Book Review: Human Rights in Global Health: Rights-Based Governance for a Globalizing World, edited by Benjamin M. Meier & Lawrence O. Gostin

This groundbreaking compilation—edited by two scholars who helped to establish the “health and human rights” field—systematically explores the structures and processes of human rights implementation in global health institutions, arguing that a rights-based approach to health governance advances global health. This 640-page volume brings together forty-six experienced scholars and practitioners who have contributed to twenty-five chapters organized into six thematic sections. This “unprecedented collection of experts” provides unique, hands-on insights into how the “institutional determinants of the rights-based approach to health” facilitate—or hinder—the “mainstreaming” of human rights into global health interventions. The “institutional determinants,” which, in the contributors’ view, promote the effective integration of human rights implementation into global health governance, are: “governance” (formal commitments, human rights leadership, and member State support); “bureaucracy” (institutional structure and human rights culture); “collaborations” (inter-organizational partnerships and civil society participation); and “accountability” (internal monitoring and independent evaluation)

From Activism to Invested Scholarship: When Outsiders Are Insiders (abstract)

Social science methodologies frequently assume that the researcher is ahistorical, bringing no background or investment to the topic they study. Yet, as activists and scholars of human rights activism we are drawn to the movements we study precisely because of our engagement with these groups, places and topics. How does our research and teaching change if we are viewed as participants rather than outside observers in the movements we study? How do we navigate interviews with people who know us as activists rather than scholars? How do we interpret materials in which our own words and images appear? Coming to academia as activists, we have personal histories intimately connected to the topics we study, including colleagues on the ground. Although we are activist ‘insiders’ we also negotiate a simultaneous position of ‘outsiderness’ as we study countries where we are culturally foreign. Employing a reflexive analysis of our own research methodologies we interrogate the dynamics of what we term ‘invested scholarship.’ We explore two human rights struggles: women’s rights in Guatemala and HIV rights in Botswana. Both studies are based on fieldwork including observation, participation, formal and informal conversations, and semi-structured and in-depth interviews. To analyse the complex role of the activist/scholar we focus on the ways in which we, the invested scholars, appear in our data, through images, statements and relationships. We find that assumptions of allegiance and ‘insiderness’ appear relatively frequently in our research interactions. Being known as activists by those we study is a status that allows us a position of trust and unique access. However, such a privileged position also comes with unique challenges and responsibilities raising questions of objectivity, ethics and methodology. We argue that this role is a negotiated nexus of activism and scholarship that presents important critiques to the paradigm of outsider objectivity

Human Rights-Based Activism: Lessons From Health Activism in South Africa and Brazil (abstract)

Drawing on South Africa and Brazil’s experiences of health activism, this paper aims to provide a full illustration of how human rights-based (HRB) activism can function as an influential agency-based social determinant of health. Social determinants of health (SDH) are usually understood as circumstances and structures that disadvantage individuals by increasing their vulnerability to disease and injury. SDH are typically conceived of as conditions that act upon individuals and communities who are relatively powerless to react against the health impacts of context such as poverty and marginalization. In addition to this ‘passive’ understanding of SDH, we put forward an ‘active’ conception whereby SDH includes processes of participation and engagement throughout which individuals are able to use their own knowledge and actions to improve health outcomes for themselves and others. We examine this phenomenon through the case studies of HRB activism in Brazil around the national health council, and HRB activism on HIV in South Africa by the Treatment Action Campaign. Brazil’s participatory experience has been described as one of the world’s most important examples of citizens’ engagement in policy making. South Africa’s Treatment Action Campaign has received widespread recognition for its work linking health and rights education with mobilization. Our case studies draw on fieldwork (including interviews, observation, document and legal analysis) carried out by Garcia in São Paulo and Brasília in 2014, and by Kenyon in the Ekurhuleni and Cape Town, South Africa offices of TAC in 2010 and 2011. Drawing on these notable cases we offer insight into ways that HRB activism can be understood as an influential agencybased social determinant of health for the fulfillment of health rights. We hope to spark new ideas of how health impacts of HRB approaches to health, including health activism, might be understood and measured in both countries, and elsewhere

Human Rights in Global Health: Rights- Based Governance for a Globalizing World edited by Benjamin M. Meier and Lawrence O. Gostin1

THIS GROUNDBREAKING COMPILATION, edited by two scholars who helped to establish the “health and human rights” field, systematically explores the structures and processes of human rights implementation in global health institutions while arguing that a rights-based approach to health governance advances global health. The 640-page volume brings together forty-six experienced scholars and practitioners who have contributed to twenty-five chapters organized into six thematic sections. This “unprecedented collection of experts” provides unique, hands-on insights into how the “institutional determinants of the rights-based approach to health” facilitate—or hinder—the “mainstreaming” of human rights into global health interventions. The institutional determinants, which—in the contributors’ view—promote the effective integration of human rights implementation into global health governance are: governance (formal commitments, human rights leadership, and member State support), bureaucracy (institutional structure and human rights culture), collaborations (inter-organizational partnerships and civil society participation), and accountability (internal monitoring and independent evaluation)

Health advocacy on the margins: human rights as a tool for HIV prevention among LGBTI communities in Botswana

Human rights discourse in health advocacy is largely correlated with experiences of vulnerability, marginalisation and discrimination, with the global story of HIV activism the most visible example. In a domestic context where culture, consensus and belonging are highly valued, both human rights and lesbian, gay, bisexual, transgender and intersex (LGBTI) people face critiques of being foreign, un-African, new, individualistic and threatening to tradition. Why, when and how do civil society actors draw on human rights to advocate for LGBTI health in relation to HIV in Botswana? I examine this paradox through a case study of the key civil society actor in this sector. I argue that while formal structures and belief shape why the group engages with human rights, when and how human rights are invoked is shaped by perceptions of threat, cultural context, and belonging.Social Science and Humanities Research Council of Canada, University of Pretoria.http://www.tandfonline.com/loi/cjca202021-03-04hj2020Centre for Human Right

Bringing the field into the classroom : methods and experiential learning in the 'Politics of Development'

Methods training is typically cordoned off into specific, designated courses and is often consequently isolated from the content of the topics we study. As a result of this separation, methods may appear abstract or technical, particularly to undergraduate students, who usually have no experience or expectation of applying methods during their degrees. This article discusses one experience of incorporating qualitative methods and experiential learning into a mixed undergraduate/graduate seminar on the politics of development. This substantive course was structured around an interview-based assignment which served to introduce students to qualitative methods alongside exposure to the views of development practitioners and scholars. I argue that integrating experiential methods training into substantive courses can prove a useful introduction to interviewing and fieldwork, enhance student engagement with subject-based literature and concepts, and serve as a gateway for further methods education.https://uk.sagepub.com/en-gb/afr/politics/journal2024812019-02-28hb2017Centre for Human Right

Viewing international concepts through local eyes : activist understandings of human rights in Botswana and South Africa

Human rights are an increasingly common language of advocacy for civil society organisations, but are these groups using the same words to mean different things? Although the spread of human rights has been well examined, little attention has been paid to the content of these rights as understood by civil society actors in diverse settings. Focusing on this gap in the literature, this paper examines how personnel in human rights-based non-governmental organisations (NGOs) in Botswana and neighbouring South Africa perceive human rights. Drawing on interview-based case studies of two human rights-based organisations operating at the national level, I analyse how activists draw on domestic context to interpret human rights. This paper argues that personnel in these NGOs understand and articulate human rights in distinct ways that are shaped by and responsive to the contexts in which they live and work. Emerging from a more homogenous consensus-based culture, Botswana respondents are more likely to integrate cultural concepts, emphasise inclusion and understand human rights as timeless and innate. Reflecting South Africa’s progressive constitution, unequal society and a history of struggle, South African respondents highlight contrast, agency, change over time and the law.Drafts of this paper were presented at the Prairie Political Science Association Conference, the American Political Science Association Conference, the Canadian Political Science Association, the International Studies Association Conference and the International Political Science Association Conference. A related paper was presented at the Global Rights and Democracy workshop at UBC (a summary of which was subsequently featured as a blog post on Open Global Rights).The Social Sciences and Humanities Research Council of Canada under Grant 756-2014-0553 and by postdoctoral funding from the Centre for Human Rights at the University of Pretoria.https://www.tandfonline.com/loi/fjhr202020-12-03hj2019Centre for Human Right

Exploring human rights based activism as a social determinant of health : insights from Brazil and South Africa

Social determinants of health (SDH) are usually understood as circumstances and structures that disadvantage individuals by increasing their vulnerability to disease and injury. In this model social determinants of health act upon individuals and communities who are relatively powerless to react against the health impacts of factors such as poverty and marginalization. With the aim of expanding the concept of social determinants, we examine the role human rights-based activism can play in improving health outcomes by exploring two well-known cases: activism through Brazil’s National Health Council, and HIV activism by South Africa’s Treatment Action Campaign (TAC). Drawing on these cases we argue that, in addition to the valuable current and historical conceptions of social determinants of health as contextual factors that act upon people, social determinants can and should also be understood as processes of participation and engagement whereby individuals are able, through their own knowledge and actions, to improve health outcomes for themselves and others. Building on a phrase proposed by Heywood, we posit that human rights-based activism can be an influential agency-based social determinant of health.Postdoctoral funding from the Social Sciences and Humanities Research Council of Canada and the Centre for Human Rights at the University of Pretoria (to Kristi Heather Kenyon), and the Liu Institute for Global Issues at the University of British Columbia (to Regiane A. Garcia and Kristi Heather Kenyon).http://jhrp.oxfordjournals.org2018-05-31hb2017Centre for Human Right

Choosing rights : the puzzle of the rights frame in human immunodeficiency virus activism

HIV activists are at the vanguard of a critical point of expansion in the use of human rights discourse in advocacy, marking a site of civil society innovation. Drawing frequently and emphatically on rights in place of more traditional frames of development or public health, civil society groups working on HIV provide valuable insight into how and why the language of rights is being adopted in new fora. This dissertation examines why civil society groups conducting advocacy on HIV in sub-Saharan Africa, the region of the world hardest hit by the pandemic, choose to (or choose not to) employ the language of rights in their advocacy. Using a comparative case-study approach, this study examines nine civil society organisations conducting advocacy on HIV. Organisations were selected from countries (Ghana, Uganda, Botswana, South Africa) in the three regions of sub-Saharan Africa (West Africa, East Africa, Southern Africa). Within these countries, civil society groups were identified with variation in regards to their use or non-use of the rights frame. A total of 145 semi-structured interviews were conducted within these organisations, as well as with other organisations in the HIV sector, international organisations, and government officials. Data from interviews was triangulated with information from naturalistic observation, analysis of organisational materials, and laws and press accounts. These case studies highlight the roles and beliefs of individuals, as leaders, advocates and recipients. Organisational adoption of rights is heavily influenced by leadership, and by secretariat-based organisational structures which allow for a high level of interaction with leaders. Within these groups, a strong personal belief in the rights frame is common. The chief motivation for rights use in advocacy within these organisations is rooted in a belief that the rights frame has a profound impact on the identity and behaviour of the group’s constituents. Proponents understand rights as an empowering force enabling their target group to better seek and access health care services and to do so from a position of strength and entitlement. In contrast, in groups with limited or no rights use, need-based claims highlighting vulnerability were dominant.Arts, Faculty ofPolitical Science, Department ofGraduat