[TLDR (too long didn’t read): If you are reading this, chances are you care about HR. This Reader is about what is so painfully missing in global health governance from the perspective of the right to health. For a quick overview, just read the bolded text].

What the hell is the point of running an ambulance service when our politicians do nothing to prevent the accident? (John Le Carre, The Constant Gardener)

-Maybe if we forced our government leaders to dig their own latrines –and use and clean them– they would develop the political will to solve the simple problem of lack of access to sanitation. (Hesperian)

1. By now, it is clear that our global efforts towards the realization of the universal right to health and to a healthy life on earth have not really yet been set in motion to truly fulfil the needs of all the planet’s inhabitants –and this in harmony with the respect for the rights of nature. (Riccardo Petrella et al)

2. Even now, over two years since COVID-19 was declared a global pandemic, the greatest obstacles to health justice and the right to health stem, not from a novel pathogen, but from the pathogenic forces of apathy, cynicism, marginalization, and historical amnesia that drive us to accept the suffering of those rendered poor as inevitable misfortunes to be endured’, as opposed to injustices to be cured.

3. Urging governments to adopt human rights-based approaches to health are thus paramount to challenging the opaque mechanisms through which global health agendas are set. We are witnessing the emergence of a nihilistic narrative arguing that people rendered poor in countries rendered poor should just be patient and wait for their turn, something that will, in the case of Covid, come once the rest of the world is vaccinated. So, you see? A starkly colonialist mentality endures in the countries rendered rich in our unfair world. They still emphasize solutions basically based on charity while staying away from approaches rooted in justice.

4. Human rights activism is thus to be centrally concerned with repairing our deeply unequal, global political economy and reimagining and changing international health governance to enable a sustainable global health, as well as climate justice. (Alicia Yamin, Paul Farmer)

Achieving health equality is a ‘power-saturated’ long game

5. This game highlights the unrealistic expectation of turning health inequalities around in a short time given the long-term embedded power dynamics and inequities within policy systems under Capitalism. (Sharon Friel et al)

6. The current governance setup is controlled by a rigid hierarchy of ‘technical solutionism’ and an uncritical acceptance of whatever ‘expert knowledge’ offers as the most viable and effective solutions for policymakers. Take, for instance, global health: its governance legitimizes the hegemony of neoliberal values and contributes to the depoliticization of the true causes of preventable ill-health and preventable deaths. (Nicoletta Dentico)

7. The promises of the World Bank (better health if you apply technical solutionism and wait long enough…) have a truly bad influence. If mainstream public health professionals engage with the forces of money and with World Bank ideas that purport to shape a better tomorrow, we, right to health activists, need to use language and foster actions that ultimately allow claim holders to begin speaking about the global dynamics of money and power and the ways these dynamics affect them and their health. (David Legge)

8. Mainstream professionals ought to understand that maintaining integrity, but remaining mainstream both in practice and in life, does not imply impartiality. For doctors and medical students who are properly informed about the world around them, it is virtually impossible not to be outraged at the injustices, corruption, cruelty and toxic ideology that surrounds us all, including in the health services they work-in. So much of the illness we see stems from the socioeconomic conditions created by the way our society organizes itself, often perpetuated by those who are chosen to lead it. (Khadija Meghrawi et al, https://www.bma.org.uk/news-and-opinion/should-medical-students-be-political )

Claudio Schuftan, Ho Chi Minh City

Your comments are welcome at schuftan@gmail.com

All Readers are available at www.claudioschuftan.com

Postscript/Marginalia

-I have the firm personal conviction that leadership means nothing if it is not linked to the collective purposes of society. The effectiveness of leaders in the health sector must not be measured by their charisma, visibility or by the individual power they have, but by the real social changes they bring about. In all truth, I think true leaders are those willing to assume the challenges and defies that come with leadership. In my experience, it is local community leaders that much more forcefully fight for justice and equality. (Halfdan Mahler, former DG of WHO)

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