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<p>For me, this PHM comment is a tour de force. Big thanks to the
author, presumably David.<br>
</p>
<p>I quote one para in particular because I feel that this point
MUST be transmitted (by us) to journalists, above all. Also, if we
can, we must all try and spread this message through articles in
our local or national media. <br>
</p>
<p dir="ltr"><span><b>"The</b><b> SDGs provide an inspiring vision
of ‘the world we want’. However, they also serve to distract
attention from the economic and political forces which are
preventing the realisation of this vision. In effect they are
helping to maintain an appearance of good faith and commitment
on the part of those who are in effect working to prevent the
achievement of the goals. This is the legitimation function of
the SDGs." <br>
</b></span></p>
<p dir="ltr"><span>We need to identify explicitly who "those" are
(those who are working to prevent the achievement of those
goals). Briefly, the rich and powerful countries and their TNCs.
How do they do this? Through multistakeholder partnerships,
mostly. <br>
</span></p>
<p dir="ltr"><span>I think that these mechanisms are not understood
at all, even on the left. (For example, Le Monde Diplomatique
partners with the Global Fund and publishes articles from them,
seemingly uncritically.) <b> <br>
</b></span></p>
<p dir="ltr"><span>WHO today will claim, as it usually does, that
the role of the current economic order is beyond its mandate.
This to me is the other key point to debate publicly now. As
part of its advocacy role, and as a knowledge organization, the
question is well within WHO's mandate. And I am sure we can find
articles/sentences in the constitution and in the Alma Ata
Declaration (which has not been repudiated) and of course in
General Comment 14 on the Right to Health, that illustrate that
point. <br>
</span></p>
<p dir="ltr"><span>Anyway, big thanks again and I hope these
critical points get wide airing. alison</span></p>
<p dir="ltr"><span>PS when is GHW5 coming out?<br>
</span></p>
<p dir="ltr"><span><br>
</span></p>
<p dir="ltr"><span> <br>
</span></p>
<p dir="ltr"><span><br>
</span></p>
<p dir="ltr"><span><br>
</span></p>
<p dir="ltr"><span><br>
</span></p>
<p dir="ltr"><span><br>
</span></p>
<p dir="ltr"><span><br>
</span></p>
<span></span>
<p> </p>
Le 08.04.19 à 10:22, Claudio Schuftan a écrit :<br>
<blockquote type="cite"
cite="mid:CAKpaG8gnqFw=jU=Qh4zjmDy7vdGDTPkFpuoDDaWtcjXv=M-ZxQ@mail.gmail.com">
<div dir="ltr">
<div dir="ltr">
<div class="gmail_default">
<h1 dir="ltr"
id="gmail-docs-internal-guid-b869ee4e-7fff-77b6-8375-a2d7f434c441"><span>PHM
Comment</span></h1>
<h2 dir="ltr"><span>SDG shortfalls point to core
contradiction</span></h2>
<h1 dir="ltr"><span>Notes for discussion at WHA72, WHO, end
May 2019</span></h1>
<div>(The links refer to documents in the WHO website)</div>
<div><br>
</div>
<div><span>Your feedback welcome; to be sent to David Legge
<<a href="mailto:dlegge@phmovement.org"
moz-do-not-send="true">dlegge@phmovement.org</a>><br>
</span></div>
<p dir="ltr"><span><span></span></span></p>
<p dir="ltr"><span>Part I of </span><a
href="http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_11-en.pdf"
moz-do-not-send="true"><span>A72/11</span></a><span> is
a burning indictment of the health consequences of the
prevailing global governance regime. Likewise the more
detailed figures provided in </span><a
href="https://www.who.int/gho/publications/world_health_statistics/2018/en/"
moz-do-not-send="true"><span>WHS18</span></a><span> and
the actual 2030 targets here. </span></p>
<p dir="ltr"><span>Part I of </span><a
href="http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_11-en.pdf"
moz-do-not-send="true"><span>A72/11</span></a><span>needs
to be read far more widely than just within WHO. Health
science students and practitioners should read this and
ask why. Journalists should read and ask why.
Parliamentarians should read and ask why.</span></p>
<p dir="ltr"><span>Unfortunately </span><a
href="http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_11-en.pdf"
moz-do-not-send="true"><span>A72/11</span></a><span>
does not seek to explain the looming shortfalls in the
SDG targets. </span></p>
<p dir="ltr"><span>Various reports including the </span><a
href="http://sdgindex.org/" moz-do-not-send="true"><span>SDG
Index and Dashboard</span></a><span> report show that
no country is on track to achieve the SDGs by 2030. In
fact the number of people living in poverty in Africa is
increasing; likewise the number of children who are
stunted. Global maternal mortality (now 216 per 100,000
live births) is unlikely to reach the target of 70 by
2030 if the rate in Africa remains high (currently 542).
</span></p>
<p dir="ltr"><span>Part II lists a range of WHO programs,
projects and engagements and seeks to demonstrate how,
through these activities, WHO is contributing to the
achievement of the SDGs. Many of these are admirable
initiatives and WHO staff are to be congratulated for
their commitment and achievement. </span></p>
<p dir="ltr"><span>Unfortunately, despite these valiant
efforts, in many areas the shortfalls with respect to
achieving the health related targets are growing. </span><a
href="http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_11-en.pdf"
moz-do-not-send="true"><span>A72/11</span></a><span>
does not seek to explain these widening shortfalls.
Simply listing all of the activities which WHO is
contributing to is not enough. </span></p>
<p dir="ltr"><span>The key to understanding the widening
shortfalls in achievement is the contradiction between
the humanistic aspirations of the SDGs and the dynamics
of liberalised transnational capitalism. </span></p>
<p dir="ltr"><span>Simply measuring poverty distracts
attention from the distribution of global wealth and
global income and the dynamics which maintain extreme
inequalities of wealth and income;</span></p>
<p dir="ltr"><span>Simply measuring stunting distracts
attention from the world food system including
protection and price supports in the rich world; the
capture of arable land, water, and energy to over-feed
the rich; the global structures which drive small
farmers off their land.</span></p>
<p dir="ltr"><span>Simply measuring health care
impoverishment distracts attention from the global
forces, political and economic, which extract the wealth
of resource rich countries leaving governments without
the fiscal capacity to underwrite health care costs;
which enforce high prices of medicines in order to
maintain pharma profits and export earnings. </span></p>
<p dir="ltr"><span>Simply noting the impact of global
warming on food production and environmental disaster
distracts attention from the corporate and political
forces seeking to prevent and defer action on greenhouse
gas emissions. </span></p>
<p dir="ltr"><span>The SDGs provide an inspiring vision of
‘the world we want’. However, they also serve to
distract attention from the economic and political
forces which are preventing the realisation of this
vision. In effect they are helping to maintain an
appearance of good faith and commitment on the part of
those who are in effect working to prevent the
achievement of the goals. This is the legitimation
function of the SDGs. </span></p>
<p dir="ltr"><span>PHM urges member state delegates to speak
truth to power at the Health Assembly.</span></p>
<p dir="ltr"><span>PHM urges health activists around the
world to raise public awareness and lobby their
governments around the disaster that is looming behind
the language of ‘sustainable development’. Key talking
points in such advocacy include: </span></p>
<ul>
<li dir="ltr">
<p dir="ltr"><span>insist on naming liberalised
transnational capitalism as a failed economic system
(driving widening inequality, deepening the
imbalances between productive capacity and
consumption, increasing financial fragility and
deepening our peonage to the banks through
increasing debt);</span></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>insist on naming neoliberalism as a
policy package (austerity, small government,
privatisation, tax competition and corporate
privilege) being implemented in order to protect the
transnational corporations and preserve the
privileges of the transnational capitalist elite; </span></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>recognise the contradictions between
the neoliberal program on the one hand and the goals
of reducing poverty, promoting Health for All, and
mitigating climate change on the other;</span></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>reject the bizarre assumption that
the SDGs can be paid for through increased economic
growth (as measured by GDP) without attention to the
harms or benefits of the market transactions so
measured;</span></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>insist on the need for a New
International Economic Order as called for in the
1978 </span><a
href="https://www.who.int/publications/almaata_declaration_en.pdf"
moz-do-not-send="true"><span>Alma-Ata Declaration</span></a><span>
(and completely ignored in the October 2018 </span><a
href="https://www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf"
moz-do-not-send="true"><span>Astana Declaration</span></a><span>);</span></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>insist on naming the xenophobic
backlash, and the populist demagoguery which is
stoking it, as barriers to effective action on the
SDGs; and</span></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>continue to denounce the restrictions
imposed on WHO’s capacity and its voice by the donor
chokehold and the ACs freeze.</span></p>
</li>
</ul>
<p dir="ltr"><span>These issues are all strikingly absent
from </span><a
href="http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_11-en.pdf"
moz-do-not-send="true"><span>A72/11</span></a><span>. </span></p>
<h2 dir="ltr"><span>Internal contradictions</span></h2>
<p dir="ltr"><span>In previous commentaries we have focused
on the contradictions within and across the SDGs
themselves. These remain important. </span></p>
<p dir="ltr"><span>See </span><a
href="https://docs.google.com/document/d/1Hy64u7j2T6f0flFdxglfh_-UKwLJd7vu7_0vktnWftk/edit?usp=sharing"
moz-do-not-send="true"><span>PHM comment on Item 31.2 at
WHA69</span></a><span> which highlighted:</span></p>
<ul>
<li dir="ltr">
<p dir="ltr"><span>Goal 12 which promises sustainable
consumption and production but lacks any drivers to
achieve this;</span></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>Goal 8 which promises high rates of
economic growth but ignores the contradictions
between economic growth and ecological
sustainability; and</span></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>the contradictions between the SDGs
and the real effects of ‘free trade’;</span></p>
</li>
</ul>
<p dir="ltr"><span>See also </span><a
href="https://docs.google.com/document/d/1710S9ZzSn5W_g1Y6H5sdQ-PHjcaByPqn4Ant8K9rCeA/edit?usp=sharing"
moz-do-not-send="true"><span>PHM comment on Item 16.1 at
WHA70</span></a><span> which highlighted:</span></p>
<ul>
<li dir="ltr">
<p dir="ltr"><span>the need for a real world ‘theory of
change’ regarding how the SDGs could be achieved;</span></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>the dangers of the drive towards
‘multi-stakeholder partnerships’, as in SDG17.16 and
17.17, which projects universal beneficence and
completely ignores the Trojan horse functions of
many such ‘partnerships’;</span></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>the importance of following the
health implications of </span><span>all</span><span>
of the SDGs.</span></p>
</li>
</ul>
<p dir="ltr"><span>Two of the chapters in the current Global
Health Watch</span><span> also carry powerful criticisms
of the SDGs:</span></p>
<ul>
<li dir="ltr">
<p dir="ltr"><span>A1: </span><a
href="https://phmovement.org/wp-content/uploads/2018/07/A1.pdf"
moz-do-not-send="true"><span>Sustainable Development
Goals in the age of Neoliberalism</span></a></p>
</li>
<li dir="ltr">
<p dir="ltr"><span>A2: </span><a
href="https://phmovement.org/wp-content/uploads/2018/07/A2.pdf"
moz-do-not-send="true"><span>‘Leave No One Behind’ —
are SDGs the way forward?</span></a></p>
</li>
</ul>
<p dir="ltr"><span>SDG8 proposes that the cost of meeting
the rest of the goals will be met through ‘sustained per
capita economic growth’. GHW comments that the assumed
metric, GDP, is a measure of market transactions
regardless of their contribution to ecological
sustainability or human development (or health).
Manufacturing and deploying weapons of mass destruction
makes a powerful contribution to GDP. </span></p>
<p dir="ltr"><span>SDG8 calls for full employment (Target
8.5) and for ‘higher levels of economic productivity’
(‘increase in real GDP per employed person’). This
combination of targets ignores the role of productivity
increases (as measured) in creating unemployment!
Conventional economic theory assumes that the labour
displaced by increased productivity will simply be
re-employed in new forms of better-paying work. What
such theory disregards is the massive displacement of
agricultural labour from ‘increased productivity’ in
agriculture and the huge mobilisation of Third World
workers (displaced from agriculture) in global
manufacturing: “too many workers competing for too few
jobs to produce too many goods or services for too few
consumers with too little income to afford them without
increasing their already high levels of personal debt”.
</span></p>
<p dir="ltr"><span>GHW5 also comments on the continuing call
for increased ‘development assistance’ as a key pathway
to funding the SDGs. This strategy has failed to impact
on sustainable development over several decades even
while fragmenting health systems and placing huge
administrative burdens of governments. Meanwhile no
action is proposed on tax evasion through transfer
pricing and tax havens nor on the pressures of tax
competition and corporate tax extortion which have held
back tax revenues and public spending. </span></p>
<p dir="ltr"><span>GHW5 also comments on principle of
reciprocity (non-discrimination) in the current regime
of trade agreements; a principle which treats poor
countries the same as rich countries despite massive
differences in economic and political power. The New
International Economic Order, which features in the
Alma-Ata Declaration (and is notably missing from the
2018 Astana Declaration), envisaged discrimination in
favour of developing countries to be structured into a
rules based trading regime. Not only are modern trade
agreements non-discriminatory (in the sense of including
few or no provisions for ‘special and differential
treatment’) but they discriminate blatantly in favour of
the rich countries through extreme IP provisions,
regulatory harmonisation and investor protection. </span></p>
<p dir="ltr"><span>GHW5 also addresses the difficult topic
of population control. It is established that family
sizes fall with economic development and the provision
of social protection. However as population levels level
or fall in the rich countries the call is increasingly
heard for encouragement for population growth through
fertility and (selective) immigration. GHW5 labels this
as a Ponzi population policy:</span></p>
<p dir="ltr"><span> Its argument is that, with population
aging, immigration and/or incentives for larger families
should be encouraged to re-swell a comparatively
shrinking working age cohort (those between 15 and 64
years).The economic rationale is that the taxes
collected from the productivity of the working age
population is needed to pay for the services and
pensions of a proportionately greater and increasing
number of elderly.That makes sense, perhaps, for the
short-term. But fast forward 40 or 50 years, and the
re-swelled working age cohort has itself become elderly
(and far more numerous), requiring an ever larger
expansion in the base of the working age population.And
so on, and on, and on. </span><span> </span></p>
<h1 dir="ltr"><span><br>
</span></h1>
</div>
</div>
</div>
<br>
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