title: Will the struggle for health equity and social justice be best served by a Framework Convention on Global Health?
abstract: The idea of a Framework Convention for Global Health (FCGH), using the treaty-making powers of the World Health Organization (WHO), has been promoted as an opportunity to advance global health equity and the right to health. The idea has promise, but needs more thought regarding risks, obstacles, and strategies. The reform of global health governance must be based on a robust analysis of the political economy out of which the drivers of inequality and the denial of the right to health arise. Some of the published commentary has focused on using the proposed FCGH to institutionalize a paradigm change regarding international aid for health care, i.e., reconceptualizing such aid as obligatory, based on human solidarity rather than strategic considerations, based on global stability and national security. We warn against limiting the project to questions of inter-governmental financial transfers because of the risk of neglecting the underlying structural determinants of health injustice. Such neglect would help to legitimize an unjust and unsustainable global economic regime. We raise further questions about the strategic logic informing any campaign for a FCGH. The governments of the United States and Europe have put considerable effort into weakening WHO through tight donor controls, and it would require heavy pressure to persuade them to sign on to a FCGH. Generating such pressure would require strong popular mobilization around the local and diverse priorities of different communities across the globe, and recognition of a common need for effective regulation at the global level. We argue for a broad-based campaign from which the need for more effective global health regulation (and a FCGH) would emerge as a common theme arising from myriad more specific claims. This type of campaign would respond to local needs, and would also be understood within a global, political, and economic perspective.
authors.affiliation: People's Health Movement.
authors.forename: Leigh
authors.initials: L
authors.lastname: Haynes
authors.affiliation: La Trobe University in Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Legge
authors.affiliation: University of Cape Town.
authors.forename: Leslie
authors.initials: L
authors.lastname: London
authors.affiliation: Centre for Primary Care and Public Health at Queen Mary University London.
authors.forename: David
authors.initials: D
authors.lastname: McCoy
authors.affiliation: University of the Western Cape, South Africa.
authors.forename: David
authors.initials: D
authors.lastname: Sanders
authors.affiliation: People's Health Movement.
authors.forename: Claudio
authors.initials: C
authors.lastname: Schuftan
mesh_terms: D014943:Global Health; D006297:Health Services Accessibility; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006806:Human Rights; D006801:Humans; D007391:International Cooperation; D012935:Social Justice