From Alicia Ely Yamin
Program Director of the Health and Human Rights Initiative
I am truly delighted to be writing this first letter as the Director of Health and Human Rights Initiatives at the O’Neill Institute for National and Global Health Law, and to share my vision and enthusiasm for everything that we can accomplish together. At the O’Neill Institute, we believe that states of health are a sensitive reflection of patterns of social (in)justice, and that advancing people’s dignity and rights should lie at the center of our responses to many national and global health problems. But in the more than twenty years since a nascent “health and human rights movement” took shape, much has changed.
These are new times, and they present new challenges and also new opportunities for health and human rights work. The world is facing one of the worst man-made crises involving human migration and forced displacement in modern history. How we react will say much about not just our appetite for humanitarian largesse, but about the meaning of our international architecture for citizenship and rights, and who gets to be treated as fully human.
At the same time, social inequalities, including egregious inequalities in health care access as well as health outcomes, increasingly tear at the social fabric of many societies, as well as being woven into the world order. Intersecting forms of discrimination and stigma keep many people and groups low on the social ladder, but we must also face the enormous economic disparities that prevent so many from living flourishing lives. Indeed, the Sustainable Development Agenda forcefully sets out a universal set of goals, including health-related goals, and in so doing acknowledges that the problems of inequality affect rich and poor countries alike.
These new challenges and opportunities call for new approaches to to advancing health through a human rights framework in order to foster systemic changes, which we welcome the opportunity to explore and advance in conjunction with partners around the world.
Over the last twenty plus years, much work has gone into exploring and clarifying the linkages that Jonathan Mann, Larry Gostin and other colleagues first suggested existed between health and human rights, and in developing normative standards. One of --if not the --principal questions that faces the diverse groups that work on health and human rights today is when and how law, and specifically human rights law, can be used for positive social transformation in health, and beyond.
The Lancet-O’Neill Institute Commission on Global Health and the Law has drawn together experts from around the world and from multiple disciplines to examine the ways in which law, including human rights law, can be used to advance global health. The report of the Commission will be launched in 2017.
In addition to research we conduct around the world to better understand the functions and effects of law in practice with respect to diverse health phenomena, we will also be regularly conducting small seminars, as well as larger symposia with practitioners, scholars and judges from different regions of the world to explore these questions in context.
The O’Neill Institute is also partnering with the Centre on Law and Social Transformation at the University of Bergen, to create a Working Paper series which will be openly accessible on the web, and which will both capture the proceedings of various symposia, as well as lead to others about specific issues.
New Domains of Action
Human rights relating to health are no longer simply the domain of lawyers, or a single “human rights community.” Human rights are used in both the rhetoric and practice of development, as well as in health and social protection policy. As a member of the UN Secretary General’s Independent Accountability Panel on the Global Strategy on Women’s Children’s and Adolescent Health, I will bring a particular focus to the O’Neill Institute’s Health and Human Rights Initiatives on women’s, children’s and adolescent’s health in exploring how to meaningfully incorporate human rights standards and tools into development practice and in the reality of health and social programming.
Our work will emphasize the central role of accountability in human rights frameworks, both within and beyond health systems at national levels, and in mechanisms at global levels. We will do this through promoting better health governance but also by examining questions such as judicialization of health rights, the roles of national human rights institutions, regulation of multi-nationals, and other issues of emerging importance for health rights.
New Calls for Evidence
Governments, donors and advocates alike increasingly seek “proof of concept” to be able to show that applying human rights-based approaches (HRBAs) has positive impacts on health care utilization and outcomes. At the O’Neill Institute we are interested not only in refining more conventional public health methodologies to better capture the impacts of rights on health without instrumentalizing them, but also in exploring how applying human rights frameworks changes the evaluative space in which we assess impact to understand whether people are enabled to live more flourishing lives.
We are committed to exploring and refining inter-disciplinary methods to apply in programs and across different settings. Some evaluations of progress require quantitative indicators and evaluations of impact that are “scaleable” to be implemented broadly, and we are and have been actively engaged in the process of looking at data for use in monitoring the SDGs. However, we also believe that there is room for more anthropological and narrative-based methods to capture effects in the lived experience of people’s lives in specific contexts. Together with several partners in the United States and elsewhere, we are currently exploring research on the use and selection of methods to evaluate impacts, and in applying different methods.
New Geographies of Knowledge and Collaboration
Sustained social change in health based on human rights principles calls for building communities of knowledge and practice, and going beyond traditional approaches to academic research as well as the “naming and shaming” of governments in the South by advocates in the North. We are committed to establishing sustained and equal partnerships with academic and civil society institutions within the United States and across the world, which allow us to undertake joint research, joint advocacy, and joint reflection.
We work with partners both on specific projects, such as amicus curiae briefs, research investigations and symposia and workshops, as well as the construction of a database on health rights judgments from around the world and a broader interchange of people, sending O’Neill associates and fellows to other institutions, and bringing people from institutions across the world to Georgetown.
We hold an annual intensive one-week course that brings together practitioners, as well as judges and academics, from over twenty countries around the globe, to explore both how to engage successfully in health rights litigation and to use it to foster increased equity in health systems and outcomes. Both O’Neill Institute Executive Director, Oscar Cabrera and I also regularly teach in other courses around the world, including for example, the regional Latin American course Diplomatura en Derechos Sexuales y Reproductivos, which is being led by CEDES in Argentina. Among other materials, my 2015 TEDx talk on “Why Applying Human Rights to Health Matters” can be found now in Spanish.
New Approaches to Pedagogy and Outreach
Understanding why human rights are relevant to health is often best captured through a combination of means that reach both our visceral and intellectual selves. We are exploring multi-modal approaches to pedagogy and outreach and their effectiveness in conveying messages about health and human rights in ways that can reach broader audiences than traditional academic outputs. As part of a collaboration with Harvard’s Global Health Education and Learning Incubator, we are developing a series of modules on different aspects of health and human rights, which will be made freely available.
We are also undertaking explorations of different artistic media to supplement our understandings of what possessing rights, and having rights violated, means to our humanness as well as to our understanding of health and well-being. We began this week by featuring photography from Social Documentary Network on Colombia.
We are excited about embarking on this new stage in the O’Neill Institute’s Health and Human Rights work, and we welcome scholars and advocates with whom to link to broaden our networks of knowledge and advocacy.
Alicia Ely Yamin
Program Director of the Health and Human Rights Initiative