Advocacy & Policy

PIH’s conviction that health care is a human right stems from our service to vulnerable communities and their daily struggle with the grim realities of poverty. Today 58% of those who need treatment for HIV/AIDS in developing nations do not receive it,[1] and worldwide only 1% of multi-drug resistant tuberculosis (MDR-TB) patients have access to proper treatment.[2] Each year more than 1.5 million children die of preventable and treatable diarrheal diseases.[3] And every single day, more than 800 million people go hungry.[4] The current global health situation is unacceptable and in clear violation of the Universal Declaration of Human Rights. The Declaration, adopted more than half a century ago, proclaimed that "everyone has the right to a standard of living adequate for the health and well-being of oneself and one’s family, including food, clothing, housing, and medical care."[5] Through the Institute for Health and Social Justice, Partners In Health (PIH) works to make the right to health a reality by mobilizing resources, informing and influencing policy, and helping to build a movement to fight for health and social justice.

The Institute for Health and Social Justice

The Institute for Health and Social Justice (IHSJ) is the advocacy and policy arm of Partners In Health. Founded in 1993 using the proceeds of Dr. Paul Farmer's John D. and Catherine T. MacArthur Award, the mission of the IHSJ is to analyze the impact of poverty and inequality on health, and to use these findings to educate and train students, academics, donors, policy makers, and lay people. Based on PIH’s service in the field and using research and education, the staff at the IHSJ advocate for policies that support greater equity and social justice.

Methods and Means of Advocating

The IHSJ is engaged in a broad array of advocacy activities to inform and educate the public on matters of health and social justice.

Through the IHSJ, staff have written, compiled, and/or edited three books documenting the health effects of policy and social inequality on the marginalized, poor and vulnerable: Women, Poverty and AIDS (1996, re-released in 2006), Dying for Growth: Global Inequality and the Health of the Poor (1999), and Global AIDS—Myths and Facts (2002). 

PIH regularly contributes to the publication of reports and policy recommendations. In December 2010,  the IHSJ joined with the Center for Human Rights and Global Justice at NYU, the RFK Center for Justice and Human Rights, and Zanmi Lasante to publish a report entitled “Sak Vid Pa Kanpe: The Impact of Food Aid on Human Rights in Haiti.”  The report, based on field and desk research, finds that while U.S. food aid may provide nourishment to many people, the way in which it is procured, delivered and administered often interferes with Haitians’ human rights by failing to improve long-term food security. And in 2009, the same partners "Woch Nan Soley: The Denial of the Right to Water in Haiti.” This report details the political motivations behind the failure of the Inter-American Development Bank to disburse loans to Haiti that had been approved for water and sanitation projects.

The IHSJ also regularly contributes to recommendations for American policy makers. The IHSJ has partnered with fellow advocates to publish “Global Health Recommendations for a New Administration and Congress” (2009), “The Future of Global Health: Ingredients for a Bold and Effective U.S. Initiative” (2009), and “Comments in Response to the Implementation of the Global Health Initiative: Consultation Document” (2010). These publications urge American policy makers to embrace a rights based framework with regard to reform of foreign assistance and global health policy.

In addition, the IHSJ works to synthesize and publicize research conducted by PIH and collaborators from Harvard Medical School and Brigham and Women’s Hospital. This research comes from many fields including public health, infectious disease, anthropology, and social medicine. This important work analyzes the current state of health and human rights in resource poor settings, evaluates and presents the outcomes of PIH work in the field, and supports the dissemination of a model of healthcare that incorporates social justice and human rights.

The IHSJ also works to create space for dialogue and the exchange of ideas. It has sponsored lecture series, conferences, and meetings on health and social justice issues, including health care in prisons, the social effect of epidemic diseases, structural violence, and the link between food security and health. The goal of these events is to build community and develop consensus around critical issues. The annual Thomas J. White symposium, sponsored by the IHSJ, addresses critical topics in health and social justice such as the legacy of the Rwandan genocide, access to HIV care and treatment, juvenile justice, and racism.

Education of young people has always been a key function of the IHSJ. Since its inception, the IHSJ Summer Internship Program has attracted students from all over the world. Interns contribute to scholarly research and other core PIH activities that support the IHSJ’s work.  Many of the interns continue to be involved in PIH, and all continue in the struggle for social justice.

Lastly, the IHSJ’s foundation rests on the strong belief that the voices of the communities PIH serves must be heard as policy is created.  Therefore, our advocacy engages decision-makers in governments, legislative bodies, and non-governmental organizations. By participating in Congressional hearings and briefings, speaking on panels of experts, and taking part in discussions with concerned legislators, the IHSJ encourages approaches to funding and program planning that are both responsible and responsive to the needs of the communities where we work.

Primary Advocacy Issues

Currently, the IHSJ is focusing its efforts on four critical issues:

  1. HEALTH SYSTEMS STRENGTHENING: Health systems in resource poor settings are grossly underfunded, understaffed, and underutilized. Public health systems must be supported so that they can provide comprehensive care to poor and vulnerable populations.
  2. FOOD SECURITY: Food security is defined as the ability of all members of a community to access enough nutritionally adequate and socially acceptable food to support active, healthy lifestyles.[6] A lack of food security is the most common underlying risk factor for poor health in the populations served by Partners In Health. The IHSJ advocates for more aggressive and effective programs to address malnutrition and global food security.
  3. HAITI: For centuries, Haiti has borne the brunt of misguided foreign policy and international interference which have prevented democracy from flourishing and have impeded social sector development. The IHSJ advocates for more public sector support and progressive social policies with regard to Haiti.
  4. FUNDING FOR GLOBAL HEALTH: The IHSJ works to increase the resources available for global health and advocates for foreign aid reform. Ensuring the reauthorization and/or fiscal stability of new and existing funding sources is important in helping to guarantee the right to health for all individuals. These sources include the President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), and the President’s Global Health Initiative (GHI).

[1] WHO. (2009). Towards Universal Access: Progress Report 2009. Retrieved August 5, 2010, from http://www.who.int/hiv/pub/tuapr_2009_en.pdf, page 5.

[2] WHO. (2009). 2009 Update Tuberculosis Facts. Retrieved August 5, 2010, from http://www.who.int/tb/publications/2009/factsheet_tb_2009update_dec09.pdf

[3] Boschi-Pinto, C., Velebit, L., & Shibuya, K. (2008). Estimating Child Mortality Due to Diarrhoea in Developing Countries. Bulletin of the World Health Organization, 86(9), 710-717. doi:10.1590/S0042-96862008000900015

[4] United Nations. (2010). Millennium Development Goals Report 2010. Retrieved June 17, 2010, from http://www.un.org/millenniumgoals/pdf/MDG_Report_2009_ENG.pdf, page 11.

[5] The General Assembly of the United Nations. (1948, December 10). The Universal Declaration of Human Rights. Retrieved August 3, 2010, from http://www.un.org/en/documents/udhr/

[6] Rome Declaration on World Food Security and World Food Summit Plan of Action (1996, November 17). Retrieved June 17, 2010, from http://www.fao.org/docrep/003/w3613e/w3613e00.HTM

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