Boarding the FCGH Express

BoardingBoarding the FCGH Express

Sometimes the right to health provides a clear answer. Discriminatory laws must be abolished to ensure the right for all people, and not deny it because of someone’s “legal status” or nationality, for example. The right to health does not always provide a definitive answer, though. To borrow an example from my colleague Alicia Yamin’s book Power, Suffering, and the Struggle for Dignity, consider the right to health requirement of equitable distribution of health services. Providing maternal health services in remote areas may well cost more than in urban areas. For countries in the process of expanding access to care, and where sufficient additional resources are not available, shifting resources from urban to rural areas to enhance equity could well slow overall expansion of coverage, leading to more maternal deaths in the near term. How far should this reallocation to a more equitable distribution go? There is no right answer.

But there is a right process to figure out the answer, a process that will give that answer legitimacy. That is a process guided by the human right principle of participation, with a fully informed public discussion and meaningful participation in decision-making, including and especially by the people whose lives will be most affected; in this example, rural and urban women who rely on public health services.

Meaningful participation, then, should be a constant guide for those involved in health policymaking, whether in allocating health resources within a community, developing a national health strategy, or seeking to secure a global treaty based in the right to health – that is, in securing the Framework Convention on Global Health (FCGH).  And this is the most significant area where the initiative to establish an FCGH has fallen short. I write as someone who has been quite involved in FCGH efforts for the past six years, beginning when a small coalition in 2010 established what was known as JALI, which later evolved into the Platform for an FCGH, where we are today.

It is not that we do not recognize the critical importance of this participation. We do. I have myself written of the importance of having the FCGH reflect, above all, the voices and concern of the people who most experience health inequities and health injustice. We know that participation is vital. This is a matter of principle. The processes related to developing a treaty based on the right to health, including in the present more formative stages, should themselves follow human rights principles. Inclusive participation is also a strategic necessity. Without broad-based support, requiring genuine engagement and a shared sense of ownership, we won’t achieve the FCGH, much less an FCGH that countries will ratify and implement.

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All Aboard The FCGH Express!

All aboardAll Aboard The FCGH Express!

(Posted on imaxi.org 4 Nov. 2016)

Over a year ago, a concept caught our attention and sparked our passions. We heard of the proposed Framework Convention on Global Health  (FCGH), an initiative to develop a legally-binding global health treaty based on the right to health, aimed at closing national and global health inequities. After many frustrating years of activism to advance the right to health, the FCGH idea seemed to be laying tracks in the right(s-based) direction.

We began to study the documents, to exchange e-mails with the welcoming Eric Friedman, point-person of the initiative, and started to mobilise a number of our peers and colleagues. Our interest was not only in the improvements the FCGH could bring to health and well-being, but also in the potential for community participation in the entire process — from drafting, organising and negotiating all the way to advocating for its ratification by individual governments in the future. We saw the development of the FCGH as an opportunity to build a broad-based collaboration between academics, experts and activists, and to practice the meaningful participation of many diverse and marginalised communities in the process. In other words, the practices and process of developing the FCGH excites us.

However, as we learned more, we realised that the initiative had been around for some eight years, circulating amongst a few well-known academics, mostly from prestigious institutions in the US and UK. Although we have been quite involved in global health activism, no one from our communities had ever heard about the FCGH initiative. An innovative idea that could move the world forward seemed to be stuck in the ‘Ivory Towers’.

The FCGH has a very impressive intellectual pedigree, but well-respected academics from elite institutions often have only a theoretical understanding of the realities of living with illness or disabilities while struggling with poverty, inequity or discrimination. Nor have many actually collaborated with any social activists on the ground. Perhaps this explains why, after some eight years, the FCGH initiative has had limited success reaching beyond colleagues working at universities, think-tanks, UN agencies and big NGOs to a broader base of people or organisations, specifically from the communities most in need of ‘health justice’.

Read moreAll Aboard The FCGH Express!