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Accountability and the FCGH at the CUGH conference

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I had the honor to join two luminaries in the health and human rights world on a panel at the annual conference of the Consortium of Universities for Global Health here in Washington, DC, two weeks ago. Sofia Gruskin, probably the first “right to health person” I came across back when I was in law school and first learning about the right to health, long at Harvard’s FXB Center and now at the University of Berkeley, and Joe Amon, who heads Human Rights Watch’s health and human rights program, were part of the CUGH conference panel on “Advancing global health through human rights accountability for a Framework Convention on Global Health.”

They had been recruited by O’Neill Institute Scholar and frequent collaborator Ben Meier, a professor at the University of North Carolina, and himself an astute scholar deeply committed to the right to health. The panel’s aim was to highlight the wide range of options for health and human rights accountability – such as courts, indicators, treaties, social mobilization, investigations and reporting, and public and government engagement. And the panel was intended to share the potential of the Framework Convention on Global Health (FCGH) to advance such accountability.

A great thing about being on a panel like this is that if you listen closely to your fellow panelists, you’ll learn plenty yourself. Joe’s presentation was a reminder of many of the current modalities for accountability, including HRW’s hallmark of careful investigations and generating evidence, which remains a powerful tool for accountability, particularly when combined with other strategies including using courts and mobilizing the public against the abuses. And the abuses are rife and varied. Examples from HRW’s work include how drug users in countries including China and Vietnam face sham treatment centers that offer more in the way of torture than treatment, the seeming omnipresent abuses against people with mental illnesses who are confined to institutions, and the lack of health care in Zambia’s overcrowded prisons.

Sofia’s presentation on health and human rights indicators explored challenges of identifying and developing such indicators. These include the tension between what might be ideal – such as extensive disaggregation of data to learn about the health status of marginalized populations and how health programs are affecting them, and indicators to probe the many dimensions of the right to health, including equity and inclusive and meaningful participation – and the realities of constrained resources and technical capacities.  Sofia brought to light other questions around adopting existing indicators for health and human rights purposes, such as of who collected data and designed the indicators, and why.

The FCGH – a proposed global health treaty aimed at closing domestic and global health inequities and rooted in the right to health – also holds great promise as a powerful tool for accountability. It could create clear standards and targets, promote and facilitate access to national courts to protect the right to health, use indicators to measure the progressive realization requirement of the right to health, require countries to develop multi-faceted accountability strategies (including, for example, standards on transparency and participation, and measures to promote community-level accountability), strengthen the capacity of civil society organizations, and establish a regime of monitoring and reporting and innovative incentives and sanctions to promote compliance. The ultimate accountability for an FCGH will need to come through social movements that unite around a shared insistence that governments fulfill their right to health obligations.

We encourage you to become involved in helping to secure an FCGH. Sign up for our listserv to stay updated on opportunities to engage the process towards an FCGH. Get involved in research around those innovative incentives and sanctions that would promote compliance — or one of a host of other aspects of the FCGH that requires research and thoughtful analysis. And let us know about organizations that might want to learn more about, contribute to, and come to support and even advocate for an FCGH – to be part of the social mobilization, the popular demand that is necessary if the potential of the FCGH is to be realized.

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The views reflected in this expert column are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.

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