Amnesty International Secretary General Irene Khan was on Democracy Now! this morning discussing her new book, The Unheard Truth: Poverty and Human Rights. Watch above or on the DN! site, which also has a transcript.

Irene kicked off a two-week U.S. book tour last night in New York. Come out and see her at an event near you!

Brima Sheriff, director of the Sierra Leone section, dancing with community in Mapaki ©Amnesty International

Gouri has wrapped up her on-the-ground reporting from Sierra Leone — but the Amnesty International caravan is still campaigning for the right to maternal health. Follow Africa campaigner Khairunissa Dhala’s posts on the International Secretariat’s Livewire blog. Today: in the rain in Kabala.

Riffing off of the news that President Obama is adding a moral component to his (heretofore mostly economic) pitch for health care reform, Desiree Evans, of the Institute for Southern Studies, writes:

Finding fresh ways to talk about socio-economic issues is not new in the health care advocacy community. Even as the Obama administration searches for a new way to pitch their proposed health reform, human rights groups and grassroots social justice networks have already been hard at work trying to shift the language and the thinking surrounding health care in the United States. They are using an oft-overlooked notion in the United States: “human rights.”

Desiree doesn’t explicitly answer the question in the title of her post — in reframing the health care debate, “is it too late for human rights?” The answer to that question is clear: no, it’s not too late.

Whatever happens with the current round of health care legislation — whether or not a bill passes, and if one does, whether it’s weak, strong, or even regressive — this is only the beginning of a long, long process in making the U.S. health care system truly universal, equitable and accountable. A bill would have to be implemented, which would take years. Crucial legislative questions will remain at the national, state and local levels. And there will be much more work to be done on absolutely central issues, like true fulfillment of the right to maternal health care in the United States.

But that’s a quibble. It’s a very informative post, on the imperatives of justice in health care reform, the historical roots of the human right to health care, and more — read the whole thing.

In an interview in next Sunday’s New York Times Magazine, Secretary of State Clinton says:

When it comes to our global health agenda, maternal health is now part of the Obama administration’s outreach. … Women die every minute from poor maternal health care. You know, H.I.V./AIDS, tuberculosis, malaria — those are all, unfortunately, equal-opportunity killers. Maternal health is a woman’s issue; it’s a family issue; it’s a child issue. And for the United States to say to countries that have very high maternal mortality rates, “We care about the future of your children, and in order to do that, we care about the present of your women,” is a powerful statement.

Maternal health is also a human rights issue, as Secretary Clinton acknowledged in another recent interview, with The Wall Street Journal:

… It’s important to look at human rights more broadly than it has been defined. Human rights are also the right to a good job and shelter over your head and a chance to send your kids to school and get health care when your wife is pregnant. It’s a much broader agenda. Too often it has gotten narrowed to our detriment.

In the human rights framework, one of the key articulations of the right to maternal health is the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), which says:

States Parties shall ensure to women appropriate services in connection with pregnancy, confinement and the post-natal period, granting free services where necessary, as well as adequate nutrition during pregnancy and lactation. (Article 12)

But the United States hasn’t ratified CEDAW (the only other countries that aren’t States Parties are Iran, Nauru, Palau, Qatar, Somalia, Sudan, and Tonga).

So it’s encouraging that the Clinton State Department supports CEDAW ratification, putting the ball in the Senate Foreign Relations Committee’s court (here’s a helpful recent primer on the state of play).

Given Secretary Clinton’s endorsement of the full range of economic, social and cultural rights (in her Wall Street Journal interview, she also mentions the rights to decent work, housing and education), her State Department should also support ratification of the International Covenant on Economic, Social and Cultural Rights — which, like CEDAW (and the Convention on the Rights of the Child), the United States has signed but not ratified. But CEDAW is the only human rights treaty on State’s recommended-action list. It’s up to the human rights community to push for ratification of all three treaties in the years to come.

Over the weekend, the Obama administration may have weakened its support for a “public option” as one part of the health care package emerging from Washington.

On Sunday, Health and Human Services Secretary Sebelius told CNN that a public option is not “essential”, a day after President Obama, at a town hall meeting in Colorado, said that a public option is “just one sliver” of reform. Major media outlets wrote up what they saw as a shift in position: “Key Feature Of Obama Health Plan May Be Out”, blared the Washington Post; “‘Public Option’ in Health Plan May Be Dropped”, said the New York Times. But some commentators, like liberal bloggers Jonathan Cohn and Ezra Klein, voiced doubts that this represented a substantive change in administration policy.

Whether or not the Obama camp has changed positions, the real Washington action on health care right now isn’t at the White House — it’s further down Pennsylvania Avenue, at the Capitol. With House staffers now reconciling the three versions of its bill, the key battleground is the Senate. The Senate Finance Committee remains locked in negotiations on its version of the mainstream health care package, and now says it will pass its bill by September 15; merging that piece of legislation with the very different Health, Education, Labor and Pensions Committee bill will be a contentious process.

And no matter what way the winds of political calculation are currently blowing in Washington, the human rights position hasn’t changed. A Medicare-like public plan for all remains crucial for realizing the human right to health care in the the United States. Health care is a public good, not a commodity. Public financing and administration is the best vehicle for care that’s truly accessible and accountable. Setting up a new Medicare-like public plan in the current round of reform is a key aim for human right to health care advocates.

Senators Baucus, Dodd and Reid — the Finance chair, the HELP vice chair, and the Senate majority leader — need to support a public plan. Urge them to do that today!

July 30, 1965: President Lyndon Baines Johnson signs Medicare into law. Also seated is President Harry Truman, recipient of the first Medicare card.

 
Medicare turns 44 years old today. It’s in good health.

The program remains efficient — Medicare’s administrative costs are about three percent, much less than that of employer-based private insurance (five to ten percent of premiums for large companies, 25 to 27 percent for small ones) or individual private insurance (40 percent of premiums). Medicare, of course, doesn’t devote administrative dollars to denying coverage or claims on a case-by-case basis. Also, unlike the private insurance industry, it doesn’t seek out profits.

And Medicare remains popular, so much so that weakening it is a legislative third rail that health care reformers are finding they have to avoid at any cost. That’s true even if some of its biggest fans are confused about how it works:

At a recent town-hall meeting in suburban Simpsonville, a man stood up and told  Rep. Robert Inglis (R-S.C.) to “keep your government hands off my Medicare.”

“I had to politely explain that, ‘Actually, sir, your health care is being provided by the government,’” Inglis recalled. “But he wasn’t having any of it.”

Actually, Inglis doesn’t have it right either: Medicare is national government financing for health care, not government provision of health care. Medicare-financed health care is provided by private doctors, clinics and hospitals. Medicare is an example of what journalist T. R. Reid calls the National Health Insurance model, like the health care systems of Canada, Taiwan and South Korea. Canada, in fact, calls its system “Medicare” too.

Here in the United States, Medicare is a model for treating health care as a public good rather than a commodity: a system in which benefits and contributions are fairly shared, one that works for everybody, rather than one in which health care is something to be bought and sold — and tough luck for those who can’t afford it. Medicare is like a fire department that protects everyone’s house — like the fire departments we actually have in this country. The private parts of our health care financing system are like fire departments that only protect the houses of people who can afford to pay.

The current health care reform process offers an opportunity to move towards establishing health care in this country as a public good and a human right. A key step is establishing a new Medicare-like public health care plan that guarantees access for all, something we’re calling on Senate leaders to do.

The Senate is the key battleground now. Of all the Congressional committees with health care jurisdiction, the Senate Finance Committee is least hospitable to a public plan, and has yet to pass a bill. The eventual Finance Committee bill faces a bruising reconciliation with the Health, Education, Labor and Pensions Committee bill that’s already passed. And there will be a further fight when the full Senate debates and votes on the merged bill. In honor of Medicare’s birthday, tell Senators Baucus (chair of the Finance Committee), Dodd (HELP vice chair, running the committee with chair Ted Kennedy ill) and Reid (majority leader) to ensure the final Senate bill provides a Medicare-like public health care plan for all.

Over the looming August recess — the Senate is scheduled to adjourn next Friday, August 7 – everyone with a vested interest in keeping health care a commodity will be working as hard as possible to close the window on a new Medicare-like public plan. Which makes the delaying tactics we’re seeing on the Hill that much more galling. Health care legislation doesn’t have to take this long. In 1965, after all, in the first year of Johnson’s second term, Congress passed Medicare in late spring, in time for the president to sign it into law on July 30 — 44 years ago today.

Since July 2008, abortion in all circumstances has been banned in Nicaragua. The new law makes no exceptions for terminating pregnancies that endanger the health or life of the woman, or that result from rape or incest. Girls or women seeking or obtaining abortions are subject to imprisonment. Health care professionals providing abortions — or even unintentionally injuring a fetus — face jail time and being barred from practice.

A new Amnesty International report, The Total Abortion Ban in Nicaragua, details the effects of the new measures. Medical professionals are put in an impossible situation: they’re prevented, on pain of criminal prosecution, from providing essential medical services — in direct contradiction of best-practice guidelines from the Ministry of Health. Women who need abortions to preserve their health — or lives — have to find doctors willing to risk prosecution and suspension of their license, or seek out dangerous back-alley terminations.

The ban has a chilling effect, too, on women suffering obstetric complications: one woman admitted to a hospital following a miscarriage was so frightened that she would be charged with having an abortion that she asked doctors not to intervene. The rate of maternal deaths in Nicaragua has increased: Official figures show that 33 girls and women have died in pregnancy or childbirth so far this year, up from 20 in the same period a year ago.

Finally, girls and women who become pregnant as a result of sexual violence must either carry the pregnancy to term, or look for risky, clandestine abortions. Our researchers spoke with women, raped by relatives, who were forced to give birth — sometimes to their own brothers or sisters. In every case, it’s low-income women who are hit hardest — richer Nicaraguans are able to travel abroad to escape the ban.

Now, all of this was shockingly, appallingly predictable — but the full litany of violations makes terrible reading. That the Nicaraguan health minister is dismissing the report just shows how hard human rights supporters will have to push to overturn the ban.

Take action today!

Read the whole report (or the digest), o en Español (digest).

Lilli Evans contributed to this post.

Today is the 60th World Health Day, which the World Health Organization uses to highlight a different health theme each year. Today it’s making hospitals safe in emergencies, which WHO Director-General Margaret Chan promoted at an event in China, nearly a year after the Chengdu earthquake. The WHO’s activities to mark the anniversary of the disaster seem to have been warmly received, unlike those of environmental activist Tan Zuoren, who last week was detained by the police in Chengdu, apparently because he planned to publish a list of children who died and a report on the role corruption played in the schools that collapsed. He’s currently at risk of torture.

Here in the United States, particular hospitals are vulnerable to disasters like Hurricane Ike — and our health care system as a whole is facing a slow-motion emergency. The figure you often hear of one in six people in the United States lacking health insurance is just the tip of the iceberg — one in three non-elderly Americans was uninsured at some point in the last two years (as Families USA recently reported).

Our health outcomes are a cause for shame: on women’s lifetime risk of dying in pregnancy or childbirth, the United States ranks 41st in the world, and black women have three times the maternal mortality rate of white women (as AIUSA is currently investigating).  

Will health care reform fix these problems? That’s up in the air right now. But the starting points for that process are cause for despair: What can get past a filibuster? What will entrenched interests sign off on?

Human rights give us a fundamentally different place to begin. As the WHO’s constitution says,

The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.

A health care debate that takes human rights seriously starts where the WHO’s constitution does: every human being has the human right to health care. That’s exactly where AIUSA’s new statement of health care principles begins: for a health care system to fulfill the human right to health care, it must be universal — as well as equitable and accountable.

Do you agree that health care is a human right? Then celebrate World Health Day by adding your name to AIUSA’s petition. Join us in bringing human rights to the health care debate!

AIUSA has joined with the National Economic and Social Rights Initiative, the National Health Law Program, and the Opportunity Agenda to form the Health Care is a Human Right Coalition. Don’t miss NESRI and NHeLP’s ten human rights principles for financing health care (long version, short version, press release), and OA’s State of Opportunity in America, 2009, which assesses the current state of health care as well as income, education, poverty and incarceration.

Yesterday, the U.N. General Assembly marked Human Rights Day by unanimously adopting the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights (OP-ICESCR). This historic step fills in a crucial gap in the human rights framework; former High Commissioner for Human Rights Louise Arbour has described the OP-ICESCR as making human rights whole.

But to the media this looks like U.N. inside baseball, and they haven’t so much as mentioned it. (ReliefWeb, a U.N. humanitarian information portal, covered it; and here’s AI’s press release.)

So what’s it all about? In a word, it provides a means for redress for violations of economic, social and cultural rights.

One way of dividing up human rights obligations is like this:

• To prevent human rights violations from happening.
• To stop human rights violations that are currently happening.
• To offer redress for human rights violations that have already happened.

The Counter Terror With Justice campaign’s call to the Obama administration in its first 100 days is a good illustration:

• announce a plan and date to close Guantanamo;
• issue an executive order to ban torture and other ill-treatment, as defined under international law;
• ensure that an independent commission to investigate abuses committed by the U.S. government in its “war on terror” is set up.

That is, the call is to stop (close Guantanamo), prevent (ban torture), and begin to redress (set up an independent commission) human rights violations committed by the U.S. government in the “war on terror”. (You should, of course, sign the 100 days petition!)

Anyone who’s suffered a violation of his or her civil and political rights — like freedom of expression, freedom from torture, and the right to a fair trial — can file for redress with the United Nations. This is a matter of international law, and it empowers people in countries whose domestic courts won’t recognize their civil and political rights. That mechanism was established by the Optional Protocol to the International Covenant on Civil and Political Rights in 1966.

But there’s never been an analogous system for economic, social and cultural rights – until yesterday. The OP-ICESCR finally provides a means for redress, under international law, for violations of the rights to water, food, health, housing, education and decent work.

This is a new tool for justice for refugees forcibly returned to North Korea and punished by starvation; for Roma children systematically segregated in Slovakia’s schools; and for poor families forcibly evicted from their homes in Angola to make way for new development projects.

Or, in other words:

For more, see the OP-ICESCR Coalition (which included AI).

Reflections on its 60th anniversary by former U.N. High Commissioner for Human Rights Mary Robinson, author and former child soldier Ismael Beah, doctor and human rights activist Farai Madzimbamuto, and our own Larry Cox.

And a classic 1988 Amnesty International animated guide to the UDHR — with voice over by Debra Winger and Jeff Bridges, and music by David Byrne (among other ’80s alt-rock luminaries).

Happy Human Rights Day — write a letter and help save a life this week!