[TLDR (too long didn’t read): If you are reading this, chances are you care about HR. This Reader follows up on the last one and is about countering privatization trends in health and nutrition with actions directed at increasing the visibility and respect of human rights. For a quick overview, just read the bolded text].

1. It is no news of how the privatization of health is galloping everywhere –dramatically so in India– and health insurance companies and hospital conglomerates are making a killing. The result is a) a difficult to reverse mix of services, private and public coexisting with the latter being underfunded and defunded, and b) the coexistence of first- and second-class healthcare delivery systems with greater out-of-pocket expenses not only for those rendered poor, but also for the middle classes (also being rendered poorer?). Multistakeholder health arrangements are less widespread…yet.    But governments are coopted by corporate health enterprises every day now.

So, what are the concerns/visions/alternatives for more democratic participation in multilateral systems and the global governance that affect health?

-Only the sum of newly conscientized citizens will make it possible to overturn what is one of the worst social inequality periods in history. (Victor Toledo)

2. What we are dealing with is a protracted crisis that we have not been able to overturn: global governance is still frustratingly skewed against human rights (HR). To change this, nothing short of an all-out war is needed –and this calls for a concerted counterattack that will require proactively engaging and mobilizing all militants in the cause …all the way to street protests.

I will here-under propose a provocative approach aiming to stimulate a debate towards a critical action agenda

3. Not staying away from controversy, I propose to you ten concerted/simultaneous actions. These will be both annunciatory and denunciatory. Here they are in no particular order:

4. Four annunciatory actions

  • Further engage with special and ex-special UN rapporteurs in their efforts seeking radical corrective measures –including encouraging them and everybody to actively put pressure to pass the binding treaty on TNCs on HR acceptable to most claim holders and those who represent them in the negotiations. (six years under negotiation at the HR Council and under attack from UN member states from the North).
  • Get in touch, support (and, if possible, help organize) pertinent UN agencies staff we know are sympathetic to the HR cause (but are constrained to speak out due to an oppressive pyramidal structure that may threaten their positions) so they can start voicing their worries and reservations from within –in a cautious progressive manner. This also applies, but is more difficult to, a) selected World Bank staff (especially their internal evaluation/ombudsman group), and b) staff from the CGIAR organizations. [The idea here is to create a growing wedge within; I am not saying this is easy, but…]
  • Engage academic researchers in more research that shows the ongoing take over by the private sector, as well as expose failures and blatant conflicts of interest (CoI) of multistakeholderism/PPPs in governance. Encourage them to bring their research findings to action. (The World Public Health Nutrition Association, WPHNA, has a portal to collect CoI case studies: www.wphna.org).
  • A more militant engagement in the UN Binding Treaty on TNCs and HR negotiations is needed if we do not risk having yet another UN treaty without teeth.

5. Six denunciatory actions (here I primarily take the food and nutrition actions as an example)

  • Continue the public interest CSOs’ successful campaign against the CoI-ridden measures proposed by the recently approved UN Food Systems Summit (FSS). (This includes denouncing content and process and individuals heading the different thematic tracks they have set up).
  • Continue our denunciation of the Gates Foundation that has coopted UN agencies.
  • Continue our denunciation of the Scaling Up Nutrition (SUN) Initiative that has coopted UN agencies.
  • Continue our denunciation of UN Nutrition that has been coopted by SUN.
  • Denounce the silence and complicity of key actors (behind the scenes and within the system) on multistakeholderism in global governance by challenging them directly.
  • Adding to the above, we will openly denounce by name the UN member states that we continuously have to fight-against in both FAO’s Committee on Food Security (CFS) and in the ongoing Binding Treaty negotiations.

[Let me finally say here that TNCs have proven to have thick elephant skin and are oblivious to our claims. Some rebellious interventions in their shareholder meetings have had some success and this avenue must also be pursued].

6. What we ought to be doing in our health, food and environment activists work is related to what I said before, namely we have to embark on an all-out war. And this includes the conscientization and mobilization of claim holders whose right to health and food are being violated to more proactively engage in forcefully demanding changes. (In the People’s Health Movement website you can find a user friendly Right to Health Assessment Tool in three languages: www.phmovement.org).*

*: PHM is very much part of the struggle. We are actively involved in WHO (see ‘WHO Watch’ in the PHM website), as well as in FAO (CFS) and in the negotiation of the binding treaty; PHM also has a grant to work on access to Covid resources world wide –including vaccines. PHM is organized in thematic groups and has a network of focal points in over 70 countries working against privatization, against extractive industries, and on health for all/right to health issues.

7. Moreover, working with the thousands of disgruntled health workers to organize them is as much a priority. We cannot here forget the targeting of private health insurance and hospital corporations, with their CoI and involvement in corruption. Some of all of this is already occurring; we have to spread the word, show achievements and support them.

Claudio Schuftan, Ho Chi Minh City

Your comments are welcome at schuftan@gmail.com

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