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<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT
face="Times New Roman">Human Rights Reader 148<?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: 11pt; mso-bidi-font-size: 12.0pt"><o:p><FONT
face="Times New Roman"> </FONT></o:p></SPAN></P>
<P class=MsoBodyText2 style="MARGIN: 0in 0in 0pt"><SPAN
style="mso-bidi-font-size: 12.0pt"><STRONG><FONT face="Times New Roman"><FONT
size=4>FROM THE HUMAN RIGHTS PERSPECTIVE, POWER IMBALANCES UNDERLIE HEALTH
INEQUITIES.<o:p></o:p></FONT></FONT></STRONG></SPAN></P>
<P class=MsoBodyText2 style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><o:p><STRONG><FONT
face="Times New Roman"> </FONT></STRONG></o:p></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>1. If you recognize and agree with <o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>a) the indivisibility of rights, <o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>b) the equal importance of people’s socio-economic entitlements, and
<o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>c) the principle of equity, <o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>you must accept that this runs counter to market-oriented development and
health policies still fostered by many an international development
agency.<o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><o:p><FONT
size=3> </FONT></o:p></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>2. Therefore, what the adoption of the human rights framework brings to
public health is that it ensures that social justice is made a constant
counterbalance to unchallenged utilitarianism; it also ensures that checks on
power relations are made routinely as well, and that these checks are the main
way to protect the vulnerable by opening avenues that confer communities the
power to get actively and de-facto involved in setting the policies and programs
that affect their health and wellbeing. <o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><o:p><FONT
size=3> </FONT></o:p></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>3. This makes human rights (HR) the centerpiece of early twenty first
century development struggles. But mind you, the HR framework will only become a
meaningful instrument to assure accountability if strong civil society pressures
on government ultimately turn HR codes and standards into laws and regulations.
<o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><o:p><FONT
size=3> </FONT></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt"><FONT face="Times New Roman"><FONT size=3>4.
Furthermore, HR are not just about empowering individual duty bearers [remember
that duty bearers are often oppressed oppressors], but are, by extension, a
framework for the contestation of power, at local, national and international
level. And where power is contested, we should expect that the products of this
contestation will actually reflect the relative balance of forces (or power) of
the different actors. Therefore, empowering claim holders we must.
<o:p></o:p></FONT></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><o:p><FONT
size=3> </FONT></o:p></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>5. On the other hand, the current emphasis <o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>-on ‘good governance’ (no matter if participatory or not…),
<o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>-on ‘representative democracy’ (no matter if through rigged elections or
not…), and <o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>-on ‘civil liberties’ (no matter if fair to the marginalized or not…)
<o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>that has emerged as the dominant paradigm in the development discourses
driven by most Western governments has ironically contributed to a
de-politicization of the human rights and of the development discourse, because
it strips the struggles-for-health of any content that challenges power
imbalances --again at local, regional and international levels.
<o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><o:p><FONT
size=3> </FONT></o:p></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>6. Because of the above underlying power issue, many have questioned “Why
rights, why rights now?” “Is human rights work the most effective way to tackle
power imbalances?” <o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=3>We respond: If and when the language of rights becomes denuded of a focus
on power relations, it is turned into an ineffective, worthless technical
exercise of compliance with existing norms; human rights then become palliative
rather than the cornerstone to ease human suffering. In practice, in health,
placing demands from a rights framework, among other, challenges service
providers to see their role as fulfilling the state’s human rights obligation to
assure comprehensive and universal health care rather than simply to deliver
health services.<o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><o:p><FONT
size=3> </FONT></o:p></SPAN></P>
<P class=MsoBodyText style="MARGIN: 0in 0in 0pt"><FONT face="Times New Roman"
size=3>7. There is no unambiguous answer to the question whether, in the
reigning paradigm, public health still is
a-bundle-of-services-shaped-by-ideologically-pro-status-quo-positions. But if
you think it indeed is, the application of the human rights-based framework is
most probably the best currently available counterbalance to challenge a
paradigm that desperately needs to be replaced.</FONT></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><o:p> </o:p></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 11pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=1>Claudio Schuftan, <?xml:namespace prefix = st1 ns =
"urn:schemas-microsoft-com:office:smarttags" /><st1:place w:st="on"><st1:City
w:st="on">Ho Chi Minh City</st1:City></st1:place><o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 11pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 10.0pt"><A
href="mailto:claudio@hcmc.netnam.vn"><FONT
size=1>claudio@hcmc.netnam.vn</FONT></A></SPAN><SPAN
style="FONT-SIZE: 11pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=1> <o:p></o:p></FONT></SPAN></P>
<P class=MsoPlainText style="MARGIN: 0in 0in 0pt"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt"><FONT
size=1>_______<o:p></o:p></FONT></SPAN></P><SPAN
style="FONT-SIZE: 11pt; FONT-FAMILY: 'Times New Roman'; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-weight: bold"><FONT
size=1>Adapted from ‘Human rights and public health: More than just about civil
liberties’, EQUINET Newsletter Editorial,
2006.</FONT></SPAN></FONT></DIV></FONT></DIV></BODY></HTML>