international obligations through collective rights: moving from foreign health assistance to global...
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International Obligations through Collective Rights: Moving from
Foreign Health Assistance to Global Health Governance
Benjamin Mason Meier, JD, LLM, PhDAssistant Professor of Global Health PolicyUniversity of North Carolina – Chapel Hill
Ashley M. Fox, MA, PhDPost-doctoral Fellow
Harvard School of Public Health
November 9, 2009
Outline1. Background – Foreign Assistance for Global
Health2. Results – Limited Evolution of the Right to
Health to Codify International Obligations3. Analysis – Collective Rights as a Means to
International Obligations4. Proposal – Employing Collective Rights for
Global Health Governancea. Developmentb. Implementation
Background Results Analysis Proposal
Foreign Assistance for Global Health• Entrenched poverty –
Neoliberal Development Policy
• Neoliberal Development Policy – Health Inequity
• Foreign Assistance– ODA
– Megaphilanthropy
– IFIs
• Vertical vs. Horizontal Aid– Biomedical services
– Primary health care systems
BACKGROUND Results Analysis Proposal
IllHealth
Inequitable Poverty
Human Rights-Based Approach to Foreign Assistance
Human Right = Valid demand & Corresponding duty(An Individual has a right against the State in relation to Health)
Demand of Rights
Programs to Realize Rights
Duty bearer
Rights holder
BACKGROUND Results Analysis Proposal
The existing gross inequality in the health status of the people particularly between developed and developing countries as well as within countries is politically, socially and economically unacceptable and is, therefore, of common concern to all countries.
Limited Evolution of the Right to Health to Codify International Obligations
1945 1965 1985 2005
Universal Declaration of Human Rights
International Covenant on Economic, Social and Cultural Rights
Declaration of Alma-Ata
Millennium Development Goals
General Comment 14
UN Special Rapporteur on the Right to Health
MDGs for Health
Background RESULTS Analysis Proposal
Incomplete Success of the Right to HealthRight to Health Cannot Address Primary Health Care
• Is a Right to Medicines All We’ve Got?
Right to Health Cannot Address International Development• What is Sovereignty in a
Globalized World?– State responsibility for human
rights is unable to address changes to state sovereignty
– Where the violator is an • international institution or • transnational corporation,human rights law cannot provide redress to the national victim
Background RESULTS Analysis Proposal
Collective Rights as a Means to International Obligations
• Collective Rights as Necessary to Realize Global Public Goods
• The Rise of Collective Rights to Challenge Global Institutions
Background Results ANALYSIS Proposal
Employing Collective Rights for Global Health Governance
• Vector of Rights for Interconnected Determinants of Health
• International Obligations against the International Community– Enforce Global Health
Commitments– Channel Assistance to
Primary Health Care– Ensure Cooperation in
International Institutions
Collective Rights– Development– Implementation
Background Results Analysis PROPOSAL
A State has a right against the International Community in relation to Primary Health Care Systems
Demand of Rights
(International/Intra-national)
Developing State – Rights holder
International Community – Duty bearer
Policies to Realize Rights
Respect Protect Fulfill
Refraining from infringing states’ autonomy to develop primary health care systems
Regulating transnational private actors
Promoting cooperation through international institutions
Background Results Analysis PROPOSAL
Developing Human Rights Claims – Policies to Realize Collective Rights
Respect Protect Fulfill
Refraining from infringing states’
autonomy to develop primary
health care systems
Regulating transnational private actors
Promoting cooperation
through international institutions
Background Results Analysis PROPOSAL
Implementing Human Rights Claims – Demand of Collective Rights
• International– Restructure international
institutions – Create multilateral
global governance institutions
• Primary Health Care through WHO
• Intranational– Ensure assistance is
channeled through • General budgetary
support• Sector-wide
approaches to national primary health care systems
Background Results Analysis PROPOSAL
Benjamin Mason Meier, JD, LLM, PhDAssistant Professor of Global Health PolicyUniversity of North Carolina – Chapel [email protected]