PHA-Exchange> Food for challenging a conventional thought (4)

[claudio at hcmc.netnam.vn]

Human Rights Reader 160


Exploring a critical, systemic approach to health rights
Summary of a paper by Abhay Shukla * (part 4 of 4)

Beyond the conventional human rights approach, towards a radical view of rights

31. The standard conception of human rights relies significantly on the 
international legal framework discussed earlier. But the same often operates 
more at the moral level rather than. analysing the politics of exploitation, 
which is responsible for large scale denial of socio-economic rights. We also 
often ignore the link between historical social struggles  --such as working 
class struggles, anti-imperialist struggles, struggles by various oppressed 
groups--  and international human rights law. This tends to make invisible the 
political context in which it was primarily a combination of socialist 
countries and post-colonial developing countries which pushed for the adoption 
of an international instrument on social, economic and cultural rights.

32. Abstracted from their origins, human rights appear ahistorical, and de-
contextualised. In such a ‘de-politicised’ view, the human rights framework 
appears as the product of benevolence of certain well-meaning international 
bodies rather than the culmination of decades of social struggle.

33. Similarly, this frame of mind tends to create the illusion that the 
international human rights system, by its good intentions, may gradually 
impose rights by their moral force without much social upheaval and struggle. 

34. The conventional human rights approach does not always analyse and 
consider the massive structural constraints which today prevent the 
realization of economic, social and cultural rights and, similarly, does not 
always emphasise the central importance of social and political mobilization 
in challenging these structural constraints. 

35. This leads to a strange dichotomy for at least some human rights 
activists: they feel a sense of somewhat unreal optimism when they look at the 
well-worded legal and philosophical framework of human rights, especially in 
international covenants, but they cannot avoid also feeling that the same are 
more like wish-lists than concrete-programmes-of-action.

36. Knowledge of the contents of the Universal Declaration of Human Rights and 
other UN covenants will hardly advance the condition of those whose rights are 
violated. What activists need to foster is a movement that channels these 
frustrations into articulate demands that evoke responses from the political 
process. So far, many real life struggles for social justice have been waged 
despite human rights groups --often not by or because of them.

37. Hence there is now a need to move beyond this dichotomy and to create a 
solidly grounded radical view of rights which stresses the centrality of 
social movements and proposes an alternative socio-economic and development 
model.   Then, the time will have come:
•	to confront and challenge current structural violence resulting in 
human rights violations, 
•	to name the oppressors, and 
•	to identify the global and national exploitative systems and policies 
which are responsible for this structural violence.
 
38. In summary, rather than endorsing the international human rights framework 
as the guiding ideology, rights have to be developed as useful tools for a 
struggle that is part of a more systemic, larger strategy for social change. 
In the health sector, this struggle:
•	should be based on a vision of collective (along with individual) 
health rights, 
•	should emphasise the rights of communities and hence should promote 
community mobilisation,
•	should integrate the right to health care and the right to the 
determinants of health as part of a holistic approach,
•	should assist in the formulation of concrete demands and strategies to 
achieve the RTH,
•	should not hesitate to identify and denounce the strong vested 
interests which create obstacles for the realisation of the RTH care, and 
•	should facilitate alliances of the health movement with other social 
movements.
 
39. Again, if people are not aware of the historical and contextual nature of 
human rights, and are not aware that human rights become realized only by the 
struggles of real people experiencing real violations of their rights, then 
human rights are all too easily used as symbolic legitimisers for a variety of 
instruments of domination.

40. We thus have to take a larger historical view and have to remember that 
systematised rights are by-and-large a creation of a capitalist society. The 
idea that claims for economic and social rights date back to the emerging 
socialist and workers' movements of the nineteenth century also needs to be 
kept prominently in mind. 

41. By the very nature of their origin, rights have a dual character: they 
often sustain the capitalist order and the associated freedoms of the 
privileged sectors, but may also be wielded by the oppressed as a defence 
against exploitation. But either way, while rights can regulate and limit 
exploitation, the framework of rights in itself does not transform the society 
which continually generates this exploitation. 

42. [To use a metaphor, the anti-slavery movement did not just codify more and 
more rights the slaves should have; it had to struggle for the abolition of 
slavery itself, wiping out any further discussion about the ‘rights of 
slaves’]. 

43. In short, we may either limit the use of rights to a system of checks and 
balances to ‘improve’ the system, or expand them as a tool (in conjunction 
with various others) to fundamentally challenge and transform the system. 

44. We need to increasingly focus our efforts on fundamentally changing the 
global and national political-economic architecture which is perpetuating and 
increasing these inequities. Then, rights become one more basis for organising 
and mobilising a spectrum of oppressed people who, in the process of 
collectively fighting for their rights will, after a point, also begin to 
question and challenge the system itself that institutionalises their 
exploitation. 

45. Our goal thus is to catalyse the transition to a new situation where these 
rights become subsumed under a much more equitable social system; such a 
vision changes the way we look at rights themselves. 

46. The present developments in some countries of Latin America and elsewhere 
do generate cautious hope that neo-liberal policies can begin to be rolled 
back and reversed by popular mobilisation, bringing social and economic rights 
centre-stage. However, such mobilisation will need to be intensified to 
ultimately confront and transform the basic socio-economic system; this alone 
can definitively ensure these rights in a lasting manner.

47. There is no ‘End of History’ here.  Though we have many more lessons to 
learn, and many more struggles to wage, we can look forward to a time when 
history will be made once again.

Claudio Schuftan, Ho Chi Minh City
claudio at hcmc.netnam.vn 
_____________________________
*: Adapted from Abhay Shukla’s “A compiled review of the rights approach to 
health and health care”, submitted for publication to ‘Beyond the Circle’, 
India, 2007. This summary includes adaptations of certain quotations from 
other authors, references for which can be found in the full article.


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