Today is the anniversary of Dr. Martin Luther King’s birth. It’s a good day to think about health justice.
Over a billion poor people around the world are still waiting for their right to health to be “progressively realised”, as mandated seventy years ago by the United Nations in the Constitution* of the World Health Organization (WHO). Although the WHO is the ‘guardian’ of the right to health and the leading global health authority, it has failed to press its Member States to advance this right or to implement a human rights-based approach (HRBA) in health programmes. The WHO appears to ignore the fact that it signed, along with all the other UN agencies, the Common Understanding on adopting the HRBA in 2003, which requires signatories to use the rights-based framework in their practices and to help national governments to do the same. This ongoing failure at the ‘top’ of global health makes it almost impossible for the ‘bottom billion’ to claim or demand their rights, and limits the capacity of community organisations to respond to local health needs.
Although meaningful participation of affected people and their civil society organisations is a key principle of the HRBA, the WHO does not allow more than a token voice from folks from these communities. The WHO’s general exclusion of civil society participation has also weakened the position of NGOs working to improve health and well being in communities everywhere — Governments look to to WHO to set standards, and some see that keeping civil society out of programme development and implementation is a model to follow. The message from Geneva is that NGOs may possibly be allowed to be service providers, but not to contribute to the design of the programme nor to hold governments to account, nor even to simply advocate for improved public health services.
Dark clouds are fast approaching. Our rights are being rolled-back in many countries through cutbacks in public health expenditures, privatisation of services, and increased discrimination against marginalised communities. Even the concept of global health as a ‘public good’ is now at risk from growing nationalism, the decreased support of multilateral institutions such as the United Nation’s agencies and the increasing influence of the profit-seeking health industry. In dozens of countries, civil society organisations are under attack by governments that see NGOs as a threat to their authority, not as a partner. Even raising a voice in support of our rights is becoming more difficult, and finding the resources to organise and mobilise to defend them has become almost impossible.