Review
Theodore H MacDonald, Health, human rights and the United Nations – inconsistent aims and inherent contradictions? Radcliff Publishing Ltd 2008 ISBN 13: 078 1 84619 241 8, 196 pages
This book follows Health, trade and human rights (ISBN 1-84619-050-9) 2006, and The global human right to health – dream or possibility? (ISBN 978-1-84619-201-2), 2007. Forthcoming is Sacrificing the WHO to the highest bidder. This publication rate is in keeping with Theodore MacDonald’s over 200 research papers and over 40 books (from which he draws no financial gain) reflecting his life-long commitment to human rights and immense contribution to health promotion and public health, emphasising that without primary health care for all, nothing else is achievable.
Imperialism’s barbaric practices are meticulously documented, using easily accessible examples. MacDonald ensures that revolutionary Cuba is prominent in the discussion of alternative ways of organising society in the interests of the people and that socialism is on the agenda.
Health, human rights and the United Nations gives the history of the establishment of the UN, its initial declarations, aims and objectives, the other organisations that have come under its umbrella and the political and economic forces at play that stop the objectives’ achievement. This is set in the context of the most basic levels of health access for the world’s population, which are as far away as ever from attainment.
The 1948 Universal Declaration of Human Rights at the establishment of the UN and the setting up of the World Health Organisation (WHO) aimed to promote and defend global access to primary health care as a basis for all other human rights and personal dignity. The 1978 Alma Ata Declaration recognised that the barriers to adequate health are economic and political rather than clinical.
The WHO was developed to ensure that the UN’s basic declarations could be safeguarded, enable access to primary health care for all, eradicate diseases and promote public health; similar agencies were UNICEF (United Nations Children’s Fund) and UNESCO (United Nations Educational Social and Cultural Organisation).
Other agencies came under the umbrella of the UN: the International Bank for Reconstruction and Development (World Bank), the International Monetary Fund (IMF) and the World Trade Organisation (WTO). MacDonald shows how these prevent UN goals from being achieved.
The WB’s and IMF’s Structural Adjustment Policies (SAPs) force oppressed nations to cut back on publicly funded services such as health and education as a condition for loans. This has slowed progress towards achieving the 1973 Health For All campaign’s 38 targets by 2000. Former UN general secretary Kofi Annan introduced the Millennium Developmental Goals in 2000 to try and prevent the WHO being undermined.
The WTO has controlled global trade through the General Agreement on Tariffs and Trade (GATT), the General Agreement on Trade in Services (GATS) and Trade Related Intellectual Property Rights (TRIPS). Trade is organised against the poorer nations through protectionist tariffs and these have a direct impact on health. The effect of TRIPS, ‘a radical re-interpretation of patent law’, is illustrated by the pharmaceutical companies who produce anti-retroviral drugs for those with HIV/AIDS too expensive for the majority of affected countries to buy. However, when India and Brazil produced a generic version at 5% of the cost, TRIPS restricted the sale.
MacDonald details human rights abuses: child soldiers, sexual abuse by UN personnel, human trafficking, and shows how the failure of the UN to protect human rights has led to its undermining, and the encouragement of NGOs.
A chapter deals with Britain’s appalling record on human rights. The arms trade promoting more effective ways of killing; the treatment of asylum seekers; Britain’s involvement in people trafficking and the Labour government’s contempt for the Human Rights Act when it did not fit its military and political objectives. A UNICEF 2007 report found that ‘the human rights of British children were more seriously violated than any of the other 21 developed nations studied’ with unacceptable levels of poverty and low aspirations for their future, deprived in affection, education, materially and socially;
Despite the WHO’s achievements, 17 million people still die every year from infectious diseases. MacDonald asks whether the structure of the UN will allow the WHO to fulfill the Health For All mandate and concludes that reforming or replacing the UN will not solve the problems of manipulation and domination of corporate interests. What is needed is a ‘socially responsive philosophy, essentially egalitarian and socialist in its world view’.
Hannah Caller
FRFI 202 April / May 2008
