Although I have not met Adam Gaffney, I feel indebted to him. Through his new book, To Heal Humankind: The Right to Health in History (Routledge), Gaffney, a physician and instructor at Harvard Medical School and active member of Physicians for a National Health Program, has given me a big boost in my work as an activist and teacher. The book provided me with cautionary tales, inspiring stories, and clear-eyed analysis about the development of the human right to health. It is a gift I am eager to pay forward to colleagues, clients, and students.
My guess is that most readers of the Health and Human Rights Journal can rattle off many of the treaties and declarations that articulate a right to health. Gaffney gives those documents appropriate treatment here, but also goes far beyond this quite recent history to walk us through the millennia of evidence about real-world access to healthcare being sometimes realized and sometimes ignored.
Gaffney’s review of the legacy begins with the philanthropia obligations of Greek physicians and the development of medical charity obligations in various religious traditions. He marches us all the way to today’s mixed bag of expanded but uneven provision of healthcare, saddled too often with deadly neoliberal burdens like “skin in the game” user fees and corporate monopolies on essential medicines.
International declarations and national constitutions promising the highest attainable standard of health have value, as does litigation to enforce them. Gaffney deftly and charitably describes those developments, but also rightly points out that neither documents nor court orders provide a guarantee of care and treatment for those in need, not to mention access to the social determinants of health. History has taught us that laws are meaningless without the political will to back them up. And that will, Gaffney convincingly shows, is built through social movements like the HIV/AIDS treatment campaign and the grassroots electoral advocacy that led to the labor-oriented governments that created universal healthcare systems in places like Britain and Canada.
All of which serves as a good reminder for us intellectual types who may be more comfortable in committee hearing rooms with a laptop than on street corners with a placard. It’s also a good reminder for those of us in the law business, who can be guilty of seeing healthcare access challenges as the proverbial nail waiting to be pounded by the litigation hammer that dominates our toolbox. But effective activism is well-informed activism, so it is a real compliment to Health and Human Rights Journal, and affirmation to all of us who read it faithfully, that Gaffney’s sources disproportionately include many of its strong articles, including the important user fee analysis by Rick Riordan and Lisa Forman on trade agreements on access to medicines.
Speaking of compliments, it is perhaps the most sincere form of flattery to an author like Gaffney that my copy of his book is littered with my scribbled margin notes about points to be made in class and community presentations. I am sure he would forgive you if you defaced your own purchased copy too.
Fran Quigley is a clinical professor and director of the Health and Human Rights Clinic at Indiana University McKinney School of Law, and coordinator of People of Faith for Access to Medicines. His book, Prescription for the People: An Activist’s Guide to Making Medicines Affordable for All (Cornell University Press), will be published in November.