THE GREATEST PUNISHMENT FOR THOSE WHO ARE NOT INTERESTED IN POLITICS IS THAT THEY ARE GOVERNED BY PEOPLE WHO ARE. (Arnold Toynbee)

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Human rights: Food for a punishing thought

Human Rights Reader 414

Politics without value-grounded ideas stimulates corruption (Revista Primera Piedra)

 

  1. In its true sense, politics is to be taken as an emancipatory process; in our case of human rights (HR), it calls on fellow colleagues and on claim holders to go beyond their routines to join the political struggle over equality and dignity issues.* Philanthropy (or philanthrocapitalism), on the other hand, is not emancipatory. It acts as a ‘voluntarist invasion’ of what should clearly be the space of political processes.

*: I acknowledge though that not everyone is sensitive to political facts. Beliefs, values and ideologies can be and are a big filter for the perception of facts. (V. Masson-Delmotte)

 

Critique/Trends

 

  1. In this day and age:
  • The world that has accompanied globalization has transformed political parties into machines of public opinion, directed to solve administrative problems. Citizens are deserting and politicians seem more interested in their perpetuation, and polling while marketing tools have substituted a direct dialogue with citizens. Values have regrettably disappeared from the political debate. (Roberto Savio)
  • Angry voters have one thing in common: They have been left in the dust by globalization. (Der Spiegel)
  • It is thus extremely difficult or even almost impossible for citizens to make an intelligent use of their political rights. Our educational system as a whole suffers from quite the same influence: It inculcates a competitive attitude on students that are ultimately trained to adopt greed as a preparation for their future career. (Albert Einstein)
  • The shift to the left we are seeing in younger citizens is more and more based on perceiving the growing and overwhelming evidence base.

 

Oh, politicians!

 

– The political language of tyrant politicians vies to make lies believable and to make crimes respectable. (George Orwell)

– Since light travels faster than sound, some politicians appear bright until you hear them speak.

 

  1. Four of my ‘iron laws’ apply very well here to the current situation we are living in:
  • Politicians running for office better be careful about announcing a political moment, given how many such proclamations turn out to be ludicrous. (Paul Krugman)
  • One of the dangerous concepts that you can find in a democracy is charisma. Charismatic politicians can inspire followers with soaring rhetoric –which also too often proves divisive and damaging to a nation’s fortunes. (David Barnett)
  • Worse for a politician than talking with a full mouth is talking with an empty head. (Albino Gomez)
  • If you cannot get rid of the politicians who govern you, you do not live in a democratic system. (Tony Benn)

 

It is about power, stupid!

 

Would more opportunities and more diversified sources of wealth mean more sources of power and less scope for authoritarian attitudes? (Hans Dembowski)

 

  1. Anonymity is both a symptom and a cause of the undue political power concentration we have right now. Excess power has played a major role in a remarkable variety of recent crises: the financial meltdown of 2007‐8; the offshoring of wealth and of power (of which the Panama Papers offer us merely a glimpse)*; the slow collapse of public health and education; resurgent child poverty; the epidemic of loneliness; the collapse of ecosystems, …the rise of Donald Trump. (The Guardian)

*: Some defenders of the present system are already maintaining that scandals are proof that democracy is alive and works. But if the citizen’s growing lack of trust in the political and economic elites’ power continues, it is difficult to see how scandals will help nurture democracy. (Roberto Savio)

 

  1. The rapprochement or fusion of corporate power with government generates an elite brand of politics based on a political-financial revolving logic in which money buys power and power rewards money. Calls for a post-democracy era are nothing but a rehashed imitation of what we have had. These calls have a populist ring, a consultative appearance while the real politics of power and money consists of a continuing round of inter-personal (golf club?) transactions among elite members. This cozy paradigm creates a sort of ‘designer activism’ deeply compatible with the circuitry of power in the current order. It emphasizes the role of private foundations/philanthropies as the world’s problem solvers, so that social programming is decided by the untaxed wealthy in their boardrooms in a discretionary manner –rather than by democratic processes based on universal HR and entitlements. (Alex de Waal)

 

  1. How long can it be denied? Power relations are at the heart of how our world is run. As a consequence, more and more social movements are uniting to influence power relations. It is becoming clear to them that the ideology convincing people that poverty is due to individual failure is what is making economic power structures of exploitation invisible. Therefore, opposing this approach has to start with analyzing underlying power relations. The analysis shows that all actors have power, sometimes overwhelming power; sometimes just a little, but power nonetheless. Awareness-raising simply has to start with raising the idea that change can happen and power relations can be better balanced. Bringing people together in determining their own destiny is a central feature of HR and of empowerment understood as influencing power relations. (PHM)

 

Capital will allow no one to govern, but its own

 

– The separation of powers must be preserved for the true democratic political process to resume its course.

– Members of the legislature are selected by political parties that are financed (or otherwise influenced) by private (capitalist) sector actors. For all practical purposes, this separates the electorate from the law-making process. As a consequence, the ‘representatives of the people’, in fact, end up not really protecting the interests of the non-privileged groups in the population. (Albert Einstein)

– Political domination has, so far, successfully depended on instilling a perception of legitimacy. (David Legge)

 

  1. Have you noticed? Courts deal exclusively with individual rather than collective disputes and are designed not to interfere with the ruling classes and elites that are protected by immunity and other privileges. But citizens do now increasingly have growing awareness of their rights. So, to counter, when faced with political deadlocks in controversial issues, the political elites selectively use the courts as a way of lifting the political weight off certain decisions. An example is the control of constitutionality as the tool used by the ruling political classes to defend themselves against potential threats to their interests resulting from the growing groundswell of democratic politics by the upside-down ‘tyranny of the majority’.

 

  1. Be it as it may, these developments all lead to a new kind of judicial activism known as the judicialization of politics and this inevitably leads to the politization of justice. The judicial system –supposedly the ultimate defender and guarantor of the legal order and of HR– can and has become a dangerous source of legal disorder. Blatantly illegal and unconstitutional judicial measures, plus a selective persecutory zeal, an aberrant promiscuity in which media outlets are at the service of the conservative political elites, and a seemingly anarchic judicial activism can result in injunctions relating to a single political act: bringing democracy and HR to the edge of chaos. With the legal order thus turned into legal disorder and democracy being hijacked by the non-elected sovereign elite, political and social life, as well as HR, have become a potential field at the mercy of political vultures.

 

  1. This is why: Rules are these days regularly ignored by a judicial system that has not only been conformist, but also complicit with the privileges of the ruling political elites. We must beware that the latter elite assumes a politically neutral position precisely to defend the judicial system from the attacks it is being subjected-to by those targeted by their investigations and prosecutions of activists and HR defenders. Moreover, external pushes clearly lie behind such defenses of the judiciary. Those pushes are what dictate the glaring selectivity of any investigative and accusatory zeal –HR issues quite consistently excluded. Courts can show a shocking display of double standards, punishing with severity actions committed by the far left and showing great leniency towards the violence of the far right.

 

  1. Backed by a conservative legal culture that is widely predominant in too many judicial systems and law schools, wielding a full arsenal of high-powered, high-precision media weapons, the conservative bloc does everything it can to distort facts –the political taking precedence over the judicial. Courts must be barred from putting their own independence at the service of any corporate or sectoral political interests, no matter how powerful. Although easy to say, the principle is very difficult to enforce. Disciplinary proceedings by reason of reiterated procedural abuse must be initiated. When progressive governments are defeated, the right comes to power possessed with an unprecedented virulence and bent on destroying all that was built in favor of the popular classes during the previous period. (rings a bell?) Then, along comes the vindictiveness seeking the complicity of the judiciary (even the supreme court…). (Boaventura de Sousa Santos)

 

 

Needed: Think and act bottom-up

 

  1. What I miss in the prevailing political discourse is looking at the political constraints we face globally and nationally to implement the meaningful changes we HR activists so passionately pursue in a world clearly dominated by those with excess power. Yes, many have and do document the powerlessness of the majorities, but consistently fail to conclude with advice for those powerless to mobilize so as to exert pressure (or rather counterpower) to change this indeed oppressive situation. The best self-proclaimed experts can come up-with is to say something like: “Vigilant monitoring of these inequalities, combined with forceful engagement with the economic and social determinants, will be needed to ensure that the favorable trends in the contours of human rights become each person’s priority”. I also read calls “to compile evidence across disciplines to rethink our ideas of a just society”. The question is who is ‘our’…are they talking to their already-convinced-fellow-social-scientists?

 

  1. If you allow me the generalization, these social scientists aim to deliver reports addressed to all social actors, movements, organizations, politicians and decision-makers, in order to provide them with the best ‘evidence’ on questions that bear on social change. The flaw in this thinking though is that the politicians who are to take the decisions that these experts (mostly tangentially) call-for are not convinced by evidence produced by academics; they have their own political agendas! This is why even thinking that elected members of governments and parliaments are supposed to generate public hearings and decide according to grassroots networks and not according to the policy sets and narrow ideologies for which they were chosen by the people is so senseless. Ideology plays the major, key role.* Advice-to-policy-makers is what we have been doing for decades; to what avail? Top down does not work! We cannot depoliticize the issues.

*: All of us are deeply attached-to and even defined by our beliefs and ideology, for they define our reality and are thus elemental to our very selves, so any challenge to our core beliefs tends to feel like a personal attack. This is equally true of ourselves as it is of those who hold opposing beliefs. (Maria Popova)

 

  1. We see governments, politicians, the justice system, external funders… hushing and denying the needed key change-fostering knowledge to the people. We thus have to organize the necessary debates and actions to bring that knowledge to the fore since it is intentionally eclipsed and withheld. (Hernan Cardinale)

 

Claudio Schuftan, Ho Chi Minh City

schuftan@gmail.com

 

All 400+ Readers are available in http://www.claudioschuftan.com

 

Postscript/Marginalia

– Bertrand Russell famously said, “The whole problem with the world is that fools and fanatics are so certain of themselves and wiser people so full of doubts.”

– The truth is that the UN now comprises a bunch of politically and financially exposed, as well as financially vulnerable intergovernmental agencies.

– According to the British Diplomat Lord Carnavon, the professional quality of a diplomat is best demonstrated by how efficiently he follows orders he does not agree with.

-In life, we have to avoid three geometric figures: Vicious circles, love triangles and square minds. (Mario Benedetti)

– A great advantage of your enemies over your friends is that the former are always authentic and very consequent in their behavior; additionally they give the person they consider their enemy, you, a great importance. In short, they are very stimulating. (A. Gomez)

 

HEALTH CARE FOR THOSE RENDERED POOR OFTEN ENDS UP BEING POOR HEALTH CARE, SO THAT THE MORE WE TARGET BENEFITS AT THEM ONLY … THE LESS LIKELY WE ARE TO REDUCE POVERTY AND INEQUALITY. (Amrtya Sen)

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Human rights: Food for a thought to be fought-for

 

Human Rights Reader 413

We can safely say that, in the case of health, inequality is a passive outcome: ‘it happens’; conversely, equality in health must be fought-for actively. (Hernan Sandoval) [In the same vein, we have always pointed out that political rights are guaranteed; social rights must be actively proclaimed and fought-for by claim holders].

 

Did you know?

 

When it comes to global health, there is no ‘them’…only ‘us’. (Global Health Council)

 

  1. When we want to say that Primary Health Care (PHC) is a Core Human Right Obligation, we mean that it is far more than a procedural issue; it is a structural issue encompassing equitable distribution of these services, non-discrimination, and a participatory national plan of action. The only PHC intervention actually specified as a core obligation is access to essential medicines; there is no mention of the social determinants of health, i.e., minimum essential food, basic shelter, housing and sanitation, and safe water. Other substantive components of PHC are listed, but separately, as ‘obligations of comparable priority’. Here we find reproductive, maternal, and child health care actually explicitly mentioned, as well as immunization against major infectious diseases, the prevention/treatment and control of epidemic and endemic diseases, health education, access to information and appropriate training for health personnel. Let us be clear: Core obligations refer-to and demarcate ‘essential’ aspects of the right to health as a baseline of people’s protection –regardless of any given country’s shortage of national resources or international assistance.

 

  1. Additionally, be informed that actions to realize core aspects are part of the legally binding human rights (HR) framework that was designed to have considerable normative and political implications. Primary health care as such is thus not explicitly listed as a core obligation; much of what we would expect to find in an obligation to provide essential PHC is explicitly placed outside the core obligations, i.e., under obligations of comparable priority. General Comment No. 14 does not sufficiently address the question of the resources necessary to meet core obligations; it merely emphasizes that states cannot justify non-compliance under any circumstances. The role of international assistance and cooperation is strongly reasserted in GC 14 and thus clearly applies to core obligations. Core obligations should be understood and applied as providing a universally applicable ‘bottom line’ of essential health care –in contrast to any other standards that can shift from country to country depending on available resources.

 

  1. The focus of the right to health’s understanding of core obligations is far more on processes (e.g., non-discrimination, equitable distributions, and participatory plans of actions) than on outcomes. Core obligations do not prescribe a globally applicable and fixed set of health care benefits, but rather prescribe a framework for action that encompasses non-discrimination (including affordability), equity and participatory decision-making. The emphasis on affordability elevates socio-economic status to one of the grounds for discrimination, meaning that any version of Universal Health Coverage (UHC) that is not affordable to all violates core obligations under the right to health.* (Lisa Forman et al)

*: Note that the risk of UHC becoming targeted (rather than offering comprehensive, truly universal health care) and giving inadequate attention to health systems strengthening is great. This is not a frivolous statement since states live not in an abstract world as governed by the aspirations of the SDGs, but live in the real world, where policies to implement UHC exist alongside ongoing austerity, financial crises, free trade agreements, and pressures to commodify health services –all of which directly threaten policies on access to medicines and sustainable health financing. (L. Forman)

 

It is the design of a financing mechanism that determines equality in the access-to and the payment-for health care

 

The human rights framework does offer practical guidance for addressing the political economy challenges of health care reform.

 

  1. A focus on the redistributive potential of health care financing recasts health reform as an economic policy intervention that can and will help fulfill broader economic and social rights obligations. For instance, a business tax directed against wage disparities can foreseeably generate the resources needed. A health system financed through equitable taxation can indeed produce significant redistributive effects thus increasing economic equality while generating sufficient funds to provide comprehensive health care as a universal public good.

 

  1. Regressive health care financing is a significant contributor to economic inequality, producing an inverse correlation between household income and household health care spending. Conversely, a redistributive universal health care system can deliver significant financial relief to lower- and middle-income families. Health care can thus function as a strategic lever for building a more equitable society through the universal provision of the goods and services needed to exercise/fulfill economic and social rights.**

**: The market-based insurance system in the United States demonstrates that private pre-payment schemes are neither intended nor equipped to guarantee equality in access-to and payment-for health care.

 

  1. Therefore, in the design of a financing mechanism, the three principles of universality, equality, and accountability can be achieved if: a) financing is be based on health needs and is sufficient to meet all needs; b) equitable financing is ensured through progressive taxes and guarantees free access to care at the point of service; and c) the mechanism is public so as to secure full accountability for the effective and efficient use of resources necessary to fulfill the human right to health.***

***: It is clear: The proactive engagement with the question of health system financing places right to health campaigners squarely in the territory of budget and revenue policies.

 

  1. The human rights-based approach requires budgeting for health to begin with a participatory assessment of needs to then develop a needs-based budget that calls for the mobilization of the maximum amount of resources in an equitable way to meet these budget obligations. Assessing the needs, accountable decision-making based on the depth of need****, mobilizing public funds through equitable taxation, and strengthening public sector capacity, are all prerequisites to fulfill the economic and social rights obligations pertaining to health. Promoting needs-based, equitable taxation as a rights-based instrument for achieving universal health coverage, opens up an economic and social rights perspective on health policy.

****: Universal health coverage is quintessentially a needs-based system. Human rights activists cannot afford to stand on the sidelines of the political economy debates over UHC. (Anja Rudiger)

 

We have to put states on notice that they remain accountable for the right to health and health care in the private sector (Audrey Chapman)

 

  1. An identification of the various components of UHC, on the one hand, and the right-to-health framework, on the other, reveals many close connections between the two. For example, while affordability is a key component of the right to health, it also underpins UHC. As the primary duty bearers, governments have a responsibility to ensure that health care services (even if privately provided) are available, accessible, acceptable, and of good quality. They must ensure that mechanisms are in place for patients to seek legal redress if they have received inadequate or untimely care. The HR obligation to protect is of particular significance in this context since it requires government’s active monitoring of the activities of third parties.***** When certain services fall into private hands, there is a shift from the state respecting and fulfilling the right to the state’s obligation to protect which includes the obligation to regulate; the obligation to monitor; the obligation to ensure that there is accountability for violations committed; and the obligation to ensure the population’s participation in health care decision-making. (Regulatory efforts have to cover the provision and financing of health care, as well as the manufacturing and equitable distribution of all health care goods).

*****: For example, in terms of geographic access, the operation of private hospitals should not mean that health services are available only in affluent areas. Human rights law provides an authoritative set of legal tools for assessing the consequences of private sector involvement. (Birgit Toebes)

 

Bottom line

 

  1. A focus on the redistributive nature of health systems recasts health care reform as a broader economic policy intervention. There are though a range of policy and political obstacles, e.g., the specific power relations producing these obstacles and the systemic factors contributing to human rights denials.

 

  1. Only anchored in local movement building efforts and social mobilization will the momentum for universal health care reform continue to grow. It is mass organizing that will eventually tackle political resistance through rights-based redistribution models. (A. Rudiger)

 

Claudio Schuftan, Ho Chi Minh City

schuftan@gmail.com

 

All 400+ Readers are available in http://www.claudioschuftan.com

 

Postscript/Marginalia

– UHC is like a short blanket that, as such, leaves something uncovered. It is worrisome that it does not fully cover the ‘you-know-who’, that it risks accentuating inequality by involving private insurance companies and by making health systems ever more curative and less preventive/promotive. (Daniel Esteban Manoukian)

– It is clear that equality of access to healthcare means that healthcare is to be accessed by everyone who needs it whereas priority of access implies that healthcare will be received by some and not by others. It thus is not about re-allocating resources from one type of patient to another, to the detriment of the former. It is in fact about cost-effectively manage primary health care delivery for all based on the public health principles of fairness, equality and social justice. (Denise Nascimento)

 

Science and Society – Illuminating the New Dark Age

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A new video from the Public Health and Social Justice website

Donohoe M. Science and Society: Illuminating the New Dark Age. Conversations with Dr. Don (cable television program). Available at https://www.youtube.com/watch?v=DjxgqucWmSA  (first 15 minutes general discussion, topic covered 15 minutes onward). Posted April 25, 2017 – I believe it is airing on cable later this week.

The program covers the nature of the scientific enterprise, how governments and religion have responded to science throughout history, how science is and should be taught, the role of corporations in subverting science, the Trump administration’s war on science, and what scientists/journalists/citizens should be doing.

Other videos can be found on the Videos/TV/Radio page of the public health and social justice website at https://phsj.org/videos-tv-radio/. Feedback and new content always welcome.

Keep up the fight.

 

 

YOUNG PEOPLE MUST OCCUPY THEIR RIGHTFUL PLACE IN HUMAN RIGHTS DECISION-MAKING. THEY HAVE TO PROGRESSIVELY TAKE THE HELM OF THE SHIP.

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Human rights: Food for a youth-reminding thought

 

Human Rights Reader 412
 

The future will ultimately either go in the direction of the youth’s commitment, or along their indifference about human rights. (Oscar Arias)

 

And here are a couple bonus topics for them to understand.

 

Insist on rights not goals

 

The possibility for minority groups to actively claim is perhaps one of the main reasons for the existence of human rights. (Paul Hunt)

 

  1. The absence of a specific human rights (HR) focus in Agenda 2030’s 17 goals is, as so many keep saying, problematic. In the SDGs, there rather is an accent on investment and infrastructure goals, while there clearly are more negative environmental and social and political impacts where using the HR framework would have been clearly more central …a challenge here for young activists in the next 14 years. The clock is ticking.

 

  1. What this boils down-to is that, among other, the human rights to equality, to life and to a decent livelihood, cannot be reduced, as we now have, to aspirational ‘development goals’ and to voluntary codes of conduct or guidelines that can be (and are) usually underfunded, are left to the private sector, or are missed or pushed back due to ever-new ‘unforeseen circumstances’. (ESCR-Net)

 

  1. If development is about all people’s unquestioned and equal entitlements, what must be used is binding HR language, e.g., language on claim holders and duty bearers, on HR principles and on HR standards —all referred to the respective UN HR covenants as duly ratified by nation states.* [Sure, this is further underpinned by the clearly stated principle of progressive realization –which does not undermine the idea of binding commitments— as we should have had (and did not have) in Agenda 2030].

*: As I said in HR Reader 411: We are not making this up: the vast majority of states have obligated themselves to respect, protect and fulfill all human rights.

 

Extraterritorial obligations (ETOs) are a sorely missing link in the universal human rights protection system

 

There indeed are collective obligations from states-in-a-position-to-assist to states-in-need-of-assistance.

 

  1. Without ETOs, HR cannot assume their proper role as the legal basis for putting checks on the excesses of globalization and ensuring universal protection of all people and groups the world over: A challenge our youth should not miss. ETOs also provide for state regulation of transnational corporations, provide clauses for state accountability for its actions and its omissions nationally and for the inputs it provides to intergovernmental organizations in which it participates. ETOs also set standards for the HR obligations of intergovernmental organizations themselves and are a tool needed to ultimately also address climate change and the destruction of eco-systems. (Laura Michele, FIAN)

 

  1. Although ETOs address only economic, social and cultural rights, it would be legally correct to apply them to civil and political rights as well,** except in limited instances where they refer to concepts that have been applied uniquely to economic, social and cultural rights, such as their ‘progressive realization’. (L. Michele) [To begin with, the ETO’s Maastricht Guidelines’ affirmation that economic, social and cultural rights (ESCR) impose three types of obligations on states is now widely accepted. They include the obligation to respect, to refrain from interfering with the enjoyment of ESCR; the obligation to protect, to prevent violations of such rights by third parties; and the obligation to fulfill, to take appropriate legislative, administrative, budgetary, judicial and other measures towards the full realization of such rights].***

**: A reminder here: Implementing the civil and political rights is cheap (no great investments are needed); implementing the economic, social and cultural is invariably expensive.

***: Implementation measures are bound to vary from one country to another, not least because all countries are at different stages of progressive realization (or non-realization) and have different resource capacities. (Paul Hunt)

 

Justice/Law: Although both are vital in order to protect the innocent, they do not always work to everyone’s benefit (Paulo Coelho)

 

Young activists, remember: S/he who was born privileged, does not feel the chains. (Albino Gomez)

 

  1. Given that HR are one way to challenge the negative impact of neoliberal economic policies on claim holders (Paul Hunt), it is fair to ask: Have criminal and civil justice too often become a grand and biased spectacle requiring change? I would contend that it is the judges who day-in-day-out apply unfair laws who are to be denounced; the accused, often claim holders, do deserve being given the benefit of the doubt.**** (P. Coelho)

****: Some call this ‘the futile madness of some laws’. The judiciary also often transgresses the law in judgments in which connections, influence and means triumph over claim holders’ lack of all of these. If these things continue to happen, HR are condemned with very limited right of appeal. For claim holders, justice becomes a tangle of clauses, jurisprudence and contradictory texts. (P. Coelho) (I heard somebody mention the following paradox: When God sent his Son to save the world, what happened? He fell into the hands of the very justice He had allowed to take hold).

 

International human rights law is to be understood as an instrument designed to maintain and promote the ideals and values of a true democratic society

 

  1. Built on a bedrock of HR principles, international human rights law is essentially concerned with validating the entitlements of individuals and calling on states to heed their correlative obligations. In other words, the main, but not only, focus of international HR law is intra-state; it is for the benefit of persons within the state’s jurisdiction. Our young activists are thus to relentlessly continue reminding states they have to submit themselves to a legal order within which they, for the common good, have to assume various obligations, not in relation to other states, but towards all individuals within their jurisdiction. (Paul Hunt)

 

  1. Two corollaries flow from this:

 

  • Subsidiarity applied to HR means ‘not governing anything at a higher level than need be’. If we think in terms of subsidiarity, we have to ask ourselves which problems are primarily global –then HR clearly jump to the foreground. But local HR actions are as important (although they may not always seem self-evident). Something for the youth to keep in mind thus is the fact that too much subsidiarity can lead to more influence of local powerful interests opposed to HR. [For claim holders, this calls to mind the old adage “Fool me once, shame on you; fool me twice, shame on me”] Ergo, think, strategize and act globally and think, strategize and act locally. Both.
  • Human rights standards offer a powerful, universal and comprehensive normative framework in which to ground claims importantly for tax justice. The duty to devote the ‘maximum available resources’ to economic, social and cultural rights (a HR standard) gives legal force to demands for effective and way more equitable taxation systems that better contribute to the realization of HR for all. Framing taxes as a HR issue takes it beyond the elite-technocratic sphere and into the arena of legitimate public scrutiny, active demands and debate. (CESR)

 

Claudio Schuftan, Ho Chi Minh City

schuftan@gmail.com

 

All 400+ Readers are available in http://www.claudioschuftan.com

 

Postscript/Marginalia

– I want to have faith and I have it. The best news that we can expect about the major world’s crises is that we have already achieved the ‘critical level’ of a mass consciousness of big chunks of humanity, i.e., the proportion of human beings whose respect for the whole is sufficiently big, and coalescing, so as to bring about a massive awakening of consciousness of the people, as we are, more and more, seeing these days. (Lola Hofman) [This awakening has now to lead to a mass mobilization demanding the needed changes –with HR at the very center].

– Fraternity –as in the French Revolution– is merely an individual human idea, solidarity –(as in HR)– is a universal idea. (Victor Hugo)

– The simple replacement of the word ‘stakeholders’ by ‘peoples’ (or claim holders/duty bearers) provides us with the correct hint of the sort of conceptual-HR-widening that is dear to us. Claim holders/duty bearers is original and sanctioned UN language. Stakeholders is originally business language, i.e., to have or to hold a stake in something is the same as having an interest or holding shares! (Alison Katz)

 

WE ARE NOT MAKING THIS UP: THE VAST MAJORITY OF STATES HAVE ALREADY OBLIGATED THEMSELVES TO RESPECT, PROTECT AND FULFILL ALL HUMAN RIGHTS. (ESCR-Net)

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Human Right: Food for an endangered thought

 

Human Rights Reader 411

 

The human rights framework, a major instrument for accountability, is under attack

 

  1. The UN is explicitly an intergovernmental body; if UN member states do not like human rights (HR) and accountability, then the UN does not either.*

*: It is no coincidence that the Human Rights Council (HRC) receives only 3% of the UN’s budget, less than the UN library. Moreover, within the HRC powerful members like the US, Europe and Commonwealth countries consider only political rights, not economic, social and cultural rights.

 

  1. Furthermore, regrettably, a move towards voluntary guidelines is underway throughout the UN. These lead to there being practically no HR influence in the SDGs which, if one really looks dispassionately, talk of ‘following-up’ rather than monitoring for accountability.** (Hilal Elver)

**: Accountability is to be thought-of in terms of answerability, but also of enforceability through mechanisms of redress and sanctions. The process of participation-in-accountability we often find is said to be open, but then participation is set up in a highly technocratic way so that the space for true contestation by claim holders is, in reality, reduced. (Peter Newall)

  1. Given both the above, General Comments of the United Nations’ Human Rights Treaty Bodies have attempted to add flesh to the bare bones of HR treaty provisions.*** (Paul Hunt) A ‘beginning has thus been made’ to provide treaty provisions with detailed normative and operational content. (Hurrington and Stuttaford) But beware, trade-offs and deeply contextualized political realities necessarily enter the equation in this. (Alicia Yamin)

***: Using General Comments in their assessments of Periodic Country Reviews, specialized UN HR Committees produce ‘Concluding Observations’ that are not binding, therefore making it tough to demand accountability (not to mention the fact that many States are overdue in reporting, including some States that have never reported).

 

The UN Special Rapporteur on Poverty proposes a framework for ensuring that economic, social and cultural rights are recognized and implemented

 

The framework he proposes is centered around securing Recognition, Institutionalization and Accountability (RIA). (Philip Alston)

 

  1. The Special Rapporteur makes the point of the importance of treating economic, social and cultural rights (ESCR) straightforward as HR, rather than as ‘desirable goals’, ‘development challenges’ or ‘social justice’ concerns. He strongly justifies this since, ESCR specifically:
  • focus our attention on the rights of individuals;
  • directpolicymakers to the internationally agreed HR standards, jurisprudence and accountability principles;
  • introducethe needed element of immediacy;
  • recognizeand insist on dignity and meaningful participation of all individuals and;
  • are intentionally empowering.

 

  1. He goes on to state that consequences of neglecting ESCR include:
  • the undermining of indivisibility;
  • the fracturing of the hard-fought ideological and political compromise reflected in the Universal Declaration of HR;
  • diminishing the prospects for eliminating extreme poverty and extreme inequality;
  • producing conditions conducive to violent extremism; and
  • eroding the legitimacy and credibility of the HR enterprise, particularly in the eyes of the billions of people whose fundamental needs continue to be of only minor relevance to the core HR agenda’. (P. Alston)

 

 

Is the idea of accountability in danger of being coopted, instrumentalized and emptied of political meaning?

 

  1. Evidence exists that it is. Accountability has become a part of the comfortable discourse of ‘good governance’. One finds talk about accountability everywhere in multistakeholder processes, but with no reference to grassroots democracy. Responsibility for the enforcement of accountability has been shifted onto the shoulders of public interest civil society and social movements acting as watchdogs –however, without providing them with adequate resources and political space and clout. [The essential starting point is indeed to ensure that those rendered poor are made visible and, by one means or another, attain a space to speak and to have influence. (Paul Hunt)] The challenge thus is: Should this watchdog function be forcefully reclaimed?****

****: Social movements are indeed where change has to begin, because they affect the narrative directly and they are directly affected by the dysfunctionalities and injustices of the current system. Some feel this question is related to the need to actually resist a ‘broader’ program that replaces struggling-for-rights-and-empowerment with vaguer struggles based on ‘dignity’. In this context, the idea of accountability can and should be re-politicized by asking on all occasions ‘accountability by whom, for whom, for what purpose’? So, how is this to be done? Start with the claim holders. Find ways to support their struggles against dispossession and oppression and ways to defend the solutions they are coming up with. Social participation and control, especially by those who are living the problem, is the basis of accountability. (ESCR-Net)

 

We thus need a program and a way of organizing ourselves around the needed structural changes

 

  1. La Via Campesina programs for land reform and for taking agriculture out of the free-trade context, seems to me to be really an excellent case study to look at and eventually to follow. The point the HR movement has to learn from them is that we have to better organize, to make our movements stronger and to learn to act together to demand accountability. I very much hope we will go that route. As is true for us in the HR movement, La Via Campesina is a movement that is aligned and networked, aiming at creating a post-capitalist world. But it would be an illusion, I think, to believe that our HR movement has gone far enough to be reaching the edge of ‘post-capitalism’ –much less doing so under the constraints of the still current capitalist domination. La Via Campesina is all about the creation of a new transformed productive system that works for farmers and consumers without extractive intermediaries –very much a HR objective. They, as we HR activists, are not about capitalist accommodation. (Francine Mestrum)

 

Claudio Schuftan, Ho Chi Minh City

schuftan@gmail.com

 

All 400+ Readers are now available in my website http://www.claudioschuftan.com

 

Postscript/Marginalia

– Should somebody who is not fully versed on social and economic issues voice an opinion about HR? For a number of reasons, I think that the answer is yes. We should not assume that experts are the only ones that have the rights to express themselves on issues that affect how society is organized. (Albert Einstein)

– I do come to the conclusion though that some people are so wedded to certain unrealistic ideas of human justice and rights that they cannot make concessions to necessities of any kind. They say: “This self-styled-equal-rights-based-democracy has aims and objectives that are simply not mine”. (These people, you actually do not want to do violence to –you just feel like smearing their faces…). (Philip Roth) This de-facto marginalization from HR we see is evident also in these people’s general assumption that economic, social and cultural rights are synonymous with development and poverty alleviation and need no special, separate addressing. Yet, as we by now well know, this is not necessarily the case: development initiatives can be non-rights promoting or protecting. (Philip Alston)

– When these same people’s beliefs are challenged, most hold onto them as though these are a life-vest on a sinking ship. The problem is that oftentimes their beliefs are the sinking ship. No one can decide what is right for you but you. What they ought to be going for is questioning some of the deep assumptions about their beliefs and ideology (and about HR…). They need to develop the ability to see that ‘other side’. And those few occasions when it does appear more likely and more valid, hop-on over. The fact that you are asking some guy or gal on the internet (or looking for it in a book or something) is itself part of the problem –you are looking to know what others think before acting. Lesson: Your ability to succeed and learn over the long-term is directly proportional to your ability to change what you believe in response to your ignorance and mistakes. (Mark Manson)

– One of the problems clearly is that many self-proclaimed development experts/advocates do not work with a rigorous enough perspective that searches for clarity and shared meanings, but instead start from a strong belief in the correctness of their views. They firmly believe they have the alternative for the future and once you start questioning these beliefs, they retract as if their personal integrity were threatened. Hence, what I very often feel to be a fear to even start a meaningful debate. (F. Mestrum)

 

JUST AS CAPITALISM IS GLOBALIZED, WE MUST GLOBALIZE THE STRUGGLE FOR THE RIGHTS OF THOSE RENDERED POOR. (Roshan Bhati)

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Human rights: Food for a combative thought

 

Human Rights Reader 410

 

Keep in mind: The power of the people is stronger than the people in power. (Babu Owino)

 

Human rights embody a social learning process originating from social struggles for legal recognition

 

  1. Human rights (HR) have to be demanded by those who are the victims of the existing unjust, discriminating structures. This is essential to ensure that HR are appropriately contextualized, are clearly linked to social mobilization, and are based on in-depth political analyses of national and global structures and policies.

 

  1. But what we see is that people’s struggles and claims are constantly de-politicized and distorted by those in the service of the-power-of-the-day; distorting and misusing the HR vocabulary is often the cynical tactic integrated into their lingo. Consequently, in their hands, de-politization of the development agenda acts as a powerful tool to silence any dissent. The HR discourse is thus ideologically abused. Quite often too, their official references to HR principles and standards take the form of ‘soapbox oratory’ confirming there is no real intention to fulfill the realization of HR. Ultimately, therefore, HR projects are always at risk of becoming distorted-elite-driven-projects disconnected from those whose rights have been violated.

 

  1. The conditions for the struggle for the realization of HR are thus dependent on a bottom-centered logic including the capacity of public interest civil society and social movements to organize ad-hoc campaigns at the national and transnational level. We cannot forget that the ‘political will’ of duty bearers must be pushed –and this depends on the capacity of local, national, and transnational civil society to push governments and relevant international agencies to be consequent with the HR framework —regardless of its complexities.*

*: Take an example: If the SDGs are reduced to a poverty eradication (and not a disparity reduction) program, our struggles will not really challenge existing global power imbalances; they will miss recognizing and acting upon inequality as a central aspect of human development and as the precondition for any progress towards sustainable development. The central issue of equality cannot simply be considered an indicator; it is our central and most desired outcome. What this implies is that the SDGs agreement and its implementation must be used as an opportunity for (re)politicizing global governance with special attention to the voices of the people who have been so far structurally marginalized.

Take another example: The debate over universal health coverage (UHC) is not to focus on the ratification of a particular model, but rather ought to start our struggle for a much wider discussion on the structure of global governance for health.

 

  1. Rather than emerging from a democratic process, global development policies are too often determined by the interests of the powerful and the political elite backed by a bunch of technocratic development professionals.** There is now a generalized and justified skepticism based on the fact that those shaping the current Post-2015 Agenda are the very same groups that have for too long perpetuated problems of inequality and inequity. Therefore, in our struggle, global governance is to be introduced as an essential part of the Post-2015 Agenda.

**: Another serious issue here is that there is often a breach between the description/ analysis of the problems at hand and the solutions that are being put forward. The solutions adopted tend to be those that are always praised as being acceptable-to all-parties, but that, in reality, are being imposed by the relevant powerful interest groups.

 

  1. Furthermore, it is no longer a secret that Private Public Partnerships (PPPs) contribute to the globalization of the neoliberal model of statehood and its social policies. As such, they hinder sustainable development by deliberately not empowering the structurally disadvantaged and disempowered. PPPs hide the fundamental conflict of interest between the profit-oriented enterprises with a transnational orientation and the societies being subjected to these partnerships. This being the prevailing fashion, foreign aid reinforces the existing power imbalances in which the rich Northern and BRIC countries act as donors.

 

  1. In this context, the statements, lobbying, and legislative actions and struggles on the part of progressive groups and entities are of tremendous importance. But they can only be successful when, on the ground, there are strong social movements active-for-the-long-run.*** Mostly, these movements need to push a development agenda that is based on the HR framework. This implies the need to deconstructing false promises, as well as to establishing counter-hegemonic political processes and institutions. The point not to be forgotten here is that alternative development paradigms and models of governance already exist –only that now is the time to bring them into the Post-2015 agenda.

***: Never forget that social movements are such, as long as there are people who actually ‘move’ them… (all the above adapted from Nadja Meisterhans)

 

The activists’ role is to break the isolation of emerging grassroots struggles confronting powerful, increasingly global, interests

 

  1. Today, people rendered poor, impacted by economic, social and cultural rights (ESCR) violations, and/or threatened with losing the basis of their livelihoods, reside in every country in the world. If not explicitly united in a common struggle, these communities-upon-communities and social movements risk becoming ineffective and obsolete. No one is voiceless, but the voice of the many is louder! In fact, a united leadership of those directly impacted by dispossession, impoverishment, exploitation and environmental devastation –together with those who have made a political commitment to secure human rights– is critical if a global movement for positive social change has any prospects of succeeding.

 

  1. What this means is that victory in the struggle for decent jobs in the Philippines will only be fulfilled when there is adequate housing in South Africa, safe and abundant water availability in the Middle East, and secure livelihoods in Sri Lanka. Otherwise, each of these victories becomes a reason for powerful economic actors to shift their operations elsewhere in the world and continue their pursuit of ever-increasing profit and growth at the expense of HR and environmental sustainability.

 

  1. In connecting these struggles, a coherent plan for collective action (perhaps in the form of a global campaign) will reveal not only the contradictions of the current economy and related political systems, but will build the analytical capacity and a broader leadership necessary for a global movement to make HR and social justice a reality for all.

 

  1. Given the current isolation of existing grassroots struggles, we must bring more-and-more movements, communities and public interest civil society organizations to this campaign, reinforcing the recognition that: ‘Your-problem-is-my-problem-and-your-struggle-is-my-struggle’.****

****: We also have to contend with the deepening backlash by powerful private actors and government officials against communities and individuals (HR defenders) who have mobilized to demand the respect of HR. (all the above adapted from ESCR-Net)

 

  1. The more people hear about and make the HR discourse their own, the more their mindsets will strive to change the dominant discourse and the more they will join the struggle. This evolves over time, but there is a periodicity in this –peaks and valleys that accompany the rise and fall of the political heat. To repeat: The expansion of all HR has always been the result of pressure and struggles from the affected people. Due to these respective pressures, the language of HR is eventually being incorporated into hard law in different countries, as the rights of indigenous peoples and the right to food demonstrates.

 

Our struggles should not allow anyone in our respective societies to have insufficient income for a life in dignity

 

Economic and social rights did not fall out of the sky: they were conquered through hard social struggles in which many people lost their lives.

 

  1. Social protection and the welfare state have a long history, not unrelated to HR. Both have been consistently eroded since the introduction of neoliberal policies. But now, capitalism does not want welfare states, because it knows they will ultimately destroy it. On the other hand, capitalism cannot exist without the welfare state, so it will try to maintain it. Seems contradictory, no? This dichotomy explains why even the World Bank today is defending social protection, even if it gives it a totally different meaning now than what it had in the past. Well, but social security was meant to be universal, wasn’t it? But it did not eradicate poverty… Some say “social security is about targeting and this is bad”. Well, I am aware of this, thank you. Be it known that I have been pleading all my professional life for universal systems, but applied with differentiated benefits –which is different. All neoliberal ideologues do want to target since they do not want public money to be spent on non-poor people: the latter ought to buy their insurances in the market. What targeting means for the World Bank is that you have to carefully look at which poor people can receive money, i.e., it is targeting and selecting the poor according to the old division between deserving and non-deserving poor: a deplorable stands… All of us have universal rights, but how these rights are to be realized depends on the different political, economic and social arrangements within countries. (Francine Mestrum)

 

Bottom line

 

  1. In our struggles, we are invariably, and all the time, swimming upstream, always trying to push the system to address structural problems. But are we doing so within-the-way-the-system-works? If yes, this tends to make life more difficult than it ought to be for those claim holders who have been rendered vulnerable by the system. (Nancy Birsall)

 

Claudio Schuftan, Ho Chi Minh City

schuftan@gmail.com

 

All 400+ Readers are now available in my website http://www.claudioschuftan.com

 

Postscript/Marginalia

-There are two special, but not rare, kinds of colleagues: those who do not take action, because they feel it threatens their position, and those who think they take action, because they perceive a threat if they do not. Many of them want to be wise, but lack political skills; want to be just, but lack wisdom and determination; want to act politically, but lack the courage. (Paulo Coelho)

Moral absolutism applied to others, combined with moral relativism applied to our own actions is hypocritical –and this is the worse of social sins. (Mario Waissbluth)

-Of course, indifference can be tempting –actually more than that, seductive. It is so much easier to look away from victims. It is so much easier to avoid such rude
interruptions to our work. It is, after all, troublesome to be involved in another person’s pain and despair. Indifference reduces the Other to an abstraction. (Elie Wiesel)

-Ultimately, being HR-based, being ecological, being intercultural, and emphasizing the importance of mobilization and participation of affected people, not forgetting women and children –this is what it is all about!

Slide Shows on Public Health and Social Justice Website Updated for Spring, 2017

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Dear Friends and Colleagues

Slide Shows on Public Health and Social Justice Website Updated for Spring, 2017

The major (starred, *) 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 766 slides (yes, seven hundred sixty six, 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 http://www.publichealthandsocialjustice.org or http://www.phsj.org.

Topic areas are listed below. Some have much more content than others, so submissions are always welcome and can be sent to martindonohoe@phsj.org 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 http://phsj.org/public-health-and-social-justice-reader/ – Click for table of contents, endorsements, and use discount code MPH20 to use to receive 20% off.

Note that all information in the slideshows comes from real, not “alternative” facts, and is culled from peer-reviewed journals, respected news organizations (e.g., AP, Reuters, BBC) and periodicals (e.g., Harpers, New Yorker, National Geographic, Smithsonian, etc.). Note that I have not included developments from the early days of the Trump administration, as it is hard to keep up with the moment-to-moment dismantling of human rights and the Constitution coming from this narcissistic, sociopathic, temperamental, xenophobic, racist, misogynistic, ecocidal, profiteering, anti-science, war-mongering pseudo-Christian and acknowledged perpetrator of sexual assault, and his amoral, complicit to actively-involved toadies, who lack basic human qualities like empathy. Those committed to social justice, human and environmental health, and world peace should resist the dictatorial urges of this demagogue at every turn.

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 – http://phsj.org/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; note dates on links sometimes refer to date of original upload, not revision):

https://phsj.org/wp-content/uploads/2017/03/Activism-History-Literature-and-Contemporary-Movements.ppt
Slide show on activism and public health & social justice, with literature, history, and photography

https://phsj.org/wp-content/uploads/2017/03/Environmental-Degradation-and-Social-Injustice.ppt
Slide show covering causes and consequences of environmental degradation and social injustice – the most comprehensive slide show on the phsj website

https://phsj.org/wp-content/uploads/2017/03/Corporate-Control-of-Public-Health-Case-Studies-and-Call-to-Action.ppt
Slide show covering the effects of corporations on various aspects of public health

https://phsj.org/wp-content/uploads/2017/03/Luxury-Primary-Care-Academic-Medicine-1.ppt
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.

https://phsj.org/wp-content/uploads/2017/03/Obstacles-to-Abortion-and-Comprehensive-Reproductive-Health-Care.ppt
Comprehensive version of slide show covering obstacles to abortion and reproductive health care

https://phsj.org/wp-content/uploads/2017/03/GMOs-and-Biopharming.ppt
Comprehensive slide show covering health and environmental risks of genetically-modified organisms, biopharming, genetic modification of trees and vertebrates, and synthetic biology

https://phsj.org/wp-content/uploads/2017/03/Ideals-of-Beauty-and-Methods-of-Body-Modification.ppt
Slide show on historical and contemporary ideals of beauty and body modification

https://phsj.org/wp-content/uploads/2017/03/Symbols-of-Love-Flowers-Diamonds-and-Gold.ppt
Comprehensive slide show on the environmental, health, human rights, and economic consequences of flowers, diamonds, and gold

https://phsj.org/wp-content/uploads/2017/03/Incarceration-Nation.ppt
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

https://phsj.org/wp-content/uploads/2017/03/Causes-Costs-and-Consequences-of-War-Militarism.ppt
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

https://phsj.org/wp-content/uploads/2017/03/Doctors-Gone-Bad-Experimentation-Murder-Torture-and-Terrorism.ppt
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.

https://phsj.org/wp-content/uploads/2017/03/Drug-Testing-and-Privacy-Scientific-Legal-Ethical-and-Policy-Issues.ppt
Slide show covering scientific, legal, ethical, and policy issues relevant to drug testing (including physician drug testing), genetic testing, and privacy

https://phsj.org/wp-content/uploads/2017/03/Economic-health-and-human-rights-issues-of-racial-and-ethnic-minorities.ppt
Overview of economic, health, and human rights issues of racial and ethnic minorities

https://phsj.org/wp-content/uploads/2017/03/Health-Care-US-and-Worldwide.ppt
Overview of health care in the US and the world, including what constitutes health, major health problems, and how health care is financed

https://phsj.org/wp-content/uploads/2017/03/Scans-Scams-and-Unnecessary-Testing-in-Medicine-1.ppt
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

https://phsj.org/wp-content/uploads/2017/03/General-Electric-New-York-Presbyterian-Alliance-A-Critique.ppt
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

https://phsj.org/wp-content/uploads/2017/03/Womens-Health-Human-Rights.ppt
Comprehensive slide show covering myriad issues relevant to women’s health and human rights (including individual and societal violence against women)

https://phsj.org/wp-content/uploads/2017/03/Coal-Exports-Through-the-Pacific-Northwest.ppt
Environmental and health consequences of planned shipments of Powder River Basin coal through the Pacific Northwest

https://phsj.org/wp-content/uploads/2017/03/Minamata-Disease-the-Minamata-Treaty-and-the-Photography-of-W-Eugene-Smith.ppt
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

https://phsj.org/wp-content/uploads/2017/03/Confronting-Pseudoscience-and-Threats-from-a-Corporate-Front-Group-The-American-Council-on-Science-and-Health.ppt
Exposé of the American Council on Science and Health – based in part on articles on “Science and Pseudoscience” page of phsj website

https://phsj.org/wp-content/uploads/2017/03/Agricultural-antibiotics-factory-farms-bayer-cipro-and-anthrax-putting-profits-before-people.ppt
Slide show covering the relationship between Bayer, overuse of agricultural antibiotics, and the anthrax scare

https://phsj.org/wp-content/uploads/2017/03/rBGH-hormones-in-meat-and-milk-breast-cancer-and-pink-ribbons.ppt
Slide show with brief overview of health effects of rBGH and hormone use in milk and meat production, breast cancer, and “pinkwashing”

https://phsj.org/wp-content/uploads/2017/03/Obesity-and-Public-Health.ppt
Slide show on epidemiology, causes, consequences, treatments, and public health approaches to obesity

https://phsj.org/wp-content/uploads/2017/03/Tobacco-Health-Effects-Costs-WHO-Treaty-Academia-and-Control-Measures.ppt
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 – http://phsj.org/wp-content/uploads/2009/11/Death-and-Dying-in-Literature3.ppt
Slide show on literature relevant to death and dying, uses of such literature in health care education

http://phsj.org/wp-content/uploads/2007/10/Violence-Against-Women-in-the-Military17.ppt
Slide show covering violence against women in the military, covering both active duty military and veterans

https://phsj.org/wp-content/uploads/2017/03/War-and-Peace-in-Literature-and-Photography.ppt
Slide show with famous quotes, some poems, and photos relevant to war and peace

http://phsj.org/wp-content/uploads/2007/10/War-Rape-and-Genocide18.ppt
Slide show on war, rape, and genocide, with historical perspectives and an overview of Darfur, Sudan

https://phsj.org/wp-content/uploads/2017/03/Cosmetic-surgery-past-present-future.ppt
Slide presentation on cosmetic surgery

http://phsj.org/wp-content/uploads/2007/10/Ethical-Policy-Qs-re-beauty-cosm-surg-obesity4.ppt
Slide show on ethical issues relevant to ideals of beauty, cosmetic surgery, and obesity

https://phsj.org/wp-content/uploads/2017/03/Female-genital-cutting.ppt
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 https://www.youtube.com/watch?v=_B6nlNtaqQc

*Social Justice. Conversations with Dr. Don (cable television program, February, 2013). Available at http://www.youtube.com/watch?v=CD7fMoG1zWk

*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 http://www.veoh.com/watch/v21004742PCxDDT99 and http://www.veoh.com/watch/v21004742PCxDDT99?h1=CWDD+2011-05-26+(2)+Does+Today’s+U.S.+Government+Serve+Corporations+or+The+People+

*War and peace, Conversations with Dr. Don (cable television program), September, 2013. Available at http://www.youtube.com/watch?v=XmGy8HmibWU&feature=c4-overview&list=UUfi1QHZLKx3ESeO0GrdeO2Q

*Corporations and Health, “Conversations with Dr Don” (cable television program, March, 2011). Available at http://www.veoh.com/watch/v208492269jJ8APJN (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 http://www.youtube.com/watch?v=9dVp1pNqy_U&list=UUfi1QHZLKx3ESeO0GrdeO2Q (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 http://www.veoh.com/watch/v21170152kDqfHBPE

*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 http://www.veoh.com/watch/v24892987MqXa2ySr

*Obesity epidemic: causes, consequences, and solutions. Conversations with Dr. Don (cable television program), Portland, OR, August, 2012. Available at http://www.youtube.com/watch?v=3Q6STkJ-Xfo&feature=plcp

*The Costs of the Symbols of Love: Floriculture, Diamonds, and Gold, Conversations with Dr. Don, Portland Community Television, February, 2014. Available at http://www.youtube.com/watch?v=92ZO6CVplV8&feature=c4-overview&list=UUfi1QHZLKx3ESeO0GrdeO2Q (first half of program is general conversation; second half of program covers topic).

*You are being watched: privacy, public health and society (one hour program, first half features mostly discussion about current political situation with respect to Syrian refugees, terrorism, and the rise of xenophobia and nationalism; second half covers privacy). Conversations with Dr Don (cable television program), Portland, OR, December, 2015. Available at https://www.youtube.com/watch?v=OQBP5vdlZY0

*Doctors gone bad: research, torture, and terrorism. Conversations with Dr Don, (cable television program), Portland, Oregon, August, 2016. Available at: https://www.youtube.com/watch?v=gUr1EYuLw7I

*Social justice take on the 2016 election. Conversations with Dr Don (cable television program), October, 2016. Available at: https://www.youtube.com/watch?v=TfOq8V0JR_w
Covers American democracy and exceptionalism, a variety of domestic and international social justice issues, and how to create a progressive and more just society.

*Gun violence: public health and public policy (last 17 minutes covers reflections on the election of Donald Trump). Conversations with Dr Don (cable television program), Portland, OR, November, 2016. Available at https://www.youtube.com/watch?v=K5cwchwu0kM

Martin Donohoe
http://www.publichealthandsocialjustice.org
http://www.phsj.org
martindonohoe@phsj.org

 

IN 1793, THE MILITANT REVOLUTIONARY OLYMPIA DE GOUGES PROPOSED A DECLARATION OF THE RIGHTS OF WOMEN INCLUDING THEIR CIVIC RIGHTS. THE GUILLOTINE CHOPPED HER HEAD. (Eduardo Galeano)

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Human rights: Food for an unacceptable patriarchal thought

 

Human Rights Reader 408

 

In many parts of the world, cows are given more rights than women. (Huffington Post)

 

We cannot let anybody forget the-female-face-of-poverty

 

  1. Women are subjected to multiple and intersecting discrimination and negative gender stereotypes that continue to subjugate them and impede efforts to achieve equality between men and women.  Not only do discrimination and stereotypes prevent women from escaping poverty, but they inhibit women’s political participation and, therefore, among other, their ability to influence the distribution of resources.

 

  1. While both men and women suffer in poverty, gender discrimination means that women have far fewer resources to cope. Women rendered poor and living in poverty face extra marginalization. Measures targeted to reduce women’s poverty are thus critical. Therefore, starting by collecting better information to track how poverty affects women differently, is essential for solving the problem. Let us be categorical: Ending extreme poverty will come within reach only by fully involving women and respecting their rights –at every step along the way. (http://beijing20.unwomen.org/en/in-focus/poverty#sthash.NoITORtY.dpuf)

 

 

Humankind cannot accept macho attitudes (Hans Dembowski)

 

Our anthropocentric culture is, in reality, androcentric (Julio Monsalvo)

 

  1. A fundamentalist backlash against women’s claims to equality, and especially to sexual and reproductive rights, is badly affecting national sovereignty in many countries. Culture and religion are used as excuses for perpetuating patriarchal discrimination and violence (including the control of women’s fertility). This is clearly no longer tenable. (C. Bunch)

 

  1. To a certain degree, the SDGs recognize women’s economic empowerment as a prerequisite for sustainable development*, for greater equality and for the achievement of SDG 5 (Gender Equality) and SDG 8 (Decent Work and Economic Growth). But ‘realizing’ women’s rights is not as important as securing their right to livelihood plus their ability to realize all human rights. The right to livelihood is linked to other human rights such as the right to food, the right to health, the right to work, the right to education and the right to social security and protection.

*: As per the UN CEDAW Committee, one of ten UN Treaty Bodies, advancing the economic equality of women is one of the key human rights standards. [The other nine human rights Treaty Bodies that monitor implementation of the core international human rights treaties are: the Human Rights Committee on Civil and Political Rights (CCPR), the Committee on Economic, Social and Cultural rights (CESCR), the Committee on the Elimination of Racial Discrimination (CERD), the Committee against Torture (CAT), the Subcommittee on the Prevention of Torture (SPT), the Committee on the Rights of the Child (CRC), the Committee on Migrant Workers (CMW), the Committee on the Rights of Persons with Disabilities (CRPD), and the Committee on Enforced Disappearances (CED)].

 

  1. In this context, there are 18 human-rights-linked-musts to secure women’s rights

 

  • States must not, in the name of development, displace people, especially women, from resources that support livelihoods and adequate standards of living.
  • Women’s access, ownership, control and management (including decision-making power) of productive resources and their outputs –land, water, forests, livestock, credit, energy, technology, knowledge, education, skills– must be ensured with deeds, not promises.
  • Most women work, be it paid or unpaid must be recognized; therefore, states must recognize women as workers, as growers and as producers.
  • States must further recognize, reduce and redistribute women’s multiple burden of work including those in domestic chores.
  • States must provide better infrastructure facilities to meet rural women’s needs to reduce their day-to-day drudgery in providing for themselves and their families.
  • Women must be given individual rights over productive resources (including natural resources) to secure sustainable livelihoods, irrespective of who they are and where they come from.
  • Land and property must be either in the woman’s name or under joint ownership. Single women including widows must have individual land ownership.
  • Gender-differentiated statistics and indicators must be collected nationally and regionally in order to measure gender gaps and consequently adjust development programs to rectify inequalities.
  • States must ensure universal, but not uniform, social security for all, and make all state welfare schemes applicable to all working people (old-age pension, health benefits, pension, gratuity, and maternity benefits).
  • States must also set up a recurring welfare fund by setting aside three per cent of the total revenue of the government and women must be part of the system.
  • All countries must strive towards universal respect for human rights and dignity, rule of law, justice, gender equality and non-discrimination, respect for all ethnicity, race and diverse culture for the realization of human rights and shared prosperity.
  • Notwithstanding the fact that women have a miniscule role in the events of war and terrorism, they however suffer most owing to large-scale killings, injuries and instances of displacement. States must recognize women as the primary claim holders in matters of security and peace and be given the major role in re-building and reconstruction in post-conflict regions.
  • The adverse impacts of natural and man-made disasters on women’s livelihood must get due policy recognition and women’s voices must be heard in decision-making on issues related to them.
  • Women lack control over their bodies including their sexuality, decision making in choice of their partner and marriage, and when and whether to have children. Social and cultural norms prescribed by patriarchal control over women’s bodies and sexuality result in limited mobility, brutal violence including honor killing, sex-selective abortion, marital rape, domestic violence, child marriage and limit access to sexual and reproductive healthcare services and information. Similarly, sexual minorities and sex workers are subjected to violence from different sections of society. They also face extreme social rejection and exclusion. State governments must protect and ensure women’s bodily integrity and autonomy.
  • Sexual and reproductive health and rights must be protected and freedom from violence must be ensured.
  • States must also include universal comprehensive sexuality education and information for young people and adolescent girls.
  • Violence against women is one of the most pervasive universal violations of human rights, a public health crisis, and one of the greatest obstacles to development and peace. Women are facing sexual harassment, abuse, misconduct, verbal and psychological degradation, as well as non-acceptance in higher positions. They are subordinate at their work places and institutions including market places, public transports, bus stands and in the electronic media which limit the mobility of women and their hoes to live a life with self-esteem. States must ensure women-friendly and speedy grievances redressal mechanisms and procedures, as well as a reinforced culture of accountability.
  • Women lack access to justice due to the existence of informal justice systems and the unavailability and inefficiency of judicial protection and legal aid. So, last, but not least, this aspect must also be addressed. (SAFA)

 

  1. Because states are being called to comply on all these musts does not mean these actions will, by divine grace, be taken. A global push on women’s organization and mobilization is needed so that, as organized claim-holders, they coalesce into movements to increasingly demand these musts become reality — one-by-one.

 

Looking ahead

 

  1. All big change starts with small groups meeting regularly –take the women’s movement, the civil rights movement, the Chinese revolution. You cannot do it by yourself to create a different set of possibilities. The need is to have an alternative regular space to discover that you are not crazy: the system is crazy. And this needs to be a regular part of your life. My wish for the women’s movement is the following: the ideal structure will resemble a whole lacework of regular women’s meetings and drop-in meetings, i.e., a whole lacework of little groups meeting in schools, churches, around village wells, where any woman can drop in, leaderless, free, with the goal of supporting each other’s self authority. This is what we need to start a revolution. (Gloria Steinem)

 

Bottom line

 

  1. By mainly attributing value to gender equality in relation to economic development, the issue of power is thrown out of the window completely –and if gender is about anything, it is about power relations. Issues of gender inequality produce and reproduce power relations around the world, and while power relations are not a zero-sum game, achieving gender equality cannot be reached without some redistribution of power. We need to understand that gender issues are always relational. Talking about gender while excluding half of the global population from the discussion does not make sense, neither will it get us anywhere if we want to improve the situation for ‘the other half’. We cannot remain stuck in our safe discourse in which empowering women is only seen as valuable in economic terms and in which, for political reasons, many women around the world are excluded. We must dare to speak up, and dare to disagree. This is the only way we can make the Sustainable Development Goals global and inclusive so that they secure human rights for all people, regardless of their sex, gender or age. (Jannemiek Evelo)

 

Claudio Schuftan, Ho Chi Minh City

schuftan@gmail.com

 

All 400+ Readers are now available in my website http://www.claudioschuftan.com

 

Postscript/Marginalia

Women’s human rights are affected not only by poverty, food insecurity, lack of political participation, etc., but also by religion, especially when the State and other groups misuse religion, a deeply personal experience for many people, for political power and to exert control over people –and over women. While patriarchal interpretations, as well as religious fundamentalisms and extremisms, can disempower women and girls, women and girls can also use religion as a source of emancipation, empowerment and agency.

 

INEQUALITY IS NOT JUST AN ECONOMIC ISSUE, BUT A HUMAN RIGHTS ISSUE. EXTREME INEQUALITY IS THE ANTITHESIS OF HUMAN RIGHTS. (Philip Alston)

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Human rights: Food for a long but important thought

 

Human Rights Reader 407

 

[Taken from ‘From Disparity to Dignity: Tackling Economic Inequality Through the SDGs’, Human Rights Policy Brief, CESR, November 2016. I found this briefing to be a gold mine of what I call iron laws. I wanted to share them with you in case you have not had the opportunity to read the full document –which I highly recommend. I do apologize for the length and compactness of this Reader].

 

There are (long surpassed) limits to the degree of inequality that can be reconciled with notions of dignity and commitments to human rights for everyone.

 

  1. If economic growth over the last 30 years had been more equally distributed, the world would be on track to eliminate extreme poverty completely by 2030

 

  • The current global indicators proposed to measure progress towards SDGs Goal 10 (‘to reduce inequality within and among countries’) are manifestly inadequate –for example, in failing to include a robust measure of economic inequality.
  • The agreed indicators to measure SDG10 do not properly address the scope and intentions of the goal and targets. They do not incentivize those policy actions that have been proven effective in advancing equality in society and the economy.
  • SDG10 does address a central and much-noted weakness of the MDGs, namely, that they praised and celebrated aggregate progress while masking (or even encouraging neglect-of) economic and social inequalities. But, beware, Goal 10 remains vulnerable to strategic neglect, and in some cases political backlash.
  • There is a high risk that Goal 10 will remain an ‘orphan’ goal –hostage to the ebbs and flows of competing international development priorities and diverging national interests. Governments will simply need to take much more proactive and timely steps towards achieving Goal 10 –and we are not seeing this.
  • SDG10 has no obvious set of institutions at the national or international level whose mandate is to drive actions and funding-to or monitoring this goal.
  • Furthermore, the policies that drive inequalities between countries go largely unmeasured by Goal 10 targets.
  • The World Bank’s approach to Goal 10 is shaped by its institutional priority to promote what it calls ‘shared prosperity’ rather than embracing a more comprehensive need to tackle income and wealth inequality.

 

  1. An approach to development that pays attention only to absolute poverty and basic needs is far from sufficient if not altogether wrong

 

Soaring inequality is not only a development failure; it is both a symptom and a cause of the human rights crisis, perpetuating poverty, entrenching a widespread dearth of opportunity for many individuals and communities, and contributing to alarming outcomes in health, education, employment and other areas.

 

  • At present, there are few institutions –either at the national, regional or international level– set up with the express mandate to address one of the biggest challenges of our time: economic inequality.
  • Many of the key determinants of inequality –from the erosion of labor rights to the weakening of public service– can be framed as denials of internationally guaranteed human rights (HR).
  • Inclusive societies are not compatible with the extreme inequality that is now undermining social cohesion, political stability and civic security.
  • All countries in the world have stark and persistent inequalities, which in many cases have grown in recent decades (including in China and in Vietnam).
  • Leaving No One Behind’ is unfortunately more a rhetorical slogan; it camouflages fundamentally exclusionary policies.
  • Sustainable development policies will need to grapple with the top end of the income and wealth spectrum, or else starkly compromise any promise of leaving no one behind.
  • Vertical economic inequality (inequality in income and wealth between individuals and households) has been relatively neglected by HR bodies. Increasingly, however, the HR impacts of economic inequality are being explored, as contributors to rather horizontal inequalities (social disparities and other HR deprivations).
  • Laws and policies that appear to treat women and men equally are not enough to ensure that women are able to enjoy the same rights as men. (Such a ‘formal equality’ can never be sufficient). This is due to the legacy of historical inequalities, structural disadvantages, biological differences and biases in how laws and policies have been/are implemented.
  • Discrimination is often indirect and/or can be structural leading to chronic inequality; both unequal opportunities and unequal outcomes must thus be scrutinized as different treatments will be required to move towards equality in practice.

 

  1. Inequality is not natural, inevitable or intractable

 

Power is an expression of wealth.

 

  • The question is not if, but how public law and policies must be formulated to challenge the fundamental disparities found in economic opportunities and outcomes.
  • ‘Neutral’ measures to reduce economic disparity can have unintended adverse effects on particular social groups; they can in fact discriminate. Therefore, robust measures to be put in place must, first and foremost, prioritize redistribution towards the most disadvantaged groups.
  • Strong labor unions with the power to bargain collectively are an important factor in ensuring more equality. Moreover, joining a trade union that is allowed to function freely is a HR.
  • Wage protection measures are just as important in reducing the growth of inequality. Policies to address unemployment and to create more decent jobs must, of course, also be put in place.
  • Since a gender pay gap exists in all countries of the world, labor and wage policies must address wages and labor conditions in the informal, as well as the formal sector, making sure they are gender-sensitive.
  • Along with well-funded childcare services, family leave is also crucial to ensure the HR of both caregivers and the claim-holders receiving care.

 

  1. More important than attributed, financial liberalization has lead to growing economic inequality

 

Economic inequality is inextricably intertwined with other dimensions of social exclusion.

 

  • Financial deregulation has invariably been linked to a more unequal distribution of income. It has exacerbated the fiscal austerity measures (antithetical to achieve Goal 10 and set to intensify in the coming years) that many governments have taken.
  • Human rights principles –including participation, transparency, equality and non-discrimination and above all accountability– provide powerful tools to counter financial regulations biased in favor of the economic elite.
  • In countries across the globe, economic inequality has escalated since the onset of austerity fuelling the worldwide trend of increasing income disparity and wealth concentration.
  • Policy areas in tax, social protection, education and health are all redistributive especially if all implemented (They are all necessary, but not sufficient).
  • Regressive taxes do cancel out the equalizing potential of healthcare spending.
  • An effective action agenda against unjust inequalities will thus require an integrated approach, rather than merely measuring the distributive effects of siloed interventions, such as tax policy or conditional cash transfers alone.
  • Governments are obliged to explore all fiscal alternatives before introducing retrogressive measures, such as cutting back on social spending, even in times of economic crisis.
  • As regards social protection, while Brazil’s much-lauded targeted cash transfer scheme Bolsa Familia has undoubtedly played a role in tackling inequality, research has shown that it is actually the country’s pension system that has had the biggest impact on income inequality.
  • Human rights-informed social protection policies must also be carefully designed to be gender-sensitive. Family and child benefits and paid maternity leave are essential planks in these policies.
  • In health, interventions must go beyond past interventions that were often limited to the boosting of physical access.
  • Health services are a crucial equalizer by redistributing wealth into ‘virtual income’ for all.
  • The human right to health relates not only to health care services and goods, but also to the underlying determinants of health such as water, education, sanitation and housing. If implemented hand-in-hand with the commitments to allocate a minimum of 15 per cent of the national budget to health, Universal Health Coverage could provide people with a nationally determined set of promotive, preventive, curative and rehabilitative health services that will ensure the enjoyment of the right to health for all without discrimination.
  • User fees and privatization of essential water, health and education services that exclude the poor clearly contradict governments’ HR duties. Actually, user fees in education or ‘low-cost’ private schools have been shown to be detrimental to greater equality and the enjoyment of HR.
  • Additionally, one extra year of education is associated with a reduction of the Gini coefficient by 1.4 percentage points. Yet formal schooling between the ages of 5 and 18 is increasingly insufficient by itself to ensure equal chances for all in the modern economy.
  • Early childhood education is one of the most effective ways of combatting economic inequality throughout life.

 

  1. Taxation: no progress without progressivity

 

Tax policy is one of government’s most powerful tools to reduce income and wealth inequalities.

 

  • The decline in tax rates for the top end of the spectrum has been a key factor in the growth of inequality since the 1980s.
  • In order to tackle inequalities, taxation measures must be progressive in nature, ensuring the well-off contribute a larger proportion of their income.
  • The value added tax (VAT), popular in many countries, hits the incomes of the poor the hardest, and particularly affect poor women.
  • Governments are to also substantially crack down on tax abuse and eliminate unjustifiable tax incentives that largely benefit wealthy individuals and large corporations. Low-income countries in particular lose billions of dollars in potential revenue through these channels.
  • Rich countries are most responsible for –but currently most resistant to– creating a fairer international tax system that can tackle economic inequality within and between countries.
  • Also included and crucial must be improving the regulation of financial markets, enhancing the voice of developing countries in global financial institutions, in facilitating safe migration, in special trade treatment for developing countries, in tackling illicit financial flows and in encouraging official development assistance to those states that most need it.
  • One of the most important ways to create more equality between countries is to stem this hemorrhaging of wealth away from the countries in which it is generated.
  • Substantial reform in global economic governance is necessary in order to redress the power imbalances among states that have prevented effective international cooperation for the fulfillment of HR and the reduction of inequalities within and between states. Most high-income countries have proven very resistant to such measures.*

*: Developed countries at the Addis Ababa Conference on Financing for Development in July 2015 forcefully blocked developing countries’ and civil society’s demand for an intergovernmental tax body within the UN with the mandate and resources to create a coherent and more equitable global framework for international tax cooperation.

  • Without these reforms and others like them in equally critical areas such as debt, trade and investment policy, it will be very difficult to move towards a fairer balance of power between countries.
  • As discussed above, inequality is largely a political problem –the result of a conglomeration of specific decisions made by policy decision-makers with particular narrow interests in mind.
  • Politics is very often a zero-sum game in which the empowerment of a small elite results in the disempowerment of the many.
  • The weaker and more underfinanced the government or civil society is, the more this elite is able to lock-in its own economic privileges, creating a vicious cycle of elite capture and rent-seeking that weakens both democracy and the economy.
  • Existing HR standards provide powerful tools to challenge elite capture. Equal access to remedy, justice and the rule of law, free and fair elections, access to information that affects people’s lives, meaningful participation in the design implementation and monitoring of laws and public policies –these are all HR in an of themselves.

 

  1. Robust and inclusive monitoring and accountability institutions will be indispensable to drive actual changes on the ground

Note that the most privileged in society are largely uncaptured by official statistics.

 

  • Wealthy families are under-sampled in household surveys while, for example, capital gains are rarely captured in income statistics, and significant amounts of offshore wealth escapes the tabulations of both tax collectors and statistical agencies.
  • Yet, data does not translate into usable information without context and purpose behind it.
  • It is concerning that the agreed list of SDG targets and indicators is not informed by HR considerations and is thus inadequate at present to hold governments to account for tackling inequalities.
  • Given these shortcomings in the targets and indicators, the importance of using HR obligations and principles as a guide to implementation and monitoring becomes yet more urgent.
  • Efforts at the national and regional levels to more robustly measure and tackle inequalities will be crucial, as much as to improve global tools, datasets and the benchmarks set for processes that need to be put in motion towards the progressive realization of HR.
  • Public interest civil society –including academics and HR organizations– will be crucial in envisioning and operationalizing alternative and more rigorous measures of inequality.
  • Public interest civil society organizations are to be involved in formulating and interrogating accountability plans, as well as holding governments answerable for implementing them.
  • The power of the High Level Political Forum on the UN to review and hold states accountable for the implementation f the SDGs is, as of now, insubstantial and limited, especially given its reliance on voluntary self-reporting by states, and a meeting time of only eight days per year.
  • Given the HLPF’s institutional weaknesses, other accountability mechanisms must also be engaged. In particular, the international HR monitoring mechanisms must be encouraged and supported to play a key role.
  • Review mechanisms are to seek to examine the transnational dimensions of SDGs implementation, for example, the impact that country policies are having beyond their borders, or the impact of transnational multi-stakeholder partnerships.
  • Enabling public interest civil society to meaningfully engage in shaping the structures, processes and substance of global follow-up and review of the SDGs will simply be crucial to ensure accountability.

 

  1. Recommendations: What, at the very minimum, is needed is:

 

  • A serious worldwide commitment to a more equitable redistribution of resources and of decision-making power over all the above is indispensible.
  • This will need to be pursued via three main policy areas: taxation, social protection and universalization of public services.
  • Ultimately, this can be broken down into overhauling what is pursued, i.e., i) how and from whom resources are raised, and ii) how and for whose benefit they are spent. Both questions are necessary to see real improvement in equality.
  • Governments have to raise revenue for achieving SDG10 from those most able to pay, including by cracking down on tax abuses by corporations and wealthy individuals and closing loopholes which enable them to avoid paying their fair share of tax.
  • Labor markets, workplaces and financial systems must be regulated to protect against exploitative practices and unfair accrual of benefits at the top end of the income spectrum.
  • Disadvantaged groups, including people having been rendered poor by an unfair system, must be primarily supported and enabled to access decent jobs that pay a living wage.
  • Excessive speculation must be regulated to stop accumulation at the top and against the losses to the 99 per cent, especially those already living in poverty or at risk of falling into poverty.
  • Benchmarks chosen to monitor processes set in motion towards the progressive realization of the different HR are to be complemented by time-bound targets to progressively eliminate inequalities between groups by prioritizing a more ambitious rate of progress for those most disadvantaged groups.
  • The engagement of ordinary people in the design, implementation and monitoring of sustainable development policy processes and outcomes is not a discretionary privilege, but a right.
  • Governments are to foster citizen-led monitoring of the implementation of the SDGs, particularly SDG10.
  • Civil society space for engagement in SDGs implementation must be protected and expanded.
  • Revenues must be raised in ways that reduce inequality, in particular through progressive taxation; resources raised must be spent in ways that help equalize socio-economic opportunities and outcomes.
  • Fiscal abuse of power must be checked.
  • Governments must assess and address the gender equality effects of policies as a priority task in implementing the SDGs, as well as invest in addressing the structural barriers that drive gender inequality in the economy.
  • Minimum wage thresholds are also to be tracked and regularly improved.
  • National statistics offices and UN agencies are to be empowered to collect the data needed to monitor disparities on the widest possible range of relevant grounds.
  • Affected communities are to be closely involved in deciding the types of data required, and the indicators and benchmarks to be/being used.
  • Donor countries are to conduct HR and equality impact assessments to ensure their proposed policies and programs reduce rather than reinforce economic and other inequalities in other countries.
  • National Human Rights Commissions must be strengthened and given the resources, independence and mandate to effectively monitor inequalities under the rubric of SDG10 and existing HR obligations.
  • The HLPF is to move to more binding reporting, as well as complement national and regional follow-up and review mechanisms on priority issues such as economic inequality, macro-economic policy, climate change and other.

 

Claudio Schuftan, Ho Chi Minh City

schuftan@gmail.com

 

All 400+ Readers are now available in my new website http://www.claudioschuftan.com

 

SUBSTANTIVE WORK OF WHO, PARTICULARLY IN RELATION TO HEALTH SYSTEMS DEVELOPMENT, SHOULD COUNTER THE PRIVATIZATION AGENDA, BUT DOES IT?

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Human Rights: Food for a captive thought

 

Human Rights Reader 406

 

 

  1. Donor countries (the US in particular) continue to push WHO towards working with industry through ‘multi‐stakeholder partnerships’, rather than giving WHO the chance to implement regulatory and fiscal strategies that could make a real difference. (David Legge) Moreover, bilateral donors (and big philanthropies) demand WHO provides data according to their particular interests. Therefore, the types of data produced by WHO (and other UN agencies) are greatly influenced by a donor mandate that goes beyond the simple compilation of country-reported statistics. We know that donors seek to add value primarily through providing technical interventions (and not right to health or social determinants, for instance). So, here we are clearly faced with a biased stumbling block?* (Elizabeth Pisani, Maarten Kok)

*: Consider: While economics is not WHO’s core expertise, the impact of poverty and income maldistribution on population health clearly justifies WHO working with other agencies within or outside the UN system to focus much more attention on these questions of disparity.

 

  1. Things being the way they are right now, it is difficult to make sense of the shrinking scope of WHO’s role in global health governance, partly because of the ambiguity of the slogans about ‘stakeholders’ and the fait-accompli of ‘multistakeholder platforms’ and ‘public-private partnerships’ now used profusely. The continued use of the term ‘stakeholders’ (and the bundling together of public interest civil society organizations with international NGOs, private sector enterprises and philanthropies under the term ‘non-state actors’) appears to endow all of these private ‘stakeholders’ with having the right to have a ‘seat at the table’, with only the tobacco and arms industries declared off limits. Such ‘sitting rights’ sharply jeopardize the human rights enshrined in the various human rights (HR) instruments that address the rights of real people –the right to health prominently included.** (D. Legge)

**: It is important to note that the treatment of WHO by the rich countries is part of a wider onslaught on the UN system generally. The whole UN system is held hostage to short-term, unpredictable, tightly earmarked donor funding. The same strategies of control have been applied across the UN system generally through: freezing of countries’ assessed contributions, tightly earmarking voluntary contributions, and creating dependence on private philanthropy, as well as periodic withholding of assessed contributions and applying continued pressure to adopt the multi‐stakeholder partnership model of program design and implementation that, as said, gives global corporations an undeserved ‘seat at the table’.

 

  1. The Reform of WHO, aimed at realizing the vision of its Constitution, will require a global mobilization around the urgently needed democratization of global health governance; and this is not separate from, but part of, a global mobilization for HR and greater equity. Why? Because to claim that global health governance is somehow independent of global economic and political governance, is simply absurd. Nonetheless, such claims, still voiced by many, play an important political role for them in that they help to obscure the vested interests and power relations at play in the constraining (shackling) of WHO. (D. Legge)

 

Is WHO tinkering with a bureaucratic model inherited from the postwar era?

 

  1. WHO actually seems strangely detached from the broader political turmoil unfolding around the world. Globalization has created new collective health needs that cross old spatial, temporal and political boundaries. In response, we need global health governance institutions that represent the many, not the few; are sufficiently agile to act effectively in a fast-paced world, on top of being capable of bringing together the best ideas and boundary-shattering knowledge available. (Kelley Lee)

 

  1. WHO may point to its 193 member states and claim to be universally representative, but it is far from politically inclusive. Like the political alienation felt by millions around the world, many members of the global health community have turned elsewhere to move issues forward and get things done. What we see is a steady decline of WHO, clinging furiously to obsolete political institutions and bureaucratic models, yet kept alive by member states as an essential public institution. This decline is not because WHO is not needed, but because it has not adapted to and is not publicly financed for a changing world; it is not the WHO that we need today. (K. Lee)

 

  1. Political innovation must become a fundamental part of the process of WHO reform. Think: How might virtual and interactive town halls improve communication between global health policy-makers and the constituencies they serve? How might the closed world of global policy-making be opened up and strengthened through virtual public consultations, feedback systems and monitoring systems –all of them also aiming at reforming WHO? How might the concept of global citizenship become institutionalized within our global health institutions, especially WHO? (K. Lee)

 

Prescribing “LEGO models’?

 

  1. Otherwise, in the first decade of the new millennium, donors have pushed for increases in development assistance for health, yes, but in particular for medicines. This has clearly contributed to the re-legitimation of the ‘free trade agenda’ in health and has strengthened intellectual property (patents) protection regimes with their well-known negative consequences. Furthermore, in that development assistance, the mantra they preach to recipient countries is the one called ‘realistic costing of outputs’ that prescribes a LEGO model of program implementation, i.e., with each program comprising a set of planned outputs each of which comprises a known number of prescribed activities all of which have known costs. This approach leaves little, if any, room for flexibly managing complexity in planning and carrying out program implementation.*** (D. Legge)

***: WHO is made wary of prolonged project implementation processes, in part because they disrupts the ‘production schedule’ demanded by its paymasters. (Elizabeth Pisani, Maarten Kok)

 

  1. What is missing from the whole discourse is carrying out a robust analysis of the root causes of the preventable global disease burden. Only this will provide clearer criteria regarding which ‘stakeholders’ (duty bearers in the proper HR lingo) are part of the problem and which are part of the solution –and therefore which of them can be trusted to have a seat at the table. Human rights principles provide such criteria and so does the WHO report on Social (and political) Determinants of Health of 2008.****            (D. Legge)

****: The importance of non-medical factors is largely recognized as being a key predictor of health. In 2008, the WHO Committee on Social Determinants of Health stated: “Social injustice is killing people on a grand scale and constitutes a greater threat to public health than a lack of doctors, medicines or health care services”. The general conditions under which people live and work thus have a major impact on health outcomes. These social determinants of health further comprise, among other, the structural determinants of socioeconomic development, working conditions, education, housing, sex and high-risk behavior… What this implies is that health care is just one of the factors to influence health and can, therefore, only be considered part of the solution. (Koen Detavernier)

 

  1. The influence/control of donors over ministries of health in the South is nowhere more evident than in having kept any possibility of these ministries focusing on the human rights based approach in their agenda beyond mere lip service. Instead ministry officials keep pushing the newest slogans such as ‘universal health coverage’, ‘development assistance ‘and public-private partnerships’ that, in essence, are part of a common agenda consistent with the program of the 1% richest. They thus speak for the priorities of the 1% perhaps not realizing that they do so from within a worldview that accepts as natural and unchanging the global inequalities, the environmental degradation and the beneficence of private enterprise. (D. Legge)

 

Claudio Schuftan, Ho Chi Minh City

schuftan@gmail.com

 

All 400+ Readers are now available in my new website http://www.claudioschuftan.com




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