Strategies for Health & Human Rights: Theory to Practice - Proposed Action Plan, Study Guides, Projects, Research of Tourism

Download Strategies for Health & Human Rights: Theory to Practice - Proposed Action Plan and more Study Guides, Projects, Research Tourism in PDF only on Docsity! COMMON STRATEGIES FOR HEALTH AND HUMAN RIGHTS: From Theory to Practice Stephen P. Marks M y task is to encourage the participants in this Con- ference to think about the ways forward, to devise a strategy to move from theory to practice. In offering some thoughts about a common strategy for health and human rights, I am starting from two assumptions. The first assumption is that the health and human rights communities that the Fran~ois- Xavier Bagnoud Center has brought together at these two Conferences share a growing awareness of a common agenda. There are numerous indicators of this trend. One is the in- crease in the number of participants from the first Confer- ence to the second. It is truly extraordinary that five hundred people have come to explore a theme that, a few short years ago, might have appeared esoteric and marginal. A second indicator is the spectacular growth in subscriptions to Health and Human Rights, truly remarkable for a scholarly journal. There is something that is capturing the attention of people. A third sign of this shared perception is the extraordinary number of relevant projects under way around the world, about which participants have reported at this Conference. The second assumption behind a strategy for the future is that the problems to which we would apply a common strategy of action are both numerous and urgent. The sub- stantive program of this Conference is an excellent indicator of the quantity and urgency of the issues. The program lists eight or nine different forms of violence and interpretations thereof; it focuses on several emerging and existing diseases and approaches to dealing with them; it deals with a consid- erable number of health and society issues. Taken together, that list is itself an agenda calling for a common strategy. Stephen P. Marks is Director of UN Studies at the School of Internationa and Public Affairs, Columbia University. Please address correspondenc to Stephen P. Marks, School of International and Public Affairs, Columb University, 420 West 118th Street, New York, NY 10027, USA. HEALTH AND HUMAN RIC.HTS The President and Fellows of Harvard College is collaborating with JSTOR to digitize, preserve, and extend access to Health and Human Rights www.jstor.org ® It is not enough to acknowledge the need for a common strategy; we need to move from thought to action. To do so I propose to focus on a) the actors or the partners who are go- ing to join in a common strategy; b) the points of entry for such a strategy to be put into practice; and c) the resources that can be marshalled to make it possible to carry out such a strategy. Partners for a Common Strategy If the ideas shared at this Conference are to have a wider impact, we need to work with partners. Approximately five categories of potential partners can be mentioned as able to contribute, in one way or another, to this common strategy. The first are, of course, the professional categories, subdi- vided into two. The health professionals include both health prof essionals and the medical professionals, each with differ- ent professional backgrounds and approaches but working together in a remarkable way throughout this Conference. The human rights community includes those professionals who focus, to a large extent, on the application of law and on the use of advocacy. These two professional groups-of health and human rights-are the core partners in our common strategy. The second category of actors are public institutions. Frequently during the conference the notion of the state it- self was challenged. And yet we are constantly reminded that some of our best partners work for and represent the state. Some of those who have put together the most forward-look- ing programs belong to state institutions. We learned, for example, that the Swiss government has a new three-part policy of health and development that draws explicitly on the essential linkages between health and human rights. The Swiss officials who elaborated and who implement this pro- gram are ahead of us. They are putting our theory into prac- tice already. Of the billions of dollars being spent on official development assistance (ODA), most goes through govern- ment channels. That is where the resources are; that is where policies can have an impact on a vast scale. Those who are in charge of implementing those policies need to be partners in this enterprise. I have learned from talking to some of the 96 Vol. 2 No. 3 sanctions and health and human rights after being convinced of the need to do so by the International Association of Bio- ethics and Physicians for Human Rights. This is what I mean by intervening in the norm-setting arena. A second norm-setting environment is the legislature. Parliaments draft laws and elaborate principles that affect health and human rights. We have heard at this Conference about a magnificent example happening in South Africa where legislation is being drafted which draws upon the principles we are articulating here. Parliamentarians and their staffs are not likely to reinvent on their own the ideas that have been presented at this Conference; we need to bring the ideas to them. We need to create opportunities to discuss our strate- gic objectives with members of parliaments and their staffs. Intergovernmental organizations constitute a third norm- setting environment where the principles we are elaborating here can be adopted in the form of resolutions and normative instruments (i.e. conventions and recommendations). Many opportunities have been discussed, such as sessions of the World Health Assembly and the Commission on Human Rights. We have heard about the African Commission on Human Rights and its role, the Sub-Commission on the Pre- vention of Discrimination and Protection of Minorities; the Committee on Economic, Social, and Cultural Rights and other human rights treaty bodies. We have learned about the technique of counter- or shadow-reports submitted to the Committee on Economic, Social, and Cultural Rights. A com- plaints procedure would also be useful. Draft optional proto- cols allowing individual complaints are in preparation for both the Covenant on Economic, Social and Cultural Rights and the International Convention on the Elimination of All Forms of Discrimination Against Women. These procedures would put some teeth into the standards that are basic to health and human rights concerns. Lobbying efforts within the inter- governmental organizations will be increasingly valuable as we move from theory to practice. The third point of entry is the service delivery area, cov- ering such issues as refugee relief, vaccination programs, and humanitarian actions taking place on a vast scale around the world. With few exceptions-all of which were probably mentioned at this Conference-these programs function with- HEALTH AND HUMAN RIGHTS 99 out a conscious policy of integrating health and human rights. It is an urgent and vital point of entry. The research agenda is the fourth point of entry. There is no need to give any examples because the agenda of this Conference provides a rich list of research themes that can be taken up by any number of our partners willing to focus on the intersection of health and human rights, as well as their application to the policy agenda. And the fifth point of entry for this strategy, I would argue, is the educational level. We were reminded by Jacqueline Pitanguy at the opening session that you cannot educate politicians. They are "hopeless." This reminds me of experiences I have had with programs to teach human rights to military and police officers. A two-week seminar will not create a new value system nor alter the thought and behavior of adults, already socialized in their political, military or cor- rectional environment. It is a slow process, the crucial mo- ments of which exist much earlier on the individual's psy- chological development. Before educational activity can change the behavior of those individuals who may partici- pate in torture and other acts that violate human rights or who might be inclined to adopt an unsound health policy or practice violative of human rights, it is essential to obtain firm directive at the top of the hierarchical structures in which those individuals operate. The order comes from the top down, from the commander of the troops, the commissioner of po- lice or the top of the party structure or bureaucracy. When the order comes from the top down, as a result of the politi- cal pressures brought upon the person issuing the order, those who execute the order tend to obey, assuming the system of rewards and negative inducements with which they are fa- miliar, is operative. A politician who knows there is a con- stituency that believes that health is a human right does not need to be educated about human rights texts; that politician wants to be re-elected, and will begin to believe that health is a human right. Without such inducements where it counts, the politician will not budge. This is also true for the tortur- ing police officer. If the police officer knows that he or his superior is out of a job if torture occurs, and maybe even pros- ecuted, the order is given in a way that the torturing police 100 Vol. 2 No. 3 officer understands. Now, an educational program can rein- force and direct the behavior of officials who already have an objective motivation to observe sound health and human rights practices. With this proviso, an education program di- rected at officials belongs in our common strategy. A second observation on the educational level applies particularly to the United States. This month of October is Roosevelt History Month. Instead of Roosevelt history, we are fed lengthy articles about the death of liberalism and how being tainted with the "L-word" means political suicide. How- ever, this country has a political tradition of believing that, even after a devastating war, freedom from want is a funda- mental human right, is a part of human rights, and should attain a normative level beyond that of merely "desirable" governmental programs. That heritage, that legacy, needs to be reclaimed. This, despite the reality that this tradition is on the wane today, is making the United States one of the least-developed countries, normatively, in the world. There has also been considerable discussion here about the forms of education, of mass education, and the relation- ship between the health and human rights agenda on the one hand and the human rights education agenda on the other. Our common strategy should place a priority on issues link- ing health and human rights within the framework of the Plan of Action of the UN Decade for Human Rights Educa- tion. Planning and Funding the Common Strategy Let me make a specific proposal for the implementation of the strategy I have outlined. What is needed to transform these ideas into action is a plan of action for implementing a common health and human-rights strategy. It would not be hard to draft. The Frantois-Xavier Bagnoud Center, with one or two other partners, could hold a one-day meeting to trans- form what has been discussed here into concrete project pro- posals. While the Center is not in a position to provide the resources to carry out many projects, this should not be an obstacle. For I am proposing a plan of action based on the premise that the most likely groups to carry them out would be able to incorporate them into their respective budgets and HEALTH AND HUMAN RIGHTS 101