PHA-Exchange> Food for the right thoughts in health fedback

[Claudio]

From: "George Kent" <kent at hawaii.edu>
A few comments on Human Rights Reader 91
> > THE HUMAN RIGHTS DISCOURSE IN HEALTH. (Part 1 of 2)
(Claudio's reactions added)

> > 2.... This is to be seen in good
> > part as a failure of beneficiaries themselves to act as empowered
> > claim holders placing their demands from a power base that can
> > force non-performing duty bearers to provide the services and resources
> > needed to reverse those violations.

 (gk1) Rights holders normally do not have a clear idea of the services to
> which they are entitled on the basis of international human rights.
> It is essential to have human rights law concretized in national
> law to spell out how the national government understands it obligations.
(cs1) Agree.

> > 3....We have become quite good at doing detailed Situation Analyses
> > of unfulfilled needs and entitlements.

 (gk2) We have? Can we cite some good examples?  Do we have ANY examples of
such analyses undertaken by the rights holders themselves?
(cs2) I think there are a few. For example, the people of Iringa province in
Tanzana on the 1980s come to mind.

(gk2a) Sound human rights education should prepare rights
holders to do situation analyses.
(cs2a) Agree.

>>... But these only list and  sometimes characterize the multiple
violations of >> the right to  health. So these represent diagnoses only.

 (gk3) Only? This is a major achievement! I have not yet seen any
 analysis that distinguishes between health service deficiencies in
 general, and those particular deficiences that represent violations of
 the human right to health.
(cs3) True.

>>...  Moreover, entitlements and needs do not carry correlative duties for
> duty-bearers. Rights do!

 (gk4) In my usage of the term, entitlements do have correlative duties.
 How are you using the term?
(cs4) I am sure needs do not carry correlative duties. Entitlements, I
declare my ignorance. Will check.

> > 4.... Capacity Analyses have also been
> > called Accountability Analyses, because seeking accountability
> > provides claim holders with the opportunity to understand how duty
> > bearers have discharged their obligation and provides duty bearers
> > with the opportunity to explain their conduct.

 (gk5) Capacity alone does not automatically imply obligation. Thus I
 prefer the term "Accountability Analysis." In using this term, do you
 mean the process of figuring out who is accountable in general terms, or
 do you mean the actual process of calling the duty bearer to account in
 relation to a specific violation?
(cs5) Calling the duty bearers to acount in relatoin to a specific
violation.
The literature calls this 'capacity analysis'; not my invention.

> > 5. ...After carrying out these capacity analyses, we have to --in an
> > organized way, through proactive community mobilization-- embark
> > with the beneficiaries in doing-something-about-those-violations.

 (gk6) I prefer to speak of them as rights holders, rather than
 beneficiaries. The rights holders themselves should participate actively
 in the analyses, insofar as that is feasible.
(cs) Agree.

> > 7. ...Unfulfilled-needs-and-entitlements-seen-as-violations-of-human-
> > rights, on the other hand, DO bind duty bearers legally under
> > international law and, among other, under the Constitution of the
> > World Health Organization (WHO).

 (gk7) Human rights law alone is
 not concrete enough to give rights holders a clear idea of what they
 should expect from their national governments and other duty bearers.
 National governments should be pressed to make their commitments  very
clear by passing appropriate national legislation that
 says how they will carry out their obligations.
(cs7) Agree.

> > 8. ... There is
> > thus now a growing body of international HR law and practice to
> > help us identify the specific interventions and policies that are
> > needed to achieve human (people's) rights goals in health.

 (gk8)  I would say much  of this work should be about lobbying for
appropriate national law that  is designed to concretize existing
obligations under international human rights law.
(cs9)  Agree.

> > 10. ...It needs to be emphasized here that reaching the MDGs also will
> > have to pass through breaking the poverty syndrome behind pretty
> > much all the indicators of the MDGs. In our case, looking at these
> > goals only through the prism of the right to health will only
> > advance our cause in the health indicators (goals), i.e., a very
> > partial victory.

(gk9) The leaders of the MDG process at the global level are not
 proposing strategies that can seriously be expected to achieve the
 goals. They are simply elevating the levels of disappointment. Perhaps
 we can get serious strategic efforts to achieve the goals within a few
 countries. Which are the most likely candidates? Where are these goals
 being taken seriously?
(cs9) Agree. Do no have an answer to the two questions.

> > 11. ...The HR cause gives us the possibility to advance our political
> > agenda towards equity, towards the indispensable structural
> > changes that need to be made for health and other social services
> > to receive the resources they need to reverse the corresponding
> > rights currently being violated.

(gk10)There is the danger that in strategizing the task of sharply
> improving health, food, and economic situations, many poor countries
> look to rich countries for assistance of various kinds. All the evidence
> tells us the rich really don't care enough to do what needs to be done.
> There is a need to rely more on the resources of those countries that
> have the problems, and on their strong leaders. They need to do their
> own strategizing, because the strategies proposed by the rich are based
> largely on protecting the interests of the rich.
(cs10) Agree, but have my doubts about 'their strong leaders".

> > 12. ...If not willing to cooperate, we now can face duty bearers
> > accusing them of violating international law. And that is a
> > tactical advantage. We can now demand structural changes under the
> > wing of international law.

 (gk11) Yes, international human rights law is of enormous value in
 that it clearly articulates widely accepted norms. However, there is
 still a need for concretization of these norms at the national level,
 and for serious political work to assure that these norms are met. This
 means there is a need to mobilize serious strategic thinking, not among
 the supposed patrons of the poor, but among the poor themselves.
(cs11) Agree.

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