Hesperian Weblog

Health advocates condemn Binayak Sen’s unjust conviction

On December 24th Dr. Binayak Sen, a vibrant voice for bringing health as a human right to the poor in India, was sentenced to life imprisonment for sedition. Hesperian has been campaigning against Dr. Sen’s unjust imprisonment and conviction, and stands with health advocates around the world in condemning his sentence. More than two dozen Nobel Prize winners have signed statements demanding his release and demonstrations have been held in many countries around the world against his trumped up conviction.

Read statements from our partners in Jan Swasthya Abhiyan (the Peoples’ Health Movement – India) and The Lancet below, and a statement from Dr. Sen here. You can also read mainstream media coverage of the initial protests against his sentence here, listen to radio coverage here, and find more information on the Free Binayak Sen campaign website. The campaign will be organizing a Global Day of Protest around January 30th, including a protest outside of the Indian Consulate in San Francisco on January 28th at 10am.

PHM India (JSA) statement on Binayak Sen's conviction
Date: 27 Dec 2010

We, the Jan Swasthya Abhiyan, a coalition of national networks and organizations actively working for health rights in the country, express our outrage at the verdict of the Raipur district and sessions court, on 24th December 2010, declaring Dr Binayak Sen, General Secretary of the Chhattisgarh People's Union for Civil Liberties and Vice-President of the National PUCL, guilty of sedition and treason, and sentencing him to life imprisonment.

Dr Sen has an illustrious record of over 25 years of selfless public service in areas of health and human rights. He has been an active member and former convenor of the Medico Friend Circle, a national organization of health professionals working towards an alternative health system responsive to the needs of the poor. He has been closely associated with the Jan Swasthya Abhiyan, the Indian chapter of the People’s Health Movement. In recognition of his work, the Christian Medical College, Vellore conferred on him the Paul Harrison Award in 2004, which is the highest award given to an alumnus for distinguished service in rural areas. He continues to be an inspiration to successive generations of students and faculty. Many of his articles based on his work have been internationally appreciated.

His indictment under the draconian and undemocratic Chhattisgarh Special Public Security Act, 2006, and the Unlawful Activities (Prevention) Act, 1967 is utterly condemnable. Not only has the farcical nature of the trial been reported in the media, the charges against Dr Sen, of engaging in anti-national activities, have been widely held as baseless. This judgment is an unacceptable attempt to intimidate and vilify those who advocate for the rights of the poor and the marginalized, and reveals the indiscriminate use of state machinery to stifle democratic dissent.

JSA believes that a great injustice has been done, not only to Dr Sen but also to the democratic fabric of this country. JSA salutes Dr Sen’s work, and demands that justice be delivered in his case.

Binayak Sen’s conviction: a mockery of justice
The Lancet
January 8, 2011

On Jan 4, the day this issue of The Lancet went to press, Binayak Sen should have been celebrating his 61st birthday. Instead, found guilty of treason and sedition by a court in the central Indian state of Chhattisgarh, Sen is facing the bleak prospect of a life behind bars. It is an inhumane sentence for a committed humanitarian, whose life before his imprisonment was devoted to improving the health and welfare of some of the most marginalised and poverty-stricken people in India—the Adivasi. This work led to Sen becoming the first Indian recipient of the Jonathan Mann award for Global Health and Human Rights in 2008.

From the outset the charges against Sen reeked of political motivation—a reaction to Sen’s tireless documentation of human rights abuse at the hands of the state. He was accused, on the flimsiest of evidence, of acting as a courier for the imprisoned Maoist leader Narayan Sanyal. The subsequent trial, spanning more than 3 years, was Kafkaesque. Its conclusion is a travesty.

Reaction to the ruling was swift, with the Indian press unanimous in their criticism of the court’s decision. Amnesty International described Sen as a prisoner of conscience, while a statement signed by over 80 prominent academics worldwide decried the sentence as savagery. The Lancet adds its voice to this chorus of condemnation.

In April, 2009, we called for the Indian Government to intervene in the case, and ensure that justice be done. An injustice can still be overturned by India’s supreme court. If it is not, the already profound damage done to India’s credentials as an upholder of human rights will be damaged for years to come. Where the state failed to provide for its poorest citizens, Sen stepped in to give them health care and to champion their rights. His reward: to be convicted under a section of the penal code first introduced by the British to quell political dissent, and later used to convict Mahatma Ghandi. On his conviction, Ghandi argued that the administration of the law had been “prostituted consciously or unconsciously for the benefit of the exploiter”. The conviction of Binayak Sen shows that, in parts of modern India, precious little has changed.

Photo courtesy of AFP/Getty Images via The Lancet. 

US affirms Human Right to Health with signing of Declaration of the Rights of Indigenous Peoples

On December 16, 2010, President Obama announced that the United States will sign the UN Declaration on the Rights of Indigenous Peoples. Among many other rights, the Declaration affirms that indigenous people are entitled to the human right to health:

Article 24, Section 2: Indigenous individuals have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realization of this right.

Hesperian joins the People’s Health Movement and tribal leaders across the United States in applauding this move, especially in President Obama’s choice to specifically recognize the health disparities that exist in Native American communities. During a speech at a White House Tribal Nations Conference, President Obama said, “We know that Native Americans die of illnesses like diabetes, pneumonia, flu – even tuberculosis – at far higher rates than the rest of the population. Make no mistake: These disparities represent an ongoing tragedy. They’re cutting lives short, causing untold pain and hardship for Native American families. And closing these gaps is not just a question of policy, it’s a question of our values – it’s a test of who we are as a nation.” Hesperian and the People’s Health Movement have long believed that to achieve good health, communities (and governments) must address the underlying causes of poor health, including poverty, discrimination, and economic disparity.

A detailed, 15-page statement from the U.S. government on their support of the declaration can be found on the United States Mission to the United Nations website.

Graphic courtesy of UN Permanent Forum on Indigenous Issues

Hesperian friend Amy Hagopian under attack by Bill O’Reilly

Should We End Military Recruiting in High Schools as a Matter of Child Protection and Public Health?  

Amy Hagopian is an Assistant Professor at the University of Washington, and a long time friend of Hesperian who is now under attack by Bill O'Reilly of Fox News. Hesperian’s Director, Sarah Shannon, has worked with Amy on the Governing Council of the American Public Health Association, and in various activities within the International Health Section of the APHA and the People's Health Movement.

O'Reilly is attacking Amy’s well-researched and thought-provoking study, “Should We End Military Recruiting in High Schools as a Matter of Child Protection and Public Health?” published in the American Journal of Public Health. The study, co-authored with Kathy Barker, makes the case that military recruiters in high schools are a violation of the UN Convention on the Rights of the Child and a threat to the public health of adolescents. We're sharing a link to Amy's excellent paper, and an article from the Huffington Post denouncing O'Reilly’s attacks on her.

Read Amy’s paper here. 

An Indecent Man: Bill O'Reilly's Shameful Campaign Against Amy Hagopian
Dave Zirin, Sports correspondent for the Nation Magazine

In my mind, when the Fox News star Bill O'Reilly decides to make you a target, it's a badge of honor. This is a man who politically is a proud Islamaphobe, declaring, "We have a Muslim problem, not a Muslim extremist problem." And personally? Anyone who likes to tell people how his "happy ending" masseuse thinks he's well endowed clearly has trouble distinguishing fantasy from reality.

That's why his latest attacks on University of Washington Assistant Professor Amy Hagopian tells far more about the twisted mind of O'Reilly than the serious study the professor authored. Hagopian wrote an academic paper for the American Journal of Public Health making the case that military recruiters in high schools were in violation of the UN Convention on the Rights of the Child, a threat to the public health of adolescents, and even suggesting military recruiting behaviors were akin to -- as she put it -- "predatory grooming." It's a serious, data-packed analysis of the way recruiters have manipulated information and targeted the most economically disadvantaged students to fill the ranks of those fighting and dying in Afghanistan and Iraq.

The overarching thesis of the study is hardly shocking or groundbreaking. After all, we know that in 2005, the Army ordered its recruiters to "stand down" for a day of retraining because of habitual mendacity. We know the intense pressures on military recruiters to meet quotas has led to a series of high profile ethical violations. I know from my work at DC area high schools that the recruitment booths aren't set up at elite institutions like St. Alban's or Georgetown Prep. They're at public high schools like Ballou and Bell. In other words, recruiters fish in places where young people have fewer options. Hagopian's academic study simply backed up what has been over the last five years, a very public scandal. This is what I thought when I read her paper.

When O'Reilly read her paper.... all right let's stop there. I will contend there is no way Bill O'Reilly actually read her piece. None. He doesn't reckon with any of Hagopian's sobering data. He doesn't reckon with the suicide rates among troops, the effects of exposure to depleted uranium, or any of the ways that the realities of war are fudged over by recruiters to fill their quotas. There is just O'Reilly doing his neo-McCarthyite best to chill free speech. All O'Reilly needed was Hagopian's use of the word "predatory" when describing recruiters. Next thing you know, he was hitting the airwaves attacking Hagopian for calling recruiters "child molesters."

This is sick. Why this is where O'Reilly and his producers' minds go is honestly between them and their internet browsers. But tragically, when he sends his shock troops into battle, they can damage a person's life. Now, Amy Hagopian, for the unholy crime of conducting academic inquiry into a public scandal, has been harassed by O'Reilly's loyal listeners. They have sent threatening letters and emails to the school offices. They have made a series of profane phone calls to her colleagues. They have contacted her university and demanded that she should be fired for writing what is a peer-reviewed publication in the primary journal of public health in America. Please take a moment and imagine if that was you. Imagine if you created a contribution to public discourse to provoke discussion and debate. Imagine if you were ready to defend your findings against others who would surely disagree. And then imagine if instead you found yourself a personal target for a reactionary media giant using his outsized pulpit to make your life a living hell. That's not journalism and it's not punditry. It's the actions of an obscene, indecent bully. If there is one object lesson I've learned about O'Reilly's character from these attacks, it's that he clearly despises women who tell sobering truths. I suppose he just wants them to administer happy endings.

Photo by K. Barker, from the AJPH paper: Students at Garfield High School in Seattle, WA, drop to the floor for pushups under the command of a military recruiter at the school in 2009

Digging beneath the Chilean mine rescue

As we take a rare collective moment worldwide to celebrate the rescue of 33 men from a collapsed Chilean mine this month, our PHM colleague Tim Holtz calls on us not to forget the millions of other miners who never make the news.

In their excellent editorial in the Toronto Star this week (posted below), Anne-Emanuelle Birn, Timothy Holtz, and Thomas H. Gassert remind us that wherever and however it is done, mining destroys the environment and endangers people’s health.

When we wrote A Community Guide to Environmental Health, we struggled with the bleakness of this situation. Working with miners, communities, and environmental health activists, we collected strategies and ideas for reducing harm from mining, and stories from communities that have organized to hold corporations accountable for their health and safety. These stories and strategies—now published in the book—are practical and perhaps show a way forward: to continue struggling for better conditions, more recycling of metals, less use of coal as fuel, and more intelligent consumption patterns. And no path forward would be worth taking if it didn’t also include time to celebrate, for instance, the lives and victories of the Chilean miners and those who worked tirelessly for their rescue.

Digging beneath the Chilean mine rescue

October 17, 2010, Toronto Star

Dr. Anne-Emanuelle Birn, Dr. Timothy Holtz, and Dr. Thomas H. Gassert

With the world’s eyes focused on the dramatic rescue of 33 miners trapped in Chile’s San José mine, it is high time to shed light on mining’s bleak reality.

Across the globe, some 13 million of the world’s most impoverished people — including 1 million children — work as miners, either in underground ore extraction or surface-level quarries and pits.

Mining is one of the world’s most dangerous occupations.

In addition to the explosions, falling rock and entrapments that have killed thousands of people in recent years (as this article was going to press, a blast at a Chinese mine killed at least 20 workers and trapped another 17), miners experience among the highest rates of work-related illness and premature death of any industry. Chronic obstructive lung disease, tuberculosis, lung damage from exposure to heavy metals, exposure to asbestos and silica which cause lung cancer, and black lung disease are all common.

There are frequent ergonomic and crush injuries and deaths due to equipment failure, mine collapse and falls. Chemical, gas and hazardous dust exposures to radon, uranium, diesel particulates, methane, cyanide (used as a gold and copper solvent), and other substances can result in fatal poisonings and lead to tortuous deaths from cancer.

No global tears are shed over these horrendous conditions. Although safety measures — including masks and respirators, adequately maintained equipment and limited working hours — have all been proven to reduce disability and death, occupational safety and health standards are lax or poorly enforced. The 1966 International Covenant on Economic, Social and Cultural Rights, which Chile signed and ratified, explicitly describes the foundations of labour rights, which include the right to just and healthy working conditions. However, these human rights are routinely violated in Chile and nearly every country where mining takes place in the Americas, Europe, Asia, Africa and Oceania.

Indeed, the company that operates the San José copper-gold mine, Empresa Minera San Esteban, was cited 42 times for safety violations between 2004 and 2010, and in fact was shut down temporarily in 2007 due to safety concerns after the death of a miner.

Between 2003 and 2007, at least three miners have died in the San José mine, and at least one has lost a leg. Several of the miners rescued this week reportedly told the company that they feared a collapse in the mine, but the management did nothing to prevent this occurrence.

In addition, the type of grid mining that the company was conducting generates the highest profits for mining companies, but is also the most dangerous for miners underground. To compensate, their salaries were reportedly 20 per cent higher than in comparable mines, but their safety was not assured.

Mining also causes enormous environmental damage, including seepage of heavy metals, acids and other toxic by-products into the land and waterways, erosion of topsoil, destruction of forests and natural habitats, and killing of wildlife. Surface strip mining, now occurring with more frequency in northern Canada, is particularly damaging to ecosystems as it strips all vegetation from the earth.

Amidst such human and environmental destruction, mining is one of the world’s most lucrative industries, with hundreds of billions in annual revenues. It is also one of the most exploitative industries, with CEOs typically earning thousands of times the wages of miners. One of the most poignant aspects in the early days after the trapped miners were discovered to be alive was the fear they expressed that they would be unable to pay their bills while they were not working.

All of these problems could have been addressed, in large part, through strong unions protecting the safety and livelihoods of miners. However, the mining sector has one of the most sordid union-busting histories of any industry, from the 1914 massacre of several dozen Ludlow, Colo., miners and their families seeking to obtain union protection to improve working conditions, to present-day repression of miners and mining critics in settings as disparate as Peru, Tanzania and Papua New Guinea.

Indeed, mining multinationals, among which figure prominently Canadian-owned Barrick Gold and Anaconda Mining, have huge interests across Latin America and have ensured profits by fending off protestors and union organizers alike.

The great irony of the rescue of the brave and resilient miners in Chile this week is that the mining sector, as well as Chile’s heavily pro-corporate government, has garnered a huge public relations coup. Meanwhile, its role in what led to the mining collapse in the first place is left unspoken.

Although the San José mine has now been closed, the health and safety conditions of all the other miners across the country and the region remain unknown, and it is unclear whether the Chilean government will take home the lessons learned in order to improve the safety of the hundreds of other mines in the Atacama Desert region.

Ultimately, the most fitting tribute to the survival of Chile’s 33 is to improve the health, safety and well-being of miners and their families around the world. Following Canada’s humiliating defeat for a UN Security Council seat just as the miners were being rescued, this country has a chance to resurrect its international reputation by becoming a lead player in global mining safety.

Professor Anne-Emanuelle Birn is Canada Research Chair in International Health at the University of Toronto. Dr. Timothy Holtz is a founding member of Doctors for Global Health in Decatur, Ga. They are co-authors (with Yogan Pillay) of Oxford University Press’s Textbook of International Health: Global Health in a Dynamic World (2009). Dr. Thomas H. Gassert is an occupational and environmental medicine specialist at the Harvard School of Public Health and the University of Massachusetts Medical School.

Photo credit: Chilean government/Handout/Reuters

Environmental Justice in Detroit and Beyond – Fighting the World’s Largest Trash Incinerator

The next time some perky, well-meaning health professional cheers you on to take charge of your health, remember to ask her how to do it without breathing. That’s what it would take for Detroit residents who live in the shadow of the world’s largest incinerator, owned by Covanta.

A coalition, including local environmental justice groups, the Teamsters, and neighborhood residents, is calling for the plant to be closed. Hesperian staff and several hundred others attending the US Social Forum, joined them by participating in a march on June 26. The coalition says, “Detroit’s children suffer asthma rates three times the national average. The municipal incinerator is a major contributor to these devastating health impacts. Meanwhile, the recycling rate in the city is less than a third the national average.” They are advocating for resources to be put into recycling instead of incineration, which provides good jobs and is better for people and the planet.

As we walked through the urban neighborhood near the incinerator, marchers covered their faces, choking on the thick, foul air. We walked by a park, a school, a church, and down residential streets, where people daily breathe in the incinerator fumes. We were appalled to see houses literally right next to the incinerator.

The march made it painfully clear to us that whether we are able to live healthy lives has only partially to do with the individual decisions we make or our genetic makeup. More critically, our health is a product of our environment, of our social, political, and economic realities.

Activists from Detroit and around the country described those diverse but connected realities and their common struggles for health and environmental justice—fighting coal mining in West Virginia, trash incineration in New Jersey, and the Chevron oil refinery right here in Richmond, CA. Their stories echoed others we had heard earlier that week, of people fighting for their right to health in communities across the country and around the world, often in the face of incredible odds.

Detroit’s weekly, The Metro Times, described the march in their summary of the USSF:

On Saturday, when an estimated 1,000 people marched from the city's main public library on Woodward Avenue to the incinerator located near the intersection of Interstates 94 and 75, residents of the 48217 ZIP were shoulder to shoulder with environmental activists, out-of-town forum attendees, people living around the incinerator and a dozen men wearing shirts that identified them as "Teamsters for Clean Air, Good Jobs & Justice."

Asked why Teamsters would be supporting an action like this, one of them replied, "We breathe the air too." And, moreover, said organizer Alex Young, recycling operations in places like Oakland, Calif., are providing union members good-paying, green jobs.

Among those joining the march on what has been described as the world's largest incinerator was Cynthia Mellon of Newark, N.J., home to what she said is the world's second-largest incinerator.

"We didn't know you existed before," she told the Detroiters. "Now we are all part of a big cause."

Rhonda Anderson, who does environmental justice work for the Sierra Club's Detroit office, has been one of those working for more than two years to get the incinerator shut down. One of several speakers to address the crowd, Anderson choked back emotion as she declared: "You have lifted our spirits. You have raised our expectations. You have served as a model for our children."

San Francisco author and historian Chris Carlsson described the action to close the incinerator on his blog:

“Demonstrations took place around Detroit to address local issues, from a small-ish demo outside DTE Energy, the local utility, to a larger march on Saturday against a massive trash incinerator. …. Incineration of trash instead of a curbside recycling program is a self-defeating industrial process. The utility claims that burning trash to make electricity in a state-of-the-art facility reduces carbon emissions over putting it all in landfill, which is questionable at best. But if you take into account the “externalities” of local health problems, air pollution, etc., not to mention that it takes rather fewer people to collect the garbage and dump it into an incinerator than it does to run a robust recycling program that makes use locally of the materials it recycles, and you are compounding a whole series of social problems… I learned later that the fight against the incinerator has been going on for over 20 years!”

Hesperian has long recognized the connection between health and the environment. Our newest book, A Community Guide to Environmental Health focuses on giving people the tools to address environmental problems in their communities. It includes an entire chapter of alternatives to incineration to deal with solid wastes, as well as detailed plans for health clinics to safely handle health wastes without burning.

Photo by Amanda Starbuck

Health and Human Rights at the US Social Forum

 At the end of June, two staff members from Hesperian traveled to Detroit, Michigan for the United States Social Forum, where we joined 15,000 other community organizers and social justice activists from around the US to network, share, and learn. We’ll be blogging about the Social Forum over the next couple of weeks, and wanted to begin by sharing some of the inspiring stories we heard from people across the country who are organizing around the human right to health. 

At a popular education workshop put on by the Highlander Center and Colectivo Flatlander, we came away with the clear message that, to quote the facilitator Pancho Argüelles, “people won’t fight for shit they don’t think belongs to them.” In other words, understanding that human rights – including the right to the highest possible level of health and well being – belong to all of us without exception can give us the strength to fight to make sure that those rights are realized.

In this spirit, several groups, including Hesperian and the People’s Health Movement, organized a People’s Movement Assembly (PMA) on the right to health and health care, titled “What the health happened and how do we get the health care we need?” The goal of the PMA was to develop a joint resolution outlining shared values and ways to move forward together. 

Over 100 people participated in the PMA, and many shared stories of both hard times and successes – when they were denied health and dignity, and when they fought back. Often, these stories highlighted some of the opportunities (and challenges) for using a human rights framework to organize in the US.

For example, Vermont is the site of a major state-level victory in the struggle for the right to health. The legislature recently passed a bill requiring that the state hire an independent consultant to develop three plans for a universal health care system, including one single payer model.

A speaker from the Vermont Workers Center explained the human rights approach that led to this remarkable success: “human rights… really means engaging folks first. It is about finding out from people where the system has failed them.” The VWC spent the first year of their campaign holding community meetings across the state, declining to include legislators. Focusing on people’s stories and experiences meant that the campaign was centered on those most affected. Only after they had developed a broad base of support did they approach the legislature.

In the end, although legislators balked at using the term “human rights” in the bill, they enshrined fundamental human rights principles by requiring that all 3 plans “ensure universal access and coverage, be comprehensive and affordable, be transparent in design and… ensure public participation in the design, implementation, evaluation, and accountability.” Plenty of work is still needed to make sure this bill is effectively implemented, and the Vermonters called on all of us to stand with them as they continue this fight.

On the other side of the country, in South Los Angeles, shared values of health and human rights have allowed organizers, service providers, and community residents to build bridges and mobilize around the many causes of poor health in their community. Last summer, 700 people, including Hesperian staff, came together for a historic conference in South L.A. Individuals and groups working on diverse issues including homelessness, violence, transportation, food, and health care, collectively developed a framework and goals: the South Los Angles Declaration of Health and Human Rights.

 Here in the Bay Area, Hesperian has helped to start a health and human rights learning circle to strengthen our understanding about the framework and build community locally. We certainly have a lot to learn from the struggles in other parts of the country and the world, and will be continuing to meet monthly over the next year (contact phm@hesperian.org if you are interested in receiving information about meetings and events).

Nationally, many other groups are actively advocating for a just and inclusive health system—to learn more, visit the websites of the National Economic and Social Rights Initiative and Healthcare-NOW!.

Of course, in addition to envisioning and working towards truly universal and accountable health systems at different levels, we also have to address immediate challenges as best we can. We’ll be writing more on that and a workshop organized by the People’s Health Movement and Doctors for Global Health in the coming weeks. Also stay tuned for our reflections on the June 26th protest against a local incinerator in Detroit, a clear example of how realizing our right to health requires working for social and environmental justice.

Opening march photo by Chris Crass, photos of PMA by Leona McElevene

People’s Health Movement statement on Israel’s attack on the civilian ships carrying humanitarian aid to Gaza

The People’s Health Movement* (PHM), strongly condemns the Israeli government’s violent and premeditated attack on the civilian flotilla’s carrying peaceful activists and humanitarian aid to Gaza on 31 May 2010.

The Israeli army’s attack using live ammunition, which resulted in death of civilians and took place in international waters, was a direct violation of international maritime law. The activists were protesting the Israeli blockade on Gaza. It appears that at least 9 civilians were killed (according to the Israeli sources), with dozens of others injured.

We note that the flotilla, among other forms of humanitarian aid, was carrying vital supplies required to address the rapidly deteriorating situation in Gaza as regards health and health care. It included essential medicines, wheelchairs and building materials – vital supplies needed to rebuild health facilities, address the acute shortage of medicines and help in the rehabilitation of people maimed as a result of military action by Israel.

The United States-backed Israeli government has for many years violated the human rights of Palestinian people, through the occupation of Palestinian territories; the economic blockade against Gaza; and ongoing military action against civilian population under occupation. The impact on the physical and mental wellbeing of people, especially women and children is severe (please see People’s Charter for Health).

Many eyewitness reports and independent studies have documented the health effects of the brutal Israeli blockade of Gaza. Construction supplies desperately needed to repair or rebuild water or sewage treatment facilities, health clinics, and schools have led to crises of public health in Gaza. The interruption of pharmaceutical provision has harmed people with chronic health issues (such as diabetes and hypertension) as well as those requiring acute care. The refusal to allow more than a minimal amount of food into Gaza has led to unconscionable rates of malnutrition, especially among children (45% of children under 5 are underweight, 63% are anemic). [data from April 09 report of Physicians for Human Rights-Israel and Palestinian Medical Relief Society] These are the conditions that the Gaza flotilla was attempting to redress because our governments refuse to. In their recent Human Rights Report, Amnesty International highlights the impact of the collective punishment of people living in Gaza as having “deepened the ongoing humanitarian crisis. Mass unemployment, extreme poverty, food insecurity and food price rises caused by shortages.” Clearly, the people in Gaza face a health emergency, contributed to by the decimation of health care facilities, as well as by the impact of the blockade and military actions on social determinants of health.

The People’s Health Movement demands:

• A credible and independent investigation into this barbaric attack on peaceful civilians and aid volunteers;
• Israel to allow for the free flow of humanitarian aid to Gaza. According to the UN, only a fraction of aid required is entering Gaza.
• That Israel immediately suspends the economic blockade on Gaza and ends the occupation of Palestinian territories;
• That governments around the world sever diplomatic, trade and military ties with Israel and support the international campaign of Boycotts, Divestment and Sanctions (BDS) against the Apartheid Israeli state.

We call on civil organizations and citizens around the world to pressurize their governments to take action against Israel, to put pressure on Israel to allow humanitarian aid and food into Gaza; to end the occupation of Palestinian territories; and to end the blockade on Gaza which is negatively impacting on large numbers of women and children, elderly and the sick. We recognize and appreciate the growth of social forces within Israel who are actively opposing the continued siege of Gaza, and we call upon the Israeli government to end the increasing harassment and repression inflicted upon them.

On behalf of the People’s Health Movement,

Bridget Lloyd (Global Co-ordinator on behalf of the secretariat), Prem John (Co-chairperson, India), Fran Baum (Co-Chairperson, Australia), Hani Serag (Associate coordinator, Egypt), Amit Sengupta (Associate Coordinator, India), Alexis Benos (Greece), Arturo Quizhpe (Ecuador), Bala (Sri Lanka), Claudio Schuftan (Vietnam), David Legge (Australia), David McCoy (United Kingdom), David Sanders South Africa), Delen de la Paz (Philippines), Ekbal (India), Jihad Mashal (Palestine), Lanny Smith (USA), Maija Kagis (Canada), Margarita Posada (El Salvador), Maria Hamlin Zuniga (Nicaragua), Martin Khor, (Malaysia), Mira Shiva (India), Qasem Chowdury (Bangladesh), Ravi Narayan (India), Sarah Shannon (USA), Zafrullah Chowdhury (Bangladesh)

Download a PDF of this statement here.

* PHM is a global network bringing together grassroots activists, civil society organizations and academics from around the world, particularly from low income countries. PHM works towards the revitalisation of primary health care and works to address the social determinants of health, including in particular, the growing inequity within and between nations, mostly due to unfair economic structures which lock so many people into poverty and poor health. We have a presence in more than 70 countries around the globe.

India's Unholy Nexus: a talk by human rights activist Kamayani

Who makes decisions about development? How do you fight injustice? When is violence justified? 

These were some of the questions raised by a presentation by noted Indian human rights activist Kamayani Bali Mahabal in Berkeley in April during a talk titled 'Naxalism, Violence and Development: The Unholy Nexus.' She was discussing her fact-finding mission in Chhattisgarh and other regions affected by the Indian government’s “Operation Green Hunt” against Maoist insurgents – commonly known as Naxalites – in the so-called "Red Corridor."

She visited the site of the Vanvasi Chetna Ashram, near Dantewada, run by Himanshu Kumar, which was completely leveled in May 2009 by a group of 1,000–1,500 police. For 17 years Kumar had worked with the local people in Chhattisgarh helping to provide food, housing, medicine, and job training to those who had been forced from their traditional lands. The rise of a government-funded paramilitary force, “Salwa Judum,” in the area caused alarm; in the course of fighting supposed Naxalite terrorists, the Judum and police were accused of rapes, murders, and other human rights violations. Kumar began filing official complaints on behalf of the victims; as a result, he received a police notice one Saturday to evacuate the next day. Within 2 hours, the ashram was bulldozed. Kumar was charged with aiding the Naxalites, running a prostitution ring (the police found a lot of condoms in the ashram, which Kumar used to teach about HIV and safe sex), and finally kidnapping a tribal woman (who had sought refuge in his home). His trial is still pending.

So why did this happen?

A little background: The regions of Chhattisgarh, Jharkhand, and Andhra Pradesh, among others, are home to the earliest inhabitants of the subcontinent, the “tribal” people or adivasi. Living in isolated groups in central India’s hills and forests, they practiced small-scale agriculture and collective land ownership. But during the Mughal and British periods, their lands were taken away and given to feudal landlords, leaving them impoverished and in debt. At the time of Indian independence, the tribals were recognized as needing special programs to support their development and laws were adopted to protect their rights.

However, it also happens that the traditional adivasi lands are rich in minerals, especially tin, coal, dolomite, bauxite, and iron ore, and international corporations became interested in exploiting that wealth. The Indian government created a plan to remove the people from their lands in order to “protect” them and “bring them into the mainstream.” But the adivasi didn’t want to go.

According to Kamayani Mahabal, India’s 60 years of independence have largely benefited the already-privileged classes. In 1967, the deep, persistent inequalities in Indian society and the ineffective implementation of the laws set up to protect tribal rights led to an uprising by poor farmers in the village of Naxalbari in West Bengal, where there had been a history of peasant agitation. The Naxalbari uprising was put down by the police after a few months and the leaders, some of whom were Maoists, were arrested. But the ideas did not die, and the Naxalite movement grew, even in spite of brutal repression by the police.

Thus the tribals find themselves now in a “sandwich” (to use Bahabal’s term) between the police (and Salwa Judum) and the Naxalites. The government wants to remove them from the land, and the Maoists want to help them get it back. Both sides use violent tactics, and the violence is increasing, with civilians forming the greater percentage of the casualties. But who is a civilian? Recognizing that the tribals are suspicious of outsiders and often speak different languages, the government instituted a force of SPOs (“special police officers”) recruited from among the local people with the promise of a steady paycheck. The Naxalites also recruit from the local people. And the local people sometimes switch allegiances, depending on their needs for livelihood or security.

In her talk, Mahabal made it clear that she opposes violence by any group. She insists that the state has a responsibility to protect its citizens (including the tribals), which they are not doing. Instead of using state resources to fund programs to alleviate poverty and malnutrition, the government is promoting militarism to combat “the greatest single internal security threat” India has ever faced.

So what does she suggest? The Naxalites and the government should have a dialogue.

But do the Naxalites really want to talk? They have said that if a discussion is arranged with Arundhati Roy or a similar supportive celebrity as mediator, they will come. Yet they also say that they do not believe the Indian government supports their interests. They want autonomy, to establish their own state, based on their own principles.

According to Mahabal, the government needs to take the first step. But does the government want to talk? If they initiate a dialogue with the Naxalites, it means elevating them to the status of equals, not of “terrorists.” Will the government allow that?

And who represents the tribal people? If new leaders emerged from among the tribals to speak out against the atrocities, the government would likely arrest them, just as they arrested the activists working with Himanshu Kumar on the ashram, and as they arrested doctor and human rights worker Binayak Sen in 2007.

And what kind of development should take place in these areas? Adivasi culture and land use is protected under India’s Forest Rights Act of 2006, but those protections have largely been ignored. The tribals also suffer from crushing poverty, malnutrition, high maternal death rates, and high rates of suicide. Health and education services are needed, but with the violence and poverty that have characterized adivasi history, in the words of BD Sharma, for the adivasi “development means exploitation.” They need to be an equal partner in any development plans, and as of yet, they are barely even consulted.

Kamayani Bali Mahabal’s presentation in Berkeley was sponsored by AID-India Berkeley Chapter, Hesperian, the UC Berkeley Center for South Asia Studies, and People’s Health Movement USA. She is also an active member of PHM India.

Novartis threatens Indian generic drug industry

Health activist Dr. Gopal Dabade recently came to Berkeley to speak on the ongoing struggle against Swiss Pharmaceutical company Novartis in India. Dr. Dabade is a Hesperian partner who developed the Kannada edition of Where There Is No Doctor, and he has long been working for the rational use of essential medicines.

For decades, India has been known as the “pharmacy of the developing world” for its ability to supply lifesaving generic drugs at a fraction of the cost of those with brand names. People living in India and throughout the Global South rely heavily on these affordable medicines, and without them antiretrovirals, cancer drugs, and hundreds of other basic medications would be out of reach for millions.

However, this fall Novartis appealed a case to the Indian Supreme Court pushing for a more aggressive patent law that would jeopardize the country’s generic drug industry. Currently, India’s law requires real innovation to obtain a new patent. Section 3(d) of the Indian patent law prohibits ‘evergreening,’ a strategy where pharmaceutical companies make small, trivial changes to existing medicines in order to extend the period of patent control on a drug, and thereby extend their profits as well.  Removing Section 3 (d) would enable multinational corporations to gain monopolies over already existing drugs and prohibit cheaper generics.

Novartis is challenging Section 3 (d) in order to obtain renewed patent protection of a leukemia drug imatinib mesylate, which it markets as Glivec. Glivec is a drug that has been available for 16 years, but Novartis is seeking a new patent for a recently developed crystalline form. This change is simply a different form of the original compound and does not increase the drug’s efficacy. Gaining patent control would force generic versions out of the market, and put this drug (priced at $2,500 per month by Novartis compared to $175 per month for an Indian generic version) out of reach for 99% of patients who need it.

Novartis argues that “intellectual property rights are an essential safety net to protect the substantial investment of time and money required to bring a drug to market.” However, granting patents for drugs that are neither new nor more effective is not a rational use of intellectual property rights. Further, as Dr. Dabade pointed out in his presentation, it has been shown that more than 40% of the industry‘s research and development (R&D) is aimed at producing minor variations of existing drugs, not at turning out new ones, and that marketing costs are double what is spent on R&D.
 
This case could endanger the availability of affordable drugs around the world, as the fate of thousands of similar ‘evergreened’ patent requests pending in India rest on this decision. If Novartis wins, accessibility of essential medicines for millions will be eliminated, and pharmaceutical companies will rake in billions more, adding to their already bloated profits at the expense of the world’s poor.

We urge you to take a stand against corporate greed and placing profits before people’s lives. Please join us, Dr. Dabade, and the People’s Health Movement in the fight for health for all by signing the petition against Novartis.  Contact phm@hesperian.org if you would like to learn more about how to get involved.

Photo courtesy of Dr. Gopal Dabade.

PHM-US Editorial featured on cover of The Lancet

The latest issue of The Lancet features the editorial below, written by members of the People’s Health Movement-US. Click here to view the full December 5, 2009 Lancet, which also includes a letter from PHM activists Wim De Ceukelaire and Pol De Vos from Belgium, "Social movements are key towards universal health coverage."

The Lancet, Volume 374, Issue 9705, Page 1887, 5 December 2009
doi:10.1016/S0140-6736(09)62086-9

 

Health-care reform and the right to health in the USA
Laura Turiano^a, Matthew Anderson^b, Todd Jailer^c, Maureen McCue^d, Mohammad Shahbazi^e, on behalf of People's Health Movement—USA

The House and Senate of the US Congress have released their health-care reform proposals, revealing the range of possible changes for the US health-care system. Even the best of these proposals have little chance of covering everyone, or controlling health-care costs overall, let alone meeting human rights standards of universality, equity, and accountability.

As a presidential candidate, Barack Obama's original reform plan only partly met human rights standards.¹ As President, he has not promoted a plan that would most benefit the American people. Instead he has courted Republicans and the medical care industries. The result will be a windfall for insurance, hospital, and pharmaceutical corporations through the mandate to obtain health insurance that is a key component of each reform bill.² In exchange for submitting to a few new regulations, such as guaranteed issue and renewal, insurance companies will get millions of new customers, many subsidised by the government.
Despite subsidies, health-care costs will still burden some families, particularly those just above income cut-offs.³ The proposed public plans are specifically structured to be available only to those not insured by their employer, rather than an option open to all based on Medicare. Specific regulations, and probably small enrolment, will limit these plans' ability to negotiate lower prices.

Meanwhile, despite the efforts of a few Democrats, legislation consistent with the right to health is mostly ignored. Publicly popular proposals, HR676 and S703, would create a national health insurance system, by expanding and improving Medicare to cover everyone. However, their passage is unlikely given massive campaign donations and lobbying from medical care industries, and the assertion that policies to improve public welfare equal socialism.

The health-care reform process exposes how corporate influence renders the US Government incapable of making policy on the basis of evidence and the public interest. The right to health requires that a health system, available and accessible to all, includes protection and promotion of health, and treatment of illness. There is no excuse for the USA not to adopt a system like any of those in many other countries that cover everyone and control costs—systems that better integrate public health and individual medical care. Without such a system, comprehensive primary health care will not be implemented, nor will the social determinants of health be effectively addressed.

The belief in US exceptionalism must be laid to rest. People living in the USA are as entitled to the right to health as others, and the USA should be accountable to the same standards as any other country.

We declare that we have no conflicts of interest.

References
1 National Economic and Social Rights Initiative, National Health Law Program. Human right to health care: nominees' plans lag behind public demands. Issue brief. http://www.nesri.org/Human_Rights_Assessment2.pdf. (accessed Sept 15, 2009).
2 Hamburger T, Geiger K. Healthcare insurers get upper hand. Los Angeles Times Aug 24, 2009. PubMed
3 Center for Policy Analysis. HR 3200 delays public plan, skirts affordability. http://www.centerforpolicyanalysis.org/id41.html. (accessed Sept 24, 2009).

a People's Health Movement, Oakland, CA 94602, USA
b Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
c Hesperian Foundation, Berkeley, CA, USA
d Global Health Studies, University of Iowa, Iowa City, IA, USA
e Jackson State University, Jackson, MS, USA