Environmental Engineering Reference
In-Depth Information
has achieved changes in domestic governance across a 'strikingly different range of
regions, countries, socio-economic systems, cultures, and types of political regimes'
(Risse and Ropp 1999, 238). The efficacy of human rights-based advocacy in non-
democratic and non-human rights societies can be seen to disconfirm the notion that
'international human rights are fundamentally alien to particular cultures or regions
of the world' (239).
thus far from being imposed on developing countries from the top down as
part of a western 'civilising mission', human rights are also being claimed from the
bottom up by 'subaltern' actors themselves. not only do these social claims add to
the growing efficacy of human rights, but these dialogic processes may also ground
rights in diverse domestic contexts, realise them, and ensure their cross-cultural
application.
International human rights law therefore offers global health governance a
normative framework rooted in moral consensus and reflected in the coercive and
strongly persuasive mechanisms of law. this is not to suggest that human rights
should crowd out alternative ethical frameworks for global health governance.
Instead, rights should be seen as an important complement to other projects concerned
with achieving global health equity, such as public health ethics (see, for example,
benatar
,
Daar, and Singer 2003). Indeed, integrating human rights with other
ethical approaches to global health may overcome some of the more fundamental
limitations of rights and rights strategies. to some extent, these limitations are
reflected in the greatly amplified yet persistently limited access to aIDS medicines
in developing countries. Indeed, at 28 percent, two thirds of people in need
remain without access. this limited access suggests the broader limitations of the
stimulus-response-innovation model identified by cooper, Kirton, and Schrecker,
where social actors only innovate in response to the demands arising from severe
shocks or crises. The limited success of reactive strategies is similarly identified
by Kimberly crenshaw (2000, 72), who argues that if rights strategies simply point
to contradictions between dominant ideology and certain material realities, they
run the risk of adjusting circumstances only to the extent necessary to close the
contradiction. this outcome is evident to some extent in the fact that the activists
have only been able to achieve a limited carve-out for using compulsory licensing
or other TRIPS-compliant flexibilities in relation to AIDS medicines in Africa. As
persistent litigation and trade sanctions against thailand's compulsory licensing
of medicines suggests, other health needs in other jurisdictions are still not seen
as adequately entitling this action. these outcomes suggest that transcending the
limitations of existing strategic approaches requires more systemic and less reactive
solutions to problems such as medicines access.
International human rights law offers a normative framework within which to
explore such systemic solutions to global health challenges. Human rights offer a
practical and normative tool for increasing the priority that the human rights and
public health needs of the global poor receive in general, and particularly when
these are deemed to conflict with free trade and commercial interests. the aIDS
medicines experience suggests the potential of rights and social movements to make
