Health inequalities represent perhaps the most consequential global health challenge and yet they persist despite increased funding and innovative programmes. The United Nations is revising the Millennium Development Goals (MDGs) that will shape the world for many years to come. What would a transformative post-MDG framework for global health justice look like? A global coalition of civil society and academics - the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI) - has formed an international campaign to advocate for a Framework Convention on Global Health (FCGH). Recently endorsed by the UN Secretary-General, the FCGH would reimagine global governance for health, offering a new post-MDG vision. This Special Communication describes the key modalities of an FCGH to illustrate how it would improve health and reduce inequalities. The modalities would include defining national responsibilities for the population’s health; defining international responsibilities for reliable, sustainable funding; setting global health priorities; coordinating fragmented activities; reshaping global governance for health; and providing strong global health leadership through the World Health Organisation.
Values, Policies and Rights
The People's Health Movement (PHM) would like to invite civil society organizations, interested individuals and groups to participate in discussing the possibility of hosting such a campaign in South Africa. It would also contribute to building civil society for the Third People’s Health Assembly, planned for 2010 at an African venue (to be determined). This edition of Critical Health Perspectives sketches the background to the campaign and some of the thinking behind it.
The authors of this paper argue that current forms of co-operation are often ineffective, insufficient and incapable of achieving progressive realisation of the right to health. They propose that, after the many international and regional Commissions, Declarations, and institutional innovations of the last 20 years, the logical next step for the promotion of the right to health is the drafting and enforcement of a Global Framework Convention on Health (GFCH). Significant contemporary international challenges make national health an issue that needs to be protected by global agreements. Such challenges include the international but unequal market for health workers that result in the recruitment of health workers from developing countries and the prohibitive cost of essential medicines and of meeting the health needs and rights of migrants and refugees. Developing countries are struggling to bear these financial burdens. The authors call for a GFCH that broadly sets out national and international duties towards health, health challenges and their cost, and helps make people of low income countries less vulnerable to shifting developed-world priorities.
"The international migration of health workers away from underserved areas in low income countries is increasingly recognised as one of the most profound problems facing health systems, and the safeguarding of health, in these countries. The problem is particularly acute in sub-Saharan Africa where the burdens of poverty and underresourcing, infectious disease and, worthy of distinct mention, HIV/AIDS which has infected up to a quarter of the population in some countries, are causing public health systems to break down...The language of human rights is commonly used when describing the motivations of health workers to migrate to seek a better life and to further their careers. But human rights are less commonly invoked to articulate the consequences of their migration, which may include most notably the impact on the right to health of health system users in the country of origin," says the abstract of this paper commissioned by health charity Medact as part of its programme of work on health, poverty and development.
* Read the related paper 'The ‘Skills Drain’ of Health Professionals from the Developing World'
One of the most fundamental human rights is the assumption that each person matters, and everyone deserves to be treated with dignity—this is the tenet from which all other human rights flow. Another is that those who are most vulnerable deserve special protection. However, in many developing countries, vast numbers of children are born but never counted, and their health and welfare throughout their lives remains unknown. And because single-mean measures of population health mask inequalities among the best-off and worst-off, the health of vulnerable populations is not effectively documented and acknowledged. Health information systems can play an important role in supporting these rights by documenting and tracking health and health inequities, and by creating a platform for action and accountability.
On the basis of an analysis of popular and medical texts which address a debate over the ethics of clinical drug trials designed mainly for sub-Saharan Africa, this paper argues that the international public health discourse about infant HIV infection in Africa reflects and legitimates a anti-reproductive justice ideology. The author argues that the texts most commonly advance the view that biomedicine, funded from outside Africa with medicines from outside the continent, is the magic bullet that addresses mother and child HIV, avoiding issues of domestic advance in reproductive and sexual rights. This dominant focus is argued to give greater control over HIV to biomedical perspectives and to strengthen right-wing movements against advances in reproductive rights.
The goal of this methodology is to assist in the creation of valid, useful and ultimately meaningful human rights impact assessments. This followed the United Nation’s Special Representative on Human Rights and Business Professor John Ruggie's presentation to the Human Rights Council with a framework for delegating human rights and responsibilities between governments and companies. The process of creating and using HRIA is still in its early phases. Their relevance will depend on a continuing improvement of method, capacity and result which can only be accomplished through the sharing of experience and information between companies and assessors. The methodology looks at HRIA assessment sources, goals, and types. It covers basic concepts and looks provides five steps for implementation: gather project contexts and company information; drawing up a preliminary list of impacted rights; drawing up a preliminary list of impacted right holders; special topics; and inquiry guided by topic catalogue. The methodology offers recommendations for policies, procedures, structures and action. It also provides an appendix of other tools and selected best practices.
The current context indicates that exceptional measures designed to combat the spread of COVID-19 need to be continually evaluated, taking into account the positive obligations that States bear to protect life, access to health and health security, and the extent to which these obligations should be shaped by countervailing negative rights. The authors indicate that striking an appropriate balance between these positive obligations and countervailing negative rights, in this rapidly evolving environment, can only be successfully achieved in an environment of democratic, judicial and scientific contestation. Moreover, in the context of positive obligations, it is imperative to emphasise the least coercive means through which public health can be achieved. This report provides a human rights analysis using this lens of a cross section of jurisdictions from different countries globally, including South Africa and Zimbabwe.
In order to understand how and why social movements are fighting for women's health and rights you need to have a 21st century notion of these rights. This is a central message of the book Global Prescriptions: Gendering Health and Human Rights. The rights that Rosalind Pollack Petchesky discusses are not those determined by grey-suited lawyers and bureaucrats, and enshrined as fixed, universal, and unalienable principles. They are rights that exist in an era of global capitalism; rights that are influenced by sex, race, class, geography, and ethnicity; rights that are dynamic and malleable; and rights that, above all, are a necessary and irrepressible element of movements for social change. Petchesky views individual and social rights as "two sides of the same coin". She ascribes equal importance to social and economic rights as to those related to reproduction, sexuality, and health; noting that together they form "a single fabric of rights".
In this journal feature, Issa Shivji, Peter Lawrence, John Saul, Natasha Shivji, Ray Bush and Ndongo Samba Sylla pay tribute to the late Samir Amin. Issa Shivji writes of Amin’s support for younger generations, ‘His intellectual works, scholarly contributions and political interventions have been sufficiently covered in dozens of tributes that are pouring in every day. I will not go over them. I wanted specifically to capture Samir’s attitude and treatment of younger generations, done as a matter of course and without pretense.’ Peter Lawrence highlights one of Amin’s key ideas, ‘Amin rejected the prevailing view in both the capitalist ‘West’ and the socialist ‘East’ that development entailed catching up with the developed capitalist countries. … The history of the world was not about followers catching up with leaders but about dominant civilizations being ‘transcended’ by peripheral ones as the former decline and the peripheral overtake them with different social organizations.’ John Saul illuminates Amin’s concept of ‘an actual and active ‘delinking’ of the economies of the Global South from the Empire of Capital that otherwise holds the South in its sway. For Amin, delinking was best defined as ‘the submission of external relations [to internal requirements], the opposite of the internal adjustment of the peripheries to the demands of the polarizing worldwide expansion of capital’. Amin saw it as being ‘the only realistic alternative [since] reform of the [present] world system is utopian.’ Ndongo Samba Sylla concludes by writing on Amin’s notion of ‘daring’ in coordinated struggles, ‘by the emergence of an anti-monopolies front [in the Global North] and in the Global South by that of an anti-comprador front' challenging subservience to neoliberal globalisation. The authors collectively highlight how through his writings, his interventions and engagement Amin profiled the perspective of the Global South 'and the wretched of the earth.’