according to need and not capacity to pay;
    • in guaranteeing quality of services (security in the services for patients, as well as for staff, protection of the rights of patients and of labor rights with clear recourse mechanisms to seek restitution when appropriate);
    • in setting up regular support supervision functions of the actual provision of services;
    • in enhancing the capacity of regulatory and supervisory structures to carry out their duty;
    • in respecting the binding character of participation and representation of claim holders that allows them to actively participate in the policy decision making process at the national, regional and local levels of government (with claim holder representation being 50%+1 in the lower decision making levels);
    • in respecting the participatory surveillance and monitoring role of claim holders in the delivery of health care services;
    • in bringing together and eventually unifying the different existing sub-systems of health care financing and health care delivery (as well as strengthening the capacities needed in each of these sub-systems so as to facilitate their evolution towards true complementarity);
    • in guaranteeing that financial and other resources are made available to make universal health coverage a reality for all (with those who have private or social health insurance schemes paying their premia in part subsidizing the state’s own funds allocated to those who cannot afford health care costs;
    • in curbing corruption;
    • in guaranteeing access to generic medicines;
    • in reinforcing the social security system aiming to reach the ILO’s recommendation of 12% of wage contributions to this function (includes democratizing the management of social protection services with meaningful workers’ participation and representation with a binding character);
    • in the state assuming the remuneration of the majority of professional and overall health staff;
    • in eliminating any bonuses paid out-of-pocket by patients;
    • in eliminating any barrier to access to health care based on any previous administrative or bureaucratic requirements that interfere with the fulfillment of the human right to health; (no citizen must die or her/his health and economic situation be aggravated by any perfectly treatable disease);
    • [in national human rights bodies closely monitoring the elimination of barriers and keeping vigilant about ministry of health decisions that endanger the fulfillment of the right to health especially when reform measures are regressive towards commoditizing the delivery of health services]. (M. Rios)


  1. It is fitting to end this Reader by reminding us of Latinamerica’s ‘Five Ds in the Struggle for Health’. They are: Decolonize our thinking, Demedicalize life, Decommoditize health, Deindustrialize development and Dignify life. (ALAMES)


Claudio Schuftan, Ho Chi Minh City



-Now more than ever, we need more critical insights about the MDGs pertaining to health with their serious shortcomings, as well as the courage to apply human rights to health beyond them being a legal paradigm.

-Some top down ideas ought to begin at the bottom; then rise like the sun. (J. Koenig)

-Science and technology cannot put order in our lives; it is values that put order in our lives. (Albino Gomez)



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Food for a cleverly hidden thought


Human Rights Reader 370

 1. The fact that the corporate sector is expressing satisfaction over the SDGs and the emerging Post-2015 Development Agenda should be enough to raise alarm bells for public interest civil society critical of the corporate-led, ‘free’ market-centered paradigm that has dominated development policy over the last four decades. Indeed human rights are just one more form of currency used by TNCs when deceivingly calling for the goal of “Good Governance and the Realization of Human Rights”.


  1. In Issue Paper 10 of the UN Global Compact we read: “The UN Guiding Principles for Business and Human Rights sets out a clear framework for this approach which is, not only a social responsibility, but also a means for strengthening brand credentials, building customer loyalty and attracting investment.” (Author’s emphasis) (p. 2)


  1. Instead of exercising the political will* to redistribute a significant portion of the surplus wealth of global oligarchs through:

-progressive tax reforms,

-taxing financial speculation,

-reversing illicit capital flows,

-eliminating tax havens,

-arresting tax competition among countries,

-amending unfair trade and investment agreements,

-cancelling illegitimate debt, and a myriad of other systemic reforms,


governments, especially from the OECD, are instead putting an emphasis on enticing the private sector to ‘invest in sustainable development’.

*: Political will is usually understood as a greater resolve on the part of states. But political will is not due to the benevolence of politicians –they usually act only in response to consistent and compelling pressures. Therefore, it is not a lack of political will, but rather the accumulation of a political will by the powerful to oppose or stall the implementation of progressive policies that tackle human rights abuses.


  1. And what a better setup to achieve this than Public-Private-Partnerships (PPPs) that can also take the form of ‘agreements’ that shift the risks associated with private investments to the public sector. Clever, no? PPPs can take the form of:

-guaranteed subsidies or generous credit such as state-guaranteed loans to farmers buying new commercial miracle seed varieties, or

-payment guarantees such as in power-purchasing agreements between a private coal-fired power plant and a state-owned utility, or

-revenue guarantees, such as an agreement that ensures a minimum income stream to a private toll road operator regardless of actual road usage.

The essential feature of these PPPs is that they provide private companies with contract-based rights to flows of public money or to monopoly income streams from services on which the public relies such as roads, schools, hospitals and health services.


  1. The above means that if, for some unforeseen reason, investors are not able to recoup their costs, for instance from user fees, the government has to put up the money that investors had projected, but failed to realize.


  1. In short, the proliferation of PPPs is one of the factors behind the rising contingent liabilities of quite a few middle-income countries today.


  1. There are then the so-called Multi-Stakeholder Partnerships (M-SPs) which bring together donor agencies, non-governmental organizations, private philanthropy, private sector and other actors to address specific challenges –from vaccinations, to agricultural research, to child health, to provision of education, or even hand-washing.


  1. There is little evidence to show that either PPPs or M-SPs benefit the most marginalized and impoverished. The World Bank Group’s own internal evaluation of PPPs it has supported from 2002-2012 revealed that the main measure of success for PPPs is “business performance.”


  1. The multi-stakeholder approach to governance relies on the voluntary commitment of coalitions-of-the-willing and (for some) serves as a welcome alternative to the private sector to instead have a legally binding framework with clear obligations on the part of states including the obligation to regulate private sector participants. So, while PPPs and the multi-stakeholder approach increase the influence of corporations over public policies and government spending priorities, they also weaken the accountability** of both big business and the state towards the people.

**: Accountability, what does it entail?: Do away with conditionalities? Name and shame? Fire or replace somebody for inefficiency or corruption? Tax culprits? Kick out a TNC? Regulate, legislate? Bring in users (claim holders) to the decision-making process? Demanding participatory budgets? Preempting free trade agreements (FTAs) on human rights issues? Public interest CSOs taking an active role as watch dogs? All of the above? Pick your choice.


  1. Simply put, there is no real accountability where there are no repercussions for states or companies failing to achieve their avowed social and environmental commitments.


  1. PPPs further:

-co-opt NGOs, the state and UN agencies;

-weaken efforts to hold transnational corporations accountable for their actions;

-obscure the ultimate obligation of governments in providing public goods and services and fulfilling people’s human rights.


  1. As a consequence, the provision of public goods becomes unreliable as it increasingly becomes dependent on voluntary and ultimately unpredictable sources of financing. This adds pressure to fully privatize this provisioning, thereby flouting the human rights-based understanding of people as claim holders and governments as duty bearers compelled to account for their human rights obligations under international and national laws.


  1. And there is more: PPPs allow corporations new ways of enhancing their public relations and making themselves appear environmentally and socially responsible, but without real accountability.***

***: Anything less than full and meaningful accountability risks rendering the SDGs a set of lofty, but empty, promises rather than the transformative agenda that public interest civil society, social movements, the Secretary-General and many of UN state delegates envision. It is not only about targets and indicators, but also about financing and lining up the means of implementation. (CESR, Human Rights Caucus, Amnesty International) And then there is the problem of accountability fatigue when accountability mechanisms are not binding on responsibilities and duties of the state. If not binding, these mechanisms only bring promises and promises are broken. Therefore, not rhetorically: How can we ask for accountability when the SDGs are not binding?


Where does this put us?


  1. If nothing else, for all the above reasons, we need to ask the following questions regarding the emerging post-2015 agenda:

-is it a people’s agenda? or

-is it too much a vehicle for expanding and strengthening transnational corporate power?

-is it an agenda that is simply about expanding and building on the MDGs? or

-is it a strategy that re-legitimizes the global capitalist model and neoliberal globalization?


  1. If the agenda that finally emerges in September 2015 turns out to be a rehashed version or even an expansion of the MDGs, but lacks substantive action to overhaul the dominant neoliberal development framework (which it seems to be), then it is an agenda that will definitely perpetuate and deepen the impoverishment, inequality, environmental degradation, and the climate crisis.


We need to examine the post-2015 process, not in isolation, but in relation to wider trends and the broader context of development policies


  1. We need to be organized. Many groups are doing their own bit in terms of promoting people’s agendas and alternatives, but what we are facing is a systemic problem concerning the entire development model. So, it requires organizational linking up of civil society across issues, across sectors, and at different levels –from local to national, national to regional, regional to international.


  1. It is not just enough to come up with development goals unless one challenges the roots of the problem of underdevelopment, of poverty, of the violation of human rights, and of the ecological crisis.
  2. Development and human rights justice is a term coined by public interest civil society and social movements for their vision of a new development model to counter the neoliberal assault.


  1. Broadly, development and human rights justice comprises five transformative shifts, namely:

-Redistributive Justice,

-Economic Justice,

-Social and Gender Justice,

-Environmental Justice, and

-Accountability to the People.

(all mostly taken from P. Quintos)


Claudio Schuftan, Ho Chi Minh City


More Readers can be found in

Slide Shows on Public Health and Social Justice Website Updated for Fall, 2015

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phsj website photo 1

The major topical Powerpoint slide shows on the Public Health and Social Justice have all just been updated to include the most recently available research and policy information. They range in length from 50 slides to 750 slides (yes, seven hundred fifty, for the Environmental Degradation and Social Injustice Powerpoint). All slide shows are open access, meaning that anyone can use all or part of one, with appropriate citation. See or .

Topic areas  are listed below. Some have much more content than others, so submissions are always welcome and can be sent to

Below the topic areas are direct links to some of the most popular slide shows and videos.

You can also order a copy of the Public Health and Social Justice Reader (2013, Jossey Bass/Wiley) through the website at Click phsj book discount flyer pdf for table of contents, endorsements, and discount code to use to receive 20% off.

The website and I have no disclosures, I/it receive(s) no external funds, and I have not made any money off the book…..the site is a labor of love and my goal is to just to get the word out and hopefully help educate and motivate others.

TOPIC AREAS (with direct links):

External Links –

Direct links to some of the most popular slide shows (short versions are also available for most of these, continue to scroll down for most popular videos):

Activism 101 – Public Health and Social Justice Slide show on activism and public health & social justice, with literature, history, and photography

Environmental Degradation and Social Injustice Slide show covering causes and consequences of environmental degradation and social injustice – the most comprehensive slide show on the phsj website

Corporate Control of Public Health – Case Studies and Call to Action Slide show covering the effects of corporations on various aspects of public health

Luxury Primary Care & Academic Medicine Comprehensive version of slide show covering the links between luxury care clinics and academic medical centers, along with a general overview of concierge care, medical tourism, retail clinics, relevant ethical and legal issues, etc.

Obstacles to Abortion and Comprehensive Reproductive Health Care Comprehensive version of slide show covering obstacles to abortion and reproductive health care

GMOs and Biopharming Comprehensive slide show covering health and environmental risks of genetically-modified organisms, biopharming, genetic modification of trees and vertebrates, and synthetic biology

Ideals of Beauty and Methods of Body Modification Slide show on historical and contemporary ideals of beauty and body modification

Symbols of Love – Flowers, Diamonds, and Gold Comprehensive slide show on the environmental, health, human rights, and economic consequences of flowers, diamonds, and gold

Incarceration Nation Comprehensive slide show covering the US criminal justice system, including jails/prisons, racism, the war on drugs, prison health care, the prison-industrial complex, and the death penalty

Causes, Costs, and Consequences of War & Militarism Slide show on health, economic, and environmental consequences of war and militarism; also covers historical epidemiology of warfare, WMDs, current wars, and U.S. military and foreign policy

Human Subject Experimentation – Nazis – Present Slide show on human subject experimentation in the 20th Century, covering WW II Germany and Japan, Willowbrook, Tuskeegee, contemporary research issues, government-sponsored torture, doctors as murderers/torturers/terrorists, etc.

Drug Testing and Privacy – Scientific, Legal, Ethical, and Policy Issues Slide show covering scientific, legal, ethical, and policy issues relevant to drug testing (including physician drug testing), genetic testing, and privacy

Economic, health and human rights issues of racial and ethnic minorities Overview of economic, health, and human rights issues of racial and ethnic minorities

Health Care – US and Worldwide Overview of health care in the US and the world, including what constitutes health, major health problems, and how health care is financed

Scans, Scams, and Unnecessary Testing in Medicine Slide show covering direct-to-consumer marketing of unnecessary (and potentially harmful) screening tests. Slide show also reviews benefits and risks of CT scans (including coronary calcium CTs and lung cancer screening) and examines health care fraud

General Electric – New York-Presbyterian Alliance – A Critique Slide show re troubling agreement between corporate polluter and human rights-abusing company and large hospital system, with an historical and contemporary overview of General Electric’s activities antithetical to human and environmental health and human rights

Women’s Health & Human Rights Comprehensive slide show covering myriad issues relevant to women’s health and human rights (including individual and societal violence against women)

Coal Exports Through the Pacific Northwest Environmental and health consequences of planned shipments of Powder River Basin coal through the Pacific Northwest

Minamata Disease, the Minamata Treaty, and the Photography of W Eugene Smith Slide show on Minamata Disease, mercury toxicity, the Minamata Convention, W Eugene Smith’s photography, and famous photographs relevant to public health and social justice

Confronting Pseudoscience and Threats from a Corporate Front Group – The American Council on Science and Health Exposé of the American Council on Science and Health – based in part on articles on “Science and Pseudoscience” page of phsj website

Agricultural antibiotics, factory farms, bayer, cipro, and anthrax – putting profits before people Slide show covering the relationship between Bayer, overuse of agricultural antibiotics, and the anthrax scare

rBGH, hormones in meat and milk, breast cancer, and pink ribbons Slide show with brief overview of health effects of rBGH and hormone use in milk and meat production, breast cancer, and “pinkwashing”

Obesity and Public Health Slide show on epidemiology, causes, consequences, treatments, and public health approaches to obesity

Tobacco – Health Effects, Costs, WHO Treaty, Academia, and Control Measures Slide show covering US attempts to scuttle Global Tobacco Treaty, with comments on the links between medical schools, the insurance industry, and the tobacco industry; discusses health effects and costs of tobacco use and current tobacco regulation

Death and Dying in Literature Slide show on literature relevant to death and dying, uses of such literature in health care education

Violence Against Women in the Military Slide show covering violence against women in the military, covering both active duty military and veterans

War and Peace in Literature and Photography Slide show with famous quotes, some poems, and photos relevant to war and peace

War, Rape and Genocide Slide show on war, rape, and genocide, with historical perspectives and an overview of Darfur, Sudan

Cosmetic surgery – past, present, future Slide presentation on cosmetic surgery

Ethical & Policy Questions re beauty, cosmetic surgery, & obesity Slide show on ethical issues relevant to ideals of beauty, cosmetic surgery, and obesity

female genital cutting Slide show on female genital cutting

Direct links to some of the most (hopefully) interesting videos:

*The kind of world we want for our children, Conversations with Dr. Don (cable television program, May, 2015). Available at

*Social Justice. Conversations with Dr. Don (cable television program, February, 2013). Available at

*Does today’s U.S. government serve corporations or the people? (topics include the appropriate role of government in society and the U.S. health care system) Debate with Howard Ellberger, “Conversations with Dr Don” (cable television program), Portland, OR, May, 2011. Available at and’s+U.S.+Government+Serve+Corporations+or+The+People+.

*War and peace, Conversations with Dr. Don (cable television program), September, 2013. Available at

*Corporations and Health, “Conversations with Dr Don” (cable television program, March, 2011). Available at (note: download Veoh web player, as per website, to watch full video).

*Everything you Wanted to Know About GMOs. Conversations with Dr. Don (cable television program), Portland, OR, September, 2014. Available at (first 26 mins general discussion of social justice, 27 mins through end focuses on GMOs).

*The corporate assault on human health and the environment (topics include General Electric, the American Council on Science and Health, and corporate infiltration of public education). Conversations with Dr Don (cable television program), Portland, OR, July, 2011. Available at

*Food Justice (show also includes discussion of activism and medical/public health education and training). Conversations with Dr Don (cable television program), Portland, OR, July, 2011. Available at

*Obesity epidemic: causes, consequences, and solutions. Conversations with Dr. Don (cable television program), Portland, OR, August, 2012. Available at

*The Costs of the Symbols of Love: Floriculture, Diamonds, and Gold, Conversations with Dr. Don, Portland Community Television, February, 2014. Available at (first half of program is general conversation; second half of program covers topic).

Best wishes,

Martin Donohoe



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Food for an under-appreciated thought


Human Rights Reader 369


  1. More than 30 organizations comprise the UN Development System (UNDS). Virtually all are members of the UN Development Group (UNDG), but comprise a ‘system’ in name only since each operates autonomously. Many, therefore, set aside the word ‘system’ in favor of ‘family’, because the UN is, in that sense, a bit dysfunctional. Each organization guards its independence fiercely, even though most report to the General Assembly and many are under the authority of the Secretary General. Funding patterns are the prime cause of atomization. As core resources have stagnated, all UN organizations have pursued ‘extra-budgetary’ funding for operational activities, often from the same donors, in reality thus chasing what, in reality, are earmarked (specifically assigned) monies.*

*: With 80% of resources being non-core (not contributed by member states), it is not unfair to characterize the members of the UNDS as sub-contractors. Has the UN come to resemble a consultancy firm –essentially an adjunct to bilateral (country-to-country) and other multilateral assistance? The more UN organizations serve as the agents of funding sources, the more rapidly will they be marginalized by those sources of funds. Bottom line is that UN agencies should not be distracted by indiscriminately following donor money.


  1. Importantly, on the other hand, the United Nations is an under-appreciated source of development wisdom. It is no exaggeration that many UN ideas have ‘changed the world’ –human rights (HR) not the least of them. The UN has attracted some of the most creative minds laboring in the development vineyards.


  1. Therefore, discussions of reforming the UN should rather be about ‘how’ and not ‘whether’, more and more, aiming at greater synergy around HR principles. Why? Because competition among UN organizations works against them coming together under the key HR paradigm. They wrongly perceive they have had more to gain in visibility, resources and reputation by going it alone.


  1. But by going it alone, the UN agenda continues to reflect the outmoded North–South theater that began with the rapid decolonization process of 50 years ago, for sure aided by the dubious wisdom of sectoral summitry in the last 25 years.


  1. The top-down approach of the above theater has divided the complex development process into sectoral silos: fix the economy, boost the social sector, and manage the environment. Any effort at integration within the existing disparate and disputed system is to be welcomed, but the proliferation of integrated approaches often involves additional transaction costs, as organizations establish cumbersome coordination arrangements with little benefit, either to themselves or to recipient countries. The sectoral approach inevitably creates orphans, importantly such as democratic governance and HR. Moreover, this leads to situations where responsibilities are expressed in terms of fulfilling human needs, or ‘developmental requirements’, but not in terms of society’s obligation to respond to the inalienable rights of individuals. Demanding such rights, we know, empowers people to demand justice as a right, not as charity, and gives communities a moral basis from which to claim international assistance where and as needed. (Kofi Annan, 1998)


  1. Both democratic governance and HR are left out when focusing on sectors. Why? Because they are considered politically ‘toxic’ in consensus-seeking-UN-gatherings. But the United Nations better, once and for all, focuses on assisting countries to comply with global HR norms and conventions that UN member states, have agreed-to (and ratified), but for which compliance remains more than elusive.


  1. When the UN convenes key working groups to work on important development problems, these bodies unfortunately too often comprise mainly non-specialist diplomats. In by-now-classical-UN-tradition, these working groups will favor continuity over originality and innovation; and they will endorse a set of goals within which all existing UN organizations can find their place and defend acquired turf and mandates. All organizations will thus find a way to fashion their future programs within this framework, leading us to expect a replication of development assistance as delivered since the 1960s. But is ‘more of the same’ what the world needs? A UN system that continues to be ineffectively development-assistance-driven? …when traditional forms of aid are not working?** The focus should rather be on the quality of domestic governance, on institutions and ultimately on respecting HR, no?

**: “When the conditions for development are present, aid is not required. When local conditions are hostile to development, aid is not useful, and it will do harm if it perpetuates these conditions”. (Angus Deaton)


  1. No use to continue following myriad technical assistance avenues with limited impact; the UN should pursue its comparative advantages, i.e., keeping its role in peacekeeping and humanitarian assistance, in building inclusive institutions of justice, HR and sound governance, in short, ‘promoting the values, principles, norms and standards of the United Nations Charter…and…supporting member states to integrate these international norms into national policies’ (Ban Ki Moon) [I would add ensuring compliance with the same; always raising the issue of compliance!].


  1. The UN must return to being the custodian of universal norms and standards, primarily human rights and then technical standards. Above all, it is to be foremost people-centered and driven by its founders’ vision to promote freedom from want and freedom from fear.***

***: In 2012, the UN launched a global electronic platform called ‘The World We Want’. Based on over a million responses, the main message received was ‘a call for a new agenda built on human rights, and universal values of equality, justice and security”. Calls for better governance underpinned many of the calls made. Intriguingly, there was a strong call to not only capture the momentum generated by the MDGs, but also to bring in additional areas and principles from the Millennium Declaration from which the MDGs were simplistically excerpted. [It is now clear the UN has not used the results of this poll in the now completed intergovernmental process formulating the new post 2015 development agenda!]. But the call from the public the world over for a people-centered approach is unmistakable. (All the above adapted from S. Browne and T.G. Weiss)


So, is the UN we want right for the world we want?


  1. This issue is often discussed and debated at far too high a level of abstraction, and just about always, using complicated jargon. The discussion generally does not unequivocally relate to the realities on the ground. But the question of focus might not be a matter of either-or, but of both. What is clear is that the UN will not go away in the foreseeable future; it will be a key actor and it will have potential influence over the states and state agents who will continue to have a lot of influence over the lives of people where they live. But we just said that the UN has, up to this point, been on the road to continuing acting following its old manners –having much less beneficial impact than what it might have on development matters. Bottom-up, top-supported has not worked. There is still a shocking lack of well-demonstrated and well-communicated models of living well together, adaptable to different circumstances and contingencies. We all, hopefully, retain the hope that the UN has something to offer to this effort into the future. It is time to put much more attention on the myriad bottom-up processes. (D. Parker)


Claudio Schuftan, Ho Chi Minh City



The United Nations has lost its significance in the area of convergence and creating legitimacy. The two engines of globalization, trade and banking, are outside the realm of the UN that was left with solving the issues of development, peace, human rights, the environment, education, and so forth. Although these are crucial for a viable world they are not seen as such by those who hold power. The UN risks slipping into irrelevance. Would it be possible today to approve the Universal Declaration of Human Rights, voted unanimously by the assembly in 1948? Today it is generally forgotten that in 1974 the world came very close to signing a global plan for a New International Economic Order based on International Social Justice, Solidarity and International Law. Reagan regarded the UN as an inconvenient straitjacket, as far as American interests were concerned, and multi-polarity as an anti-American policy. [The United States governments actually decide when to use the UN or not…].

The main result has been that Capitalism has ran out of control with insufficient work being done towards solving urgent social problems, with upwards redistribution of wealth, with obliteration of trade unions and with poor recognition that regulation, controls to preserve (or bring back) social justice are not necessary, but a must. (R. Bissio)




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Food for an anti-status-quo thought


Human Rights Reader 368


#: Taken from the People’s Health Movement’s Global Health Watch 4, November 2014.


Say it loudly, say it often


-Public systems must be reclaimed by citizens and reformed in the interest of people so duty bearers are decisively made accountable. (This quote is meant to stimulate you to reflect about what needs to change).

-Yes, there are considerable potential risks and obstacles in the road to achieve the fulfillment of human rights of all. Nevertheless, the status-quo can simply not linger on.


  1. Mind you, we have been through a 40 years-old uncontrolled experiment in neoliberal globalization –its dominance having began in the early 70s. It was rolled out in three phases: structural adjustment, financialization* and austerity. Neoliberalism was never about eliminating the state; instead, it was about occupying it, reconfiguring both the state and the market so that they became thoroughly enmeshed. The experiment reduced social protection, increased user payments for social services, it privatized state assets, increased public private partnerships (PPPs), eliminated food and fuel subsidies; additionally there were wage bill cuts, a reduction of safety nets expenditures, pension reform to delay eligibility for retirement, reformed public health systems and a broadening of consumer taxes to include items disproportionately consumed by poor households. Among other, this increased homelessness, dependence and reliance on low cost, highly processed obesogenic food, increased stress levels, as well as suicide rates. Add to this increased unemployment, increased people working in short term jobs with no benefits and the harmful health effects of austerity with a fall in median wages disproportionately affecting women workers: all HR violations!

*: Financialization refers to periods where financial markets dominate over the traditional industrial economy and agricultural economics.


  1. But there is more: Take transnational corporations (TNCs). They rarely invest their profits and dubious tax savings in new economic productive activities. The net effect of tax cuts granted to corporations in this period has been a redistribution of capital from the public to the private sector.** This is nothing short of Capital-Accumulation-Through-Dispossession. Never forget that a small redistributive tax on the richest quintile of the world would have a far more dramatic impact on poverty and inequality reductions than conventional trickle down growth.

**: Taxes are the price we pay for civilization. (O.W. Holmes) They are also the price we pay for decent and equitable health and other social services: that is the activists’ take home message. (Note that, over this period, the WB has consistently pushed for ‘basic’ rather than for truly comprehensive public services).


Freeing governments from their neoliberal prison is one of the most important political tasks of human rights activists.


Those opposed to the welfare state never waste a good crisis to impose more austerity. Public health and other development professionals must not remain silent at a time of financial crisis; they need to develop and get involved in strategies of activism; they must act against economic deprivation and political suffocation. (D. Stuckler)


  1. Many people mobilize in anger for-a-time, but it takes a more inclusive vision to figure out how we ought to organize and support people mobilizing so that a true process can sustainably take us forward. What we ultimately need to aim-for is an economy that is not driven by maximum profit for the few, but by the fulfillment of the human rights (HR) of the many.


  1. But we must not be fooled. After the onset of neoliberal reforms, aggregate economic indicators may improve, however at the expense of equity and equality. In fact, liberalization and structural adjustment policies have severely undermined what was before a well-developed social protection system. Under neoliberalism, old social classes with ties to all political branches find themselves standing upright regardless of who takes power. And although we may have ‘new regimes’ these follow older policies, sweeten them for political consumption thus ensuring that there are unchanging elements that maintain power regardless of who is now in charge.


The neoliberal prison in health


  1. Much is being said these days about Universal Health Coverage (UHC). But also, much of what is said, does not propose a unified, all-encompassing system of public provision.*** (Coverage rates are usually presented as averages thus hiding often enormous inequalities!). The UHC model talked-about-most provides ‘choices’; yes, but within a particular political and economic environment that is not neutral. The dominant neoliberal environment can and does exploit the ambiguities of the UHC model and pushes a model that is market driven –an anathema to what the human right to health stands for. We understand efficiency in health care not in the way used in a market environment, but in terms of the returns achieved through investment in a public good!

***: Nothing would challenge the power of private service providers as much as quality, accessible public sector health services. (Jean P. Unger…)


  1. Historically, health care systems worldwide have been shaped by labor’s fight for better living conditions through the extraction of better terms from the ruling classes.


  1. Therefore, the loss of national public health services signals a profound failure of organized labor exerting sufficient pressure. Simply put, public interest and common sense are defeated by neoliberal ideology when there is a failure of people (workers) to resist. But when activist leaders speak up they hardly receive people’s organizational support. As a result, simple patronizing by leaders is dismissed by the powers-that-be as something they can live with. Regrettably, often, unions pay much more attention to aspects of pay and working conditions thus becoming increasingly inward looking; this shows that market ideology has reached deep into the labor movement.


The prison of current global governance regimes:


-In the face of increasingly undemocratic governance, health professionals, alongside public interest civil society, need to be prepared to confront power.

-A purely institutional view of global health governance is a race to the bottom; it does not help confront the global health crisis rooted in the global neoliberal economic system.


  1. The aim is to turn growing public dissatisfaction to a movement that challenges the Establishment. History is replete with examples of the failure of professionals to challenge or resist egregious policies to the detriment of all concerned and of their HR.****

****: Note that the right to health, as well as the notions of equality, universalism and solidarity have different meanings according to who uses them. We are then left playing a role in a battle over true meaning in a sort of ideological warfare. Written protests over the misuse of these terms by those who favor the status-quo have been mostly relegated to the grey literature.


  1. A final note here: The WHO we need to firmly take up global governance in health as per its constitutional mandate will not emerge from the current reform process under way. But it would be a serious mistake to write WHO off as an institutional failure.


The prison of official development assistance (ODA)


  1. To begin with, addressing development as something that refers only to underdeveloped countries, invariably presents development as a process to be mediated by charitable-giving-as-development-assistance.


  1. ODA legitimizes the global and national governance structures, because it is not accompanied by structural changes in global finance, trade and investment.


  1. The dependency that ODA creates redirects accountability away from being accountable to grassroots constituencies towards being accountable to funders and corporations.

[Much has been said in these Readers about foreign aid so no more details will be brought up here. See Human Rights Readers 120, 202 and 358].


The prison of the neoliberal welfare state


  1. Social protection systems in the welfare state exemplify several features of the neoliberal approach to development, one that individualizes problems and their solutions and frees governments from promoting the collective welfare of their citizens.


  1. As set, ‘social protection floors’ suffer from serious flaws. They do not strive for universalism or a shift away from neoliberalism. They do not seek redistribution of wealth; they propose no changes in the prevailing economic paradigm; they do not shift away from productivism and perpetuate a growth orientation model despite well-known grave environmental constraints. Little surprise then that social protection schemes do not automatically bring about political, economic and social change.


  1. Let’s face it, poverty reduction policies have never been really meant to implement fair social protection floors, but have been an alternative to it. In a nutshell, these policies have nothing to do with disparity reduction, i.e., a correction of the negative processes and outcomes of neoliberal policies.


A couple ways of breaking out of the prison


The indispensable role of community health workers


  1. Health is created before and beyond the health system. It is nested in the social conditions in which we grow up, live, learn, work and play.


  1. This is the reason why community health workers (CHWs) must have a dual role as providers of basic services and as agents of social mobilization. They are much more than ‘task shifting agents’ (in a shift away from formally trained health professionals*****) and do work well given adequate support supervision. CHWs have a dual accountability: to health sector authorities and to their communities. They cannot be deployed as single-purpose-workers, but rather as ‘community care givers’. They should thus not be seen as health providers, but as community representatives. Activism and leadership should be part of their training so they can tackle the social determination of health, as well as tackle urgent environmental issues. Their role is to contribute to a fair distribution of health resources and ultimately of power. In short, they are not in the business of treating diseases, but rather in the business of promoting community health.

*****: Much of it as a result of the ongoing brain drain: It is time to repoliticize the discussion to address the brain drain/brain robbery issue!


  1. The (not so) new thinking about CHWs is them being providers of first contact care including treatment and referrals, plus addressing the broader social and environmental issues including advocacy and social mobilization, plus engaging communities in action concerning their health situation by addressing its causes, including structural causes.


NGOs versus pubic interest civil society


  1. These days, traditional NGOs (especially international) are drawing local partner social groups and their activism into the safe professionalized and often depoliticized world of development practice. This often means their evolving into mere service providers or single-issue lobbyists. It also means their shifting from providing more critical to increasingly providing technical, apolitical skills over activism and proactive community engagement. In short here, this marks a departure from their traditional previous watchdog role.


  1. On the other hand, more and more, public interest civil society groups are not so much about the particular actors in them but, more and more, about opening new spaces, spaces where their points of view are directed towards influencing the political discourse. Yes, so far, they often do this in isolation. But it is becoming clearer an clearer to these organizations that there are strengths joining together in a loose network of organizations and individuals to come together on one-issue-at-a-time to increasingly engage the state on structural issues.


  1. Then, there is the criticism that such an engagement can eventually serve only to legitimize a fundamentally anti-poor state that gets away with yielding a-little-bit-at-a-time. So the strategic question is how to most effectively negotiate with ‘the system’ for changes-beyond-small-changes in a way that joint actions take us towards the long-term goal rather than diluting the end vision itself. In this context, PHM asks: Must civil society restrict itself to engaging in a slowly progressive dialogue when such becomes an option or must it combine it with a more confrontational approach?******

******: The principles of democracy and the dialogue that ought to go with it are poorly realized in the modern nation state; there is only a rhetorical commitment to democracy an dialoguing –and this is dangerous… and perhaps the reason for the need of a dose of confrontation…


Shifting the paradigm to a human rights paradigm


  1. To take just one example, there is a dearth of mechanisms for patients, especially women and children, to demand their right to health and to nutrition (i.e., access-to and results). Much of what we see is victim blaming: “It is their fault, because of…bla bla bla”. But be warned: the basic underlying health issue here is a total lack of a state-supported equality response in the spirit of HR –a commitment UN member states undertook when solemnly ratifying the respective UN covenants.


  1. There must thus be constant pressure and mobilization to demand the fulfillment of these rights. Initially, we have to start by fighting for what is legitimately due to the people given their inalienable rights –even if it provides only temporary reprieve.


  1. Campaigns in this area must develop resource materials for grassroots organizations in the form of pamphlets, primers, booklets; all generating evidence, from the field, on the status of violations of HR in general, and the right to health and to nutrition more specifically. This ought to lead to public action in the form of protest demonstrations, rallies, public hearings, sit-ins, as well as advocating with the media, with academics, with politicians and with parliamentarians on existing and needed policies and legislation.


  1. And, to end, a not-so-facetious caveat: With a predominantly corporate-controlled media and an apathetic middle class, it has been demonstrated that a large number of people on the streets protesting against HR violations do make headlines –but only for the traffic jams they cause…sad, no?


Claudio Schuftan, Ho Chi Minh City



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Food for a change of language thought


Human Rights Reader 367


Underdevelopment is not a phase on the road towards development. Underdevelopment is the historical result of somebody else’s development. (Eduardo Galeano)


Why does the ‘development industry’ need a total overhaul of strategy and not just a change of language?


  1. The crisis of applied development approaches so far has become so patent that development practitioners are scrambling for alternative responses (unfortunately not all along the human rights pathway…). The dominant development narrative has simply not yet come to see poverty as a matter of injustice; it sticks with business as usual, endlessly wrapping it with fresh new language that is way passé.


  1. The best strategy we see these days goes about peddling the following mantra: Talk about the poor as ‘equals’ who share our values and aspirations; emphasize that development is a ‘partnership’; stop casting rich people and celebrities as saviors of ‘the poor’; and, above all, play up the idea of ‘self-reliance’ and ‘independence’ with special attention to empowering women and girls. ‘Progressive’ Northerners love this stuff. But this new framing amounts to little more than a propaganda strategy. ‘The poor’ are still treated as an impersonal entity and there is no mention about partnerships understood as a coming together of equals, for once, leveling the playing field…


  1. Instead of changing their actual approach to development, philanthropies, foundations and international NGOs just want to make people think they’re changing it. In the end, the existing aid paradigm remains intact, and the real problems remain unaddressed –unfortunately, I fear, also post-2015 despite the SDGs… Piecemeal gains are not tantamount to long-term success! Poverty is not a natural phenomenon, disconnected from the rich world, and people and countries rendered poor need much more than piecemeal bits of charity to allow them to help themselves out of it. All of this makes it clear that poverty really continues to be a state of plunder. It is thus delusional to believe that charity and foreign aid are meaningful solutions to this kind of a problem.* (J. Hickel)

*: It would seem then that the time is overdue to denounce safety nets and targeting as only being forms of risk management –since the only risk they really mitigate is the risk of subversion. (Can we thus say that they represent a form of common, but differentiated irresponsibility…?).


  1. For instance, just consider: As part of the jargon en vogue, donors offer and/or demand ‘transformative policy packages’. But the problem is that these typically pay too little attention, if any, to the inherent political obstacles to transformation. Naiveté? Hardly…! (D. Messner)


  1. With this said, it is not an exaggeration, then, to also denounce that the current inter-governmental system is not being able to act in the true interest of humankind (and of human rights). Look at the post-2015 agenda, the climate and the human rights (HR) talks so far: The pacts arrived-at were or are adopted by every country, simply because they carry no obligations! They are a kind of global gentlemen’s agreement, where it is assumed that the world is inhabited only by gentlemen …including those in transnational corporations (!). Carrying on business this way, is an act of colossal irresponsibility where, for the sake of international consensus agreements, not one realistic set of more radical solutions has been agreed-on and approved. It is all like in a hospital where the key surgeon announces that the good news is that the patient will remain paralyzed. The paramount issue sought is to say that the inter-governmental system can unanimously declare to the world its unity and its ‘common engagement’ –no matter how non-specific, non-binding and vague the latter is. Needless to say: The interests of humankind and of HR are not part of the equation in such a consensus.** (R. Savio)

**: Ought not each individual in the South then virtually be an enemy of the Northern Development Model, given that the above ‘consensus’ is ultimately imposed by a minority?


  1. At this point, it is fitting to raise the issue regarding the use of the term Development. Any word has to mean one thing; it cannot represent two opposite meanings. Lately, development has come to mean increases in infrastructure, industrial growth, capitalization of agriculture, free global flow of financial capital and of technology; also, privatization, liberalization of laws regarding labor, environment and direct taxes, etc. All this has led to an alarming worldwide rise in inequality, pauperization of workers and farmers, destruction of the commons and its resources*** with pollution reaching alarming proportion: In short, a threat to peace and to life on earth itself. Therefore, no surprise that HR have all but been forgotten in this biased kind of development!

***: Claims that we live in an era of limited resources fail to mention that these resources happen to be made more available now than ever before in human history. (P. Farmer)


  1. A few years ago, I was comfortable in using the concept of Sustainable Development. But now, I feel that the corporate world has appropriated even this qualified development concept.**** As you must see, I do not see HR being a criterion either when the mainstream media (‘the Fourth Estate’) talks of development. Then, why should a HR activist like me use the word development to represent what I do not wish for? (Dileep Kamat)

****: Activist public interest civil society organizations and social movements do understand the subterfuge the corporate world uses under its HR discourse to, in fact, promote its own (development) agenda.


In human rights work, what is now necessary is to go a step further and move from an aspirational to an operational mode


  1. It is not an exaggeration to say that, so far, the HR contents of the Post 2015 Agenda remain at normative (window dressing) level at best. For instance, the ‘Six Essential Elements for Delivering on the SDGs’ proposed by the UN Secretary General, namely Dignity, Prosperity, Justice, Partnership, Planet and People are OK. But they detract from the Three Core Dimensions of Sustainable Development, i.e., the Environmental, Economic and Social dimensions –as well as detracting from the HR Framework! Inequality cannot be considered to automatically fall within the realm of the Dignity element above; doing so makes inequality caused by the non-fulfillment of HR emerge with its place diminished in the hierarchy of post 2015 development priorities; we must trumpet its importance more forcefully since equality is and will continue to be built on the bedrock of HR principles. (K. Donald, CESR)


  1. We cannot thus miss the opportunity to denounce and illustrate how previously close-to-universally-agreed and well-defined HR obligations are not being carried over into development planning and practice. (Even the all-important post 2015 SDGs have failed us). Aiming for a ‘Shared Prosperity’ through development is a typically vague and not adequate marker of success if not coupled with gauging the realization of HR as a way to assess progress on sustainable development goals.


  1. The way forward must thus be marked by seriously addressing the current dominant macroeconomic and fiscal policies that undermine not only HR, but also economic, gender, environmental and other aspects of justice in this, our ailing world.


  1. Truly people-centered and participatory accountability mechanisms used at the local, national and global level require a new approach and, at the very least, a significant meaningful reform, as well as the democratization of existing institutions. This is part of what it means going into an operational mode in our work. Emphasizing the need for regulation, safeguards and mandatory reporting for private investments in sustainable development is another step in the right direction. But quite a bit more will be needed to ensure HR are respected in all development processes.


  1. At all levels, the post-2015 accountability mechanisms must be made robust and comprehensive enough to cover private sector actors, public private partnerships and international financial institutions (IFIs), as well as states and UN agencies, demanding transparency in the name of the right to information –not forgetting to demand the application of extra-territorial obligations and demanding that tax evasion and illicit financial flows are tackled. (Post-2015 Human Rights Caucus)

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Claudio Schuftan, Ho Chi Minh City



-‘Ethical policies’ invariably end up being lax if and when money or perks are offered.

– As a reminder, there are 17 sustainable development goals (SDGs) being considered, namely in the areas of ending poverty; ending hunger, improving nutrition, achieving food security and sustainable agriculture as well as healthy lives, education for all, gender equality, water and sanitation, energy for all, sustainable economic growth, employment and decent work, industrialization, reducing inequalities, inclusive cities, sustainable consumption and production, climate, marine resources, terrestrial ecosystems, forests, desertification and land degradation, peace and justice, and revitalizing global partnerships for sustainable development. BUT to transform the global development paradigm, more is needed than goals…

-The post 2015 development agenda discussions are actually geometric: they have angular problems that are discussed in round tables by a bunch of square-headed bureaucrats that, due to their skewed appreciation of reality on the ground, come up with obtuse solutions. (quoted by Albino Gomez) In the debates of the last two years, there simply have been persons who have extreme elliptical convictions with whom we should not loose our time any more. (R. Ampuero)