We live in a world of high-flown objectives, ambitious target setting and obscure acronyms.

 

  1. MDGs and PRSPs make virtually no allowances for human rights (HR) or for environmental protection. Moreover, worldwide, and bottom-line, the initiatives of the fifty-plus existing WB-sponsored PRSPs are failing. For example, today, there are +/- 550 million people who work, but still live on less than U$1/day (those 50+ countries included). These ‘working poor’ represent 20% of total world employment. Half the world’s workers actually live below the respective poverty line of their countries: 1.4 billion earn less than U$2/day. Add to this that 186 million people were unemployed in 2003.

 

1a. [Therefore, decent sustained and productive employment –not employment alone– is the key that really matters. The centrality of decent employment (a human right) to reaching the MDGs is thus highlighted here. (ILO World Employment Report 2004-05)].

 

  1. So beware: MDGs need not only to be attained, but also to be sustained on a long-term basis.

 

2a. [Moreover, a dramatic overlooked point in the Millennium Declaration and the MDGs is that inflation is likely to make the-year-2000-1U$/day a mere 60 cents/day by 2015. (J. Richter)].

 

Combating poverty is the most effective way of forestalling security and terrorism risks

 

  1. What is wrong is that too many poverty reduction strategies –like the MDGs and the PRSPs– predominantly focus on the social sectors (particularly health and education…) rather than on the entire political economy. Human rights work focuses on the latter.

 

3a. [A sample: The European Union has a more serious orientation towards the fight against AIDS than is its stand on poverty alleviation in general].

 

  1. Also to be exposed is the fact that purported gains from open trade, privatization and anti-corruption policies do not go far enough either to shrink the poverty gap or to improve the HR situation (importantly in health). Privatization can only work where there is enough competition and a working regulatory structure that makes sure the private sector behaves equitably and efficiently. Since that is not the case, privatization has not worked. Ergo, the act of privatization alone is not enough to induce the private sector to be run more efficiently than the public sector. In the real world, privatization has resulted in a strong concentration of ownership; it has led to a class of owners with vested interests capturing the state to make sure that policies work in their favor.

 

4a. [For instance, tax revenues stay low, because powerful national and transnational interest groups are given widespread tax exemptions, and tax surveillance/compliance is kept weak or is corrupt. In these cases, higher aid flows promote rent-seeking behavior by the same domestic vested interests].

 

All this runs counter to the respect of the rights of the national majority of the poor.

 

  1. In HR parlance, we think that any solution to global-poverty-preventable-deaths-ill-health-and-malnutrition entails transforming the poor countries’ economies more structurally –even if the process is slow.

 

5a. [Boosting the rate of economic growth of a country from, say 3 to 7% per annum, means that it would take 10 years instead of 23 for national per-capita income to double (and upward mobility is more likely in cities than in the countryside which is why wise families live in split households utilizing city and village environments in their survival strategy)].

 

  1. But poverty reduction is only part of the story; plain income disparities (even in the absence of absolute poverty) seem to explain differential health outcomes in rich countries. The Gini (income inequality) Coefficient can increase or decrease often leaving poverty unchanged if the distribution above the poverty line also changes; so, poverty can increase or decrease without any change in the Gini if there are corresponding offsetting changes in distribution among the non-poor.

 

  1. Poverty entails the denial of capacities, opportunities and rights, as well as a lack of dignity and of access to power. Therefore, as HR activists, we reject pro-poor policies; we support anti-poverty policies! We believe it is ultimately the poor persons that must participate in defining the nature of their poverty, how it is affecting their right to health and education and what changes they think are needed.

 

  1. The economic interests of poor persons get a boost from them organizing themselves and bundling their interest and demands. The result is political power –and that is a crucial HR precondition for a country to rise out of the poverty trap once and for all.

 

  1. As HR activists, our contribution can be to help assess existing power structures, among other, by the services being provided for the people and thus the legitimacy of the existing structure for the needs of the local population.

 

  1. It is no news that the world is increasingly shaped by powerful global forces, the action of many of which have consequences for the right to health and the social, political, economic and environmental factors that influence health; the latter factors are increasingly determined at a supranational level. As a result, local and national level efforts to influence health determinants can have only a limited impact, and it is all too easy for the individual health practitioner in the public sector to feel powerless. Yet while these practitioners, on their own, may indeed be relatively powerless, together they can achieve a great deal. The same is true for HR activists –and that is the role the People’ Health Movement has taken up. (www.phmovement.org )

 

Claudio Schuftan, Ho Chi Minh City

claudio@hcmc.netnam.vn

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