PHM-Exch> UN conference hears resounding call for human rights-based governance post-2015 (2)

[Claudio Schuftan]

In relation to this earlier posting by cesr I have a cautionary comment
centered around the human right to health. See it below the original
posting.
Claudio Schuftan
PHM Ho Chi Minh City

From: Luke Holland <lholland at cesr.org>

> A major meeting on the post-2015 agenda has heard that human rights and
>> accountability must be placed at the heart of governance at the national
>> and global levels. Global civil society’s desire for more just forms of
>> political and economic governance took center-stage as the final meeting of
>> the United Nations Thematic Consultation on Governance and the Post-2015
>> Framework was held in Johannesburg last week.
>>
>> Organized by the United Nations Development Program and the Office of the
>> UN High Commissioner for Human Rights, the meeting brought together some
>> 170 participants from all corners of the planet, ranging from
>> parliamentarians and academics to grassroots activists and civil society
>> leaders, to discuss the role governance and accountability should play in a
>> future development paradigm.
>> A new vision of governance, grounded in principles of human rights,
>> equality, participation, transparency, access to justice and
>> accountability,  should be a cornerstone of the post-2105 sustainable
>> development agenda, it was concluded.
>>
>> A high point of the meeting was the address by High Level Panel member
>> Graça Machel, who spoke of the panel´s commitment to ensuring that issues
>> of governance, human rights and inequality were central to the new
>> framework. There was wide consensus at the meeting that weak and
>> unaccountable governance, including at the global level, is one of the key
>> issues that must be addressed in a future framework, and that democratic
>> governance must be predicated on respect for the full range of human
>> rights.
>>
>> A newly-published position paper (see:
>> http://cesr.org/downloads/Beyond%202015_Governance_position_paper.pdf<http://cesr.org/downloads/Beyond%202015_Governance_position_paper.pdffrom>
>> Beyond-2015) sets out the core dimensions of "just governance" that should
>> be incorporated into more equitable and human rights-centred vision of
>> governance post-2015. The document represents the consensus of over 500
>> organizations that are members of the worldwide campaign.
>>
>
> We all have been reading that human rights, equity and equality are
universally and overwhelmingly identified as a must for the future
development agenda. But what will this entail?
A resounding call is one fine thing. Post 2015 deeds are another. (Skeptics
actually say: why wait till after 2015 if this is so important?)

As regards the *human right to health*, I am afraid the same will not be
achieved in the coming development era if the world:  (in no particular
order)



   - does not progressively introduce the human rights-based framework into
   the planning and implementation of health activities in ministries of
   health the world over (as the Millennium Declaration actually asked for,
   but was never heeded);
   - does not confront the social determinants of health (as the
   causes-of-the-causes) head-on, at the same time that we prevent and treat
   the evolving burden of disease;
   - does not transfer key elements of the governance of health to more
   democratically accountable groups that include civil society sanctioned
   representation (a new approach to decision-making closer to a direct
   democracy process is thus called for);
   - does not revive and bring to the fore key aspects of a New
   International Economic Order already called for by the Alma Ata Declaration
   in 1978 and also never heeded;
   - does not sternly and bindingly make sure that free trade agreements
   are not (will not) negatively impact(ing) the right to health;
   - does not decisively move to progressively make sure that the existing
   people's movements struggling for health and for human rights unite to form
   growing broad and vocal coalitions;
   - does not understand that to arrive at really prioritizing human
   rights, equity and equality a massive process of human rights learning and
   of empowerment is needed to address the prevailing power imbalance in
   decision-making;
   - does not understand that actions in relation to disparity reduction
   are needed both within and between rich and poor countries;
   - does not concomitantly act on climate change, tax reform, stern
   regulation of the private sector in health and int the food and beverage,
   alcohol and tobacco industry;
   - does not further concomitantly act on racism, xenophobia, homophobia
   and violence against women, as well as exclusion, exploitation and, last
   but not least, environmental degradation;
   - does not decisively change the focus of foreign aid from charity to
   human rights and international solidarity;
   - does not appropriately fund WHO through much greater states
   contributions so it can regain the independent status as the agency in
   charge of world health matters away from the current dependency on
   earmarked funding from the private sector....

In short, I purport that the prospects for the quantum improvements needed in
post 2015 health are dim if structural changes do not occur. In practice,
this can only mean that organized civil society has to, de-facto, increase
its level of consciousness so as to come together and exercise real power
to hold governments and international institutions to account. The list
above is a starting point.

The widely touted Health in All Policies and calls for Universal Health
Care are *not* panaceas; they can deceive us making us believe that 'what
needs to be done will be done'. But without some of the structural *changes
mentioned above happening HiAP and UHC will be like Christmas
toys...batteries not included*.*
*: To live up to the expectations being placed on it, universal health care
will, as a minimum, have to assure truly universal access and coverage to
all health services (in the name of equality). It will have to
beintegrated, comprehensive and covered to full cost; it will have to
tackle
the social determinants of health; it will have to be organized around the
principles of PHC, not be segmented and not be commercialized/commoditized;
foreign solidary aid will have to go to the public sector; minimal benefits
packages will not do it (a safety nets approach will not be acceptable);
there will be no user fees for referrals to secondary and tertiary care
services; the delivery of health care services will have to progressively
move away from current vertical programs; and claim holders will have to be
mobilized in their communities, among other, to take up a role as watchdogs.

I am fully aware you can add to the list above  only to show that the list
of structural changes needed should not be underestimated in the --to quote
cesr-- 'resounding call for human rights-based governance post-2015'....
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