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Health and human rights in the era of globalization

Paper presented to the First National Symposium on:
Health and Human Rights: Refugee Health and Issue for Action. Sydney, 4-5 May 1998

Last updated:  23 December 1998


Is health a human right, and if yes, how healthy are human rights in the era of economic, social, cultural, and political globalization? The answer is simple: they are sick. But there is also a more complex response which would ask: how can human rights and health be in good shape when living and working conditions of the majority of people living on Mother Earth are threatened by economic policies aiming at gaining control over national economies through powerful multinational corporations and international governmental organizations like the Worldbank, the International Monetary Fund, the Organization for Economic Cooperation and Development, the World Trade Organization and a few more? And if you happen to work in one of these organizations you probably would state: What a simplistic question regarding the complex and complicated issue of international cooperation. This response is not wrong given the current state of affairs of international politics. Health as much as human rights have become a matter of international negotiations and treaties. We have made them negotiable.

In 1997, the World Health Organization (1997a) published the report Health and Environment in Sustainable Development. Five years after the Earth Summit in which you find the following sentences on page 1:

Every parent hopes that their newborn child will enjoy a healthy, happy and long life. This is nothing new. Good health has been a fundamental aim in every culture, and various rules, rites and practices to protect health have been developed throughout history. Not all of these practices worked, and some may even have had the opposite effect to the one intended. Nevertheless, the recorded experience and scientific research of the last century provide much evidence of how good health can be promoted and protected. We now know that the living environment is a corner-stone for good health and we have largely identified what makes the environment healthy. Human society is thus more able than ever before to achieve the fundamental aim of good health for each community. But how are we actually doing? (World Health Organization 1997a, 1)

This quote touches on almost all problems regarding health and human rights1). The entire report only marginally refers to Indigenous People or different cultural systems but takes a unifying viewpont when diversity and multi-dimensionality would have been more appropriate. We cannot afford to neglect diversity when diversity is at the core of the eco-system we are part of and therefore at the heart of its sustainability.

Lost - and found?

Firstly, and most importantly: WHO pretends that "we" had to learn about how the environment impacts on individual and public health, thereby assuming that "we" refers to all humans on Mother Earth. This is a gross misconception of our collective knowledge which has been available to us for centuries, even millenia. Indigenous People know about the delicate connections between human lifeworlds, environment, spirituality and health (Lambert Colomeda 1996, 1998). They have told us for quite some time to re-adjust our mindset and realize that White Man is not the creator of this world. Like all other species inhabiting the planet, we are only one element of the global eco-system and we are connected to other species of nature in order to be able to live and survive. However, White Man

take[s] in a manner that does not replenish. We search out the last corners to do injury to them as if we have become confused - as if forgetting that we cannot live, cannot survive, without grace and magic (Bass 1996, 7).

We act as we have done for centuries because we believe in human reason and rationality as the main tools and ends of White Man's lives. Our concept of life is inherently based on the assumption that we can plan, organize, direct, and finally end life at our own will. Cogito, ergo sum  (I think, therefore I am), wrote the French philosopher René Descartes in the early 17th century and thereby introduced the concept of reason and rationality to science and culture. Its application led mankind away from the spiritual dimensions of life. Since then, the Creator or Great Spirit have become merely meaningful metaphors. They have become shallow words for cultures believing in the doable and manageable, in the feasible and accessible - and each of these based on the overarching principle that money facilitates human will to take over control. White Man's idea of the world is the world organized and run by money because we are obsessed to put a price tag on each and everything. Insurance companies pretend to be able to tell us how many dollars a human life is worth, let alone the lives of a frog, a tree or a species of rice.

Once you put a price tag on everything, you lose the sense of value, respect, and humility which is essential to keep Mother Earth alive.

For Indigenous People (and for an increasing number of other people) such an approach to life on Mother Earth is not only unthinkable, senseless and stupid, it is also not acceptable when observed with others. They do not and cannot comprehend why we do believe in our supremacy over Nature. They do not and cannot comprehend why we have set up megalomanic institutions for the sole purpose to "develop" societies aiming at destroying what has grown over millions of years. They do not and cannot comprehend our politics because they are not rooted, but only ruthless.

Indigenous Peoples may be on the losing end not because they are wrong but they are relatively unorganized in a highly organized and globalized world of power relations. Though we are currently witness of improvements in this respect, particularly with regard to the World-Wide Web (WWW) and its potential to disseminate information and calls for solidarity in very short time-spans, the degree and quality of Indigenous Peoples' non-governmental organizations are still inferior compared with those of established corporations, institutions and agencies in the so-called developed world.

This diagnosis, however, also applies for most of White Man's people. We, too, will have to cope with the destruction put into place by our very own organized power systems. We do not seem to be able to protect our own lifeways against corporate and governmental policies. The sociology of social movements reports on the difficulties of people in so-called developed countries to organize their interest and gain power to maintain their lifeways against those who claim to do good for the people by building nuclear power plants, more highways or super-markets (Eder 1993). Human rights do not play a major role of concern when it comes to economic opportunity.


When discussing health as a human right - and this leads to my second concern - then we have to ask ourselves what we mean when saying "health". This is not the opening sentence for a discussion of the health definition of WHO aiming at coming up with a new definition. I rather prefer to raise a few issues directly related to our understanding of health and what it may stand for:

  • All Indigenous People know (and White Man has known centuries ago) that health or well-being is directly related to the land we live on. When we lose our land, when we lose the connection to our land, our well-being is threatened in real terms (Goudie 1997). The technical term "environment" does not reflect the deep spiritual quality of men's connection to land. It rather conceals it, thereby opening the door for reason and rationality to treat the environment as just another commodity (Wenzel 1997). This is what has happened during the past centuries, particularly since industralization has become the major characteristic of the so-called developed countries. Land is there to be used, or as someone else once said "Wilderness = Land of no use" (quoted in: Bass 1996, 5).

  • From this attitude follows that those, claiming spiritual connections to land, are in the way of what White Man calls "development". This is an interesting term as it has taken a variety of meanings: it refers to economic as well as to human growth, it reflects exploitation of resources as well as of humans, it notifies progress as well as distress, it replaces values with wealth, and it overall tells us that it is good! As long as we develop, we will survive. We have gone so far and have established a "development industry" - language is a lifeform, said the philosopher Ludwig Wittgenstein, and he could not possibly know how perfectly right he was. We are industriously developing, breathless, always on the run for the next quick dollar, mindless when it comes to warning signs and ruthless when other humans stand in our way. Our well-being is linked to this concept of "development" which is why we set up a "health industry" which is supposed to take care of our well-being.

  • Just imagine for a minute: agencies "taking care of our well-being" as if we have been disowned from the connections to ourselves, as if we have compartmentalized ourselves in domains offered to external supervision, monitoring and treatment. The "body-industry" is just one example of the aberrations of our culture. We have become obsessed with the "ideal body" only a handful of us will ever be able to develop (Wenzel 1994). The rest of us will have to live with the assessment of not fitting in. We have only recently begun to realize what the body-craze is doing to all of us, but particularly to our disabled fellow humans (Seymour 1998).

    We seem to be disconnected from the foundation of life, that is, we do not seem to feel anymore who we are and what we are as we refer ourselves to what we call "professionals" when we need help to feel well. How can anybody become a professional of well-being? And does it mean that the rest of us is sick and almost dead unable to lead a life full of love, respect, and humility regarding all other species walking on Mother Earth?

  • When health or well-being are seen as a product which can be "developed", purchased, consumed, digested, and defecated, like any other product the superstores of White Man's economy offer, then we have expropriated ourselves regarding the material, spiritual and ethical foundations of our lives (Brandt & Rozin 1997). We have made ourselves a shallow shell, an object of economic desire and social control, and a case of professional diagnosis and treatment.

    This becomes obvious, for example, with regard to the role of the pharmaceutical industry in health care provision. Medical drugs become increasingly only available for those who have the adequate purchase power. The recent case of AZT is one example how human rights and health become almost irrelevant within the "health care industry". The World Health Organization, Regional Office for Europe (Copenhagen) has launched a major public health initiative, the Verona Initiative (WHO-EURO 1997), which is financially backed up by a global pharmaceutical company (Glaxco Wellcome, which ironically also produces AZT). The Jakarta Declaration on Health Promotion of 1997 calls for the integration of the industry into public health programs under the heading "New players for a New Era"; there are no standards and procedures described how this could be realized without harming public interests and concerns. Corporate business is invited to take care of public health concerns on global level. I cannot imagine how much further we can go to give away the "public" of public health and replace it with "economic". It sounds to me like inviting the fox to take care of the hen-house.

Health is not a human right. It is a necessary condition of life. Without health, we will not be able to survive. Our current narrative of "health as a human right" falls into the trap of what I have called judicilization, i.e. the socio-political process of dealing with fundamental social, cultural, political, economic, and environmental issues on a legal rather than on a political basis taking account of power structures, money, and international trade mechanisms (Wenzel 1997). When we look at health as a human right, we look at it as a legal good which can be purchased via lawyers. It is true that we have made health such a commodity, but that does not mean that it is a commodity in the first place. It is true that we need to fight legal battles to establish living and working conditions conducive to health, but that does not mean that health is a matter of legal codes and principles. We cannot continue to pretend that health is something we can negotiate. It is one of the fundamental conditions of our very lives and as such it is not negotiable. Our language, however, conceals this fact when linking it to the judicial system of human rights and opening the door for negotations on degrees and levels of health for those who care to sue. As a consequence, we seem to accept differences in health and we undertake research to analyze these differences as if they were essential to human life. What is essential is that humans develop different ways of health and well-being. But we cannot and should not accept that different people develop different morbidity and mortality patterns only because others pollute their environment, for example.

Re-search ?

When we look at the ways, governments deal with public health, we can detect a pattern of activity which leads to inactivity. Once someone or a group of people has identified a "problem", experts are called in to set up research priorities. The priorities are formulated in terms that they become accessible for standard research projects, i.e. the problems identified are translated into terms of available methodology and in terms of governmental funding practices! Rather than research, we should call it re-search, i.e. the activity to re-establish what is known in general and to re-formulate the results in new words and phrases. Tobacco is a good example here. We know that the constant intake of nicotine is health-hazardous because nicotine is a drug, and we can conclude that smoking the drug is health-hazardous, too. In order to develop public policies aiming at the prevention of tobacco smoking we do not need to spend money on whether and to which degree smoking may harm people.

What happens between the naming of a public health problem and the formation of a governmental recommendation or policy is the reduction of public to individual. The problem may have been: increase of non-communicable diseases, the "research" was on cholesterol as it may contribute to the development of certain non-communicable diseases, the policy puts the responsibility on the individual to take care of her cholesterol level.

Given our topic, research is not needed. We know what has gone wrong and we could act on it. We do not have to re-search facts or even the truth, it's all here in front of our eyes. We could start instantly developing and implementing policies aiming at keeping Mother Earth alive.

Do we dare?

These issues are risen here for the purpose to increase our awareness of the global conditions of human life on Mother Earth. They are global in two different ways:

  1. Geographically, we have to learn to acknowledge that we are connected to each other irrespective where we currently live. The local has never been only local as our ancestors have known. It has always been embedded in much larger contexts which needed to be respected in order to be able to live in the places they inhabited for a certain period of time. Nowadays, the local is even more connected to its global neighbors via physical lines of communication, trade and tourism.

  2. Politically or mentally, we have to understand that our very own lifeways are dependent on the lifeways of our fellow humans dispersed all over the planet. No one is independent, no one is superior, no one has more rights than others (Bretherton 1996). Mother Earth has never thought of different rights for different people and species. The fundamental reality is that only equality between all of us will help us to maintain our material living conditions in a sustainable way. Everything else contributes to their demolition (Escobar 1995).


This leads me to my third issue of concern - globalization and its impact on health and human rights. Globalization is of course not a process of our times. It has happened as soon as people started to travel long distances to explore other areas of the earth. Most of the time, these explorations were not peaceful ones. Their primary intention was to conquer land and subjugate its population to slave work of one or the other kind. The peoples of Europe have been particularly successful in this respect for the past 500 years and have set up a globalized political and economic system which still controls most of the rest of the world. Imperialism is the political term for this type of global power structure.

Fairly recently, the political structure of the world has changed dramatically due to the collapse of the so-called socialist countries. The Cold War between West and East has come to a halt while the Cola War has only begun. The establishment of multinational corporation and their expansion into all markets of the world has increased rapidly and there is hardly a remote place on Mother Earth which has not been exposed to Western consumer products and services or, even worse, to the toxic fallout of their production. As Lambert Colomeda (1996, 1998) illustrates so clearly, even the most remote areas of the Arctic suffer from lethal environmental pollution to a degree never observed before.

Globalization, therefore, needs to be disclosed regarding its different layers relevant to health and human rights:

  • the economic layer, i.e. all matters of economic relevance, from agriculture to assembly-line production, from international money trade to global trade mechanisms, from international patent rights to copyrighted knowledge bases, etc. (Mander & Goldsmith 1996)

  • the legal layer, i.e. the implications of global legal systems for national legislation, the de-powerment of national, state, and local governments elected by the people through international treaties like Multilateral Agreement on Investment (MAI), etc. (MAI-Not! Project)

  • the cultural layer, i.e. the increasing dominance of Western, mostly American culture, over all other cultures, the internationalization of electronic broadcasting and communication, etc. (Barnet & Cavanagh 1994)

  • the public health layer, i.e., the internationalization of food production and supply, international legal and illegal drug production and supply, global epidemics and newly emerging diseases, the rapid increase of non-communicable diseases, etc. (Wilkinson 1996, World Health Organization 1997a, b)

  • the environmental layer, i.e., the global traffic of toxic substances and waste, global air, water and soil pollution, global destruction of the ozone layer, the destruction of wilderness etc. (Goudie 1997)

All of these layers contribute to changes of our living and working conditions and therefore to the public health conditions of all countries and territories. Like a spider web, globalization does not leave a loop-hole for anyone covered by it. The result is the uniformization of the world, a loss in diversity, and subsequently a threat to the fundaments of the entire eco-system which is based on diversity and variety. In this respect, globalization as a political and social process does not make sense at all. Its economic advantage only applies to multinational corporations, but it would be a very short-minded policy if one relies solely on economic advantages.

However, there is also the chance of globalization which lies in opportunities to connect. Global systems of electronic communication enable us to exchange information and form coalitions of global scope. While we may not like the (side-)effects of electronic communication in general (e.g., international TV programs etc.), we also make use of it in productive ways. It has become much easier to notify colleagues and the general public on developments in one's country and within international organizations. This is true for those who have access to these modes of communication, i.e. who can afford to buy hardware and software and to pay the bill for connecting to electronic communication. We know, of course, that those living in so-called developing countries can hardly afford the expenses, though they may be the ones who would benefit from these modes of communication more than anybody else. International communication has always been a business, i.e. relating to our sisters and brothers is dependent on economic opportunity.


Regarding public health, no one is intangible and everyone contributes to it one way or the other. It is a truly public affair. This is what WHO's report on Health and Environment in Sustainable Development illustrates on almost every page. However, it does so without analyzing carefully the political background of its statements. What we learn is that the environment is in bad shape and that people can do more than they currently do to develop and maintain living conditions and lifestyles conducive to health. WHO does not address the question how this can be done within international contexts of globalized power which are not easily accessible for all of us, let alone for Indigenous People who do not share our worldview and subsequently our ways of organizing power.

However, we in the so-called developed countries are all part of the political power struggle about public health. And we all are playing our part, even if we do not seem to participate at first sight. Non-participation is another form of complicity. None of us is without guilt and responsibility as Rick Bass notes:

"It is our very complicity, however, that gives us the right - the responsibility - not to be silent, but to speak up. We have to begin putting the breaks on. We're hurtling down the rapids, with big business at the throttle, grinning a mad grin for history.

We are the ones who have let it get taken this far - all the way to the edge. It is our duty to speak up, and to stop at the edge of that which we have allowed to go so far" (Bass 1996, 162).


1 The WHO report is taken as an example for the entire UN-system. The staff of WHO is not more stupid than others or less intelligent whichever you prefer. It is the institution as such, the structure and functions of which are conducive to this type of latent, and sometimes overt racism (see the critical analysis of institutions by Mary Douglas 1986). Back


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Copyright © by Eberhard Wenzel, 1997-2001