Public Health "Army" Marches for Framework Convention on Global Health
ENVIRONMENT & HEALTH, HUMAN RIGHTS, SOCIETY & CULTURE
Wednesday, October 27, 2010
The closing paragraph of a recent article advocating the adoption of a Framework Convention on Global Health leaves little doubt regarding the interventionist mindset of those who are fighting to globally govern public health:
Public health is a slow road to social justice, but it is one of a finite number of reasonably straight paths. As we walk it behind the banner of a framework convention, no one should confuse us for a folksong army, with nothing much beyond guitar strings to tie our rhetoric to action. We are the public health army: ready, measure, intervene.
In their article, "A Framework Convention on Global Health: Social Justice Lite, or a Light on Social Justice?," Scott Burris and Evan Anderson, law professors at Temple University's James E. Beasley School of Law, pick up the discussion of a possible Framework Convention on Global Health that was initiated by Georgetown University Law Center Professor Lawrence Gostin in his 2008 article titled "Meeting Basic Survival Needs of the World’ s Least Health People: Toward a Framework Convention on Global Health."
According to Burris and Anderson, it is not enough that, according to some experts, the problem of extremely poor health can be considered a human rights violation. In their opinion, although States have the primary legal obligation to promote the "progressive realization" of the right to health for their own populations, "there can be little agreement as to when a State has breached an obligation to its people, let alone to people in far away places." The authors further lament that, "even if some obligation to offer financial and technical assistance could be read into human rights instruments, there is no systematic method of implementation and enforcement." Thus, because, in their opinions, the promotion of public health cannot be left to national, state, or local authorities, a binding international human rights framework convention is needed.
Of course, no straightforward human rights convention would suffice—it must be a "framework" convention, similar in nature to the United Nations Framework Convention on Climate Change. The reasoning behind the call for a "framework" convention on global health, rather than a single, all-encompassing convention, is evidenced by the following observation made with respect to the reason the UN adopted a "framework" convention to deal with climate change:
Rather than seeking to solve all of the problems of climate change in a single convention, a method that risked getting bogged down in contentious detail and taking considerable time, the governments and organizations concerned decided instead to pursue what they called a "framework convention." This convention would establish the principles and norms under which international action would proceed, and set up a procedure for negotiating the more detailed arrangements that would be necessary to deal with climate change. The conference of States party to the convention would become the oversight body and negotiating forum and its secretariat could provide the necessary studies.
Thus, by adopting a Framework Convention on Global Health ("FCGH"), the advocates of the global governance of public health would have a permanent forum for negotiating detailed protocols relating to public health issues and for naming, shaming, and lobbying against States Parties to the FCGH that hesitate to adopt them. The likelihood of such a scenario is evidenced by the observation of Burris and Anderson that a convention "could well mobilize public support—and thus political pressure and resources—for action that will directly address unjust social conditions."
The attractiveness of the framework convention model as a method of securing a basic international agreement on public health the details of which would be "negotiated" by organizing international public opinion in favor of later protocols was not lost on Professor Gostin:
In the initial stage, States would negotiate and agree to the framework instrument, which would establish broad principles for global health governance: goals, obligations, institutional structures, empirical monitoring, funding mechanisms, and enforcement. In subsequent stages, specific protocols would be developed to achieve the objectives in the original framework. These protocols, organized by key components of the global health strategy, would create more detailed legal norms, structures, and processes. The framework convention approach has considerable flexibility, allowing Parties to decide the level of specificity that is politically feasible now, saving more complex or contentious issues to be built in later protocols.
According to Gostin, "an FCGH would represent a historic shift in global health, with a broadly imagined global governance regime." At the conclusion of his article, Gostin set out the following broad principles that would serve as the foundation for the FCGH:
1. FCGH mission. Convention Parties seek innovative solutions for the most pressing health problems facing the world in partnership with non-State actors and civil society, with particular emphasis on the most disadvantaged populations;
2. FCGH objectives. Eestablish fair terms of international cooperation, with agreed- upon mutually binding obligations to create enduring health system capacities, meet basic survival needs, and reduce global health disparities;
3. Engagement and coordination. Find common purposes among a wide variety of State and non-State actors, set priorities, and coordinate activities to achieve the mission of the FCGH;
4. State Party, and other stakeholder obligations. Incentives, forms of assistance (e.g. financial aid, debt relief, technical support, subsidies, tradable credits), and levels of assistance, with differentiated responsibility for developed, developing, and least developed countries;
5. Institutional structures. Conference of Parties, secretariat, technical advisory body, and financing mechanism, with integral involvement of non-State actors and civil society;
6. Empirical monitoring. Data gathering, benchmarks, and leading health indicators, such as maternal, infant, and child survival;
7. Enforcement mechanisms. Inducements, sanctions, and dispute resolution;
8. Ongoing scientific analysis. Processes for ongoing scientific research and evaluation on cost effective health interventions, such as the creation of an Intergovernmental Panel on Global Health, comprised of prominent medical and public health experts; and
9. Guidance for subsequent law-making process. Content, methods, and timetables to meet framework convention goals.
In essence, the all-encompassing proposed FCGH would empower the United Nations, its health-related agencies, non-governmental and civil society organizations, regional and world human rights courts, and the permanent Framework Convention secretariat to globally govern public health to the detriment of national sovereignty, organic democratic evolution, free market capitalism, and individual liberty.
Jim Kelly is the President of Solidarity Center for Law and Justice, P.C., a public interest civil and human rights law firm based in Atlanta, Georgia. The opinions expressed herein are his own.
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