<span style="color:rgb(51,51,255)">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.<br>Claudio Schuftan<br>PHM Ho Chi Minh City<br>
</span><br><font size="1">From: <b class="gmail_sendername">Luke Holland</b> <span dir="ltr"><<a href="mailto:lholland@cesr.org" target="_blank">lholland@cesr.org</a>></span><br>
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<div class="gmail_quote"><font size="1"></font><div><div><div><div><p><font size="1">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.<br>
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<font size="1"><br>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.<br>
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.<br>
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<font size="1"><br>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. <br>
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<font size="1"><br>A newly-published position paper (see: <a href="http://cesr.org/downloads/Beyond%202015_Governance_position_paper.pdffrom" target="_blank">http://cesr.org/downloads/Beyond%202015_Governance_position_paper.pdf</a> 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.<br>
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</font></span></font></blockquote></div><font size="1"><span></span></font><span style="color:rgb(51,51,255)">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?<br>
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?)<br><br>As regards the <u>human right to health</u>, I am afraid the same will not be achieved in the coming development era if the world: <font size="1">(in no particular order)</font><br>
<br></span><br><ul><li><span style="color:rgb(51,51,255)">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);</span></li>
<li><span style="color:rgb(51,51,255)">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;</span></li><li>
<span style="color:rgb(51,51,255)">
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);</span></li>
<li><span style="color:rgb(51,51,255)">
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;</span></li><li><span style="color:rgb(51,51,255)">does not sternly and bindingly make sure that free trade agreements are not (will not) negatively impact(ing) the right to health;</span></li>
<li><span style="color:rgb(51,51,255)">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;</span></li>
<li><span style="color:rgb(51,51,255)">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;</span></li>
<li><span style="color:rgb(51,51,255)">does not understand that actions in relation to disparity reduction are needed both within and between rich and poor countries;</span></li><li><span style="color:rgb(51,51,255)">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; </span></li>
<li><span style="color:rgb(51,51,255)">
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;</span></li><li><span style="color:rgb(51,51,255)">does not decisively change the focus of foreign aid from charity to human rights and international solidarity;</span></li>
<li><span style="color:rgb(51,51,255)">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....</span></li>
</ul><span style="color:rgb(51,51,255)">In short, I purport that the prospects for the quantum improvements needed </span><span style="color:rgb(51,51,255)"><span style="color:rgb(51,51,255)">in post 2015 health are dim i</span>f 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.<br>
<br>The widely touted Health in All Policies and calls for Universal Health Care are <u>not</u> panaceas; they can deceive us making us believe that 'what needs to be done will be done'. But without some of the structural <u>changes mentioned above happening HiAP and UHC will be like Christmas toys...batteries not included</u>.*<br>
*: </span><span style="color:rgb(51,51,255)"><font face="Arial"><span style="font-size:10.0pt;font-family:Arial">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 be</span></font> integrated,
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 </span><span style="color:rgb(51,51,255)"><span style="color:rgb(51,51,255)">safety nets approach will not be acceptable)</span>; 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.<br><br>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'.... <br>
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