Stones of Hope: How African Activists Reclaim Human Rights to Challenge Global Poverty (review)

Stones of Hope is a terrific book that should be required reading for anyone interested in pragmatic advocacy for economic and social rights. It documents grassroots activists' struggles for land, housing and health care, while linking these struggles to broader theories of human rights advocacy. Stones of Hope is exceptional in the empirical depth of its case studies, and in the theoretical richness of its analysis. As such, the book will be relevant both to human rights scholars and to those interested in the individual cases.

Stones of Hope is the culmination of a project at Harvard University bringing academics together with African activists to discuss strategies for realizing economic and social rights. The book outlines three cases in which human rights NGOs successfully achieved their goals—in Nigeria, South Africa, and Ghana. The text also included one case in Tanzania that was mostly unsuccessful. In Nigeria, the Social and Economic Rights Action Center (SERAC) used a range of legal, educational, and mobilizing tactics to help an impoverished urban community defend themselves from eviction by the state. In 1997 the Lagos State government, aided by an $85 million World Bank loan, began to forcibly evict residents from the Badia neighborhood. This was done in order to make room for private developers. After previous efforts to protect similar communities through litigation failed, SERAC used human rights language to mobilize residents to protest publicly, file a complaint to the World Bank's Inspection Panel, gain national media coverage, and petition the Nigerian federal government to intervene. This political pressure forced the World Bank to offer some compensation to the displaced families, and ultimately resulted in the Nigerian government preventing the Lagos State from further evictions.

The South African case covers the more familiar story of the Treatment Action Campaign (TAC) and its struggle to achieve universal access to HIV/AIDS treatment. TAC successfully used litigation in the South African Constitutional Court to order an intransigent Minister of Health to distribute the drug Nevirapine to HIV-infected mothers. However, under this "politics-centered approach,"¹ TAC's litigation was paired with agitation in the streets, policy negotiations, and institutional re-design at every step in the process. Disruption occurred even as the government dragged its feet over implementing the court order. Eventually, combined political and legal pressure forced the government to roll out a nationwide plan to provide antiretroviral treatment to all HIV patients. TAC further institutionalized this policy change through its Treatment Literacy Campaign, which empowered HIV patients to overcome their stigma and demand their right to adequate treatment.

The case in Ghana involves a subsistence farmer named Mohammed Zakari, who was detained in a public hospital for over two weeks in 2003 because he was unable to pay his medical bills. Ghana's health care system, which was designed under structural adjustment policies in the 1990s, required patients to pay user fees for medical services. Although the poor were legally entitled to exemptions from user fees, these exemptions were almost never enforced. When Zakari was detained, the Legal Resources Center (LRC) saw an opportunity to not only defend his individual habeas corpus rights in court, but also to challenge the structural inequality of Ghana's health care system. In addition to litigation, the LRC led a petition drive in the community, a public march, and a press conference that received national coverage. Although Zakari was released before the legal case proceeded, LRC's political action helped to persuade the Minister of Health to double the funding it provided hospitals for exemptions from user fees. Continued mobilization around the right to health ultimately moved Ghana toward a system of universal health insurance.

Several important themes run through these successful cases. First, as has been noted elsewhere, effective advocacy for economic and social rights occurs as much in political and cultural arenas as it does in judicial ones.^2...