Anthropology, Health, and Human Rights:
Three Panels at the AAAs
Interested in the intersections among anthropology, health, and human rights? Attending this year's American Anthropological Association's (AAA) meetings in Minneapolis? Make time for 1, 2, or all 3 of the following panels. Panel titles link to the AAA online program, and full abstracts are included below.
1) Engaging with the Right to Health:
Primary Health Care, Evidence-based Policy, and the Millenium Development Goals
ORGANIZERS: Priscilla Magrath & Jessica Jerome
DATE: Wednesday, November 16
TIME: 2:00pm - 3:45pm
LOCATION: Hilton, Marquette VIII
SPONSOR: Society for Medical Anthropology (SMA)
* NOTE: Elizabeth Farfán-Santos' presentation, originally scheduled for Panel #3 (below), will take place on this Wednesday panel instead.
2) INVITED SESSION:
Health and Human Rights in the U.S.: Violations, Representations, Action
ORGANIZERS: Sarah Willen & Bisan Salhi
DATE: Friday, November 17
TIME: 10:15pm - 12:00pm
LOCATION: Convention Center, Room 200AB
SPONSORS: SMA & Society for the Anthropology of North America (SANA)
3) Engaging with the Right to Health:
Individualization, Commodification, and Judicialization
ORGANIZERS: Alejandro Ceron & Priscilla Magrath
DATE: Sunday, November 20
TIME: 10:15am - 12:00pm
LOCATION: Convention Center, Room 205A
* NOTE: Katerini Storeng's presentation, originally scheduled for Panel #1 (above), will take place on this Sunday panel instead.
1) Engaging with the Right to Health: Primary Health Care, Evidence-based Policy, and the Millenium Development Goals
Right to health discourses have gained prominence in global health policy in the past 25 years. Following the Universal Declaration of Human Rights, the Constitution of the World Health Organization and the Alma Ata Declaration, right to health language started to appear in national constitutions and in specific health care policies and programs. However, questions remained over the meaning of a right to health and whether governments could guarantee the right to health through legal mechanisms. Furthermore, the rise of rights-based approaches to health ran parallel to the consolidation of a competing neoliberal agenda that placed pressure on governments to transfer responsibility for health care provision to the private sector, and generated demands for new forms of accountability based on achievement of measurable targets. Alongside this history, the political understanding of the right to health and the strategies implemented to achieve it also changed. The 1978 Alma Ata Declaration advanced the notion of Primary Health Care (PHC) as a strategy for ensuring that all people gained access to the means for securing a healthy life. Within this strategy, health was regarded as a comprehensive process that responded to the specific needs of communities and required governments to commit to people’s participation in bringing health care services to their communities. In 1979, a maneuver to tame Alma Ata’s ambitious agenda was introduced with the notion of Selective Primary Health Care (SPHC), a much-reduced version that nevertheless still claimed to have PHC as its ultimate goal. SPHC emphasized first-level, cost-effective and measurable interventions such as growth monitoring, immunization and birth control and left out the importance of strengthening health care systems and people’s active participation in decision making processes. In practice, most institutions adopted the lower cost SPHC interventions. The idea of PHC continues to influence global health policy debates but is now entwined with increased pressure to use measurements and standards to achieve particular targets, as evinced in the Millennium Development Goals(MDGs) (2000), and the Sustainable Development Goals (SDGs)(2015). The papers in this panel examine the relationship between global health policy and various interpretations of the right to health in the context of particular health care systems. We examine the role of a constitutional right to health; the increasing focus on evidence production, accountability and the use of numerical targets; and local political cultures on a country’s willingness and ability to pursue the principle of the right to health through primary health care policies and programs.
2) INVITED SESSION: Health and Human Rights in the U.S.: Violations, Representations, Action
To commemorate the 25th anniversary of the Office of Minority Health and Health Equity (OMHHE) at the Centers for the Disease Control and Prevention, the CDC’s Smithsonian-affiliated museum held an exhibition titled “Health Is a Human Right: Race and Place in America.” Using images and video, historical artifacts and digital renderings of epidemiological findings, this 2014 exhibition – which drew 46,000 visitors – challenged simplistic biomedical explanations that situate health solely within the individual body. Instead, it showed visitors how colonialist logic, institutionalized racism, and structural violence have shaped American health policy and interventions, harmed the health of individuals and communities, and contributed to the egregious health inequities that persist in the U.S. today. The exhibition spanned a wide range of historical episodes and themes including the forced relocation of Native Americans and involuntary sterilization of Chicana women; medical experimentation on vulnerable peoples’ bodies (African Americans with syphilis, Navajos with tuberculosis); coercive measures targeting immigrants and their descendants (spraying bracero workers with DDT, the internment of Japanese Americans); and the ongoing pollution of air and water that disproportionately harms communities of color. The exhibition also challenged simplistic narratives of exploitation by highlighting signature moments of collective mobilization and activist fervor: the 1968 Memphis Sanitation Strike and the Poor People’s March in the same year; the Safeway agricultural boycott of the 1970s; the American Indian Movement’s 19-month occupation of Alcatraz in 1978; and the 1991 campaign by ACT-UP to pressure Dr. James Curran, then-head of CDC’s HIV/AIDS Task Force, to expand the AIDS case definition by sending him 20,000 postcards showing his own face—marked with a red-and-white bull’s eye. Taking this provocative exhibition as point of departure, this panel will consider what’s at stake in invoking the human right to health in conversations about health inequities in the U.S. When might a human rights frame advance efforts to identify and tackle health-related harms? When might its value be limited, or even yield unintended negative effects? To engage these questions, the panel will begin with a virtual tour of the CDC exhibition by the curator, followed by three papers exploring its origins and impact. One paper will consider the exhibition’s strengths and limitations as a teaching tool about health and human rights. Another will analyze a heated internal debate among CDC employees about its (or at least the title’s) central claim. A third will consider how different explanatory frameworks, or “idioms of social justice mobilization” for health, have been employed in U.S. health policy since the early 20th century including, most recently, the idiom of “health equity.” A final paper will examine one of the latest episodes in what unfortunately is an ongoing saga: the health crisis induced by water contamination in Flint, Michigan. Taking the CDC Museum’s unusual choice to characterize health as a human right as our central frame, the panel will consider the strengths and limits of health and human rights approaches in concrete efforts to tackle structural racism and health inequity in the contemporary U.S.
3) Engaging with the Right to Health: Individualization, Commodification, and Judicialization
The “right to health’ has a complicated genealogy, with historical roots in moral philosophy, law and liberal politics. It can operate both as a technology of government deployed to legitimize public health policy and as a tool of struggle used to make claims on government. The “right to health” thus operates as a flexible and mobilizing metaphor that operates in a wide range of settings, used by different actors and for diverse goals. In this panel we seek to explore how “right to health” engages with complex assemblages of government rationalities around the world. For example, in recent decades a number of countries in Asia, Latin America and Africa have seen the emergence of populist governments seeking to legitimize fragile democracies through the provision of health services and welfare benefits. At the same time there has been a diffusion of neoliberal government rationalities to these countries from Europe and the US, translated via international organizations such as the IMF and the World Bank. This has encouraged privatization of health services as well as the emergence of new modes of governance as citizens are encouraged to take greater responsibility for their own health through reducing “dependence” on government. As modes of governance evolve, the “right to health” is found to be a moving target, subject in some cases to individualization, commodification and judicialization. This panel asks how “right to health” articulates with these evolving governance assemblages to generate diverse interpretations, sometimes paradoxical deployments and unpredictable outcomes. There appears to be no clear relationship between “right to health” as a constitutional guarantee and the availability or accessibility of health services. Both governments with a constitutional right to health, such as Brazil, and those with no such guarantee, such as Ethiopia, provide public health services to their populations, although in neither case do they completely fulfill public needs and expectations. Furthermore, “right to health” is increasingly linked with the promotion of biomedical practices and this obscures broader understandings of health and wellbeing. For example, fulfillment of the “right to health” is often measured in terms of Availability, Accessibility Acceptability and Quality (AAAQ) of medical services, an indicator that misses the social conditions that influence life and wellbeing as well as the role of non-biomedical providers and practices in promoting health. Against this background, our panel aims to draw together anthropologists from diverse fields, particularly medical, policy, legal, political, linguistic and applied anthropology to interrogate the utility of “right to health” as a theoretical concept and as a platform for an engaged anthropology of human rights.
Distributed by the Research Program on Global Health & Human Rights
at the University of Connecticut's Human Rights Institute