The Right to Health is easily proclaimed, signed by all valid Human Rights packages or defined as unavoidable in progressive constitutions, such as in Brazil or South Africa. Politicians and pharmacy groups have it unbashfully on the tip of their tongues: Everyone wants good things to happen, and it is unavoidable destiny if they do not arrive.
That the reality of those rights projects a scandal, for which words and originators need to be found, is not mentioned in such platitude speeches. At the conference ‘Health Justice-Worldwide’, which took place in Berlin at the 17th and 18th of September and which was organised by medico international, Gesundheit Berlin-Brandenburg and supported by 15 other health initiatives, a political space was created to debate these issues.
Redistribution from the bottom to the top
The German philosopher Thomas Pogge, who teaches at the Yael University, left a particularly notable impression. He presented his numbers, data and results about the current global health status rather rational. In his view it is essential to put the violation of the Human Right to Health into the spotlight of the discussions. One third of the human population dies due to poverty related diseases. Pogge sees a crucial explanation for this fact: “Human Rights, are foreseeable not fulfilled under the current global economical rules”. Under the umbrella of those rules an enormous shift of wealth, from the bottom to the top, took place. 1.125 Billionaires possess three times more of the world’s capital than the poorer half of the world population. Since 1988 the richest twentieth of the population gained eight percent of the world’s capital, whereas the poorest quarter lost thirty percent. During the last centuries the financial power moved from the Billions to the Billionaires – with the result of missing shares and deprivation of rights for billions of people.
Massive income shifts, from the bottom to the top, can also be seen in Germany. At the conference this was a topic for the DGB-board member Annelie Buntenbach because that shift has huge consequences for the statutory health insurances, as their revenues decreases due to low wages. How this deficit is supposed to be compensated was just announced by Mr Rösler (German prime minister for health, editor’s note): Through the slow rise of individual allowances and the abolishment of the solitary system.
In this respect it became clear that even in Germany the roots of the health problems can be found in the current ‘global economical rules’ (Pogge). He showed that the pharmaceutical industry makes the most profit if only one fifth of the world population is addressed with upscale products. Through the influence of the richest countries and the biggest companies, the “spiral of inequity” is deeply seated upon the international rules. Pogge claims that poverty was always there, but never before so much wealth existed that only a small part of it would be needed to abolish poverty. The worldwide poverty and the related diseases are, in his view, the biggest human rights violation in the history of mankind. This sentence builds the moral, ethical and political imperative for the demanded and essential change needed.
The spiral of inequity
How can that change happen? Definitely not through the Millennium Development Goals (MDGs), which were fundamentally criticised by the present US-researchers. Not only because their failure is foreseeable. Yet if they will be realised they will leave even more poor people in 2015 than there are today. The fight against poverty does not even decrease poverty – that was the sad conclusion. “That is why we do not only have to fight it, but abolish it at its roots” demands Thomas Pogge. This is only possible if poverty becomes a central topic in all international agreements and political actions - A consensus of the conference.
As a counter argument in debates about health policies, the statement often comes up that the expenditures for international health programs grew constantly. “On the international political agenda, health became the main issue” sais the health expert Nicoletta Dentico from Italy. However, these efforts are similar to building the Tower of Babel: fragmented, focused on single diseases programmes which are built from the top to the bottom sometimes create more harm than good and furthermore erode national systems. All programs are avoiding the topic of how structural changes could be created and where they could start realistically. Just like the MDGs those programs are repairing the spiral of inequity but they are not abolishing it.
Joint Learn Initiative
At the same time basic features of an action plan appeared, which aims at nothing more than creating a basic movement to enforce norms, which aim at achieving the right to best possible health worldwide. Professor Lawrence Gostin from Washington evaluated this idea with the example of the “Joint Learning Initiative on National and Global Responsibilities for Health“. The openness of that project can be seen in the name, but some basic principles do exist. Among those are the duty of the states to ensure the Human Right to health for their citizens and the duty of the states towards all poor on the world.
The Joint Initiative on Health aims to set compulsory norms to realise Human Rights. For that purpose it suggests an obligatory finance mechanism that orientates and supports health policies in perspective of those Human Rights criteria. They aim at the WHO to develop and empower it, to in fact create a functioning global health architecture. In this context, the creation of rules were suggested, which
- allow a new orientation of pharmaceutical research, towards health needs instead of profit maximizations
- ensure that the international migration of health professionals will not be of disadvantage for countries of the South
- ensure sustainable financing of efficient supply systems if needed internationally (Global Fund for Health)
Zimbabwe - an example
A local basis is needed in an international health movement, which puts human rights as vision and norm into the spotlight, which can be seen from Itai Rusike from the medico partner “Community Working Group on Health“ from Zimbabwe. He does not just present the dramatic health situation in his country, which suffered from a Cholera epidemic in the last years. He also reports about the newest political initiatives. The Right to Health should be integrated into the new constitution. Rusike is hoping that such a right in the constitution could at least start the juristic persecution of people, responsible for disasters, such as the Cholera epidemic.
However, the Right to Health needs a normative protection. For countries like Zimbabwe this would only be possible in a global context. In Berlin it was possible to bring together such layers. Also due to this reason a highly attentive and in a lot of workshops participating audience was present at the conference.