A few weeks ago, I attended GlobeMed's annual Global Health Summit in Chicago. This year’s conference, “From Idea to Implementation: Securing Health as a Human Right,” brought together philosophers, economists, physicians, activists, and many others to debate the role of a human rights framework in realizing global health equity. Although most speakers fundamentally agreed that health is a human right, often citing Article 25 of the Universal Declaration of Human Rights, heated debates ensued once the topic drifted to pragmatics.
Between the conference and recent class discussions, I’ve noticed more and more parallels between the struggles for healthcare access and racial equality. Structural violence, unacknowledged privileges, and arguments over semantics create a glass ceiling preventing us from attaining the level of equity outlined in documents such as our own Constitution and the Universal Declaration of Human Rights (UDHR).
I don’t mean to say that the Civil Rights movement was unsuccessful or that the UDHR was not a monumental stride. Clearly we’ve come a long way the past 50 years in terms of written legislation; however, it’s easy to simply pull quotes from these documents and argue that our work is complete. I think most of us would agree that unresolved social, economic, and racial inequalities are systematically buried under the façade of equal opportunity. From the impression of an equal playing field stems the common misconception and generalization that current inequalities can be attributed to a person’s innate ineptitude or laziness. The sick are sick because they don’t care for themselves (not because they lack equal access to preventive healthcare). The poor are impoverished because they lack entrepreneurial skills (not because they lack equal access to education). At the same time, though, somehow we need to recognize the significance of the structural forces at play without lifting accountability off individual shoulders.
Both racism and global health inequity are manifestations of structural violence. Not only does the system self-perpetuate its design and hierarchies, but realization of these sedimented structures can often deter individuals from taking action. General feelings of inevitability and helplessness serve to suppress efforts to dismantle (or at least navigate) the system. This makes perfect sense from an economic perspective. Why invest in something that will likely eat your money?
The assumed role of “investor” is a privileged position. Ability to extend one’s reach to others requires a certain level of health and stability. We gripe about costs of medical care in the US, yet we are incredibly privileged to have access to top-notch hospitals, clean water, food, and other services difficult to obtain in developing countries. Typically, we are not reminded of these benefits on a daily basis, and this is just one example of Western privilege when it comes to healthcare access. For most, the phrase “global health issue” tends to evoke images of starving children in Africa. Global health is often perceived as a Third World plague, with the potential remedy lying in the hands of the West. Likewise, racialism is typically portrayed as a problem for oppressed colored people, with the predominantly white government responsible to grant civil rights. In both cases, the fundamental aspect of privilege involves unconsciously extracting oneself from the issue and assuming the role of caretaker.
Right now, other than good will, there’s not much motivating the West to cure the Rest. This is where I believe the human rights paradigm potentially takes a stronghold over civil rights in the quest for social justice. It’s impossible to conceive of a free-standing right, or one without a corresponding duty. A right always involves two parties at minimum. You have no rights unless someone else acknowledges them, and then the “other” has a duty to act in accordance with those rights. When it comes to enforcing political or civil rights, duty primarily lies in the hands of the state. For human rights, the responsibility belongs to humanity. A couple others have asked about the possible synthesis of Alternative Epistemologies, and I wonder if human rights language may be the source of a universally resonating call to action.