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<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 10pt"><FONT face="Times New Roman">Food for thought falling on
deaf ears<?xml:namespace prefix = o ns =
"urn:schemas-microsoft-com:office:office" /><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 10pt"><FONT face="Times New Roman">Human Rights Reader
128<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 10pt"><o:p><FONT
face="Times New Roman"> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt"><FONT face="Times New Roman">YESTERDAY’S FUTURE HAS
ARRIVED: THE POST-WASHINGTON CONSENSUS ONLY HAS A PITIFUL VAGUE ORIENTATION
TOWARDS THE ERADICATION OF POVERTY AND ILL-HEALTH AS HUMAN RIGHTS
PRIORITIES<SPAN style="mso-spacerun: yes"> </SPAN>(Part 2 of
2)<o:p></o:p></FONT></SPAN></P>
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style="FONT-SIZE: 14pt"><o:p><FONT
face="Times New Roman"> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt"><FONT face="Times New Roman">12. In the more specific
case of health, there is a conflict between WB policies under the poverty
reduction strategies (PRS) process and the Right to Health (RTH). Bank policies
do undermine progress in respecting, protecting and fulfilling the RTH by, among
other, restricting health care budgets. A higher level of funding of health
services is a necessary-but-not-sufficient condition for realizing the RTH of
individuals and populations. There is a minimum level of health expenditure
below which the system simply cannot function. Current funding and expenditure
levels practically guarantee that the RTH cannot be realized. On average, public
health expenditures fell 20% during WB-promoted structural adjustment programs
(SAPs), and stagnated thereafter. [To justify this, the Bank argues that without
wealth creation it would be impossible to see human rights (HR) being realized.
‘Grow now and realize HR later’ the Bank obliquely suggests]. Result: A
retrogression in the achievement of the RTH. SAPs violate(d) the critical
concept of progressive-realization-of-the-RTH in resource-poor countries.
<o:p></o:p></FONT></SPAN></P>
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style="FONT-SIZE: 14pt"><o:p><FONT
face="Times New Roman"> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt"><FONT face="Times New Roman">13. All health development
programs/projects carry immediate obligations! And these core obligations are:
universal access to equitably distributed health facilities with quality
services and essential drugs, access to minimum essential food, access to basic
shelter, water and sanitation, and a focus that addresses the major local health
concerns. To these can be added:<SPAN style="mso-spacerun: yes">
</SPAN>ensuring reproductive, maternal, neonatal, infant and child care, the
provision of immunizations, the control of epidemic and endemic diseases, health
and nutrition education, and the training of sufficient and qualified health
personnel. As the key beneficiaries, poor persons need to be empowered to
monitor and sanction health service providers making sure that policy makers
(not-only-hear, but also) respond to the demands of these marginalized groups as
regards the above-mentioned core obligations. <o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt"><o:p><FONT
face="Times New Roman"> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT
face="Times New Roman"><SPAN style="FONT-SIZE: 14pt">14. From a HR perspective,
not even the threat of macroeconomic distortions voiced by neoliberal economists
can justify public health expenditures below the level necessary to comply with
these core obligations. As past evidence shows, WB policies have played an
important role in the inability of countries to comply with their core
obligations. Moreover, the PRS process continues to result in underfunding of
health (primarily in </SPAN><?xml:namespace prefix = st1 ns =
"urn:schemas-microsoft-com:office:smarttags" /><st1:place><SPAN
style="FONT-SIZE: 14pt">Africa</SPAN></st1:place><SPAN
style="FONT-SIZE: 14pt">). <o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt"><o:p><FONT
face="Times New Roman"> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt"><FONT face="Times New Roman">15. So, it is, in good
part, up to socially conscious health professionals worldwide to assert their
public health authority to limit the negative consequences government and
corporate actions are having on health, and to ensure proper regulatory
frameworks that protect the universal right to health care are put in place. In
short, they have to see social medicine as political.
<o:p></o:p></FONT></SPAN></P>
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style="FONT-SIZE: 14pt"><o:p><FONT
face="Times New Roman"> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; mso-bidi-font-size: 12.0pt"><FONT
face="Times New Roman">16. But, to begin with, health professionals are not
looking at the more political indicators of social medicine that can show us
some retrogression, stagnation or progress in the achievement of the RTH.
Examples of such indicators we are <U>not</U> looking at are: Percentage of the
population whose RTH care is still violated (importantly, but not only, access);
the percentage of households with decreased, stagnant or increased expenditure
on food; the income distribution by quintile; the percentage increase (or not)
of income of the lowest quintile compared to other quintiles; the percentage of
reduction (or not) in infant and child mortality or the percentage of increased
survival of the same children in the lowest quintile… This is what I mean by
seeing social medicine as a vehicle for ending the violations of the RTH.
<o:p></o:p></FONT></SPAN></P>
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style="FONT-SIZE: 14pt"><o:p><FONT
face="Times New Roman"> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT
face="Times New Roman"><SPAN style="FONT-SIZE: 10pt">Claudio Schuftan,
</SPAN><st1:City><st1:place><SPAN style="FONT-SIZE: 10pt">Ho Chi Minh
City</SPAN></st1:place></st1:City><SPAN
style="FONT-SIZE: 10pt"><o:p></o:p></SPAN></FONT></P>
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<P class=MsoNormal
style="BORDER-RIGHT: medium none; PADDING-RIGHT: 0in; BORDER-TOP: medium none; PADDING-LEFT: 0in; PADDING-BOTTOM: 0in; MARGIN: 0in 0in 0pt; BORDER-LEFT: medium none; PADDING-TOP: 0in; BORDER-BOTTOM: medium none; mso-border-bottom-alt: solid windowtext 1.5pt; mso-padding-alt: 0in 0in 1.0pt 0in"><SPAN
style="FONT-SIZE: 10pt"><A href="mailto:claudio@hcmc.netnam.vn"><FONT
face="Times New Roman">claudio@hcmc.netnam.vn</FONT></A><o:p></o:p></SPAN></P></DIV><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA">Mostly
adapted from Global Health Watch, MEDACT/PHM, Nov 2005, and D+C 32:8/9, Aug/Sep
2005.</SPAN></FONT></DIV></BODY></HTML>