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IHP News 560 : a Clash of Flawed Governance “Models”

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IHP News 560 : a Clash of Flawed Governance “Models” IHP news 560 : A clash of flawed governance “models” ( 21 Feb 2020) The weekly International Health Policies (IHP) newsletter is an initiative of the Health Policy unit at the Institute of Tropical Medicine in Antwerp, Belgium. Dear Colleagues, Some terms seem to be a lot less in vogue these days than just a few years ago (like ‘Grand Convergence’ or ‘Cosmopolitan moment’) whereas others are rapidly gaining momentum - say, 'Age of extinction' or ‘The Great Unraveling’. Against an increasingly dire planetary backdrop, the new WHO-UNICEF-Lancet Commission, A future for the world's children? comes not a day too soon, in other words. Let’s hope the SDG agenda gets a much needed shot in the arm “by placing children, aged 0–18 years, at the centre of the SDGs: at the heart of the concept of sustainability and our shared human endeavour.” The report repositions every aspect of child health through the lens of our rapidly changing climate and other existential threats. Which seems damned right. Back in the real world, however, quite a few billionaires still think they can promise to ‘Save the World’ while standing at the same time for a very harsh model of neoliberal globalization and economic system (which includes for them, more often than not, top-notch “tax optimization”). Jeff Bezos is no doubt one of the worst examples of this, but there are a few others as well, well versed in “tactical philantropy”, who think they can just buy the world (and elections). The prospect of a US presidential race between 2 oligarchs makes my stomach turn - and I’m being diplomatic here. Fortunately, “Mike” was a disaster at the first big tv debate in which he was involved, and so the scenario seems a bit less likely now. But it’s too early to rule him out. M &M (Money & Men) still rules much of the world. Meanwhile, COVID-19 has led quite a few mainstream capitalist media to start feeling rather smug again about the western (presumably ‘democratic’) model of governance, after a few rough years – hope they didn’t mean the “Bring in the billionaires” “governance model” described in paragraph two, or also the televangelicals’ one, as in ““This pastor says God is sparing the U.S. from coronavirus because of the Trump administration” “ . In any case, The Economist, the WSJ et al seem to have a field day heavily criticizing the Chinese model of governance. While I agree with much of the criticism of the Chinese governance, which under Xi Jinping deteriorated further in a number of ways, I honestly don’t think we should feel smug these days in the West (either). (PS: Last time I checked, Japan was also a democracy . You might want to ask the passengers of the Princess Diamond cruise what they think of their 19th century approach. PS: Let’s not forget also that the current state of the planet (as described in paragraph one and in the abovementioned new Commission) is largely “inspired” by a ruthless and exploitative Western economic system, that went global in recent decades.) Over to Geneva then. Dr. Tedros and his team stress there’s still a chance to prevent a broader global Covid-19 crisis, and are doing their utmost to do so. Unfortunately, however, funding is materializing slowly. Again. See this (rather diplomatic) quote from earlier this week: “WHO is calling 1 for donations to help it help countries prepare. It said that $675m was needed, and that though some contributions had been made, they “have not seen the urgency in funding that we need….” Fortunately, there might at last be a solution for this (chronic) funding predicament on the horizon. CGD pointed out earlier this week, rightly, that “global development hasn't traditionally overlapped with the entertainment & music industries – until now”. Perhaps WHO should also adjust its fundraising approach? With its Contingency fund for Emergencies (much like the rest of WHO) chronically underfunded, and the WB’s pandemic bonds having turned into some sort of sick joke for investment bankers, I say it’s time for Tedros’ communication & fundraising crews to hire a rapper (or urban hip-hopper) who looks like a mixture of Kanye West and Jim Kim. In a cheeky ‘Naming & Shaming’ clip, the “bro” would be singing ‘Ho- o- o…!! I’m Bond. Pandemic Bond. And I’m making a mothafuckin’ amount of bucks! Ho-o-o- - Wo-o! against a dazzling backdrop of abundant dollar notes and scary Covid-19 & Ebola signs, while enjoying the good life in a swimming pool on the Diamond Princess cruise (the (obligatory) scantily clad “ladies” in such a clip would be (irresistably) coughing for the occasion ). And then WHO’s communications people would spread the word on all social media, together with their new friends from Google and FB - hashtag #OurWorldBankfriends #pandemicinsurance #bigbucks #Wo-o! Should really help with fundraising, I reckon. (But in the meantime, I do hope pandemic bond investors will have to pay soon.) Enjoy your reading. Kristof Decoster Featured Article What role for human rights in global health? Alicia Ely Yamin is a Senior Fellow at the Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics at Harvard Law School. My father used to say that “there are two kinds of people in the world: those who divide the world into two kinds of people and those who don’t.” In global health these days it’s difficult not to be part of the former tribe. At the start of this new decade, there are those who peddle “elixirs of optimism” about how the world has never been better off in terms of income, child mortality, etc. On the other hand, there are those of us who believe that life choices and chances have never been so unequal and that something is seriously awry in the political economy of global health. And it has everything to do with the tentacles of neoliberalism spreading across the globe and reaching into every aspect of global health—from research funding/agendas to global/national health governance, and the egregious inequalities in social and political determinants of health. There are of course notable sites of resistance, often from youth--from climate justice action to students clamoring for decolonization of global health. 2 But those of us in the so-called “health and human rights” field-- which is in truth a constellation of overlapping fields-- should be more present in these and other subversive movements for social change if human rights is to remain a relevant language of human liberation, and ensure it is not being used to deoderize the degradation that the interlocking systems of power implicated in patriarchy, colonialism and the dominant neoliberal economic paradigm leave in their wake. When “the right to health” is converted into a slogan for UHC or health-related rights consigned to UN agencies and other bureaucracies for “mainstreaming” they are emptied of their mobilizing potential. And that may explain why increasingly movements for social justice in health and beyond are turning to other frameworks. We have made enormous strides in applying human rights to health, from HIV to sexual and reproductive health and rights, from tobacco regulation to legislation regarding gender-based violence--and those strides have made real and meaningful differences in people’s lives. But today we need to do more than stand our ground in the face of toxic synergies between growing “illiberalism”, conservative populism, xenophobia, racism, and misogyny. In When Misfortune Becomes Injustice: Evolving Human Rights Struggles for Health and Social Equality, I offer critical (self) reflection on decades of human rights praxis, and argue we need to acknowledge that we have failed to show that health-related and other economic and social rights can be deployed to produce greater social equality. We are not in an “era of implementation.” We are in a heated battle for the soul of the human rights idea—that is, the equal dignity of diverse people across this shared and irreplaceable planet. We desperately need a global health governance that is fit for purpose in our grossly unequal and yet interconnected world. But operationalizing technocratic models of “human rights- based approaches to health” across agencies that are increasingly beholden to philanthro-capitalist and corporate interests will not curb the dynamics of rapacious deregulation, privatization, labor flexibilization, and the general hollowing out of fiscal space on which health rights and social equality depend. We urgently need to re-energize the original human rights aspirations of a social and international order based upon equal dignity of diverse human beings, which includes economic justice. And that calls for much bolder visions, networked strategies to shift the rigged rules of a multilateral order that has been usurped by global elites-- and for embedding human rights in popular struggles. Social struggles without concern for human dignity are betrayals; aspirations for transformative change that do not engage with law at national and international levels, are illusions. I am absolutely convinced that human rights can and must be part of broader social movements for health and social equality within and between countries, and in rethinking the deformed political economy of global health more broadly. But in today’s world, in human rights and beyond, we all need to figure out how to be part of the solution, not part of the problem. 3 Highlights of the week Lancet – Offline: Facts are not enough R Horton; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30405-0/fulltext I’m not quite sure I fully understood this -it’s Friday morning, so chronic lack of sleep by the end of the week and not enough coffee going through my veins yet, but I’m damned sure you have to read this ! Sweeping analysis of the world and the future by Horton.
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