HHR Journal: A Brief History (2006-2010)

Beginnings1

The late Dr. Jonathan Mann first launched Health and Human Rights: An International Journal, in 1994. In his essay introducing the first issue, Mann wrote,

We have created this new journal, Health and Human Rights, to inform and expand the space within which ideas about the intersection between health and human rights can venture forth into the world, to be cited and criticized, debated and discussed, torn down and built up. For it is in the nature of pioneering work—in this case, exploring the frontiers of health and human rights—that some new paths will lead forward, and others will be found, later and from afar, to have been only byways and meandering trails.2

The new journal was to be a rigorous peer-review academic research publication, a flagship journal of the (then also) newly founded François-Xavier Bagnoud Center for Health and Human Rights, a center founded by the Countess Albina du Boisrouvray and located at Harvard School of Public Health in Boston. Figure 1 lists the initial advisory and editorial boards. Mann hoped that the Center might be able to publish four issues of the journal each year.

Fig. 1. Masthead of Health and Human Rights: An International Journal Volume 1, Number 1 (1994)

Senior Advisory Board

Philip Alston (Australia) Halfdan Mahler (Denmark) V. Ramalingaswami (India) Henry Steiner (USA) Katarina Tomasevski (Croatia)

Editorial Board

Sunila Abeyesekera Timothy Harding Aryeh Neier Manuel Carballo Aart Hendriks Geneviève Pinet Lincoln Chen Hakima Himmich William Curran Emmanuel Hirsch Jacqueline Pitanguy Ernest Drucker Howard Hu Olikoye Ransome-Kuti Paul Epstein Hina Jilani Jon E. Rohde Richard Feachem Peter Kandela Renée Sabatier Harvey Fineberg Michael D. Kirby Amartya Sen Julio Frenk Maureen Law Margaret A. Somerville H. Jack Geiger Jennifer Leaning Gracelyn Smallwood Lawrence Gostin Ana Luisa Liguori Eric Stover Mirko D. Grmek Adetokunbo 0. Lucas Lorenzo Tomatis Sofia Gruskin Gerald Nagler Nahid Toubia Laurie Wiseberg

Highlights from the first two issues included: • “Conference Report” of the “First International Conference on Health and Human Rights” (Vol. 1, No. 2) • Regular sections identified as: “Articles,” “Book Reviews” and “Bibliography” • Editorial Advisory Board member, Henry J. Steiner, wrote the first entry for an anticipated new section on “programs in health and human rights from around the world” with a brief “Profile” of the Harvard Law School Human Rights Program (Vol. 1, No. 3, pp. 306–307) • Sofia Gruskin first assumes editorial responsibilities as Guest Editor for Vol. 1, No. 4, a special issue on “Women’s Health and Human Rights.”

1 This short history of Health and Human Rights: An International Journal was written by Dr. Susan R. Holman for editorial 2 J. Mann, “A New Journal, A New Beginning,” [Editorial] Health and Human Rights: An International Journal 1/1 (1994), p. 1.

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HHR Journal: A Brief History (2006-2010)

• Vol. 2, No. 3, published in 1997, was a special issue of papers from the “2nd International Conference on Health and Human Rights: Bridge to the Future,” with Harvard’s then President Neil Rudenstein offering opening remarks.

Sofia Gruskin named Editor

The journal’s first major transition occurred in 1998, when Mann left Harvard to take up a new appointment as Dean of the Allegheny University School of Public Health in Philadelphia, and Sofia Gruskin was named Editor in his place. Mann’s longterm vision for the journal is illustrated in his final note “To our readers,” in Volume 2, Number 4 (see Fig. 2).

Fig. 2. Editorial, Volume 2, Number 4 (1998)

To our readers

On January 1, 1998, I left Harvard, the François-Xavier Bagnoud Center for Health and Human Rights, and the editorship of this journal, and assumed a new position as Dean of the new Allegheny University School of Public Health in Philadelphia, Pennsylvania, USA. I have been blessed and honored by the collaborations which have made Health and Human Rights a reality. First, Albina du Boisrouvray enthusiastically supported the idea of the journal, then generously made it immediately possible. Then, a group of dedicated, supportive, and generous experts agreed to constitute the journal's Senior Advisory Board and Editorial Board; they have invested precious time and energy on its behalf. A journal brings together the work of many people. From earliest days, talented professionals like Tori Alexander, John Lauerman, and now, Jacoba von Gimborn have brought editorial skills and have ensured the journal's production, marketing, and distribution. The enormous work of dialogue with authors around the world was wonderfully and skillfully accomplished within the Center, by Sofia Gruskin, Daniel Tarantola, and Mary Pat Kieffer. For me, the launch and success of this journal, now with over one thousand subscribers, has been enormously satisfying, as well as challenging. Like so much about the François-Xavier Bagnoud Center for Health and Human Rights, and the Harvard School of Public Health in which it was created, I will miss the close proximity of collegiality and friendship. As Editor Emeritus, I will continue to be engaged with the journal; in my new position, I hope to expand and extend knowledge and awareness of the connection between health and human rights. In part thanks to the forum which a journal offers, these ideas have become, in just a few years, the basis of a profound renewal in thought and action about how best to promote and protect well-being, health, human rights, and dignity. Jonathan M. Mann Editor Emeritus

Adding her reflections to those of Mann in the same issue, Gruskin noted that:

The journal was Jonathan's idea. When, in 1994, the François-Xavier Bagnoud Center produced the first issue of the journal in a field—health and human rights—that had not been fully explored and for which a readership had to be built and sustained funding had to be secured, the challenge seemed overwhelming. Over the years, the journal has been able to generate and sustain high quality standards, to secure contributions from an ever-increasing pool of writers, and to expand its readership in both the industrialized and the developing world. Of course, as expected for a journal which is not designed to attract commercial advertising, it continues to struggle for its economic survival. The journal was and continues to be an innovative initiative, a forward-looking enterprise, and a daring project.3

The year 1998 marked the 50th anniversary of the Universal Declaration on Human Rights. Under Mann’s initial direction, the journal had looked forward to a special issue, Vol. 3, No. 2, dedicated to commemorate and celebrate this event. However, as the issue entered production, in the fall of 1998, Jonathan Mann was tragically killed, on September 2, in the flight crash of SwissAir 111 while on his way to WHO and UNAIDS meetings in Geneva. The anniversary issue opens with a memorial to Mann that reminds readers of the call to continue “on his shoulders” and in his vision:

3 S. Gruskin, “To our readers,” HHR 2/4 (1998), n.p.

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HHR Journal: A Brief History (2006-2010)

Jonathan frequently reminded us that our work is possible because we stand on the shoulders of the giants—the giants in health and in human rights—who preceded us. He believed deeply in the possibility of changing the world, of making it a better place. His life ended before he was fully able to play out his own role in doing so. We share his belief that the health and human rights movement has a collective responsibility to move this work forward as, to use Jonathan's words, "equal partners in the belief that the world can change."4

Sofia Gruskin was to stand on Mann’s shoulders by serving as the journal’s Editor for the next twelve years. A few notes of journal-related events during her tenure include:5

• 1998: “each volume will contain one general mixed-contents issue and one special theme issue with solicited contributions.” • Vol. 4, No. 2: This special theme issue on reproductive and sexual rights was funded by “a grant of $25,000 from the MacArthur Foundation toward production and distribution,” and “Center staff continued to approach other foundations, corporate donors, and development agencies in an attempt to raise additional funds for future operations.” • 1999: “The journal is now abstracted and indexed in ASSIA: Applied Social Science Index and Abstracts, Geographical Abstracts: Human Geography, International Development Abstracts, MEDLINE, PAIS International, Periodica Islamica, Social Planning/Policy and Development Abstracts, and Sociological Abstracts.” • 2000: “Fundraising for the journal remained a priority…. An issue of the Health and Human Rights journal, focusing on reproductive and sexual rights, appeared in time for the Beijing + Five activities.” • Production staff from 1994 through 2006 consistently included no less than three and often up to five people for each issue. Mastheads consistently name at least 2 individuals responsible for editing and/or managing content, a third person devoted to design and production, and two to four additional (often transitional) “editorial assistants” and “copyeditors.”6

Sofia Gruskin’s tenure as Editor came to a close with Vol. 9, No. 2 (2006). In her “Editor’s Farewell,” Gruskin reflected on the emergence of health and human rights as a field and the journal’s specific goals during these years:

When we began in 1994, not only was there no field called health and human rights but there was little engagement among the fields of public health, medicine, law, and human rights. Certainly an academic peer-reviewed journal seemed little more than a dream. Who would read it? And more to the point who would write for it? Where would we find qualified reviewers? In spite of these questions, Jonathan Mann had the vision to insist that if there was to be a field of health and human rights then there must also be a journal. He had the foresight to see that a forum was needed for rigorous academic exploration of ideas that would not fit easily within the mainstream journals of the relevant fields. …The journal is now widely respected by academics, policy makers, and activists alike precisely for the key role it has played in bringing academic rigor to a field that has now established itself as a cutting edge discipline. The start, in truth, was fairly rocky….As a fledgling journal, we ensured that our first issue was widely and freely disseminated on all four corners of the globe. We also committed to providing free access for individuals and small organizations in developing countries a commitment upheld to this day. Our editorial mission has been to ensure a journal with credibility in all relevant fields and to build on the foundations of a broad range of disciplines in order to create effective bridges, and in so doing to illuminate the power of health and human rights. Yet, to do this has required stimulating the interest of writers in expanding the scope of their work beyond their traditional paths and securing

4 “In Memoriam: Jonathan Mann 1947-1998,” HHR 1998 (3/2), p. 2. 5 These details (which are not intended to be comprehensive) are selected from both archived journal issues and from the limited available text of the archived online pages of the FXB Center between 1997 and 2006. 6 Source: archived “Frontmatter” files, 2000-2006, which include names of the constantly evolving editorial production team. Of note, Ann Barger Hannum, who has continued to serve as a consultant for detailed content- and copyediting through Dr. Farmer’s tenure, is first named for her editorial assistance on the masthead of Vol. 8, No. 1 (2004).

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HHR Journal: A Brief History (2006-2010)

peer reviewers knowledgeable about both public health and human rights … The journal's mission remains urgent and I wish the journal and its new editors well as they carry it forward.7

In the wake of substantial administrative and leadership shifts at the Center between 2005 and 2006, Stephen Marks stepped down as FXB Center Director, Sofia Gruskin stepped down as journal Editor, and all journal editorial and production staff were laid off.8 Due to this gap, the journal did not publish in 2007 (see Fig. 3).

Fig. 3. Health and Human Rights Journal: Publication history

Year published # issues Year published # issues vol/# vol/# 1994 (fall) 1.1 1 2003 6.2, 7.1 2 1995 1.2, 1.3, 1.4 3 2004 7.2, 8.1 2 1996 2.1 1 2005 8.2 1 1997 2.2, 2.3 2 2006 9.1, 9.2 2 1998 2.4, 3.1, 3.2 3 2007 -- 0 1999 4.1 1 2008 10.1, 10.2 2 2000 4.2, 5.1 2 2009 11.1., 11.2 2 2001 5.2 1 2010 12.1, 12.2 2 2002 6.1 1

Paul Farmer named Editor-in-Chief

In July 2006, Dr. Jim Yong Kim returned to Harvard from his role directing the “3 by 5” TB initiative at the World Health Organization in Geneva, and was appointed the new FXB Center Director. To help realize his vision for broadening health care delivery and the global realization of human rights, Kim invited Dr. Paul Farmer to take on the role of Editor for the Health and Human Rights journal. Farmer used the opportunity of his invited lecture at the 2006 American Public Health Association Meeting to publically indicate his acceptance:

Finally, I have been invited by Jim Kim, the new director of the François-Xavier Bagnoud Center for Health and Human Rights, to announce today that I will be assuming the role of editor for the journal, Health and Human Rights. I say this with no small amount of trepidation, since I have been more deeply involved in programs to expand access to medicine and public health than in the hard work of receiving and reviewing manuscripts in what is, and will remain, a contested field. But I will consider it a privilege to assume this role if Sofia Gruskin and others who’ve made this journal into such a precious resource will continue to help shift the paradigm in health and human rights. This doesn’t mean changing directions so much as assuming even more responsibility. It does not mean abandoning the legal scholarship and assessment of existing rights documents and laws and conventions. It does mean challenging orthodoxy in both public health and human rights discourse. It does mean understanding the ways in which poverty seeps into every aspect of both health and human rights.9

Before Farmer made this announcement, in fact, a working group had developed that shared Kim’s and Farmer’s vision for enhancing the journal’s potential to enact global change and engage more voices from resource-limited settings around the world. The person who gave most cogent shape to translating these early discussions into specific activities was Dr. Alec Irwin, an academic ethicist who had returned to Boston from Geneva to serve as FXB Center Associate Director. Irwin facilitated internal discussion that led to the crafting of a careful enunciation of where the “new” Health and Human Rights might go next, and how it might best reflect and build on the rich foundation established by Mann and Gruskin. The excerpt below (see Fig 4), from Irwin’s internal “Concept notes”

7 S. Gruskin, “Editor’s farewell,” HHR 2006 (9/2), 1-2. 8 Source: Catlin Rockman, personal communication, 2008. 9 P. Farmer, “Challenging orthodoxies in health and human rights,” Plenary lecture at the 134th Annual Meeting of the American Public Health Association, Nov. 5, 2006; later revised and published in Vol. 10, No. 1, as “Challenging orthodoxies: The road ahead for health and human rights,” Health and Human Rights: An International Journal 10/1 (2008), 5-19.

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HHR Journal: A Brief History (2006-2010)

from meetings that took place around the 2006 APHA meeting, is provided here at length because these ideas in dynamic conversation were to profoundly shape all editorial interactions and discussion throughout the next three years (2008-2010, Volumes 10 through 12) of Farmer’s tenure as Editor.

Fig. 4. Concept Note for Health and Human Rights, 200610

In his 2005 Tanner Lecture, Paul observed: “The view of many of my academic colleagues seems to be that good scholarship and activism don’t mix. The view of many of my human rights colleagues seems to be that social and economic rights—those violated in settings of poverty and disease—are ‘pie in the sky.’” Rejecting these assessments, Paul called for the creation of a global movement uniting science and activism to realize the rights of the poor:

We need … a globalized movement that will use whatever stories and images it can to promote respect for human rights, especially the rights of the poor. For such a movement to come about, we need to rehabilitate a series of sentiments long out of fashion in academic and policy circles: indignation on behalf not of oneself but of the less fortunate; solidarity; empathy; and even pity, compassion, mercy, and remorse. For such a movement to come about, we will need rhetorical tools based on fact, not ideologically motivated fiction.

For many of us, these words have a quality of incandescent moral rightness. Like Jim’s statements about the science of implementation, they seem abruptly to illuminate a path of collective action that demands our absolute commitment. Most important is the impact such ideas are beginning to have on young people. Anyone who has seen Paul or Jim speak recently to overflow crowds often composed primarily of youth is aware that a generation of young health activists is arising in response to their message and example. A growing community of young people are seeking ways to follow in Jim’s and Paul’s footsteps: from the Stanford student spearheading an ambitious and innovative fund drive to benefit PIH, to the HMS students who have founded a “Dying for Growth” study-and-action group, to the leaders of the Student Global AIDS Campaign, for whom Paul and Jim are a constant reference, to PIH’s own cadre of interns and young clinicians.

The activities of these groups of youth could remain scattered, anecdotal phenomena. Or they could become catalyzing nodes for a sustained global movement for health and social justice. It is our obligation to secure the latter outcome. To realize the human rights of poor people, in Paul’s words, “Nothing less than a movement will do.”

Some of those listening to Paul’s Tanner lecture may have taken his reference to a global social movement as a mere rhetorical flourish, intended to stir emotion but not to trace a serious agenda for action. On the contrary, I believe Paul was perfectly serious—and that he was right. For the health and social justice values advocated by Partners In Health over the past 20 years to attain their full impact, a broad social mobilization spanning borders and linking poor and rich worlds is necessary. This movement will be unprecedented in many respects. It will link a mobilization for social change among the privileged with the liberation struggles of oppressed communities. Equally important, it will connect human rights demands with “implementation science”: the practical knowledge and skills needed to deliver quality health and social services to poor people.

Health and Human Rights should become the voice of this emerging movement, the platform from which its aspirations are articulated, and the forum in which its strategies are shaped.

The formative editorial team discussions that shaped Irwin’s “Concept Note” identified certain specific necessary changes to the journal’s content, format, style, and publishing procedures. These included: • More varied content, • Multiple genres, • More accessible presentation, • Interactive electronic version, and • Engaging the next generation.11

In his quiet, unassuming way, in fact, Irwin devoted extraordinary dedication and energy throughout most of 2007 to shaping this vision into action. With his lead, the journal’s specific accomplishments during 2007 included: • A decision to focus the journal in two new sections, “Critical Concepts” and “Health and Human Rights in Practice;”

10 Source: A. Irwin, ed., “The future of Health and Human Rights: Note for internal discussion,” Nov. 17, 2006, selections. Farmer’s Tanner lectures are available online at http://www.tannerlectures.utah.edu/lectures/documents/Farmer_2006.pdf. 11 Irwin, “Concept Note,” ibid.

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HHR Journal: A Brief History (2006-2010)

• “Executive Editors” appointed for the sections: Alicia Ely Yamin ( Concepts) and Dr. Evan Lyon and Vivek Maru (Practice); • A commitment to remove all cost barriers to journal access and cease paid subscriptions; • Extensive research, discussion, and design efforts to identify the most efficient and effective way to generate a free open access online publication. Here Irwin took the lead and was responsible for the greater bulk of this effort, with the assistance of Laurie Wen (FXB Center Advocacy Director) and supported by the new FXB Center Administrative Director, Patricia Spellman, when she joined the FXB Center in the late summer of 2007; • In consultation with Dr. Gavin Yamey who was then Editor of PLoS, Alec and Tricia identified aspects of an “Open Journal System” (OJS) that would offer such web-neophytes sufficient tools to create a free academic website that would meet desired standards. As web design consultants, Fresh Tilled Soil (FTS) was selected to assist with web design and structure; • Editorial/production team-building. In addition to overseeing peer review and content/copyediting, Irwin was also simultaneously co-directing the Secretariat for the international Joint Learning Initiative on Children with HIV/AIDS (JLICA), based at the FXB Center, as well as fulfilling other duties as the Center’s Associate Director. Thus Ann Hannum was particularly helpful as a consultant copyeditor; Catlin Rockman created the necessary Adobe InDesign templates and designed a new cover for the print version of the “new” journal; and Dr. Susan Holman joined the team in September 2007, as a research writer and editor on the JLICA project who had experience managing three other academic peer-review journals, shared the new vision, and offered increasing assistance with all aspects as needed; • Tricia Spellman assumed responsibility for business management and negotiated a contract with Odyssey Press to fulfill short-run printing.

Reflecting later on these decisions as they affected production details during 2008 and 2009, the team agreed that the choices related to the OJS system had many limitations. However, these collective tools did make it possible to develop a custom-designed site in extensive dialogue with FTS so that the first free online issue of the journal (Volume 10, Number 1) went “live” in June 2008.

During the 2006 planning meetings, the editorial team had decided to focus its initial issues on certain basic concepts in the realization of human rights. The six issues that appeared between 2008 and 2010 capture key dialogue on topics of:

10/1 (2008): “What is a rights-based approach to health and why should we care?” 10/2 (2008): “Accountability” 11/1 (2009): “Participation” 11/2 (2009): “Non-discrimination and equality” 12/1 (2010): “ ‘International assistance and cooperation’ and health and human rights obligations beyond borders” 12/2 (2010): “Social determinants of health: Convergences and disjunctures”

In the fall of 2008, with the end of the JLICA project, Irwin moved to Manhattan to put his human rights ideals into practical application in nursing. He remained a very active participant on the management team dialogue and peer review decision process, and he and Holman shared management of the journal into 2009, at which time task-shifting took place to reflect actual activities on the journal in light of team members’ multiple other commitments. In 2009, Irwin moved to an “executive editor” role for the “Practice” section to supplement Dr. Evan Lyon as Evan focused on clinical care for prisoners in Alabama and hospital demands in Haiti. Vivek Maru’s responsibilities led to his appointment on the Editorial Advisory Board, with Arlan Fuller, then FXB Center Policy Director, taking Maru’s place as Executive Editor for the “Practice” section. Curtis Peterson, initially an FXB summer intern who had substantial web expertise and experience as a social activist on health issues, joined the team as Assistant Editor. Under Curt’s charismatic organizational lead, the journal sponsored a public forum at the American Repertory Theater in September 2008 to mark the new journal’s official “launch.” Curt was also responsible for creating a more dynamic journal “blog” (OpenForum); he and successive Assistant Editors, in collaboration with all of the editorial team, devoted huge efforts to identify and include student volunteers and interns,

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HHR Journal: A Brief History (2006-2010)

draft, edit, and post two new blog posts each week, and develop new ideas for engaging “the next generation” in the journal’s vision. During this time, the editorial team also negotiated the necessary legal agreement with JSTOR that made it possible to post pdfs of all back issues from 1994 as open access archive files on the journal’s website. The agreement with JSTOR ensured that JSTOR would continue to include HHR in its usual online services.

Between 2008 and 2010 the editorial team (which also included Paul Farmer’s assistant, Zoe Agoos, as Paul’s representative and copyeditor extraordinaire) met for regular weekly teleconference discussion and consensus decision making. With the assistance of two successive interns, Mialy Clark and Keri Wachter, a peer reviewer database was developed with over 650 names, including all editorial board members and all past journal authors who could be identified. Under Holman’s direction and Ann Hannum’s substantial historical experience with the journal and legal editing, a comprehensive style guide was finalized and posted online, and the journal successfully attained a regular twice-yearly publication schedule. The team also established a standard of, and detailed instructions for, all aspects of publication, including html preparation. During her internship in the summer of 2010, Dartmouth undergraduate Krista Oehlke prepared several hundred files of OpenForum blog posts for OJS archiving, and these are now also freely available in the journal’s online archives. In addition, Holman negotiated the necessary processes to ensure that HHR continues in the National Library of Medicine/PubMed database, and prepared and submitted xml files of Volume 12, the first all-online issue, which have been accepted in the NLM/PubMed reference base.

The journal underwent significant changes during 2010, when Dr. Jennifer Leaning was appointed successor to Dr. Kim as FXB Center Director, at a time when the Center was also experiencing significant challenges to its fiscal budget. These events led to the following transitions between May and December 2010: • Under Dr. Leaning’s direction, the entire editorial board was contacted and Board membership updated; • Alicia Ely Yamin, Evan Lyon, and Alec Irwin each shifted to a new role as non-stipendiary contributing editors; • Three positions were eliminated: the positions of “Executive Editor” (a faculty-related position), Creative Director (responsible for all art and layout), and “Assistant Editor.” Production assistance was dependent on occasional student interns. • Dr. Aaron Shakow was appointed as the new “Editor,” to serve under Paul Farmer’s continuing role as Editor-in-Chief; • Susan Holman moved from the FXB Center in December 2010, focusing full time on academic/research writing; serving as a consultant editor and writer for PIH and for Alicia Ely Yamin, until her 2011 appointment as Senior Writer for the Harvard Institute; • Arlan Fuller maintained his editorial role on the journal and following Holman’s departure assumed supervisory management as part of his broader leadership role at the FXB Center; • A media editor and journalist, Jessica Moore, was hired (effective 2011) to direct and manage all details of the journal’s website, editorial production, and new marketing vision.

2013 Update: Between 2011 and 2013, Dr. Shakow stepped down as Editor, and Dr. Carmel Williams was appointed Executive Editor, a position she serves remotely from her academic post in New Zealand. On June 18, 2013, Dr. Leaning announced a collaborative agreement with Harvard University Press under which the Press henceforth assumes the journal’s ongoing publication.12

12 http://harvardfxbcenter.org/harvard-university-press-publishes-hhr-journal/.

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