Venezuela’s health systems are crumbling – and harming women in particular

By Pia Riggirozzi, Professor of Global Politics at the University of Southampton

Venezuela sits on the world’s biggest oil reserves, but in terms of GDP growth per capita, it’s now South America’s poorest economy. It is mired the worst economic crisis in its history, with an inflation rate in the region of 500%, a volatile exchange rate, and crippling debts that have increased fivefold since 2006.

The economic crisis is inflaming a longstanding “economic war” between the government and the business sector – and a dangerous cycle of protest and repression is further polarising Venezuela’s already divided society.

In this scenario, violence of all sorts is approaching what could be a point of no return. The very ability of democracy to combine forces of transformation and resistance is at stake.

The crisis in Venezuela has also taken centre stage in regional organisations. The Union of South American Nations and the Organisation of American States are gravely concerned with the weakness of Venezuela’s democratic institutions, its culture of impunity, and the criminalisation of dissent. But they’re overlooking one of the biggest tragedies of the crisis: the crumbling of Venezuela’s health and welfare systems, which not long ago were beacons of hope. This collapse is truly dangerous and is affecting Venezuela’s women particularly badly.

Venezuela’s promise

For more than a decade, Venezuela was a focal point in the continental promise of a more direct and inclusive alternative to dominant marketised approaches to development and democracy. At the end of the 1990s, governments across South America began embarking on various “post-neoliberal” experiments – and for more than a decade, those experiments seemed to work.

Between 2000 and 2014, the region nearly halved the proportion of its people who lived in poverty, and the bottom 40% of its the population saw their incomes rise dramatically. In Venezuela, social, political and economic reforms between 1998 and 2012 helped cut poverty by a spectacular 50%, and extreme poverty by 65%.

Venezuela also became a regional health and welfare pioneer, greatly expanding the number of primary care physicians in the public sector and offering millions of poor citizens better access to healthcare than ever. Under a flagship programme titled Oil for Doctors, Venezuela subsidised oil exports to Cuba in exchange for deployments of Cuban medics and medical training programmes. The Barrio Adentro programme was set up to provide free basic medical care; Mission Miracle provides free eye care to people across the region, and other Venezuelan initiatives tackle the needs of people with disabilities across Central and South America.

But these remarkable projects all depended on revenue from Venezuela’s oil bonanza and accumulated reserves. Once the country was hit by an international oil industry downturn, the result was a string of shortages, outbreaks and widespread social deprivation – and a spiralling socio-political crisis.

Today, thousands of patients cannot receive essential medical treatments – and thousands more are on the waiting list to undergo vital surgery because doctors do not have the necessary resources. Likewise, diseases such as malaria and diphtheria – previously eliminated or controlled – are now on the rise, with disastrous results.

These assorted crises have implications for all Venezuelans, but women in particular. Their rights and choices are affected in distinctive ways, especially when it comes to reproductive rights, sexual health, and gender-based violence.

Women’s rights and dignity

Even before the economic collapse, Venezuela had one of the highest teenage pregnancy rates in the world. To tackle the problem, the socialist government rolled out entitlements to contraception – but the Venezuelan Pharmaceutical Federation estimates that since 2005, the country’s stocks of contraceptives have fallen by 90%. This is fuelling a rise of sexually transmitted diseases, particularly HIV, and more and more women are seeking out illegal abortions and even sterilisations.

According to Amnesty International, between 2015 and 2016 maternal mortality increased by 65% in Venezuela – wiping out recent advances and returning to the situation that prevailed 25 years ago. Among the main causes are the lack of medicines and basic medical tools and equipment, and the ever-falling number of medical personnel, many of whom are either emigrating or simply unable to work without equipment or pay.

Women find themselves in desperate situations and who fear dying in childbirth are fleeing to give birth in neighbouring Brazil and Colombia. According to the United Nations High Commissioner for Refugees, the overall number of arrivals in neighbouring states steadily increased to 5,000 a day as of early 2018. More than 56,000 Venezuelans crossed the borders in January alone – 40% of them were women.

The ConversationSo far, Venezuela’s South American neighbours and the regional multinational organisations have responded to the crisis principally as an economic and fundamentally a constitutional problem, justifiably worried as they are by the Maduro’s rapidly expanding authoritarianism. They have focused on isolating his government, condemning Venezuela’s farcical elections, recalling their ambassadors and even moving to suspend the country from organisations such as the Organisation of American States. But this is a humanitarian disaster, not just a democratic one. It’s time for other countries to step up and address the crisis’s disastrous effects on women, their rights, and their dignity.

This article was originally published on The Conversation. Read the original article.

Europe’s Russia Dilemma Is Older and Deeper Than It Seems

Kamil Zwolski, University of Southampton

The conflict in Ukraine effectively began between 6.30pm and 8.30pm on November 28 2013. This is when Ukraine’s then president, Viktor Yanukovych, confirmed that he was not going to sign an association agreement with the EU – a deal that the Russian government held in contempt. The result is well-known: mass pro-European protests in Ukraine, the ousting of Yanukovych, the annexation of Crimea by Russia, and the protracted war in eastern Ukraine. But why did this happen, and why did it unfold in the way it did?

People have been asking these questions since the Ukrainian conflict began. When Yanukovych made his decision, Herman Van Rompuy, then president of the European Council, reportedly vented his frustration: “You are acting shortsightedly. Ukraine has been negotiating [the EU Association Agreement] for seven years because it thought that it was advantageous. Why should that no longer be the case?” Despite the years of political upheaval, revolution and war that followed Yanukovych’s decision, no single clear answer is forthcoming.

For anyone interested in the future of Europe’s relationship with Russia, grappling with the question of why Ukraine changed course is a crucial part of understanding not just the roots of the Ukrainian conflict, but the deeper geopolitical dynamics that have played out in Central and Eastern Europe for centuries.

As always, in 2013, Russia was worried about the future of its influence in its “near abroad” – the term used in Russian political language to denote former Soviet republics. Towards the end of the year, Russia went out of its way to discourage Yanukovych from signing the agreement with the EU, even resorting to threats; Vladimir Putin’s representative, Ukrainian-born Sergey Glazyev, explained to Yanukovych that “the association agreement is suicide for Ukraine”.

The EU, meanwhile, faced a fiendish dilemma. The situation was neatly summarised by Alexander Kliment of the Eurasia Group during a 2015 House of Lords hearing on the future of EU-Russia relations: the question was whether it was “more important for the European Union to expand its political and economic influence in the former Eastern bloc countries” or “to have a functional, stable and growing relationship with Russia”.

In other words, the EU had two options: to stay as unified and assertive as possible while pressuring Russia to stop its arguably expansionist behaviour, or to accept that Russia was just “different” and try to influence its foreign policy by forging links where possible. And despite the events that followed in Ukraine, the EU has yet to make a choice.

As I argue in my recent book, European Security in Integration Theory, this dilemma has deep roots; in fact, it dates back at least to the period after World War I.

Friends and foes

In 1918, the severely weakened European powers had to face a new, potentially mortal threat in the east: Soviet Russia. As they tried to figure out how to safeguard European security in this new environment, they had two options almost identical to the ones Europe has today.

One idea is associated with the approach called European federalism; the other idea is associated with the approach called international functionalism. The ideas behind these two approaches are quite simple: whether the best way to face down an external threat is to unite Europe as closely as possible in opposition, or to engage the threatening power (namely Russia) openly, through forging functional links where possible – on trade, say, or culture – in hopes of changing its behaviour.

One of the most famous advocates of European federalism was Richard von Coudenhove-Kalergi, a Japanese-born Austrian aristocrat and politician. Between the two world wars, he promoted a close integration of European countries, just as the staunchest advocates of the EU’s “ever closer union” do today. What’s interesting is how he justified it. Writing in 1926, he painted a dark picture of a Europe under threat:

The world hegemony of Europe is overthrown for all time. Once feared, Europe is now pitied. From its dominating position, it has been thrown back upon the defensive. Threatened in a military way by a Russian invasion; threatened economically by American competition.

Today, calls for further European integration are often justified not in hopeful terms, but by references to the threatening “external environment”.

The current president of the European Council, Donald Tusk, has warned that “the challenges currently facing the European Union are more dangerous than ever before in the time since the signature of the Treaty of Rome” – and pointed out that whereas European countries can’t on their own do much to counter Russia and China, a properly united EU is “a partner equal to the largest powers”.

But today as in decades past, there are many who take the opposite view. Back in the 1930s, one alternative was advanced by the Romanian-born British thinker David Mitrany.

Mitrany argued that international relations should not be organised around regional integration blocs, but based on the functional idea of “binding together those interests which are common, where they are common, and to the extent to which they are common”.

According to this mindset, Europe would be better off engaging Russia on matters such as counterterrorism co-operation, hoping that the cumulative effect would make Russia more accountable and peaceful. One modern organisation taking this approach is the EU’s CBRN Centres of Excellence, a worldwide network of local experts and collaborating partners concerned with addressing chemical, biological radiological and nuclear risks. Also choosing the co-operative style are the specialised agencies of the United Nations, such as the International Labour Organisation.

The ConversationFor all that the last 100 years have transformed the continent, Europe is still in the same Russian bind. Its thinkers and politicians have spent nearly a century debating Russia’s proper place and different ways of co-operating with it. If the 21st-century’s European players re-examined these old arguments over the limits of integration with their eastern neighbour, they would be better equipped to deal with the problems they face today.

Kamil Zwolski, Associate Professor in International Politics, University of Southampton

This article was originally published on The Conversation. Read the original article.

Argentina’s Foreign Policy: In the Path to Change?

By Dr. Ana Margheritis, Reader in International Relations at University of Southampton (Twitter, Academia.edu). You can find more posts by Ana here.


Next 1st December, Argentina is going to take over the presidency of the G-20. In late 2018, it will host the summit of the International Trade Organization. The Macri administration argues that this role is an ‘acknowledgment to the change’ the country is undergoing. How much changed has happened since Mauricio Macri took office in December 2015? The recent mid-term elections (on 22 October 2017) offer an opportunity to assess the records.

cumbre-del-g-20-2263999w620.jpgIn an effort to highlight contrasts with the predecessor and expand its base of support, change has been the key slogan of the coalition in government called, indeed, Cambiemos (let’s change). In foreign policy, two ideas summarised this proposal: ‘re-joining the international community’ (volver al mundo) and adopting pragmatism (des-ideologizar). In other words, Argentina now attempts to resume its historical goals, principles and roles, open and integrate itself to the world, and pursue what officials call an ‘intelligent’ and ‘mature’ positioning in world affairs. The underlying goal is to re-establish other countries’ confidence, presumably lost in the past decade due to a confrontational rhetoric and conflictive actions mostly inspired by economic and political nationalism.

Two years down the road, there are some signs of changes, although these are still a work in progress. First, efforts to mend relations with the US led to establishing a good rapport at the presidential level during the Obama administration. This continues under Trump’s term as trade negotiations progressed and changes in Argentina’s policy orientation and discourse are welcome in Washington.

Second, expanding and diversifying partnerships follows from an aggressive trade and investment strategy. These include reviving MERCOSUR (the regional trade bloc of which Argentina is founding member), pursuing trade agreements with the European Union, and joining as observer the Alliance of the Pacific in June last year (another regional organization formed by Mexico, Peru, Colombia and Chile). This last move is consistent with increasing economic links with China and Asia more broadly –where four of the ten main destinations of Argentina’s exports are (i.e., China, Vietnam, India and Indonesia, in that order). In other regions of the world, redefining relations has proved to be more controversial at the domestic level: the agreement with Iran (signed during the previous administration) has been declared non-constitutional. The President accepted this judicial decision and did not use his veto power in this case. Iranians have been linked to the 1990s terrorist attacks to Israeli institutions in Buenos Aires. Former president Cristina de Kirchner and other high officials were to be prosecuted when a federal judge died the day before presenting the evidence. Both legal cases are still open in the context of increasing efforts of the Judicial power to re-gain autonomy and enhance transparency.

Third, relations with regional partners deserved special attention in the last two years because of the ongoing crisis in Venezuela. In clear contrast with the Kirchners’ alliance with Chavez and Maduro, Macri forcefully requested the liberation of political prisoners, denounced violations to human rights, and was in favour of not allowing Venezuela to take over the pro-tempore presidency in July 2016. He was keen on ‘passing from rhetoric to action’ and even applying the Organization of American States’ Democratic Clause. This position finally prevailed within the bloc: on 5th August 2017 MERCOSUR finally applied the 1998 Ushuaia’s Protocol, suspending rights and obligations of Venezuela as member state for indefinite time (i.e., ‘until the democratic order is restored’).

Fourth, the bilateral relationship with the UK also shows some signs of change. Aware of the constrains posed by the long-standing dispute over the Malvinas/Falklands Islands, Argentina argued that this item should not be the focus of the relationship as it represents, at most, a figurative 20% of the links with the UK; instead, Macri’s government proposed to concentrate efforts on the remaining 80% which promises mutual benefits. This new approach led to a joint declaration in early 2016 and some progress afterwards. One of the goals in that document was achieved: clarifying the identity of Argentine soldiers who died during the war and were buried in the islands. The other two are still pending: resuming flights to/from the islands and ending sanctions to economic activities by islanders. Political, diplomatic and cultural relations improved and intensified in the last two years, in the spirit of ‘construction of empathy,’ as the British Ambassador to Buenos Aires called it, that is, setting a positive, mutually beneficial and long-term bilateral agenda.

These incipient changes are not exempt of pitfalls and criticisms. The 20/80 figure used to represent relations with the UK is questioned by the opposition, which also charges the government with a lukewarm approach in the defense of sovereign claims at international forums and an ambiguous approach to the case of Venezuela. Trade partnerships also represent a source of concern because of Argentina’s trade deficit and specialization in commodities. This is more of a continuity than a change between the current and the past administrations, and a pending issue in the governmental agenda. Another sign of continuity is to be found in the management of this area of public policy: as usual, presidential diplomacy is at the driver’s seat of most initiatives in foreign policy. Signs of dissent within the Cabinet (as the ones recorded between Macri and his former minister of Foreign Affairs over the issue of Venezuela) are seen as detrimental to the overall strategy. The replacement of Susana Malcorra by Jorge Faurie in that post (last June) was presented, in the official discourse, as a sign of ‘continuity and trust,’ presumably meaning that, from now on, no fundamental changes and disagreements in foreign policymaking are to be expected.

In sum, foreign policy might not have been a top consideration for voters in the recent mid-term elections, but it certainly contributed to construct a narrative about the identity of the coalition in power and to suggest a path to the future, a projection of national interests in a certain direction that seeks social support. Macri won the recent elections, defeating the dominant political force (Peronism, in its multiple forms). However, a narrative based on contrasts with the predecessor inevitable has limits in the long-run. Interest groups and society at large are eager to see, for instance, if Argentina has the capacity to resume steady economic growth, capture foreign investments, or play a leadership role at the regional level. In other words, the challenge is now to show if slogans translate into concrete changes at both the domestic and international level.

Despite Trump, the United States Is Probably More Socially Liberal Than Ever

By Justin Murphy (@jmrphy), Lecturer in the Department of Politics and International Relations at the University of Southampton.


There is a lot of confusion about whether we’re seeing significant ideological change in the United States. With Trump and the re-appearance of white nationalism in the public spotlight, many people are wondering if conservative (right-wing) ideology is on the rise. One can find many influential outlets endorsing this notion. CBSBBCVox, and certainly others have all run articles suggesting this. On the other hand, many conservatives believe that “liberal” (left-wing in America) ideology is on the rise. There are good reasons for people to be confused, because the dynamics of ideology in the United States are confusing. To help clear up some of the confusion, I’ve written this guide to some of the basics of what political scientists know about the long-term historical dynamics of ideology in the United States. And how they shed light on what is happening, or not happening, right now.

If there is one substantial ideological shift in American public opinion in the post-war period, it is the dramatic and near-universal increase in social liberalism since the 1950s. There has not been a general shift to the left or right because economic conservatism has not changed much (although it has polarized on the left and right). There has been some cyclical, “thermostatic” movement in opinion (which is normal). There have been changes in symbolism (“liberalism” became stigmatized in the 1960s). And there have been some dramatic shifts in party identification (a pretty massive Republican resurgence with Reagan). Otherwise, one cannot say the American public has moved to the right or left as a whole, in any significant way, in the long-run or recently, except that it has become more socially liberal. There have been some interesting and substantial ideological shifts within groups, but that would need to be another post.

Racial Liberalism Data from Atkinson et al. (2011)
Racial Liberalism data from Atkinson et al. (2011) 

There is currently no good evidence I am aware of that overt racism or white nationalism is growing.1 It likely appears larger than it is, especially to progressives, precisely because it has never been less common in American history. This says nothing about how such stupid and malicious groups should be dealt with.

This is my interpretation based on what we know about long-term ideological dynamics in the United States. For a more detailed tour of that data, see the post on my personal blog, “Are Americans becoming more conservative or liberal (right or left)?”

 


  1. The only exception I have found is the data on the number of “hate groups” collected by the Southern Poverty Law Center, which reveals an upward climb since 1999. I am not going to say it’s wrong in a dismissive footnote, because it would deserve more attention than that. But I am excluding it from consideration here for a few reasons. First, it includes a wide variety of groups well beyond explicitly racist or white nationalist groups, including black separatist groups. So in this sense it does not reflect what I am considering in this post. But also the SPLC has come under fire for being increasingly politicized and untrustworthy as a data source. See this article from Politico, for instance. My personal view is that there has been a tendency in recent years for progressive groups to lower their bar for what counts as a hate group, and at least a few cases on the SPLC’s list suggest to me this has occurred there, at least to some degree.

The strange case of unpopular populism: Labour and Jeremy Corbyn

By Gerry Stoker. Gerry Stoker is Professor of Governance at University of Southampton and Centenary Professor of Governance at the University of Canberra (Twitter).


Populism encapsulates the spirit of our times, we are told. So how has Labour under the leadership of Jeremy Corbyn managed to discover an unpopular version of populism? In the discussion that follows, I argue that Labour’s election campaign has adopted many of the defining features of populism without winning a lot of support. What lies behind this seeming paradox?

The standard formula of populists is to position their movement of ‘the people’ against the corrupt ruling elite or establishment. Labour’s campaign emphasises that it is on the side of the millions rather than the millionaires. In his first speech of the campaign Jeremy Corbyn set a clear populist tone:

Much of the media and establishment are saying this election is a foregone conclusion. They think there are rules in politics, which if you don’t follow by doffing your cap to powerful people, accepting that things can’t really change, then you can’t win. They say I don’t play by the rules – their rules. We can’t win, they say, because we don’t play their game. They’re quite right, I don’t. And a Labour Government elected on June 8 won’t play by their rules…Of course those people don’t want us to win. Because when we win, it’s the people, not the powerful, who win”.

Labour’s manifesto is also populist in its main messages. There are proposals to spend more on education, health, social care, housing and so on with a clear indication that someone else – the rich and big business – will pay for it through extra taxes. There are commitments to renationalise core utilities notably where there are popular grievances against their performance. The essential claim is that the economy has been rigged for the rich and now it is time for change. As Corbyn puts it:

Don’t wake on up on 9 June to see celebrations from the tax cheats, the press barons, the greedy bankers, Philip Green, the Southern Rail directors and crooked financiers that take our wealth, who have got away with it because the party they own, the Conservative Party, has won”.

So, is the call to support Corbyn fighting for the many against a rigged system winning hearts and minds? Marginally, would appear to be the summary judgement. Labour has gained some support and may do better than some pundits predict. But with the collapse of UKIP support the Conservatives enjoy double figure leads over Labour in the polls – some as high as 20%. Bottom line, they are going to win the election easily. On the issues most important to voters, it appears that PM May is more trusted to deliver than Corbyn. There we have it: the odd spectacle of an unpopular populist. Why?

Is it that the media is blocking Corbyn from getting his message out? There can be little doubt that the Labour leader has little editorial support among the print media. But as his own supporters have been keen to assert this is a people’s movement using social media to spread its message. Moreover, the regulation of election coverage means that mainstream television and radio outlets have to give fair access to all candidates. There does appear to be plenty of interest in politics and in Corbyn as a candidate for PM. It seems unlikely that its media coverage that is distorting or blocking the message sufficiently to explain the lack of popular uptake.

Is it that divisions within the Labour Party means that Corbyn’s position is undermined? That Corbyn does not have support of most Labour MPs is evident but from the perspective of a popular movement it is the recruitment of activists and grassroots supporters that should provide the real momentum. Corbyn-supporting groups in the party have been vocal about their presence. The manifesto adopted by Labour and the campaign and its content all appear to be in the hands of Corbyn and his supporters. Not having the support of the New Labour establishment – and figures such as Tony Blair – could be seen as a plus for a populist, so it’s unlikely that it is divisions within the party that are undermining the cause with the public.

Another explanation might be that Corbyn’s Labour offers faux populism. Labour can afford to be radical and promise a lot because its knows it’s not going to have to deliver. The aim is to shore up support for the Corbynista project when it comes to the post-election aftermath of a Labour loss. This is cult politics rather than populist politics with the aim of creating a narrative of a heroic leader offering radical solutions, deserving another chance. That argument goes against the grain of the genuine belief that things can be turned around in Election 2017 among many Corbyn supporters and the fact the  message remains strongly populist whether or not  some in the Corbyn leadership see it in more strategic terms.

The solution to the paradox of an unpopular populism is more likely to rest on the finding that rules do apply in politics, even if Corbyn claims they do not. First even for a populist competence – or the perception of competence in the case of Donald Trump – matters. People have to believe you have the skill and will to deliver. Corbyn and his team appear to be both gaff-prone and lacking in any serious ideas about how to run anything. It may be that Corbyn sees himself as offering a form of facilitative or non-hierarchical leadership – I am here to empower others – but most of the public appear to judge him as a leader at worst as useless and at best as a dreamer. Theresa May has a net satisfaction score for her leadership of +19, while Jeremy Corbyn has score of –35.

The implication of the above explanation might be: do the same populist thing next time but with a leader with a wider appeal. However, it may be that it is also difficult to do populism within the confines of an established political party, such as Labour. The Labour Party in many parts of Britain was the party of power and in power, so it is difficult to project it as the new outsider. You might say that Donald Trump won the presidency but he did so by keeping a large part of the Republican Party’s core vote with targeted policies and using populist tactics and messaging to attract other voters, a strategy made slightly easier by the degree of polarisation that has developed in US politics over the last two decades. If being an established party is a constraint of the degree of populist stance that can work, then we are back to another old rule of politics. Parties win, including Labour, when given the UK electoral system they provide their core vote with something to support but reach out to others and in a way that shows they can make sensible compromises to deliver. The solution for a mainstream party then is not to offer populism as a cure to all ills, but rather to attempt to offer a realistic narrative about how to change the country for the better.

Why Politics Still Matters

By Gerry Stoker. Gerry Stoker is Professor of Governance at University of Southampton (Twitter). You can read more posts by him here.


 

One of UK comedian Bob Monkhouse’s better jokes goes something like this: ‘People laughed at me when I said I wanted to be a comedian; they are not laughing now’. When I published the first edition of Why Politics Matters in 2006- which looked at rising negativity towards democratic politics- there was polite interest at presentations made to politicians and journalists but a sense that my concerns were not exactly the pressing issue of the day. As I publish the second edition for 2017 negativity about the practice of politics is a major news item and anti-politics and post truth politics are terms that have entered everyday debate.

Some politicians are taking advantage of the mood of anti-politics by offering populist stances on issues and by distancing themselves very clearly from something called the ‘political establishment’. The top nominations for 2016 might well have been Donald Trump in the United States and Boris Johnson in Britain, leading the Leave campaign in the EU membership referendum. Other politicians offer convoluted apologies to public audiences for being a politician. Isobel Harding, a journalist at a meeting I was chairing in 2016, argued that she would throw up if she heard another politician explain how they only took up the job ‘by accident’. They were an engineer or doctor – or some other occupation deemed socially acceptable – turned up at some political event and then, seemingly through forces outside their control, found themselves as a candidate for election and then eventually an elected representative.

If politicians fear they are social pariahs as a group, then most citizens would not try to persuade them that the situation is otherwise. In 2011–12, we asked some people in focus groups to indicate what words they associated with politics. The eight most popular grouping covered: deception, corruption, feather-nesting, self-serving, politicking, privileged, boring and incomprehensible. Not a terribly positive list, I think you would agree. We know that millions around the world like the idea of democratic governance in the abstract but struggle to be convinced by the politics essential to its delivery. Why Politics Matters tries to understand this contradiction and, because politics matters, it asks what, if anything, we could do to make it work better.

While the problems and solutions to the current malaise of democratic politics will vary from country to country, I believe that my focus on common features and key comparisons provides a good starting point for discussion of where we are, and what needs to be done. The negative response to politics that many of us share is, I think, a very human reaction to the way politics works. As an intricate mechanism in our multifaceted and complex societies, politics exists because we do not agree with one another. Politics is about choosing between competing interests and views often demanding incompatible allocations of limited resources. Crucially, because it is a collective form of decision making, once a choice has been made then that choice has to be imposed on us all. In the context of greater individualism and a determination to make your own choices the mechanics and institutions of politics can appear out of touch. Yet although social media may be changing the technological expression of politics but it does not mean the fundamental nature of politics has changed. It’s still about making and then imposing collective decisions.

Perhaps there is something in addition about the way that politics is done today that moves citizens from being slightly irked by politics to outright annoyed People don’t like to be taken for a sucker or treated like an idiot. Politics as experienced daily often seems calculated to do exactly that. When politicians debate issues in simplistic terms, when they imply that we can have it all at no cost and appear to manufacture arguments they think will play well to different groups, it is hardly surprising that we think they are taking us for a ride. Nor is it odd that cynicism becomes a common coping response. My book does not berate citizens for not engaging in politics but tries to understand why they often don’t but also how they might be persuaded to do so more. You can’t have democracy without politics. In this light, it’s clear that we need to change some of the practices of politics.

The Second Edition brings into play new research conducted with colleagues over the last decade.  It offers a more comprehensive portrait of rise of political disenchantment in different countries. It provides a fuller and better organised account of many of the competing explanations of that rise in anti-politics. It is updated to deal with the rise of social media, changes in party politics and the rise of populism. Finally, it offers a more extensive discussion of some of the democratic innovations that are being trialled to bring new life to politics.

In truth, the book ends on a slightly more pessimistic note than the First Edition. The Trump campaign and the EU referendum in 2016 seems to have established a new low in politics which is pulling many other actors towards it in a cycle of misinformation, dishonesty, and fear mongering. However, a favourite saying is: ‘a week is a long time in politics’. Perhaps if I ever get round to a third edition I will have something more positive to report. There are many people out there who care about creating a better politics. If my book gives them any ammunition in their battles I will be a happy author.

Gerry Stoker Why Politics Matters Second Edition is available from Palgrave https://he.palgrave.com/page/detail/Why-Politics-Matters/?K=9780230360662

 

 

Zika and the political battle of rights

By Pia Riggirozzi, Associate Professor in Global Politics at the University of Southampton (@PRiggirozziAcademia.edu). You can find more posts by Pia here.


 

In recent years there has been growing global awareness of the interplay between rights and social development. In 1997, in an attempt to mainstream human rights as a central feature of all UN programmes, the UN Secretary-General Kofi Annan, called for a reorientation of the UN’s mission to reflect the realisation of human rights as the ultimate goal of the UN (UNDP 2005). Within this approach, the UNDP declared that human rights should not be regarded as the outcome of development but should rather be seen as the critical means to achieving it. With the signature of the Millennium Declaration and more recently the Sustainable Development Goals (SDG) there has been a renewed focus on the links between global poverty and human rights in development. As a consequence, protecting and promoting rights, and creating opportunities for individuals and groups to access, enjoy and reproduce those rights have increasingly been furthered in transnational campaigns promoting broader civil liberties, the ‘right to development’ (Grugel and Piper 2009) and ‘human right to health’ (Oslo Declaration).

However, as Easterly (2009) argues ‘which rights are realised is a political battle’ contingent on a political and economic reality often determined by what is considered (national and internationally) visible and urgent. The response to the outbreak of the Zika in South and Central America is manifestation of that battle.

Zika and systemic injustices

In February 2016, South America became, for the first time, the epicentre of a Public Health Emergency of International Importance when the World Health Organisation (WHO) declared that the Zika virus and its link to neurological disorders deserved global attention. After nine months Zika dropped from the international radar as the WHO declared it was no longer an international emergency. But the crisis is not over. The Zika outbreak that began in 2015 and has now spread across much of Central and South America has implications over the medium and long term on equity, health, education, gender and community relations. The challenges of managing the medium/long-term impact of outbreaks, as previously seen in the case of Ebola, are still poorly understood, and so are the prospects of safeguarding the right to health and the right to development in policies advanced by international and national health agencies addressing those amongst the most vulnerable.

The Zika virus, as with other insect-borne diseases such as Dengue and Chikungunya, is part and parcel of troubling inequities, amongst which health inequality is key, based on deprived living conditions. What raised international alarm in 2015 was the number of cases of microcephaly detected in countries affected by the Zika virus, particularly in Brazil. Microcephaly is a condition where babies are born with unusually small skulls. It is a developmental defect and is usually also associated with serious nervous system disorders – including deficiencies in mental functions and muscular weaknesses of varying degrees (WHO 2016). More than 1.5 million people in Brazil have been stricken with the mosquito-borne Zika virus, and since the outbreak began in 2015, the country has logged around 4,000 confirmed and suspected cases of microcephaly. This is alarming, particularly compared to 2014 when there were 147 cases.

Economically disadvantaged segments of the population are at higher risk of exposure to Zika, of being infected, and of their children of being born with microcephaly or other genetic conditions that require special care in the long term. The Zika crisis has also reinforced the socio-cultural expectations about the role of child-raising/caring that disproportionately fall on women, limiting even more opportunities to engage in education programmes or seek/obtain formal employment. Finally, promiscuity, lack of education and the simple fact that poor women might spend more time at home and thus are more exposed to dirty water, sewage, and mosquito breeding grounds than men, also means that women bear the burden of the prospect of infection. This drama typically unfolds in conditions where infrastructural deficiencies and lack of quality medical care and social services are the norm.

Consequently, poor women and their families are likely to be stigmatised as poor, as women, as sexually irresponsible, as families marked by disability. The Zika crisis is, in effect, a window that exposes systemic injustices related to poverty and marginalisation of poor women and children. It also a constitutive dimension of the ‘structural violence’ as global, regional and national responses to the Zika outbreak have disproportionately concentrated on prevention of infection and transmission which although necessary and urgent do not change the structural and related socio-cultural conditions that perpetuate injustice and inequality in these societies.

Which rights are right? 

The Zika crisis is not gender neutral and a focus on women is needed. Take Brazil, where there is a large proportion of single parent families, the majority of which are headed by women. These households are more likely to experience perpetual cycles of poverty as a result of the economic shock of disease. In addition, where children are born with potentially disabling impairments, they are often further isolated by limited support or social protection. The significant increase in the number of infants with microcephaly in the Northeast of Brazil which triggered of the WHO declaration of international emergency, highlights the centrality of the social determinants of health in the transmission chain, as well as issues such as the social division of care and debates on sexual and reproductive health.

During 2016, a roll out of official declarations put women at the centre: the High Commissioner for Human Rights and the WHO reinforced the importance of women’s human rights being central in the response to the Zika outbreak in many states (Gostin and Phelan 2016), while the US Center for Disease Control and Prevention advised pregnant women to refrain from travelling to countries affected by the Zika virus. Most dramatically, health officials in El Salvador urged women not to get pregnant until 2018; Colombia called on women to delay pregnancy for six to eight months.

This particular response focusing on behaviour is problematic for at least three reasons. First, implementing vector control programmes in the poorest areas is particularly challenged by more structural issues of lacking infrastructure, running water and access to healthcare. And even if such operations are conducted, mosquitoes have previously shown their capacity to quickly resurface whenever there is inadequate funding or surveillance. Second, shifting responsibility to women’s behaviour delinks the disease from its social determinants and their rights; not least because most pregnancies amongst poor and vulnerable women in the region are unplanned. As Davies and Bennett (2016: 1046) note, responses tend to focus on the ‘immediate’ health-care problem, while the status of gendered inequality that underpins the prevailing unhealthy conditions is considered ‘beyond’ the capacity of public health interventions. Add to this prevailing high rates of sexual violence, elusive contraception, teen pregnancies and the lack of sexual education prevalent in Zika-affected countries. According to a study published by the Guttmacher Institute in 2014, as many as 56 per cent of pregnancies in Latin American and the Caribbean are unintended, either because of lack of access to contraceptives or because of associated forms of gender violence.

Third, reducing the problem in this way to a few modifiable behaviours ignores factors of social determinants of health and poverty. Responses to communicable diseases such as Zika, and before Ebola, have so far tended to focus overwhelmingly on short-term-vector control and surveillance (Gostin and Hodge 2016; Davies and Bennet 2016). Such responses may be effective in terms of disease containment, effectively masking the precarious social conditions in which they live, in which many rights remain merely notional.

A final issue raised by the Zika crisis is that of reproductive rights. In a region where birth control is limited and sexual violence is widespread, the debate on legalising abortion has gained prominence. Last February, the Obama administration put under Congressional consideration $1.8 billion in emergency funding to help prepare for and respond to the threat posed by the Zika virus. But abortion politics sterilised these discussions as Republican lawmakers leading a congressional hearing on the Zika outbreak made funding conditional on anti-abortion policies in recipient countries. And while Pope Francis hinted at softening the rigid stance of the Catholic Church on contraception because of the threat posed by the Zika virus, it is the region’s restrictive abortion laws that remain a critical problem. In most Latin American countries affected by Zika, abortion is illegal or can only take place in exceptional situations. In El Salvador, for instance, where more than 7,000 cases of Zika were reported between December 2015 and January 2016, abortions are illegal under any circumstances and miscarriages could even lead to homicide convictions if proven to be self-induced.

Advocacy groups in Brazil are increasingly presenting legal cases to the Supreme Court to legalise abortion and secure reproductive rights for women under the principles of the 1988 National Constitution that guarantees the right to health. But the challenges ahead are many, not least in what a human rights-based approach to health may mean in addressing the long-term consequences of Zika (and other such health crises).

To be clear, vector control actions are imperative, but policies and recommendations based on behaviour, control and prevention are not only not enough to address women’s marginalisation in society and the effect this has on their health, they may further exacerbate this problem in addressing the immediate health risk. More academic and policy debate is needed on the scale and nature of future needs (health, social, economic, educational, welfare) of vulnerable communities particularly women and children, and how to calculate them. Government awareness of this issue is still low in Central/South America and although regional, global and expert/practitioner networks might be able to provide support in the future (Riggirozzi 2015; Riggirozzi and Yeates 2015) both in defining the scale of need and in providing support to governments in developing policies to address them, their roles over the medium/long term require greater definition.

Governments in South and Central America are in urgent need of a multi-policy approach – and funding- if they are to put in place effective responses to mitigate long-term effects and not derail progress in terms of meeting the SDGs targets on gender, childhood, disability and inclusive growth. Vector control and compliance could be seen as first step. The right to health needs to be delivered with a view that development in general and the delivery of health in particular should be anchored in an understanding of the inequalities, discriminations and power relations that prevent many people having access to good healthcare systems, care provisions and education and a view that states have legal and ethical obligations under international law to ensure the best possible provision of services for all.

 

Pia is currently involved in a funded project on regional organisations and access to medicines in South America.