69. Health and Human Rights Readers (contd.)

41. Beyond Capacity Analysis: Additional Elements of a Human Rights-Based Development Strategy - II

1. A New Human Rights-based Strategy will thus

· food and nutrition (macro and micronutrients),

· be rights-based (emphasis here on purpose),

· be process and outcome oriented,

· be beneficiary centered/driven,

· be participatory in a de-facto empowering way (4),

· be problem identifying/problem solving (using participatory positive AAA processes as an operational framework),

· be guided by a scientific causal analysis (using an explicit conceptual framework),

· be implemented progressively and in a targeted way, and

· be advocacy/activism-focused (using ethical, scientific, technical and political arguments and avenues to achieve the goals set; the “global embarrassment” trump card is also to be used widely). (5)

3. Decentralization-cum-democratization (and not only deconcentration) with devolution of decision-making power to the periphery through community-driven actions backed by funds being truly made available locally are all crucial to the Human Rights-based approach.

4. The mobilization of financial resources is to cover both (the higher) initial costs of interventions and their (lower) recurrent maintenance costs --the latter being progressively borne by local communities for a) sustainability purposes, and b) to assure the process is actually more and more controlled by the beneficiaries themselves.

5. In the existing ocean of confusion about the term, ‘community participation’ will be more clearly defined as a truly empowering tool in the context of the Human Rights-based strategy. (4) Guidelines will need to be written on how to apply its principles.

6. The long-term vision and aims of the Human Rights-based strategy will have to be defined as well, especially on how priorities will respond to the most pressing felt needs of the people as set locally (and not set in general by the strategy proponents at central level).

7. Additionally, beyond completing a participatory capacity analysis, the Human Rights based strategy will focus:

· on empowering people (this is crucial),

· on reducing poverty and inequities (especially around gender issues),

· on mobilizing all necessary local and external resources for relevant actions (with the community progressively gaining control over them),

· on using the pressure of facts --acquired through the use of local information systems-- to trigger action by fueling relevant positive AAA processes and genuine micro-regional planning. (This encompasses the participatory assessment and measurement of actionable indicators so as to create awareness and a true dialogue among the people),

· on using this community surveillance data to prompt and keep up local mobilization efforts,

· on demanding accountability and transparency, as well as on exposing corruption at all levels,

· on delivering basic services, and on expanding access to and coverage and utilization of them, as well as improving their quality,

· on assuring an adequately functioning peripheral health care system with both viable and fitting curative and preventive, as well as rehabilitative care strategies (arrived at in true partnership between providers and users),

· on making services more responsive to the needs of the population,

· on building capacity and raising people’s political consciousness,

· on developing human resources that are conversant with the principles of the Human Rights-based approach,

· on strengthening existing institutions to do the above, as well as on organizing meaningful exchange visits,

· on achieving sustainability and assuring replicability, as well as on geographically converging different actions to maximize outcomes,

· on communicating and sharing successes,

· on networking, on building coalitions and on doing active national and international solidarity work,

· on identifying and working with strategic allies/helping forces and on neutralizing strategic opponents/hindering forces,

· on applying operations research techniques to decide on the best long-term course of action to follow,

· on setting up ongoing on-the-job cum support supervision activities that will replace workshop-based, mostly theoretical, training,

· on building, equipping and staffing minimum needed PHC infrastructures and, from there, providing ongoing outreach services,

· on working with ‘deserving’ NGOs that have revisioned their future and have taken up a new mission around the Human Rights-based approach,

· on giving environmental protection a higher profile, and

· on setting up more equitable cost-sharing approaches.

9. The strategy will need one or two explicit, quantified and timed ‘poverty redressal objectives’ monitored at least yearly. (6) Social and political mapping of resources and their control will thus have to be carried out yearly as well. (7)

10. Finally, the Human Rights-based strategy will have to take an unequivocal proactive stand towards reversing the negative effects:

· of structural adjustment programs,

· of the processes of globalization and privatization being pushed by the WB, the IMF and other agencies,

· of the diverse multilateral and bilateral donor, as well as NGO development projects not in line with the Human Rights-based approach,

· of social marketing unidirectionally applied to change people’s behavior without letting them decide why such change is needed,

· of existing national development policies that have become obsolete, and

· of existing current government development resources allocation formulae not in line with Human Rights priorities.

11. The additional elements here presented emphasize the sizeable dissemination and lobbying challenge ahead of us in the next decade in our efforts to have governments, development agencies and NGOs --as well as beneficiaries-- adopt the new Human Rights-based strategy.

12. We are talking about creating a movement; not only using the Human Rights-based approach as a methodology (as a tool box); if we do the latter, we will fail, as many packaged tool boxes have failed before --even if those tools evolved some as they were used.

References:

(4) Any attempted operational definition of empowerment will carry a certain bias depending on the conceptual glasses one is wearing. What is clear is that, in a mostly zero-sum game, the empowerment of some, most of the time, entails the disempowerment of others --usually the current holders of power. Different local contexts may make the same action(s) sometimes empowering, other times not. (Also, empowering people in community development work may sometimes be dangerous; it can well trigger repressive actions by the authorities). Empowerment is not an outcome of a single event. It is a continuous process that enables people to understand, upgrade and use their capacity to better control and gain power over their own lives. It provides people with choices and the ability to choose, as well as to gain more control over resources they need to improve their condition. It expands the 'political space' within which Assessment-Analysis-Action processes operate in any community.

(5) Global embarrassment is a term coined a few years ago in the context of lobbying. It refers to publicly blaming national and global leaders about the unacceptable levels of poverty, ill-health and malnutrition found, as well as about the host of Human Rights being violated in almost every country in the world; the idea is that by publicly blaming them for such an embarrassment one can trigger their response and generate greater political pressure to get the problems resolved.

(6) Poverty redressal objectives are objectives explicitly worded to reflect the specific, quantified reductions in parameters/ indicators of poverty sought.

(7) Social and political mapping exercises refer to deliberate periodic assessments carried out to determine who controls the different resources the communities need to foster development actions, i.e., which social groups control them and what are their ultimate political motivations and leanings.

42. On Capacity Building Needs: The Macro Issues in Human Rights

“Capacity development is not merely the
acquisition of skills, but also the capability and
power to use them.”

1. In general, within existing institutions and structures, capacity building work towards the achievement of the rights to health and to food (or to adequate nutrition) is currently still highly inadequate.

2. The inadequacies relate largely --but not only-- to constraints imposed by the international political and economic order which is the one that is relentlessly deepening inequality, poverty and injustice --the root causes of the excess malnutrition, ill-health and mortality of poor people.

In other words, the rights to health and food are closely related to, and dependent upon, the realization of other Human Rights, frequently beyond the immediate (but eventually achievable) control of beneficiaries.

3. Poverty is the single most important determinant of health. But health is very far from being the single most important determinant of poverty. Poor health exacerbates existing poverty. [From health services one gets health only...].

4. The enormous gap between Human Rights declarations and their realization can only be filled by addressing the international and national dimensions of power, the root causes of poverty, as well as the relative current powerlessness (or procrastination) of governments to meet their Human Rights obligations.

In most developing countries, the willingness to formulate policy is yet to be matched by action.

5. And action has to start with capacity building for claim holders and duty bearers alike for them to unequivocally understand that the determinants of poverty are fundamental violation of Human Rights --evidence for which has been around for over 150 years...

[Under the same optic, the pervasive privatization-of-public-social-services model is, by itself, a violation of Human Rights...].

6. People also have to be made to understand that:

· macroeconomic policies imposed by International Financial Institutions (IFIs),

· the world crisis in democracy,

· the weakening of states,

· the control of information,

· militarization and state terrorism (bringing us to open war), and

· the ‘capture’ of the UN system by these macro issues so that it finds itself with the hands tied to turn the spirit of Human Rights declarations into reality, all are equally major obstacles to the achievement of health and adequate nutrition as Human Rights.

[We all have our preconceptions that limit our resolve to act within a true Human Right perspective...].

8. The decision to implement programs and policies within the perspective of Human Right implies an enormous effort of consciousness raising and capacity building at many levels. It is a continuous process that needs to permeate all our activities in our work and in society as a whole.

[If only this would be universally understood...].

9. But, beware, even adopting a Human Right framework does not automatically change the way managers relate to beneficiaries. This, since the latter are still not always seen as full citizens with the same rights as more fortunate members of society.

10. Let’s face it, in development circles, health is still mostly promoted as a tool for economic growth rather than as a Human Right. Medical/Technical interventions are proposed as solutions to health problems... as ‘the way out of poverty’...(!).

Furthermore, this approach disallows discussions about and actions to directly tackle structural inequalities and the root causes of poverty and powerlessness and their consequences in terms of preventable malnutrition, ill-health and mortality. In short, this approach maintains and, if only tacitly, reinforces the current international order.

11. For example, the power of transnational corporations (TNCs), accountable to no-one, is in direct conflict with the principles and aims of the UN to enhance Human Rights and the capacity for self-governance. IFIs and TNCs simply have to be made accountable for their actions in terms of meeting their (so far poorly explicited) Human Right obligations.

[But do professionals in this area --and some UN agencies flirting with TNCs-- really worry greatly about this...?].

12. Human Rights work, badly needs to produce the evidence on the obstacles faced by state parties to meet Human Rights obligations and, more so, obstacles preventing people / communities from meeting their basic needs --to then use this evidence effectively in capacity building.

[From the above, then, already flows a full mini-agenda for action...].

Four More Areas of Need

13. The ‘access-to-treatment-for-HIV/AIDS movement’ illustrates numerous aspects relevant to equity and Human Right work; it provides an evidence-based example of a strong grassroots civil society mobilization that has successfully raised legal and advocacy issues from a strong rights perspective. Their claims are now increasingly taking a regional and international dimension.

These groups now urgently need capacity building in Human Right.

They need to go beyond directly addressing equal access to care in resource-poor environments and need to start raising more overall health system concerns. A greater Human Right focus can help them contesting resources in ways that are pro-poor and open doors to access resources outside the health sector.

14. The ‘patients-rights movement’ has, so far, not been much involved in promoting a veritable right to health approach. Patients' Rights Charters have promoted the right to health care alright; but they have focused more on improving the availability of minimum quality health services and have addressed health primarily as a socio-economic right; few of these movements have been linked to de-facto strategies mobilizing beneficiaries. In short, the limitations of this movement may be as many as its successes. In the future implementation of such charters, the role of public participation will be as critical as the further capacity building of their promoters in Human Right.

15. The few existing ‘civic coalitions (or people’s movements) for health’ also have the potential to progressively adopt a rights-based approach to more effectively influence State policies. Few have done so so far. They thus also urgently need capacity building in Human Right.

Where these coalitions are active, the actual expression of social and economic rights at community level gives them a greater potential to promote more equitable public policies. This, because the Human Right approach can clearly strengthen the proactive engagement of communities with the State by fostering a participatory empowerment that promotes social justice and equity, in our case in health and nutrition.

A Human Rights approach will also confront these communities with what they need to know about how the negative aspects of Globalization impact them (this will not happen automatically though; the process has to be explicitly steered in that direction).

16. Furthermore, the role of ‘organized labor’ in pushing for health equity through a rights perspective has also been neglected. Labor unions now need as much capacity building in Human Right as the above groups.

[Another couple mini-agendas for action here. The challenge is to take a practical approach to these questions so as to make the Human Right message central and, at the same time, accessible to those being empowered through the needed capacity building...].

State, Society and Human Rights

17. It is the obligation of the State and of society to create easily accessible legal and administrative mechanisms for use by the population as instruments to denounce and seek correction of violations of Human Right.

18. Examples of such violations most of us fail to identify are actions that:

· bring about or facilitate the expulsion of small producers from their land;

· allow importing food products at below national production costs;

· cause reductions in the support to national food crops production;

· create unemployment;

· discriminate against participants in social programs;

· close down social programs directed at vulnerable groups;

· allow enterprises to violate Human Right, (e.g. mergers that result in large dismissals of staff);

· are lenient towards those responsible for oil spills that jeopardize the livelihood of small fishermen;

· condone the introduction of dangerous foods in the market;

· allow dishonest advertising of certain undocumented nutritional values of foods...

· the allocation of grossly insufficient budgets for health;
· the non-elaboration of national policies on food security;
· the non-fulfillment of agreed-upon health and nutrition (Millenium) goals;
· allowing vaccination coverages to slip;
· the non-information of citizen about their rights in health, education and other social spheres.

20. To bring home the concept of rights, we can use the not so simplistic example of our own families: Not all their members can, by themselves, guarantee their own daily sustenance. In a way, the family has to provide for those of its members who cannot provide for themselves. In the same way, society needs to guarantee mechanisms that assure all its members have the economic and physical possibility to access adequate health and food. Each individual household simply has to be treated with equity.

21. Condoning preventable hunger, disease and misery represent the negation of our individual and collective humanity. This dehumanization is not only the one that affects those who do not get their needs fulfilled, but also the dehumanization of society that does not guarantee them the corresponding rights.

22. Paternalistic approaches to secure the fulfillment of needs establish a relationship of power and submission that, in itself, violates the rights of beneficiaries. Our societies have a long history of paternalistic and authoritarian approaches to development.

The process of construction of a truly democratic society passes through the redefinition of the roles of its social actors and the State.

[How and when will each of us redefine our roles --individually and collectively...?].

23. Health staff, for instance, has the obligation of informing beneficiaries of their rights. But there is a lack of information on the side of these public servants about their duties in relation to people’s rights. Only one thing is sure: There is no justification for the non-realization of Human Right. So, again here, these civil servants urgently need capacity building in Human Right. [We urgently need to design ad-hoc training modules (both their contents and effective teaching methods) and to train a rather massive cadre of alternative trainers; let us hope that the upcoming UNICEF and CARE materials will guide us in this direction].

24. Many small, unpretentious capacity building exercises in the direction of Human Right in different sectors of society will eventually have a synergistic effect. An increase in the consciousness of the population about their rights --and decisively exercising the same-- will ultimately increase the pressure on public and private services, not allowing them to procrastinate any longer in terms of improving the same.

Joint action of all actors in their different sectors is needed.

[Divided we beg; united we demand...].

Note:

- Mostly taken from Rene Loewenson, EQUINET-news, Feb 11, 2003, Flavio Valente, Human Right and the promotion of nutrition and healthy life styles, mimeo in Portuguese, 2002, SCN News No.25, Human Right and food security capacity building, Dec 2002, pp 58+59; and Alison Katz, for the People s Health Movement, submission to the UN Committee on Human Right, Sub-committee on the Promotion and Protection of Human Right, Feb 2003.

43. The Ideological Neutrality of Human Rights is its Greatest Strength, but its Proponents should not be Neutral in Engaging to Achieve them

Neutral food for non-neutral thoughts

“There is no neutral territory in combating poverty and oppression.
Those who believe in such neutrality more often than not become prey
to the agendas of dominant social forces.”

- F. Manji

“The principle of neutrality --being indifferent-- is increasingly
obsolete; it is immoral and short sighted.”

- J. Foster Dulles

1. An undeniable contemporary fact is that, too often, our political leadership is dissociated from moral and ethical considerations. But essential for their legitimacy is precisely their ability to translate prevailing social and ethical values into politics (or ‘ethical praxis’, if you want): politics is the translation of all our scientific, ethical and historical knowledge into a fair management of society. (D. Najman, P+QLI Commission)

2. So, not trying to be facetious, if our leaders do not know how to equitably distribute wealth and justice, shouldn’t they at least equitably distribute poverty and injustice...?

3. Consequently, in Human Rights, stepping from the ‘ethics of principles’ to the ‘ethics of responsibilities’ means that our leaders must be made to stand by their signatures and made to keep their promises, basically because they made them...of their own free accord (or convenience at the time...).

4. In today’s world, the life of a person who lives by her ethics is not easy: it is rather a crusade. For her, certain principles are non-negotiable.

5. In the Human Rights-based approach, rights are not negotiable. Therefore, we have to pin down the Human Right-expected outcomes --100% of them-- as non-negotiable (in a way, a zero tolerance stance). It is this, then, that has to become our point of reference to judge which Assessment, Analysis and Action (AAA) processes in society are positive and needed in our endeavor, and which of them we have to challenge, because they do not lead to such outcomes (i.e., are negative and/or neutral AAA processes for the achievement of Human Right).

6. In the same way, by now, we know that Respect, Protect and Fulfill all represent Human Right obligations of states: they thus have the connotation of a social contract! Carrying it a bit further, some people consider Respect to be a passive obligation, Protect to be an active one, and Fulfill to be a proactive obligation. So, for instance, when governments only respect and protect, but do not fulfill state obligations towards, say, the entitlement to food, to care and/or to Health For All, they should be actively denounced and confronted by us; neutrality is not an ethical option.

7. One can ask: is it not commensurate with cowardice to live an uncommitted life in a world of growing polarization? We need to critically examine our commitments of all sorts. Uninformed innocence in a ravaged world amounts to pain and suffering that can be counted as dead bodies and children handicapped for life. We cannot be fundamentally unengaged on Human Right issues. Detachment has to be challenged. Detachment can come from our early training, disappointing experiences or mere indifference. We simply cannot selfishly shun commitment. A world of choice and action opens before us. We have to make choices. We have to take sides to remain human.... (A.A. de Vitis).

8. In troubled times, a vocal identification with ethical principles needs to be forged. Silence is a strategy to avoid commitment, in our case in Human Right work. Silence compromises the future of what we stand for. Silence is speech; it is a willed act in the furtherance of one’s objectives. (Is it self-deception?)

9. We cannot attempt to disengage; political involvement in Human Right matters and, in final instance, is humanizing. Of course, the choice can be made to act as a ‘sympathetic outsider’; from such a position, reality-out-there remains but a picture on the canvas. (Z. Pathak)

[I recognize that people exist as dismembered bodies; we are constructed as complex, fragmented subjects, in part because there is a dialectical relationship between the personal and the political...].

Can Human Rights Advocacy be Overdone?

10. All people have equal rights, but are indeed very different --and want to be different... (J.Rau, German Federal President, 13/5/02)

11. Because Human Rights pertain to all people, everywhere, one danger is that the term “Human Rights” be used for many disparate things, if not for everything under sun. The fear is that, eventually, the term be abused so that it gets diluted to the extent that it loses all its original meaning and becomes empty rhetoric --like so many other ‘big words’ we have seen abused --from democracy to freedom to equity...

12. Human Rights has actually become a ‘convenient’ moral term, so useful and effective in advocacy that, to be on the safe side, everyone (friend and foe of Human Right) throws it in...just in case. And that is where the danger of abuse and dilution lies.

13. While I am aware of the efforts to expand the traditional Human Right concept and expect that Human Right will play some role in areas such as the environment, I am wary that if everyone keeps stretching Human Right into everything under the sun, within ten years, we risk seeing a huge backlash in the Human Right arena: whoever mentions the term "Human Rights" will be suspected of being a dinosaur or a fanatic. In the next five years we will see expansion, but what in ten...? This, of course, does not mean that linking Human Right to environment issues should not be pursued... (Tran Dinh Hoang, personal communication).

14. The caveat here is that we ought to advocate for a faithful adherence to the established and already sanctioned international legal Human Rights concept and principles; expansion from there should be cautious, well justified and long-term.

If something is good, use it carefully, consistently and with care...

44. An Introduction to Children’s Rights

Food for not so childish thoughts

Review of Some of the General Underlying Principles

1. The motivation to realize all Human Rights should be based on a sense of justice and solidarity; compassion is not the right motivation.

2. In this domain, Governments have Obligations of Result (e.g., achieving the Millenium Goals) and Obligations of Conduct (e.g., implementation of a plan to achieve the latter). Remember that they do not have the option to indefinitely defer efforts to ensure the full realization of these obligations; they have to immediately begin to take steps to fulfill them. In that sense, we can identify Human Right violations through the direct action of States and through their omissions. The latter, because there are minimum core State obligations to ensure the satisfaction of, at the very least, minimum levels of each of the violated rights. Remember also that resource scarcity does not relieve States from these minimum obligations and that all basic needs are Human Right (but not vice-versa). Human Right cannot be prioritized either, but actions to reduce and end their violation can and should e prioritized (in the form of concrete, explicit plans).

3. Moreover, Human Right have no time limit: up until a specific right is fully realized, this right is violated. This brings into serious question the setting of goals to ‘halve poverty or malnutrition’. [So, should we continue to pursue goals such as halving malnutrition by 2015...?].

4. Always keep in mind that a Human Right approach does not only change what we should do, but it will also change why and how we do our work. The first change is to recognize poor people --and children-- as protagonists in their development; this requires changing the mentality of all sorts of development workers. There simply cannot be a Human Right-based society without individuals who have internalized the Human Right philosophy (hence this Reader).

Realizing Children’s Rights

5. All human beings have Human Right, whether or not a particular country has ratified a specific universal instrument. For example, children in the USA --which has not yet ratified the Convention of he Rights of the Child-- have every bit the same rights as children living in countries that have ratified the CRC.

6. Rights holders and their representatives (e.g., parents) should have the capacity and the opportunity to take action to insist that those who have the corresponding duties do in fact carry out their duties. Rights are thus to be seen as our exercise of free will and choice. Moreover, rights holders retain their rights even if they are unable to take any action to demand their realization. There is a fundamental difference between protecting children --because they are dependent (and deserve our compassion)--and respecting children, because they are powerful. [Actually, the CRC prohibits those who already have power from exerting that power in a negative way over children].

7. UN-sanctioned conventional Human Right basically regulate the relationships between individuals and the State. The CRC is different. Towards children, it recognizes duties of parents and other non-state duty bearers at all levels of society, including at the international level.

8. Not infrequently, the violations of children’ rights are a direct result of the violation of the rights of their care-givers own Human Right. To begin with, a large majority of children whose rights are violated live in poor families and poor communities. Therefore, a child-rights approach must always also be focused on the alleviation of the poverty of the family. So, when we advocate and mobilize for the realization of children’s rights, we have to do that in the larger context of Human Right, including women’s, children’s and other pertinent economic, social and cultural rights.

9. Always keep in mind that rights are not just claims, but claims against someone! Therefore, in the Children’s Rights domain (as much as in other Human Right domains), capacity building has to be empowering so as to empower children’s guardians to confront Government inertia, as well as to empower children themselves (yes, children...) to claim their rights.

Note:

- Mostly taken from U Jonsson, Realization of Children s Human Rights: Charity or solidarity?, Mimeo, 1997.

45. Globalization, Health Rights and Health Sector Reform: Implication for Future Health Policy

Food for excessively medicalized thoughts

1. In most of the world, Health Sector Reforms (HSR) are sick.

They are terminally ill --in part due to the negative consequences of Globalization (G) on the right to health. So we better recognize its symptoms. Denial of the symptoms may be a good temporary defense. But only until reality imposes itself on us.

2. This reality is that we have been giving technical solutions to what are political and Human Rights problems. Ergo, we cannot medicalize HSR any longer!

3. I am hereby sending a call for action. Calls for action are not helped by scholarly presentations. When all is said and done, a lot more is said than done...

4. We thus have an enormous task in front of us. And to prepare for that task, we need to sharpen our debating skills. We need to awaken the ‘investigative reporter’ in us; to constantly go after the Human Rights meaning hidden behind the statistics.

5. Around the world, what the poor people to be served by true HSR want is simply more: more justice for their entitlements, more from health, more from life, more from history, and more from us!

6. Hereunder are about Fifty Seven ‘bullets’; they are in no particular order, but are just primers for you to use to start a meaningful debate on this issue.

i- The structural reforms that come with Globalization have negatively affected the most vulnerable segments of society; also, income distribution and economic access to health have become much more unequal.

ii- Civil society needs to become more organized to challenge the power of the states that foster or go along with Globalization and progressively neglect their Human Rights responsibilities in health.

iii- Civil society needs to increasingly be visible as a credible negotiator between the people and public powers. It has to become a watchdog to contain market and Globalization excesses. They also have to raise the awareness of the people re the challenges Globalization poses. (Best example: the worldwide People’s Health Movement (www.phmovement.org) and the Politics of Health website). (www.politicsofhealth.org)

iv- The short-run effects of Globalization on the poor ARE negative and significant... So, compensatory policies are being promoted and designed to help the poor to deal with, for example, falling health standards. But this is reactive/palliative and not proactive/preventive...).

v- What are needed are pro-poor/pro-Human Rights budgets and growth strategies; policies geared towards ensuring that people receive adequate food, education and health care; broad participation in policy design and implementation; environmental and social awareness; and efforts to combat discrimination:

‘As individuals, we beg; collectively, we demand’.

vi- With Globalization, the non-poor benefit disproportionately from public spending, their benefits far exceeding the taxes they pay.

vii- Pro-poor structural reforms we so much talk about are yet off-limits for the macro policy establishment. At the macro level, ‘the social’ continues to be an afterthought. But macroeconomic policies should add on to social policies if they are to achieve poverty reduction. So far, Globalization treats social welfare as an optional extra.

viii- More often than not, ‘sound’ macroeconomic policies are designed and then social ‘band-aids’ are applied in order to achieve acceptable outcomes.

ix- The social exclusion inherent in neoliberal growth models should simply be rejected. We should accept nothing less than social inclusion of the poor.

x- With Globalization, the trend is thus toward a drastic reduction of state-based entitlements and their replacement by market-based, individualized entitlements... But the invisible hand of the market has no capacity to create a decent, Human Rights-based society for all. The law of supply and demand can fix the market price of bread, but it does nothing to alleviate hunger, famine and ill-health.

xi- Moreover, with Globalization, priority is granted to efficiency over other values such as social justice or environmental sustainability.

xii- We now have to think globally and act both locally and globally.

xiii- Following the Globalization orthodoxy, recommendations are made these days to privatize social protection (but privatizing basic social services and social insurance is antithetical to redistribution and equity... The idea that any pivatization is better than no privatization should be rejected.

xiv- In sum, the negative effects of Globalization are reversing some of the social gains already made; it is lessening the likelihood that developing countries will have the necessary policy autonomy and fiscal capacity to carry out and finance comprehensive health policies.

xv- Although NGOs have enjoyed a high profile in recent years they have mostly remained in the reactive mode. There are signals that their heyday is over. Many stand accused of complacency and self-interest on the one hand, and of being ineffectual and irrelevant on the other.

xvi- Globalization has brought about a shift in power: the nation state has weakened and there is a reduction in social accountability. Moreover, ‘in the dealings of Globalization’, its intricate connections are so patently disguised as to become almost invisible. Or worse, the deceptions are so brilliantly woven into its processes that falling for those deceptions is deemed as both fashionable and progressive.

xvii- Due to these negative consequences of Globalization, communities in many Third World countries are no longer able to cope --their previously successful coping strategies diminishing daily.

xviii- Governments in the Third World are simply assumed to be incapable of assuming a minimum level of welfare for their citizen. It is implied that it is necessary to look for alternatives in the private sector or to directly privatize services (...and NGOs are occasionally a convenient form of privatization). Only that, often, such privatization strategies lower the quality of services for the poor and end up widening the gap between the rich and poor.

xix- Under Globalization, the annual losses to developing countries run at an estimated $500 billion USD --an amount much higher than what they receive in foreign aid.

xx- Whatever the response, promoting the economic benefits of Globalization requires mechanisms to prevent its excesses --including the Human Rights violations it aggravates--, because there is a clear trade-off between market efficiency and the social welfare of workers and peasants.

xxi- In the international scene of (mercenary) technical development assistance, for example, issues of substance are turned into technical matters by paid consultants while underlying more structural issues get obfuscated. Or --what amounts to the same-- aid agencies too often remain unwilling to respond politically to political situations.

xxii- Remedies proposed to specifically increase equity and access to basic services thus include targeting of subsidies (i.e. selective subsidies of goods and services disproportionately consumed by the poor), prepayment plans (e.g. community-based health insurance), exemptions and the selective dropping of some fees (e.g. health and educational), prevention and on improvements of the quality of care (in health), as well as on a fairer urban/rural distribution of resources.

xxiii- Expenditures on health have to increase, they say, but to be equitable, they have to be concentrated on preventive activities in rural areas and should be targeted to the lower income quintile.

xxiv- Globalization may be inevitable, but what it looks like is not --there are forces that can shape it, and Human Rights must be one of those forces.

xxv- Actually, with Globalization, "Might is Right” has come back with a vengeance. And in a defeatist stance, we have so far accepted this fact and have bowed to the forces we think we cannot effectively oppose. Soft approaches will not do. Bolder steps will have to follow.

xxvi- Furthermore, we have to fight the indifference of our youth to the present global situation: our young and upcoming colleagues. We have thus to enroll the youth before they resign themselves... Our youth seems more interested in the information superhighway.

xxvii- In sum, an effective challenge against Globalization and its negative effects on health is possible, but demands the same kind of intellectual commitment and vigor that characterized anti-colonial or independence struggles.

xxviii- Western intellectuals have simply abandoned their commitment to challenge the exploitation and oppression of the poor as they continue being brought about by Globalization. Concerted campaigns and struggles against poverty, tyranny any exploitation will form the only sustainable basis of an intellectual renaissance of our youth and of ourselves.

xxix- Taking a minimalist stand towards Globalization will do no harm, but neither will it do much good. Inertia in history (has) and will always work(ed) against the more visionary and radical changes deemed necessary when the same fall outside the ruling paradigm.

xxx- Development cooperation must thus become more political and more Human Rights oriented, because only structural reforms will deliver sustainable and fair development.

xxxi- The solutions to the consequences of Globalization on the health and nutrition sector, for example, cannot be medicalized any longer. Technical assistance focused on health/nutrition matters only is not enough to uproot the structural inequities underlying pervasive and unrelenting ill-health and malnutrition in the world.

xxxii- But the inertia is so great and our collective virtual view of reality so distorted and entrenched, in part due to Globalization, that the likelihood of us changing that reality remains dim.

xxxiii- In short, we need to give a larger intellectual and political scope to our discussions on Globalization. In doing so, we have to manage to develop a political program of more universal appeal. We need to come up with a focused common agenda.

xxxiv- When economics has ceased to strengthen social bonds and its prescriptions are actually further pauperizing millions, it is time to start thinking in political terms again. This is one of my cherished iron laws.

xxxv- The facts discussed here are more than enough to allow us to go negotiate (or struggle) for new more radical equitable/pro-poor/pro-women/pro-Human Rights based strategies on the highest of moral grounds.

xxxvi- Globalization does not have a human face; power differentials are at its crux. It is a process we cannot wish away.

xxxvii- When government expenditures in health in developing countries are shrinking, the World Bank has them pushing for a greater role of market forces in the production and distribution of health.

xxxviii- Providing health care as a Human Right and on the basis of need is being replaced by a system based on cost recovery where exemptions for the poor have not worked.

xxxix- Safety nets are nothing but a way to manage poverty attenuating social unrest.

xxxx- The politics of health will override all other efforts to bring us Health for All. (Equity is the forgotten key thrust of Alma Ata!...this year in its 25th anniversary!). A renewed commitment and resolve to foster empowering community-based activities will have to guide our actions.

xxxxi- Countering the forces of Globalization is a step towards equity; it is futile to look for an accommodation to fit greater health into an inherently inequitable system. This, because some of the HSRs measures are actually Structural Adjustment measures in disguise.

xxxxii- At the same time, reforms being proposed to strengthen public health policies and public financing of health via taxes are being dismissed as being supposedly non-viable. But the so often proclaimed non-service mindedness of the public sector is not a given; we need to fix a system that, granted, has many flaws. But it also has many strong points!

xxxxiii- Evidence that market-oriented health care systems are more efficient are not really well founded (look at the USA...); they are just more profitable to some and too often provide unnecessary care.

xxxxiv- Conversely, evidence that public health care systems are more equity-oriented and can be made more efficient, does exist.

xxxxv- The cost recovery system is a regressive tax in which the poor pay as much as the non-poor; becoming sick thus penalizes the poor more, and high fees for health care are a major cause of pauperization.

xxxxvi- Direct and indirect progressive taxes (and non-private insurance schemes) must thus constitute the financial basis in an equity-oriented health care system.

xxxxvii- So, if our objective is to provide care according to need, our only choice is to improve public health care systems that cater to those with less ability to pay (the majority).

xxxxviii- Another perennial problem of HSRs is that decision-making has allowed limited involvement of the beneficiaries themselves.

xxxxix- Bottom line, HSRs have been used as crutches to pretend one is changing the system, but basically staying the course or even going backwards. And this is not by accident...

L- HSRs alone cannot simply address the Human Rights and structural constraints to equitable health, not even with good targeting.

Li- Tinkering with the current HSR models will simply not do. This is the sad reality. Precious time is likely to be lost only to see the problems of inequity worsen...and what is inequitable today will be inhuman tomorrow.

Lii- So what would be more effective and sustainable?

a) First, it is not for us in this distinguished virtual gathering to come up with the responses.

b) For once, it would be best to ask the beneficiaries directly to respond to this question rather than coming up with some technical responses.

c) A bottom-centered approach calls for a radical change in our priorities and our modus operandus: The locus of control has to shift to the beneficiaries.

d) The bottom line is that --together with the beneficiaries-- we need to articulate a more sustainable Equity-Oriented Health Sector Reform (EOHSR).

Liii- There is no such a thing as ‘lack of political will”. What there is, is a laissez-faire, the manifestation of a choice made, i.e. a choice not to exercise a will!

Liv- Contradictions between ministries of health and the people they say they serve have not changed a bit with the (often foreign-driven) HSR as applied in many countries worldwide.

Lv- Who wins/who loses? What is won or lost? How, through what mechanisms? and Why? --these are the kind of questions we are not asking.

Lvi- We need to get involved with beneficiaries in consciousness raising, increasing their rights awareness and their political awareness of why they are where they are.

Lvii- In short, what is needed now is a start-over, a global movement, a grassroots revolution around the right to health.

46. Stepping into the New Age of the Right to Nutrition: Snail Pace Progress? - I

The Situation

1. One of the key question perhaps not yet clearly answered in nutrition circles is: Why is the commitment of nutrition professionals to a Human Rights approach, although sorely needed, still not a reality?

2. Such a commitment was and is seen as needed as our reaction with the best chance for success to counter the increasingly perceived (and additive) negative impacts of the relentless process of Globalization. Globalization is creating and is accelerating poverty --most often with malnutrition as an accompanying outcome. This, at the same time that the negative effects of Globalization are creating growing disparities, exclusion, unemployment, marginalization, alienation, environmental degradation, exploitation, corruption, violence and conflict, all --in one way or another-- impinging on nutrition.

3. People who are being marginalized by Globalization today are really being pushed to the limit and they do need to channel their frustrations into positive action. But in real terms, the poor are still being offered top-down social services and thus are not really active claimants when it comes to ensuring their perceived needs are met. So the Human Rights approach comes to introduce or reinforce a crucial missing element in development work, i.e., people forcefully demanding de-facto accountability; and this is its added value in all work being done in the area of nutrition. One wonders why the approach has not generated more enthusiasm.

4. Because the rights-based approach takes the entitlements of those being marginalized as its starting point, to be sustainable, it must be based on equity. Human Rights and equity go hand in hand. The rights-based approach thus focuses on the basic and structural (macroeconomic) causes of poverty, the main determinant of ill-health and malnutrition.

5. Historically, there has been much circularity in the discussion of Human Rights. There is still a segment of the Human Rights community that thinks that one can settle world order issues without settling the power issues still slanted against the welfare of the majority of the marginalized. But this is almost a contradiction. In this day and age, more concrete actions directly empowering the poor need to be identified and indeed carried out.

6. The worldwide halving of malnutrition rates by 2015 will simply not be achieved through the piling up of yet more ‘benevolent’ changes centered around Free Market solutions carried out by those who, through their power, control it. We are being sold a utopia, one that extols the ultimate benefits of Globalization. This utopia is made of a similar, but dangerous mythical belief that ultimately a global free market will cater to everybody’s needs and make everybody happy. How much nutrition professionals are influenced by this myth has never been assessed.

7. Be it as it may, the Human Rights approach is here to set limits to the vicissitudes and sways of the (socially insensitive) market.

The Challenge: What Now has to Change

8. Because of the gross flaws of Globalization, particularly in the social realm, a more humane global governance is now needed --more than ever.

9. It is a fallacy to focus on whether Globalization OR bad governments is the most important cause of Human Rights violations. The Human Rights approach shows us what states should do or should not do. When they fail the test, many governments actually use the Globalization argument --of being victims of a global process-- as an excuse for stalling and not implementing their obligations.

10. But, in fact, in the implementation of rights, one more often finds considerable softness in the commitment of the governments themselves. Often, a rights-based approach is not even on their radar screens. So both the individual duty bearers, as well as the system, are to blame and to indeed be held accountable.

11. For all governments (in rich and in poor countries), how much of their general budgets they devote to nutrition, to health, to food security, to education and to poverty alleviation is indeed of substantive Human Rights concern. Further, one should look at how the various existing expenditures are distributed among the various socio-economic population groups. Governments do violate Human Rights when they fail to offer adequate and participatory health and nutrition services to the poor.

12. To take a very real and current issue as an example, should the provision of such services be privately organized, governments still remain responsible for the egalitarian and adequate provision of the same. But, are they? They most often are not; one just needs to look at the existing evidence to see that. Civil society watchdog groups should be monitoring these developments and denouncing its shortcomings more proactively.

13. A Human Rights-focused analysis of statistical data should examine the extent to which various expenditures in nutrition and other social services are distributed among the diverse socio-economic groups according to need. The same watchdog groups have a role in scrutinizing the actions funded to make sure they ‘respect, protect and fulfill’ the Human Rights of the poorest --and they should protest if that is not the case. In so doing, they will actually be addressing the whole gamut of government Human Rights violations.

14. But are governments the sole holders of Human Rights duties? Legally, the answer is yes (they are the actual signatories of the respective Covenants). But, in reality, there are indeed other duty bearers.

15. The example of children as rights holders helps us illustrate this point: The duty bearers of children’s rights are, first and foremost, the immediate care-giver (the mother or other), followed by the family/ household members, the community and neighbors, local, sub-national, national and international institutions --all linked in a web of complementary duty bearers. The case of nutrition and the responsibility of its professionals could not be more illustrative in this regard: Together with empowered community leaders, they need to seek effective duty bearers’ responses at all these levels.

16. But this is the theory. The challenge right now is to convert these concepts into working programs, where people’s claims are more forcefully exerted as their inalienable right.

The Right to Nutrition

Preamble: Human Rights concepts applied to nutrition have evolved in the last 20 years. Early thinkers in this area began talking of an inalienable ‘right to food’ of all human beings. But after the worldwide adoption of the UNICEF-proposed conceptual framework of the causes of malnutrition, it became clear that food security was only one element of nutritional wellbeing. This lead to the coining of the concept of the ‘right to nutrition’ (here emphasized as the right to adequate nutrition) which addresses all determinants of said conceptual framework. Not surprisingly, this led others to pursue yet a more ambitious ‘right to development’ goal. But the latter has encountered powerful detractors in the ranks of the developed countries, particularly the US. In the same vein, it has to be said that the overall US views on Human Rights differ substantially from much of the rest of the world: To successive US administrations, civil and political rights somehow carry more weight than economic, social and cultural rights. The US particularly objects to the responsibilities the developed countries bear in relation to the rich countries having, for long, infringed the economic and social rights of developing countries.

17. Although the recognition of the fundamental right to adequate nutrition of all humanity is the ethical and political basis of the overall approach nutrition professionals should embrace, really understanding this right has largely, so far, been confined to Human Rights institutions, especially the UN agencies. How much should/can one rely on these agencies then to be instrumental in shifting the focus of current and upcoming nutrition programs to a Human Rights focus? For the time being, perhaps quite a bit. This serious gap simply needs to be bridged as soon as possible --and this is the purpose of this Reader.

18, The first challenge will be to help create a common language to be shared by agencies, governments, NGOs and beneficiaries --a language primarily based on social commitments to Human Rights and on raising the level of responsibility of the different actors (both as more active claim holders and as more responsive duty bearers).

19. The second challenge is to make the Human Rights approach concrete and give it substance (the how)...and the field of nutrition is, for sure, an inescapable candidate.

20. Unfortunately, as of now, most governments fear that the recognition of this right to adequate nutrition would interfere with their current policy choices. They need to be appeased about this fear and made to understand that certain aspects of the rights approach may be subject to progressive (gradual) realization. But they also need to be made to understand that there is a minimum core of rights that all states simply have to uphold! In the case under discussion here, states have already signed Covenants that guarantee the respect of the right to adequate nutrition under any circumstance, irrespective of the magnitude of the resources available to them.

21. In concrete terms, what this means to nutrition professionals is that, as soon as possible, Human Rights objectives in nutrition need to be better singled out, defined and refined to more explicitly establish specific local action priorities. The right to adequate nutrition has yet to acquire a more operational meaning for people as well, and that is a major political responsibility all nutrition professionals have to deal with now.

22. Put another way, in operational terms, effectively mainstreaming Human Rights in all nutrition activities remains a challenge of enormous dimensions --and the challenge is a political one. Certainly, operationalizing the right to adequate nutrition is a priority called for to quicken the current snail’s pace; the main challenge here though is to, first, achieve consensus among nutrition actors on such an operationalization.

47. Stepping into the New Age of the Right to Nutrition: Snail Pace Progress? - II

The Key Issues to Fight For

1. What will become central in this urgently needed debate to be followed by action is to understand that mainstreaming Human Rights in nutrition work means the right to demand a whole series of things. Among them:

· that economic and physical access to basic community-based nutrition services is equally guaranteed for girls, women, the elderly, minorities and the marginalized,

· that steps be taken to progressively achieve all Human Rights (the right to adequate nutrition being only the point of departure for nutrition professionals),

· that the private sector (national and transnational) also be made to comply with Human Rights dispositions,

· that expeditious and verifiable actions be undertaken towards realizing this right -starting now,

· that accountability, compliance and institutional responsibility be required from relevant duty bearers in all processes under implementation aimed at improving nutrition,

· that administrative decisions in nutrition programs are in compliance with Human Rights obligations,

· that governments’ resilience to embark in meaningful nutrition interventions be differentiated from their inability to comply,

· that -if unable to comply- the burden of proof be put on governments to convincingly show that there are reasons beyond their control to fulfill their right to adequate nutrition obligations,

· that national strategies on the right to adequate nutrition be adopted defining clear, verifiable benchmarks,

· that the implementation of national nutritional strategies or plans of action be transparent and decentralized, and include people’s active participation,

· that the same plans progressively also move towards eliminating poverty -the main determinant of malnutrition,

· that new legislation on the right to adequate nutrition be developed involving civil society representation in its preparation, enforcement and monitoring (!).

· beneficiaries will become de-facto active claimants of their nutrition rights,

· the respective imperatives will be made more forcefully (making governments effectively liable),

· the process will underline the international and later national legal obligations of states,

· the right to adequate nutrition will become the principal framework used to make relevant program decisions,

· the process will move the debate from charity/compassion (where there already is fatigue) to the language of rights and duties (accountable to the international community) with its corresponding compliance indicators that can be monitored.

4. These obligations, let the reader be reminded, are in competition with obligations stemming from other rights, especially when resources are scarce. Nevertheless, one always has to keep in mind that the duty to fulfill the right to adequate nutrition does not depend on an economic justification and does not disappear because it can be shown that tackling some other problems is more cost-effective.

5. To put things in a historical perspective, in the Basic Human Needs-based approach, beneficiaries had no active claim to their needs being met. The ‘value-added’ flowing from the Human Rights-based approach is the legitimization of such claims giving them a politico-legal thrust.

6. Going back to the example of the child, in the Basic Needs approach, the malnourished child was seen as an object with needs (and needs do not necessarily imply duties or obligations, but promises). In the Rights-Based approach, the malnourished child is seen as a subject with legitimate entitlements and claims (and rights always imply and are associated with duties and obligations).

7. This, in a nutshell, is WHY nutritional professionals have to step into the new age of the Right to Adequate Nutrition, picking up more of a hare’s rather than a snail’s pace.

48. A Case of Logic - The Human Rights Advocacy Syllogism

Food for thought in the language of logic

1. Advocacy actually is a form of political activism.

2. If 1. is true, advocacy is part of a struggle.

3. What struggle? Ultimately, I contend, a part of the struggle for power.

4. If 3. is true, advocacy is a dialectical exercise of the fight of opposing forces and boils down to power brokering to change the balance of power in favor of people whose rights are being violated.*

5. Therefore, advocacy is about gaining the upper hand, gaining positions of strength.

6. Therefore, advocacy is about empowerment of progressively growing numbers of individuals and organizations.

7. If 1. through 6. are true, what concretely does this compel us to do in Human Rights work? This, I will leave for you to answer...

(But remember, whatever cakes you bake are the ones you will have to eat).

After this, I need to further ask you: should you be advocating for, on-behalf- of, or with the people whose rights are being violated?

...Advocacy involves taking a political stand on particular issues and principles --and this often antagonizes governments. Ultimately, people need to take their own fates into their own hands, and it is that which most Third World Countries’ governments do not like.

*: “Keep in mind that the side without power is always the side accused of being irrational.” X. Zhang

49. The Difference Between Project and Process is Ownership. Human Rights Cannot be Implemented as a Project

“Projects create islands in the ocean of poverty.”

“The origin of Human Rights lies in the rather
subversive idea of protecting the collective
interests of the poor and weak in a society against
the rich and powerful.”

- Adilisha, FAHAMU

1. One violated right is a violated right. Suffering is not increased by numbers. One body can contain all the suffering the world can take.

2. In Human Rights, we do not judge in terms of quantity (alone). By doing so, one surely betrays Human Rights’s principles.

3. We must, therefore, no longer allow the sovereignty of states to be used as a shield for gross violations of Human Rights, simply because there are times when sovereignty just protects grave suffering. (J. K. Galbraith).

4. The Human Rights struggle is about turning human suffering into history rather than destiny --and we can’t face heavy artillery with water guns. (D. A. Moi) That is the naked truth.

5. But we live in a world still in need of believing in old truths that nobody has wanted to believe in...and Human Rights are not exactly a new truth.

6. Because to achieve change one has to attain a critical mass of process ownership, human social struggles are, by necessity, intergenerational. (C. Sepulveda) But this does not allow for complacency or procrastination. Bluntly put: the struggle for Human Rights is overdue.

7. Health rights are to be taken-up-by rather than bestowed-on or given-to the people as charity. So, to move the process ahead, we need to move into new territory. For example, we need more parliamentary, civil society and student involvement in the struggle for Human Rights: more constituent groups have to take ownership of the human-rights-restoring process.

8. In the struggle to achieve that, it has been easy to meet, but not so easy to act together. (The rich are more united precisely in that sense; they close ranks very rapidly when threatened; the rich are also ‘very charitable’: they understand that they have to pay ransom for their riches). (G. B. Shaw)

9. Our challenge, then, is to interpret our individual experience from a Human Rights perspective to better serve the people so they take de-facto ownership of the specific struggle for Human Rights. But beware: experience is not what happens (or has happened) to you, but what you do (or have done) with what happens (or has happened) to you! (A. Huxley)

10. Idealism, when uninformed by experience, is abstract and dangerous in a world coerced by the cult of power. (A. A. de Vitis) Moreover, idealism and ethics are a mockery where the question of action is never even raised. (Robert Scholes) ...and our inaction and ineffectiveness in the field of Human Rights is bliss for politicians and bureaucrats. (Or, we sometimes wrongly assume that decision-makers are rational, righteous and pious, and will accept hard evidence or will react to outrageous injustice...).

11. Too often, the aim is clear, but what precisely we want to achieve, and how we can act together, is less clear; the ‘how’, on ‘how-to-get-to-our-aim’ stays in the dark. Too often too, genuine protest movements have big words, but even a bigger cluelessness. We do not want to be like that. Slogans alone no longer do in Human Rights work. The discrepancy between slogans and reality is simply too painfully apparent. The challenge thus is to go from getting-all-relevant-information -- to mounting-an-argument -- to organizing-action. But beware, too often have we tended to mistake (sometimes endless) negotiations for action. (J. G. Speth)

12. Standing up for a common cause often means to resist, to oppose, to redirect, to counter, to denounce. Getting the right information to claim holders is thus an armor and a weapon for people to take the ownership of Human Rights work. From the right to know and the duty to inquire flows the obligation to act. (S. Steingraber)

13. In the Human Rights arena, courageous individuals act; they listen to people’s complaints, learn from them and teach them; they treat them like someone of value.

14. The challenge is thus to adopt a course of action which, for all its drawbacks, positively affects social change in the direction of the achievement of all Human Rights. And when acting, just REacting limits our choices. We have to take the initiative and denounce, yes, but also announce a new order.

15. While denouncing, presenting alternatives, showing the way and suggesting alternatives, Human Rights activists have to be ‘comfort-busters’ and ‘disquieters’, as well as ‘callers-to-reflection-and-action’. This eventually makes them into true alter-egos of the civil society community. Their mission is to center-the-debate and articulate-the-reasons for Human Rights. It is indeed a heroic battle of ‘universal ideas against special interests’.

16. For all the above reasons, I see our task as critics being one of actively politicizing the Human Rights discourse and leading it into new action-oriented positions.

17. In doing so, we also often have to unveil the workings of many a colonized consciousness: Great spirits have always encountered violent opposition from mediocre minds. (A. Einstein)

18. So, if you think we are too small to be effective in upholding Human Rights, ...you have never been in bed with a flea.

50. NGOs should not be Human Rights Blind and should be Judged by their Politics

1. Too many NGOs are fragmented and trapped in project work; they are often human-rights-blind and mainly service oriented; many are caught up in sustaining themselves financially.

2. Service-oriented NGOs will find it more difficult to alter or change power relations --a must for a Human Rights-based approach.

3. Too many NGOs are not looking (or have ceased to look) holistically despite the fact that they have much knowledge of what is going on; but they are not acting on that knowledge to really serve the people they work with. (L. Haddad) They need to speak up on how they interpret what they see.

4. So, here are some ‘take-home-messages’ for NGOs who are ready to assume their due role in the struggle for Human Rights:

· In a participatory process, NGOs need to refocus their respective visions and restructure their plans in the light of Globalization and the specific historical context of each country.

· This entails retraining their staff in the new vision and sharing the vision with their respective constituencies for feedback.

· They need to network with other like-minded NGOs to join forces to courageously advocate and denounce donor agencies and governments not upholding Human Rights.

· They also need to change their organizational structure and internal systems as needed to adopt a Human Rights-based approach, as well as to set up an ad-hoc internal task force that focuses on macro and Human Rights issues.

· On the other hand, communities need greater control over NGO staff’s activities; this is what has been called ‘localized accountability’.

· So, to get out of a state of lethargy in this domain, NGOs need to amass a fair dose of creative anger.

· What problems are we dealing with now? To what extent are they related to Human Rights?

· What information about rights violations do we already have? What information do we still need to research more on? How are we using this knowledge?

· What actions are we now involved in? Are we addressing/minimizing/preventing Human Rights problems? Are we altogether “off-track” as relates to the Human Rights problems?

· If we are currently not addressing the Human Rights problems, what structures would we need to address them?

· What organizational restructuring will we need? within our own NGO? and in our work to expand the Human Rights actors’ network nationally?

· Who is responsible to make these changes: we, as an individual NGO, or a national network of NGOs?

7. Given the challenges ahead, the Human Rights agenda of NGOs cannot be apolitical; the name of the game is actually being politically smart in furthering Human Rights goals.

8. Knowing about injustice does not move many; becoming-conscious about it generates a creative anger that calls for involvement in corrective measures. That is why being socially-responsible is but a euphemism for what should really be called political-responsibility. Political commitment is important, precisely because governments function as political entities. Political forces are thus fought with political actions, not with morals or technical fixes. It is precisely a misunderstanding of reality (or a partial understanding of it) that often reinforces an apolitical position of some NGOs.

9. One national NGO should act as an umbrella Human Rights organization, i.e., to be a broker of information to its members, helping them interpret it and challenging them to use the information to their advantage; this by itself fosters activism --giving other NGOs some novel ideas on how to do new things in their Human Rights work. The umbrella organization thus becomes a catalyst and an alter-ego (the consciousness) of its members and brings all members to a common ground by setting up either lose or militant networks (even if heterogeneous otherwise, but united on Human Rights goals) in which the relationship is based on a shared vision and political outlook on Human Rights issues.

10. Bottom line: NGOs ought to put their right hand over their hearts and face the sometimes painful truth: You DO know where you stand and DO know on whose side you are acting.

51. The Need to Struggle is Actually a Built-In Principle of Human Rights Work

“The check has come back from the Bank
of Justice marked ‘insufficient funds.”

- M. L. King

1. If the title is right, it behooves us to closely examine the processes that lead to widespread Human Rights violations. We need to identify the myths behind those processes and to show how the contradictions on which they rest are generated by political needs of the more powerful at a given moment in history. (Z. Pathak)

2. Myths are seductive, but they crowd out facts; and when the facts make a compelling case for action, myths must be buried. Myths make us complacent and stifle our imperative for action. (L. Haddad)

3. This examination calls for creating a space based on facts from which we can speak out as critics, to counter the proponents of status quo who seek to homogenize the differences of religion, class, ethnic group, and gender, that we know lead to widespread violations of the respective groups’ rights.

4. If we accept the above, we simply cannot allow the Human Rights discourse to remain an artificial exercise confined to seminar rooms; this defeats the pedagogical objective of connecting our Human Rights concerns to the real world...the real world is to be our seminar room. Our function is to act as listeners, as well as teachers: so we need patience and passion to turn the passivity of many into committed involvement. The same applies to our youth; our youth is schooled, but not educated.

5. Ergo, it is not enough to have all the right ideas and attitudes and not to have real passion and a rock-hard moral center. As activists working in different cultures, we have to press for the best practices to have Human Rights prevail universally --in all those cultures.

6. In Human Rights, we cannot look at people as empty buckets --without an education, without a history, without cultural markers of the class they belong to. We cannot pretend all these are not there. People’s identity is clearly inside a social, cultural, moral and political formation, e.g., people cannot be de-coupled from the economic to re-couple them with the social.

7. Active-intelligence rather than simple-good-intentions is necessary. Too often, we see high emphasis being placed on the development of technical skills with low emphasis on the development of ‘moral-intelligence’. (M. Allott)

8. Ultimately, it is all about being committed: the modern world has no place for innocence. Innocence can and does cause harm; so, everyone of us needs a sense of mission --beyond our seeking freedom from guilt. Some call this ‘optimistic-humanism’, i.e., behaving as-if-the-world-were-as-kind-as-we-wish-it-to-be. (J. Cassidy)

9. So, we have to be alert. The ‘innocent’ and the ‘uninvolved’ remain among us, and they are not always quiet and harmless.

10. Writing (e.g., about urgent Human Rights needs) is certainly a kind of action! But not of much help if one remains uninvolved, unburdened by emotional ties....tinged with the paternalism-of-empire. Paternalism is still very much in our midst and creates havoc through misinformation. (G. Greene)

11. Our own societies have lost the sense of what we are fighting for. We are not trying to patch up the same kind of world that has produced the chaos we are in right now. Many come to this understanding grudgingly. To pity is easy, but it is difficult to really care. In the class that most of us come from, overriding emphasis is placed on complacency --and that is no good.

12. So, to reiterate, the need to struggle is both a principle of Human Rights and of development work overall; in this work, to be is to do. We-are-what- we-do, but (in this day and age) particularly what-we-do-to-change-what-we- are.

13. The focus must, therefore, be on results, not on dogma. Bottom line: It is not the nice guys who bring about social change; nice guys look nice, because they are conforming. (Denial ain’t just a river in Egypt; it is a powerful animal and some stay there most of their lives). Rights cannot be theorized in the sense of claims pursued in a vacuum, but as a means of a struggle in a concrete social and political reality. Rights are not standards granted from above, but a standard bearer around which people have to bring about a struggle from below. (I. Shivji)

14. The underlying problem to all this is that people are not organized; there is no substantial enough struggle from below (yet). The poor and marginalized are neglected by modern, so called, democracies --because democracies are held captive not just to the power that money buys, but also to the ideas that money buys. (W. Greider) Conversely, Human Rights are beyond money-metrics...

15. We, therefore, need to foster indigenous Human Rights movements of the people themselves --and movements to win the support of the people to change direction towards the Human-Rights-cause need indigenous leaders; we need to find them and work with them. After a while, it will be up to these leaders to merge into national and trans-national networks of poor people’s organizations, i.e., a “Globalization from Below” (Voices of the Poor, World Bank)

16. Because all states that ratify Human Rights documents are obliged to bring their laws and procedures in line with treaty (covenant) obligations, it is important for each of us to know which treaties our respective countries have signed and ratified --and use this knowledge to put pressure on our respective government to implement the rights found in the treaties it has ratified (You can find information on this for your country at www.unhcr.ch). Thereafter, with others, we have to build a response capability to all these Human Rights-related documents, global and national. And, if national legislation has not followed the ratification of these Covenants, pushing such legislation should become a high priority for all of us.

17. Our inability to resolve Human Rights problems at home also represents economic costs of great magnitude; ignoring the benefits forfeited through our inaction is irresponsible and criminal. (J. von Braun) If you think this statement is a bitradical, just ask yourself: Where are we going to end up if nothing is done?

18. For the needed changes to occur, we have to step out of the biomedical and neoliberal paradigms and become unashamed Human Rights activists.

This, because the prevailing paradigm allows to manipulate, dominate, exploit, expropriate the have-nots whose rights are being violated. (I. Illich)

The prevailing paradigm is prescriptive, targeting-actions-upon rather than involving-people-in decision-making.

19. This is why, as Human Rights activists, we do not condone procrastination. In Human Rights, we need action now; we need reciprocal commitments by the local, national and international community. We need an international anti-poverty alliance based on Human Rights principles, on debt relief, on increases of ODA to 0.7% of GNP, on the principles of 20/20, on taxing international financial transactions (Tobin), on fair trade...

Given increasing marginalization of the now powerless, this might appear to be a quixotic enterprise.

20. We also absolutely need to concentrate on women’s rights, because men and women experience poverty and violation of Human Rights differently. This means we cannot allow gender hierarchies to persist in a hollow- commitment-to-Human-Rights.

21. Neither can we be caught off guard in the battle for ‘a-market-share-of- the-public-mind’. We must bypass the biased editorial control of learned journals, the audiovisual media, the press, the internet space; they are as unreliable and biased as a smart advertising. (K. O’Neill) (J. Adamson)

22. In the work we are asking all of you to take-up, we cannot underestimate: We are taking on formidable enemies, and we will not have succeeded until we ultimately force (and/or replace) policy makers and other duty bearers to begin adopting Human Rights-based approaches to development.

23. In all honesty, we too often are more concerned about being scientifically correct than programmatically effective; even Human Rights have been over-studied and under-acted upon. (K. Gautam)

24. I see discussions on Human Rights usually going trough three stages:

Confusion - Anxiety - Expectations (“what do these Human Rights advocates want from me again now?”). Because of this, and to relieve these anxieties, our promises will have to live up to the expectations we create, i.e., our analysis must lead to a praxis.

25. As opposed to the soft and non-binding declarations so many of the so-called Global Summits (often also called Summits of the Lowest Common Denominator), our Human Rights plans of action must depict what is achievable in real political terms and should go for broke to implement those actions.

26. When reinforcing the sense of urgency to act, we cannot create a dooms scenario, or make people feel guilty. Be optimistic: We shall overcome! But warn everybody that things are going to get worse before they get better...

27. Perhaps with our help, each community could draw up ‘entitlement-cards’ that list which entitlements they do have access to and to which they do not; that can be a powerful basis to get organized to fight for those they are denied. (M. S. Swaminathan)

28. In the real world, the rules of free trade override the Human Rights discourse: Trade agreements are binding and are enforced; Human Rights treaties are often ignored and rely on voluntary compliance.

29. Moreover, as part of the rules permitted by free trade, access to the state has become a source and means for the accumulation of private wealth --as an end in itself among the ruling class.

Epilogue

30. This --and all other Human Rights Readers-- are not trying to load all these new responsibilities on your shoulders and make you feel guilty. We are merely trying to get a process going --with you as an active agent. We need an increasing number of people who understand the many worrisome trends depicted in this series and elsewhere and who do-give-a-damn and decide-to-be-counted and do something about these trends.

31. You will not --and are not called to-- do the needed changes. We are asking you to take the responsibility to be a catalyst and a validator of the changes needed to avert further deterioration of the Human Rights situation. Become active in your own environment in empowering popular movements. That’s what it is all about.

32. We have been deeply intimidated by the magnitude of the problem in front of us. We have imprisoned ourselves within our own skepticism, resignation and cynicism about the inevitability of Human Rights violations being a fact of life. (C. Lovelace)

33. There is no reason goodness cannot triumph over evil, so long as the angels are as organized as the mafia. (K. Vonnegut)

Note:

- Some of the quotations come from G. Greene, The Quiet American, Text and Criticism section, Viking Critical Library, Penguin Books, NY, 1996.

52. The Law is the Law...and Human Rights are not yet the Law

1. A neglected avenue is becoming increasingly important for Human Rights activists to pursue in order to more effectively meet the various Human Rights covenants' goals. The avenue: to more actively propose/promote-new and/or amend-existing legislation --rather than continue implementing traditional development projects which do not necessarily address areas where the compliance with the respective Human Rights conventions (e.g., the Convention on the Rights of the Child -CRC- and the Convention to End All Forms of Discrimination Against Women - CEDAW) is the weakest.

2. As a matter of priority, the traditional project approach has, therefore, to be complemented (or replaced?) by a holistic, more legal approach to struggle for Human Rights. This, since current, embryonic rights-based programs are only a minor part of current development agendas of UN, government and non-governmental organizations. Moreover, they mostly promote 'rights- orientations' rather than more explicitly seeking 'rights-improvements-as-an-outcome'.

3. So far, most UN agencies' and NGOs' new rights-based programs mostly inform-about, train and disseminate, but do not seem to test-rights-in-the-legal-arena (e.g., through legal challenges and/or leading claim holders to get involved in pressing-on with their legitimate demands using national and/ or international legal channels). [Note that many domestic legislatures give treaties precedence over domestic legislation].

4. Unfortunately, many of these current rights-based programs also often convey a message of powerlessness of the pertinent Human Rights conventions, i.e., that they cannot really change the deeply entrenched attitudes of duty bearers that are causing harm, for instance, to poor women and children.

5. There is thus a risk of using the concept of rights in ways that have little to do with actual progress in the implementation of the actual Human Rights conventions --or of promoting just ideas, and not linking them to action.

6. [Because of this, someone even proposed that it would perhaps be better to define 'the-inverse-of-rights', i.e., what duty bearers do not do and what the penalties are].

7. That is why we, as rights activists, have to be part of the solution beyond pronouncements, by working with claim holders and getting them actively involved in actions that will make their appeals heard and acted upon.

8. But equally important is to give claim holders pointers of where and who to turn to when their rights are being violated. Emphasis is thus not only to be placed on poor women or children receiving particular benefits, but rather on achieving changes in processes-and-attitudes-of-relevant-institutions.

9. We, therefore, need to come up with new capacity building projects --understood as platforms-to-change-behaviors-on-rights-issues rather than to foster career advancement of participants. These projects are to include a whole new set of partners, e.g., parliamentary committees, political parties, labor and student unions.

10. Additionally, coming up with a framework for analyzing existing laws and to understand their shortcomings (i.e., inconsistencies with the Human Rights conventions or the fact that promoting equality is not a feature in them) is also needed. Missing laws, failed implementation of existing laws, and ambiguities in current laws will all become apparent from this analysis as well.

11. There is an easy test that can make the global Human Rights mission clear and that can be used to 'diagnose' any program's compliance with the spirit of, let us say, the CRC and CEDAW. The test consists in taking those programs in a country and replacing the word 'children' or 'women' with the word 'farm animals' raised for productive value and the word 'school' with 'training pen'. The proof of the extent to which each of these programs (and the country's laws, for that matter) reflect the goals of the CRC and CEDAW is in the number of cases where these programs promote the essential rights and qualities that are part of being human and that go beyond (farm animals) basic needs. If the score is low on this test, there is a problem and, as activists, we need to engage in reorienting strategies in our work with the Government.

12. The rights of claim holders (poor women and children in our example) will ultimately have to be guaranteed by laws; this means that the state (and not families or donors) has to assume the major role of fostering equity and equality --and this has to be guaranteed by law-- at a time when market forces are bringing about more and more inequity and inequality.

13. The paradox is that while in some countries some development indicators are looking better, the state's role in guaranteeing the rights of all its citizens is getting weaker, at a time when the risks to and needs of those individuals being left by the wayside by economic growth are becoming greater.

14. For all of the above reasons, the reward system for project implementers has to be changed as well. They have to be assured they will not be penalized for vigorously pursuing claim holders' legally recognized rights. We have to engage them in showing the claim-holders-they-serve the bases of the conflict they have with whomever is limiting or curtailing their rights: for sure, someone concrete is holding back the actions that are needed, after claims have been rightfully placed. If duty bearers do not act, approach them repeatedly; if they still do not act, expose them! This is pointed out here, because information alone does not give project implementers sufficient incentives; it often only adds to the frustration they feel with their own powerlessness... and that is precisely what we want to avoid.

15. Laws are not something abstract, 'probably useless' and un-enforceable, just because few people are using them or are benefiting from them. Widely disseminating information about pertinent laws creates awareness, but nothing else. There is this mythical belief that awareness is the first step to achieve 'something', and that other steps will automatically follow in due course; the reality is that they do not. Without behavioral change, information can actually have no effect (or completely opposite effects than those intended)...that is why TV promotions offer discounts and free samples...

16. The big challenge ahead is for us to succeed in telling legitimate claim holders what rights are and how they work; how, as claim holders, they can exercise their given rights and how other countries' claim holders are successfully struggling for their rights. Most important of all, we cannot convey a message of powerlessness.

17. An annual reporting on progress of each of the Human Rights conventions to show progress article-by-article would thus seem to be highly desirable. Civil society is best placed to do this. (We simply have to make sure that certain groups are receiving particular benefits due them --and that is so much easier with the law on our side...).

Note:

- Mostly taken from D. Lempert, Assessment of Vietnamese national laws and policies related to children and women, UNICEF mimeo, Hanoi, 2003.

(SCROLL ON: CONTINUED UP TO READER No. 211, MARCH 2009)