Food for a marginalized thought
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Human Rights Reader 122
USING THE MILLENNIUM AGENDA AS A REFERENCE POINT IMPLIES SIDE-
LINING THE HUMAN RIGHTS-BASED APPROACH!
We live in a world of high-flown objectives, ambitious target
setting and obscure acronyms.
1. MDGs and PRSPs make virtually no allowances for human rights
(HR) or for environmental protection. Moreover, worldwide, and
bottom-line, the initiatives of the fifty-plus existing WB-
sponsored PRSPs are failing. For example, today, there are +/-
550 million people who work, but still live on less than U$1/day
(those 50+ countries included). These 'working poor' represent
20% of total world employment. Half the world's workers actually
live below the respective poverty line of their countries: 1.4
billion earn less than U$2/day. Add to this that 186 million
people were unemployed in 2003.
1a. [Therefore, decent sustained and productive employment --not
employment alone-- is the key that really matters. The central-
ity of decent employment (a human right) to reaching the MDGs is
thus highlighted here. (ILO World Employment Report 2004-05)].
2. So beware: MDGs need not only to be attained, but also to be
sustained on a long term basis.
2a. [Moreover, a dramatic overlooked point in the Millennium
Declaration and the MDGs is that inflation is likely to make
the-year-2000-1U$/day a mere 60 cents/day by 2015. (J. Rich-
ter)].
Combating poverty is the most effective way of forestalling se-
curity and terrorism risks:
3. What is wrong is that too many poverty reduction strategies -
-like the MDGs and the PRSPs-- predominantly focus on the social
sectors (particularly health and education.) rather than on the
entire political economy. Human rights work focuses on the lat-
ter.
3a. [A sample: The European Union has a more serious orientation
towards the fight against AIDS than is its stand on poverty al-
leviation in general].
4. Also to be exposed is the fact that purported gains from open
trade, privatization and anti-corruption policies do not go far
enough either to shrink the poverty gap or to improve the HR
situation (importantly in health). Privatization can only work
where there is enough competition and a working regulatory
structure that makes sure the private sector behaves equitably
and efficiently. Since that is not the case, privatization has
not worked. Ergo, the act of privatization alone is not enough
to induce the private sector to be run more efficiently than the
public sector. In the real world, privatization has resulted in
a strong concentration of ownership; it has led to a class of
owners with vested interests capturing the state to make sure
that policies work in their favor.
4a. [For instance, tax revenues stay low, because powerful na-
tional and transnational interest groups are given widespread
tax exemptions, and tax surveillance/compliance is kept weak or
is corrupt. In these cases, higher aid flows promote rent-
seeking behavior by the same domestic vested interests].
All this runs counter to the respect of the rights of the na-
tional majority of the poor.
5. In HR parlance, we think that any solution to global-poverty-
preventable-deaths-ill-health-and-malnutrition entails trans-
forming the poor countries' economies more structurally --even
if the process is slow.
5a. [Boosting the rate of economic growth of a country from, say
3 to 7% per annum, means that it would take 10 years instead of
23 for national per-capita income to double (and upward mobility
is more likely in cities than in the countryside which is why
wise families live in split households utilizing city and vil-
lage environments in their survival strategy)].
6. But poverty reduction is only part of the story; plain income
disparities (even in the absence of absolute poverty) seem to
explain differential health outcomes in rich countries. The Gini
(income inequality) Coefficient can increase or decrease often
leaving poverty unchanged if the distribution above the poverty
line also changes; so, poverty can increase or decrease without
any change in the Gini if there are corresponding offsetting
changes in distribution among the non-poor.
7. Poverty entails the denial of capacities, opportunities and
rights, as well as a lack of dignity and of access to power.
Therefore, as HR activists, we reject pro-poor policies; we sup-
port anti-poverty policies! We believe it is ultimately the poor
persons that must participate in defining the nature of their
poverty, how it is affecting their right to health and education
and what changes they think are needed.
8. The economic interests of poor persons get a boost from them
organizing themselves and bundling their interest and demands.
The result is political power --and that is a crucial HR precon-
dition for a country to rise out of the poverty trap once and
for all.
9. As HR activists, our contribution can be to help assess ex-
isting power structures, among other, by the services being pro-
vided for the people and thus the legitimacy of the existing
structure for the needs of the local population.
10. It is no news that the world is increasingly shaped by pow-
erful global forces, the action of many of which have conse-
quences for the right to health and the social, political, eco-
nomic and environmental factors that influence health; the lat-
ter factors are increasingly determined at a supranational
level. As a result, local and national level efforts to influ-
ence health determinants can have only a limited impact, and it
is all too easy for the individual health practitioner in the
public sector to feel powerless. Yet while these practitioners,
on their own, may indeed be relatively powerless, together they
can achieve a great deal. The same is true for HR activists --
and that is the role the People' Health Movement has taken up.
(http://www.phmovement.org )
Claudio Schuftan
Ho Chi Minh City, Vietnam
mailto:claudio@hcmc.netnam.vn
--
Mostly adapted from D+C 31:11, Nov 2004; 31:12, Dec 2004; 32:1,
Jan 2005; 32:2, Feb 2005 and 32:4, April 2005; F&D, 41:3, Sept
2004; SCN News No.29, late 2004-early 2005; and 'HR, Health ad
Poverty Reduction Strategies', draft, WHO/HDP/PRSP/05.1, 2005.