Equity- Equality- Inclusion Normative principles in development Gabriele

Equity- Equality- Inclusion: Normative principles in development Gabriele Köhler Development economist, Munich Visiting Fellow, IDS, Sussex office@gabrielekoehler. net G. Koehler@ids. ac. uk www. gabrielekoehler. net Ludwig Maximilians University Ph. D-Program International Health Module I Munich, 14 December 2011

Overview of presentation I. II. III. Normative framework Developmental role of human development, human rights, equity: income poverty, human development concept, social exclusion Policies for human development, human rights, equity

I. ) Normative frameworks From physical investment to social capital – from the UN development decades to human development ¡ From the UN’s social summits of the 1990 s to the Millennium Declaration in 2000 ¡ From the Millenium Declaration to a new development constellation with multi-polar views and trends ¡

I. ) Normative frameworks Universal Declaration of Human Rights 1948 Ø l comprehensive normative framework The 2 Covenants 1966 Ø Ø l ¡ ¡ ¡ on Economic, Social and Cultural Rights on Civil and Political Rights The Right to Development 1986 l economic, social, cultural and political development International Convention on the Elimination of All Forms of Racial Discrimination 1969 (CERD) Convention on the Eradication of all Forms of Discrimination against Women 1979 (CEDAW) Convention on the Rights of the Child 1990 (CRC)

I. ) ¡ Normative frameworks Recent developments: Emergence of rights oriented conventions and instruments in the UN context l FAO 2004, Voluntary Guidelines to Support the Progressive Realization of the Right to Adequate Food in the Context of National Food Security - includes livelihoods and land reform l World Health Assembly 2008 - return to Alma Ata primary health care for all l Global Social Floor Initiative since 2009 –striving for an ILO Recommendation on Social Protection for all 2012 l MDGs 2010: more emphasis on equity, inclusion, human rights l Special rapporteurs - experts of OHCHR combining the humanist with the intellectual

I. ) Normative frameworks • Ø Ø Ø Ø The Office of the High Commissioner on Human Rights and the roles of the Special Rapporteurs on poverty; the right to food; education; adequate housing; safe drinking water and sanitation; violence against women; right of everyone to the enjoyment of the highest attainable standard of physical and mental health) and other substantive areas.

II. ) The developmental role of human development, human rights, and equity (1)Income poverty (2)The concept of human development and some reflections (3)The concept of social exclusion

(1) Income poverty ¡ Poverty is often defined as living below a defined poverty line, and halving poverty is one of the MDGs.

(1) Global income poverty

Income poverty ¡ But: number of extremely poor in Sub. Saharan Africa and South Asia increased l ¡ using $1. 25 personday income poverty measure Number of poor and vulnerable people: l l 2. 5 billion persons using $2 personday income poverty measure

60 50 40 30 20 10 0 63. 2 70 56. 99 Brazil 44. 56 45. 7 Country Denmark 24. 7 24. 85 25 Sweden Japan 25. 79 28. 31 30. 9 Norway Germany Netherlands 33. 4 Bangladesch 35. 97 United Kingdom 34. 4 36. 03 Italy Vietnam 36. 8 39. 93 Russia India 40. 81 41. 98 United States Thailand 43 Turkey Iran 43. 64 Cameron Uganda 46. 9 China 49. 15 Malaysia 47. 17 50. 1 Zimbabwe Nepal 50. 8 51. 32 Argentina Zambia 52. 02 Peru 53. 84 57. 78 South Africa Honduras 58. 62 Central African Republic Colombia 61. 33 Sierra Leone 74. 3 80 Namibia Gini coefficient Country comparison Gini coefficient

(2) The concept of human development • A systematic examination of how human beings in each society live and what substantive freedoms they enjoy • A notion of the broadening of choices • Based on the idea that economic and social development matter

(2) The concept of human development The Human Development Reports (HDRs) of UNDP in 1990 introduced a 3 -pronged definition of human development Ø Distinctive human development discourse • • Longevity Educational attainment incomes Concept adjusted for gender, for equity, and for multidimensional aspects of poverty • (UNDP Human Development Report 2010)

Worldwide trends in the Human Development Index, 1970 -2010:

Weak relationship between economic growth and changes in health and education:

Wellbeing ¡ Different discourses: l l l Wellbeing as objective, subjective and relational Multidimensional poverty Missing domains

Absolute poverty in Asia, Europe and Latin America 100% Dollar-a-day poverty Dissatisfied with living standard National poverty 80% 60% 40% 20% Sources: World Bank (2009), Gallup (2010) ECU PER COL GTM GEO ARM MDA KGZ NPL BGD IND KHM CHN PHL 0%

Absolute poverty in Africa 100% Dollar-a-day poverty Share dissatisfied with living standard 80% National poverty 60% 40% 20% ETH GHA ZAF UGA MLI SEN CMR BFA COG COM COD KEN MDG BEN SLE CIV TGO MWI AGO NER TCD MOZ LBR ZMB NGA RWA TZA BDI GIN 0%

A success story? • • A lower-middle income country Average 5% annual growth rate since 1990 60% of budget dedicated to social sectors Nearly 100% primary enrollment in 2008 80% health care coverage ‘Prudent public debt management’ (42. 8% of GDP in 2009) 3% fiscal deficit Inflation at approx. 3% in the 2000 s

Tunisia Source: OECD/Af. DB/UNECA (2010), African Economic Outlook

Higher average incomes, better health and improved education do not automatically mean higher life satisfaction

3. The impact of social exclusion ¡ Systematic social exclusions are the result of the intersecting inequalities Ø Ø Cultural inequalities Spatial inequalities: Economic inequalities Political inequalities ¡ The interaction of the exclusions explains the persistence of social exclusion over time. ( Naila Kabeer)

Vectors of social exclusion • • GENDER • • • Income/economic class/ access to productive assets Caste/clan Ethnicity Faith Language Health condition/communicable/visible diseases Ability/disability Geographic location/”distance”/urban vs rural Citizenship and migration status Condition of menstruation Sexual orientation Recurrent emergency situations Conflict situation Age

(3) Impact of Social Exclusion ¡ ¡ ¡ MDG outcomes perform worse among socially excluded groups – they need special measures to enable them to claim their rights to social services and public goods Disparities based on social exclusion must be made more visible Policies to address the inequities resulting from exclusion are needed

Intergenerational education impact on child situations

Religious affiliation and deprivations, Bhutan

Literacy rate of population aged 15 years and above by yearly HH income (Rural Myanmar) 103. 00% 98. 00% 93. 00% Male Female 88. 00% 83. 00% 78. 00% High Middle Low Data Source: Ohnmar, Than-Tun-Sein, Ko-Ko-Zaw, Saw-Saw and Soe-Win. Household Income, Health and Education in Rural Myanmar. SOUTHEAST ASIAN J TROP MED PUBLIC HEALTH Volume 36 No 2 March 2005 , p 532

Ethnic identity and school enrolment, Myanmar 60% Child access to education (% enrolment) 50% 40% 30% Child access to Education (% enrolment) 20% 10% 0% Karenni Shans Naga Titain Mon Kachin Chin Data Source: IDMC (2003). Conflict, poverty and language difference behind low school attendance in the ethnic states. Access to Education. Found on http: //www. internaldisplacement. org/idmc/website/countries. nsf/(http. Envelopes)/17362 FE 0 A 66 DDFA 3802570 B 8005 AAA 68? Open. Document

III. Policies for human development, human rights, and equity

Promoting equity, equality and inclusion ¡ ¡ Equality is the principle that all human beings are equal and have equal rights Equity is a principle that refers to fairness of treatment according to needs and specific requirements.

Approaches to address income poverty ¡ ¡ Employment and decent work as the key response Agricultural development, land reform, and rural off-farm employment opportunities, access to agricultural inputs and to (micro-) credit ¡ Social protection as a core mechanism – social protection floors ¡ Systematic income redistribution

New approaches to socio-economic policy: decent work agenda ¡ Global jobs pact policies: l l l l l Retain employed in employment/rapid reentry/sustain enterprises/maintain wage levels Support job creation/investment in employment-intensive sectors/green jobs Protect persons/families affected: social protection Enhance support to women, youth Act simultaneously on labour demand supply Equip workers with skills “for today and tomorrow” Use public employment guarantees, include informal economy Increase investment in infrastructure, R&D, public services and “green production” Respect international labour standards

Social Protection Floor

Global social protection floor ¡ Movement to adopt a social floor recommendation at 2012 ILO Conference http: //www. gopetition. com/petitions/s ignature-campaign-social-protection -floor. html

Policy approaches to create equitable access to social services ¡ Ensure universal free social services delivery l ¡ ¡ ¡ underpinned by health insurance in the case of health services Equitable access to services, geographically and socially Ensure equality of services – staffing, people skills and material resources Ensure cultural sensitivity Ensure transparent information Enable inclusive participatory programming and participation Valorise community-based services

Policy approaches to address exclusion ¡ ¡ ¡ ¡ Include compensatory/reparatory measures to overcome generational exclusion – redress mechanisms Address on-going exclusion and discrimination -affirmative action (reservation, representation, protective legislations, budget allocations, social protection cash transfers) Protect against violence Address impunity Support public education to address discrimination and exclusion Ensure inclusive health services Change disparaging language and designations Enable inclusive programming-empowerment

Policy approaches Universalism and targeting Universalism is an approach in social policy that is rights based, and hence strives to cover all citizens with a social policy service or transfer, usually using taxes or other public resources to fund the intervention. ¡ Targeting is a needs-based approach, covering those most vulnerable or the poorest as a priority, because funds are limited. ¡

Emerging “innovations” in policy discourse ¡ ¡ ¡ ¡ ¡ Multidimensional understanding of poverty Attention to employment and decent work Push for social protection & social protection floors Stronger emphasis on maternal and child health Recognition social exclusion with much more focus on equity policies A discussion of tax reform incl progressive taxation Recognition of the role of agriculture, rural development and the need for some kind of land reform Universalism, social contract, rights based approach Acknowledgement of the role of the state

Emerging “innovations” in policy discourse • G 20 – Cannes final declaration (2011) Ø Global strategy for growth and jobs Ø Ø Ø Employment and social protection More stable & resilient international monetary system Deepening financial sector reforms Addressing food price volatility, increasing agricultural productivity Improving functioning of energy markets Pursuing fight against climate change Reinforcing multilateral trading system Development: investing for global growth Fight against corruption Intensifying fight against corruption Governance

Discussion: Health policies and inequities ¡ How to address inequities in access, affordability and coverage l ¡ What are the issues in your country Advantages and disadvantages of either targeting or universal approaches l l In general In the health sector

References: Sabine Alkire 2011, Oxford Poverty & Human Development Initiative OPHI – HDCA Summerschool 2011 Oxford Department of International Development. Queen Elizabeth House, University of Oxford. http: //www. ophi. org. uk/teaching/short-courses/2011 -summerschool/ Michelle Bachelet 2011. Social protection floor for a fair and inclusive globalization. Report of the Advisory Group chaired by Michelle Bachelet Convened by the ILO with the collaboration of the WHO. ILO 2011. www. ilo. org Johannes Jütting, Jan Rieländer, Christopher Garroway 2011. Social cohesion - a useful framework for assessing social progress in fast growing countries. . Powerpoint presentation based on Perspectives on Global Development 2012. Social Cohesion in a Shifting World. OECD Development Centre Naila Kabeer, Can the MDGs provide a pathway to social justice. The challenge of intersecting inequalities. IDS and UN MDG Achievement Fund. 2010. www. ids. ac. uk Gabriele Köhler, Policies towards social inclusion. Global Social Policy. April 2009: pp. 24 -29, Sage publications (have requested journal’s permission for access) Gabriele Köhler, Des Gasper, Richard Jolly, Mara Simane 2011. Deepening the MDGs: human security. Conference on MDGs beyond 2015. German Development Institute. Bonn. November 2011. http: //www. die-gdi. de/CMS-Homepage/openwebcms 3_e. nsf/(yn. DK_content. By. Key)/MPHG-8 JB 9 BB/$FILE/2 -2%20 Koehler%20 et%20 al%202011%20 Human%20 security. pdf UN. Universal Declaration of Human Rights. http: //www. un. org/en/documents/udhr/ UN 1969. International Convention on the Elimination of All Forms of Racial Discrimination http: //www 2. ohchr. org/english/law/cerd. htm UN 1979 Convention on the Eradication of all Forms of Discrimation against Women, http: //www. un. org/womenwatch/daw/cedaw/text/econvention. htm UN 1990. Convention on the Rights of the Child. http: //www 2. ohchr. org/english/law/crc. htm UN Department of Economic and Social Affairs. Rethinking Poverty. Report on the World Social Situation 2010. United Nations, New York. http: //www. un. org/esa/socdev/rwss/2010. html UNDP 2009. Delivering On Commitments. UNDP in Action 2009/2010 UNICEF, Narrowing the gaps to meet the goals. Equity-focused approach to child survival and development. New York 7 September 2010. http: //www. unicef. org/nutrition/index_55927. html UN General Assembly. Declaration on the Right to Development. 4 December 1986, 97 th plenary meeting. http: //www. un. org/documents/ga/res/41/a 41 r 128. htm