by William Easterly
I’ll write one final post to complete the human rights trilogy, then collapse from exhaustion and go back to easy topics like World Bank follies.
Paul Farmer is my hero as a man of action, who has done amazing things for poor people at great personal sacrifice. He is also a forceful advocate for the human rights of the poor to health care, to food, to housing, to literacy, and to jobs. (I will be quoting from his Tanner Lecture from 2005.)
In his words, “poor people deserve access to food, education, housing, and medical services.” He calls “for these basic rights to be extended to all those who need them.” Poverty is indeed tragic, which all of us care about, which all of us are working on.
But who will be held responsible to satisfy these rights? Farmer struggles for an answer. With health care, for example: “we’ve learned that the public sector, however weak in these places, is often the sole guarantor of the right(his emphasis) of the poor to health care.”
Yes, the poor country government is weak and has a limited budget (as they would, even after aid). What if after satisfying the right to health care, there is nothing left to satisfy the right to food? Who decides between health and food? What if there is not enough even to treat all illnesses as completely as they deserve (as there is not enough even for most rich people)? Who decides which diseases get treated and which patients get treated? Farmer treats all of these as absolutes, so there is no way to choose in a human rights approach. We are left in the end only with the original problem – there is global poverty.
No single actor gets any guidance from human rights what step that actor could take to do the MOST good for the MOST poor people. Such concrete steps by specialized actors, both public and private, already worked to reduce mortality, to reduce malnutrition, to reduce illiteracy considerably over the last half century.
Farmer is deeply inspirational on the tragedy of world poverty, but his human rights approach is vague on who is to blame or where to go next:
only a social movement involving millions, most of us living far from these difficult settings, could allow us to change the course of history….troves of attention are required to reconfigure existing arrangements if we are to slow the steady movement of resources from poor to rich—transfers that have always been associated… with violence and epidemic disease… whether or not we can say “never again” with any conviction—will depend on our collective courage to examine and understand the roots of modern violence and the violation of a broad array of rights, including social and economic rights.
I will always venerate Paul Farmer as a hero in the fight against poverty.
Guidance how to fight poverty will have to come somewhere else than from economic and social human rights.
14 Comments
There seems to be two underlying criticisms in all four of your human rights posts.
(a) You can’t have a legal entitlement to the provision of goods when resources are scarce; and,
(b) Human rights don’t provide clear guidelines to make the tough allocation decisions required in development work.
In all four posts I have argued against both points. It might be that I’m not clear, or that my arguments are unpersuasive. But I haven’t heard a response to them. Your position on rights doesn’t seem to take into consideration those opinions expressed.
On point (a), I have tried to argue — following the path so eloquently set by Cass Sunstein in The Cost of Rights — that all rights have costs, that access to them is always limited, and that the preference for one set of rights over another is an imminently political one, best left to democratic deliberation. There is nothing in the ‘nature’ of human rights that makes ‘negative rights’ inherently easier or cheaper to implement than ‘positive’ rights.
On point (b) I have suggested that human rights were not designed to guide policy-makers on tough allocation decisions (so it is both unfair and nonsensical to criticize them for this ‘failure’). That is true of choices between any set of rights: should we spend more on health or education? Should we spend more on the judicial branch, or on law enforcement? Should we prefer funding polio immunization, or AIDS treatment? Should we provide legal assistance only to defendants in criminal cases, or should we extend it to all (or to some) civil law cases as well?
You will find no guidance in international human rights, or in the US constitution, on how to allocate scarce resources between those priorities. This is no oversight: the law is not meant to decide at such level of detail, and judges (UN Committees or the US Supreme Court) are ill-placed — in a democratic system — to make those allocation decisions.
That is what you have parliaments and different levels of government for. It would actually be undemocratic to have the law — as interpreted by unelected judges — decide what to favor in terms of spending.
That does not mean that there is no contribution from judges, and from human rights. But this contribution is negative: constitutional and human rights litigation can tell governments what allocations are not acceptable, either because they violated democratic procedures for allocation, or because the allocation outcome violates a standard, such as non-discrimination.
Societies are complex. For people in the first world (most notably the U.S.A) to assign all sorts of rights to people in other countries via the U.N is artificial auto-therapy and it does not do anything about the problems at hand. Also, there may be an incentive effect. If every aid worker tells people that they have a right to say, water, they become dependent on whoever is supposed to provide that resource (in this case probably aid workers).
Broad descriptions of human rights also ignores the different contexts and complexities in third-world societies. Is it really realistic to expect people to have access to western-style health care in a country that doesn’t even have proper roads?
Wealth creation is not like the rules of grammar, where you punish someone for not following the recipe or the rules. Wealth creation is loose, vague and indeterminate and depends on the creative spark of thousands of entrepreneurs within the economy. Calling for collective action (so-called social movements)of millions of people has not lead to wealth creation in the past and I am sure it won’t in the future
For people in the first world (most notably the U.S.A) to assign all sorts of rights to people in other countries via the U.N is artificial auto-therapy and it does not do anything about the problems at hand.
Who says economic social and cultural rights were established by the first world and then ‘assigned’ to the 3rd world?
Structural adjustment policies, perhaps. But not human rights.
If every aid worker tells people that they have a right to say, water, they become dependent on whoever is supposed to provide that resource.
Isn’t it the case that you ‘depend’ on water service providers — public or private — regardless of whether you are entitled to water as a matter of right or not?
Isn’t it the case that water is an essential requirement of all human beings, regardless of race, religion, gender or income?
Is it really realistic to expect people to have access to western-style health care in a country that doesn’t even have proper roads?
No. Nor is this what human rights treaty bodies require of states.
Calling for collective action (so-called social movements)of millions of people has not lead to wealth creation in the past and I am sure it won’t in the future.
Collective action has never produced wealth? Wow, that’s quite an amazing statement.
I recall now a conversation I had with an NGO worker a few months back in South Sudan. She was European and worked with a very large NGO who will remain unnamed. There was one line she said during our 1 hour meeting and tour of their humanitarian compound which really irked me.
I had asked about whether they hired locals or brought in contractors from Kenya for most of their on site construction and other labor. I was happy to hear they were employing locals, but horrified by a ‘qualification’ she gave to that hire. That was that they were under contract and were given benefits just like other hires. But it was the way she actually worded this last sentence. That they were given and needed ‘rights.’ And this was afforded to them by their employment contract and the benefits within it. That really irked me.
All of the sudden this NGO has given ‘rights’ to a select group of locals who were hired by the NGO. So I guess everyone else was just out of luck.
A hiring policy like this and the mind set going into this throws off the entire economy and sends shock waves through the culture. I could write a thesis on this so I will stop short here. But consider what the NGO did by assigning a few ‘rights.’ What happens with the rest of the locals? What happens to those employed when their contract is up? Who will maintain these imagined ‘rights’ by the NGO?
Interesting debate and observations. My main gripe with the global rights movements is that they rarely emphasize the responsibility of poor governments to their citizens. The fact of the matter is that most countries still have deplorable health and nutrition situations because of “poor governance” (read corruption and ineffectual leadership). Unless the systemic problems associated with governance are addressed the poor will always be at a disadvantage and vulnerable to human rights violations.
But consider what the NGO did by assigning a few ‘rights.’ What happens with the rest of the locals? What happens to those employed when their contract is up? Who will maintain these imagined ‘rights’ by the NGO?
This is getting more and more surreal.
NGOs and companies don’t ‘create’ human rights. They sign contracts for services or goods. In so doing they bind themselves by legal obligations. The converse of said obligations are the (private) ‘rights’ of the other contracting party.
Rights derived from private contracts are not ‘imaginary’. They are, at least theoretically, legally enforceable. Try not paying your rent, to see your landlord’s ‘rights’ in action…
If a company or NGO decides to grant contractual conditions that are better than those usually applied locally, that’s its own problem, and certainly not an inflation of ‘rights’.
Economic rights trigger duties to respect (the state shouldn’t burn down schools); protect (it should stop others burning down schools); and fulfill–(it should have and implement a plan for providing education for all.) Only the last duty triggers the resource question, and that is the same challenge for all rights–legal systems cost money too (so I agree with Matthias and would love to see Bill’s answer).
My bigger concern is this: If you ask a principle-based tool (how to ensure that people achieve the MINIMUM conditions for living with dignity), to pass a utilitarian test–what you call “the MOST good for the MOST poor people”-it will never be up to the task in the short to medium term, but that’s not the key point of using a rights approach to make development more effective.
Ken’s comment is on point for me…a rights approach reminds us that northern donors, NGOs and contractors are never going to solve global poverty problems–ultimately the people of the South are going to have to demand service provision from their governments. Aid should focus more on how to help them do that, which it will if it takes a rights-based approach.
I personally believe you will get more good for more people over the long run by working from shared principles and asking about who is really responsible for development. If Paul Farmer does get the USAID job, I hope he starts from the premise that everyone has fundamental economic rights and then thinks creatively about how to help them realize those rights.
Paul O’Brien
There is a problem with using the language of “human rights” to discuss global poverty. Global poverty is not an abstraction but a reality that has many causes (ie. tropical disease, civil war, political instability, etc.) Rather than trying to understand the problems and the specific challenges faced by different countries, developing nations are lumped together.
The discussion shifts away from understanding what factors are affecting different countries to transferring responsibility to western nations to “do something” which usually means funding with little quality control. It seems more like a variation on the white man’s burden.
Good intentions and high minded rhetoric is unlikely to end global poverty. The only way that one finds answers is by asking questions and leveraging one’s abilities through working with others to identify approaches that work.
Thanks, Prof. Easterly, for helping to harness the internet to leverage the expertise and understanding of the aid community.
Funny. I find a lot of new and specific ideas suggested in the quotes you take from Farmer. But the biggest lesson from Farmer is that we can’t just mail it in. We’ve got to be engaged in face-to-face contact with the people who we hope to help out of poverty. That is the biggest constraint on change.
The discussion shifts away from understanding what factors are affecting different countries to transferring responsibility to western nations to “do something” which usually means funding with little quality control.
This has nothing to do with human rights, and a lot to do with how NGOs fund-raise, and how development cooperation in the north is managed.
As I mentioned in previous posts, in the human rights field, responsibility for implementing human rights is squarely attributed to the territorial state. Residual responsibility can sometimes accrue to other states, or even international organizations, but only in quite narrow circumstances, and mostly in negative terms: a ‘first, do no harm’ approach.
Good intentions and high minded rhetoric is unlikely to end global poverty.
I totally agree. I hope you are not mixing ‘human rights advocacy’, with high-minded rhetoric, however: although politicians do claim to be speaking in favor of human rights, most human rights activists on the ground are concerned with real people and real problems. If you google up ‘human rights defenders’ you’ll probably read many stories of activists being imprisoned, beaten, or killed because of their struggle for all kinds of rights, from religious freedom, to labor rights, the environment, or gender issues.
There is nothing exceptional about claiming that people have inherent dignity. What is exceptional is dedicating your life to actually have people be treated with dignity. Action, not rhetoric.
And in this, development economists and human rights activists share a lot more than they think.
Mattias,
I hope you are right.
Matthias: There is nothing in the ‘nature’ of human rights that makes ‘negative rights’ inherently easier or cheaper to implement than ‘positive’ rights.
But they are inherently easier. For example, if I want to respect your right to freedom of speech, all I have to do is to not try to stop you speaking. This leaves me free to do a vast number of things with my time, from talking myself, to playing with the dog, to going out dancing. If I want to respect your right to health care, then I have to provide health care, and this means I have less time to play with the dog, or talk myself, or whatever else I want to do.
Doing nothing is easier than doing something. So ‘negative rights’ are inherently easier and cheaper to implement than positive rights.
Your point (b) is the same as Easterly’s argument against human rights being used to guide development.
Your criticism of the human right framework makes sense in conceptual terms. In reality it is hard to think of any government that has come up against the problem of spending so much on one social priority that others suffer. The more prevalent problem is too high spending on the military and presidential slush funds.
Wouldn’t it be more helpful if you suggested solutions to the trade-off problem? Rather than trying to take down others that are grappling with this real problem?
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