Health Care From Policy to Practice

has preached" in ideological political economic policy (p 341), and argues that the west needs its own perestroika to do the same: Give up its agricultural, multifiber textile, services, intellectual property and other protectionist policies, which cost the developing countries between three and ten times as much as they receive through western development 'assistance'. "All this comes about because we lack vision in the west" (p 345) he says without considering to what extent this lack of 'vision' is the reflection of structural interests. So he proposes a "second Copernican revolution, as it were" centred not separate sovereign states, but on "a system in which nation states revolve around a set of shared core values regarding human survival and human solidarity" [p 349]. Instrumental would be some global or at least initially inter-regional [e g, Euro- Indian] 'development contracts', as already proposed by the Norwegian minister Thorwald Stoltenberg, which would commit both contracting parties to 'reciprocal conditionally' and equitably shared economic sacrifices and benefits. Good luck! Gerrit Faber proposes similar arrangements to combat the global greenhouse effect. Each country should receive a population based quota for maximum carbon dioxide and other emissions, which should also be subject to a global 'carbon tax'. To reduce these by half globally, countries in the north [west and east] would have to reduce their present emissions by 70 to 90 per cent, China could maintain them, and India and Brazil could about double them. Therefore, the latter and also less polluting Africa should be allowed to 'sell' part of their allocated quotas to bidders in the rich over-polluting countries. Last but not least, Paul de Waart confronts 'Implementing, Human Rights: Good Governance as a United Nations Concern' and Rhamatullah Khan The United Nations, Good Governance and Global Governance'. While the World Bank's World Development Reports are limited to economic growth and poverty, the recently inaugurated Human Development Report also introduces an index of human freedom reflecting three of Roosevelt's four freedoms of speech, religion and from fear, but conspicuously omitting the fourth one of freedom from want. "Given that all human freedoms are interdependent and inseparable...a truly democratic society should take economic, social and cultural rights just as seriously" as individual political ones (pp 373, 369). So much for indexing these rights. However promoting and protecting them, even the political ones, is even more problematic in a world of sovereign states in which "in a nutshell, the UN Charter has not provided an administration able to call states found guilty of bad governance to order" (p 376). On the contrary, as Khan documents, the UN was designed [but as we know does not even do well] as a peace- enforcer and nor as a 'good governance' law- enforcer, unless intra-state violation of law or human rights directly threatens inter-state world peace and 'global governance'. Nor is the UN, even or especially after the 1992 Earth Summit in Rio de Janeiro, entitled or empowered to promote 'global governance' by meddling in the 'internal' affairs of sovereign states that unduly pollute the common global environment. Moreover, today it is especially the weak states of the south who jealously try to defend their 'sovereignty' against any possible encroachments by a UN whose Security Council executive is dominated by a few powerful states in the west and two in the [former] east, as was graphically shown on TV screens worldwide during the 'United Nations' war against Iraq. Today, Bosnia, Somalia, and Ruwanda again demonstrate the legal and practical ineffectiveness of the UN in protecting, let alone promoting, either good governance or global governance. And any legal and practical alternative "could be twisted by the Great Powers into an inquisitorial undertaking against the poor and weak... [so that] a global design that enables the UN to suspend state sovereignty in situations of alleged or proven incapability of the national authorities to govern, or when anarchic conditions prevail, we cannot help but oppose", as Khan writes in his closing sentence (pp 396, 398).