Alicia Ely Yamin.

6 Questions for Alicia Ely Yamin on Partners In Health, Social Justice, and Human Rights

By Jonathan Chernoguz

Among many other accomplishments, Alicia Ely Yamin (Petrie-Flom Center Senior Fellow), will now serve as the Senior Advisor on Human Rights at Partners In Health (PIH).

Partners In Health is a global health and social justice organization committed to improving the health of the poor and marginalized as a matter of justice. PIH works with ministries of health to build local and national clinical capacity and works closely with impoverished communities to delivery high quality healthcare, address the root causes of disease, train providers, advance research, and advocate for global health policy change.

Yamin is a world-recognized pioneer and thought-leader in the field of health and human rights. She has a long track record of working on the ground as well as at policy levels, including in collaboration with PIH sister organizations from Peru to Malawi. Yamin will work across a multi-disciplinary team within PIH and the broader Global Health Delivery Partnership, to advance an advocacy and policy agenda for transformative structural change in global health architecture and its intersections. To learn more about her new role, we asked Yamin a few questions about the position, how it relates to Petrie-Flom, and the goals she aims to accomplish.

Jonathan Chernoguz: Could you describe why the work that PIH does is so compelling?

Alicia Ely Yamin: Partners In Health is not a standard human rights organization that focuses on denouncing violations; rather it’s an organization that provides services on the ground, that works with ministries of health, and that shapes health policy and programing in real time from a social justice perspective. That perspective provides a kind of credibility in this pivotal moment that is extraordinarily important and unique. My own work in applying human rights principles to health has engaged for years with moving beyond human rights law in the abstract to what is required for effective enjoyment of health and related rights in reality. So it’s a very natural fit.

JC: What is the main focus of your role as you start your new position as Senior Advisor on Human Rights at Partners in Health?

AEY: I work within the strategy and advocacy teams at PIH, which cover a broad array of issues from local to national (for example, spending on public health measures in the midst of COVID-19).

But there’s also advocacy that’s more global, which aims to shape the post-COVID reality in global health.

I would say that has three prongs: (1) promoting universally accessible health systems with fair and adequate public finance and oversight; (2) securing external financing when governments don’t have enough domestic resources to adequately fund their health system; and (3) examining issues in global economic governance – for example, debt, austerity, and intellectual property rules, which have an enormous impact on whether robust health systems can be constructed — as well as the social determinants of health.

JC: How does this position relate and build upon the work you have done for the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics?

AEY: I see it as very complementary, because the scholarly work I do at Petrie-Flom often critically examines how structural dynamics created by political economy issues, as much as formal legal rules, present obstacles to the advancement of health-related rights. The work at PIH focuses on the embodied impacts of those structural dynamics.

I’m also, as you know from the symposium that we just did at PFC, very keen to connect population health and health systems to issues of democracy and democratic institutional arrangements. So I think –and I hope–the work at Petrie-Flom is critical, but engaged, scholarship, and I think that the work at Partners In Health is the other side of that — reflective activism and advocacy. I view them as quite synergistic.

JC: Building upon some of this critical work you have done at Petrie-Flom, on March 27th you helped organize the “Debt, Dignity, and Health Care: Guaranteeing Health Rights and Universal Health Coverage” event. Speakers during the event emphasized that health care debts are common both overseas and in the U.S. Are there other issues that you’d like to highlight as more widespread and common across contexts than people might think?

AEY: I very much want to make clear through the Global Health Rights Project that “global health” is not about “health out there in resource-poor countries,” but about themes that affect different countries in different ways.

As you say, there was a very deliberate attempt in that event and in the symposium to look at issues in incredibly resource-poor settings and see how the same types of issues manifest themselves in the United States. There is quite a bit of colonialism in global health generally. I can’t take any of the credit, but I’m delighted that PIH is using lessons from having worked on Ebola in West Africa and applying them here in Massachusetts to our contact tracing efforts. And an intensive course PIH is running now on pandemic preparedness has professors from Rwanda and elsewhere, as well as from our offices here.

JC: I can imagine a lot the work that you are doing right now is related to COVID-19 given the current global climate. Would you speak a little bit more to the issues in human rights law, policy, global health, and/or social justice that are emerging for you during this COVID-19 pandemic and how you will work to try and address these issues at PIH?

AEY: COVID-19 is not just a global health crisis; it’s really a social and economic inflection point. It’s an inflection point for democracy, human rights and the rule of law too.

To be clear, it’s not that Partners In Health is working solely on COVID-19 at all. But this pandemic is so sweeping and so challenging to the institutions that exist, both nationally and multilaterally, frankly, that it does provide an opening to question directly underlying drivers of health injustice. These include the basic role of government vis-a-vis unfettered markets; and the architectures of global economic governance.

If we do not seize this opening (which will be narrow) to reimagine possibilities for global solidarity and reining in private actors, we’ll find ourselves facing even greater economic inequality and social exclusion, and shrinking of political possibility—with ensuing impacts on human and planetary health. So there’s a lot at stake.

JC: Lastly, I wanted to ask, how do you see the goals you hope to accomplish in this role relating to your career in human rights advocacy related to health?

AEY: We’ve seen in other pandemics, such as HIV/AIDS, that human rights activists, working with scientific experts and social movements could transform public discourses on what was possible and acceptable, which led to changes in national and international law, and to changes in global institutional architectures. And, by the way, PIH played a big role in breaking the nihilism that anti-retroviral treatment was too expensive or that coverage was impossible to achieve in sub-Saharan Africa.

We need to be similarly bold now, but we can’t just think about containing this one disease. We need to address the dynamics that drive pandemics of disease and health inequality alike, and hollow out governmental capacities for response.

The social inequalities that COVID-19 has laid bare were building for decades and it’s not going to be the last pandemic or the last sweeping global challenge. Before COVID-19, I was arguing that if human rights was going to remain relevant as a discourse of social justice, and a set of tools for social change, we absolutely cannot go on with business as usual. We need to work with other fields of law and other disciplines –and other social movements– to address the impacts of neoliberalism on health and social inequalities. And I feel enormously privileged to have the opportunity now to work with a multi-disciplinary team at Partners in Health, and with colleagues across the coalitions with which we work.

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