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  • Power, Suffering, and the Struggle for Dignity: Human Rights Frameworks for Health and Why They Matter by Alicia Ely Yamin
  • Paul Hunt (bio)
Alicia Ely Yamin, Power, Suffering, and the Struggle for Dignity: Human Rights Frameworks for Health and Why They Matter, (Philadelphia: University of Pennsylvania Press, 2016), 336Pages, ISBN 978-0-8122-4774-9

In Greek mythology, the Hydra is a monster with regenerative power. Chop off its head and it grows one or more new ones. Toiling to establish economic, social, and cultural rights over the last twenty-five years has felt like confronting the Hydra. Dispose of one objection to economic, social, and cultural rights and others spring up in its place.

During the Cold War, it was difficult to have a rational, informed discussion about economic, social, and cultural rights. With the fall of the Berlin Wall, these human rights were back on the agenda, as they had been in the years immediately following the Second World War. But proponents of economic, social, and cultural rights found they had emerged from one inhospitable environment, the Cold War, and stepped into another, economic neo-liberalism.

In the 1990s and thereafter, objections to economic, social, and cultural rights came thick and fast. Address one objection and another appeared. For example, they are not real human rights. If they are human rights, they are non-justiciable. They are vague and costly. They are not operational, but aspirational. What does progressive realization mean? Can it be measured by using existing indicators or do we need new ones? What is the “value-added” of economic, social, [End Page 1138] and cultural rights? Most recently, if accountability is more than monitoring and requires independent review, what does “independent” mean? Like the Hydra’s heads, one objection is dispatched, more or less satisfactorily, and others sprout.

Of course there are legitimate issues and tough questions that require coherent answers. But they are often raised, not as issues and questions to be tackled so that economic, social, and cultural rights can empower disadvantaged individuals, communities, and populations; instead they are often raised as obstacles to stymie the realization of these human rights for those living in poverty, as well as others who desperately need them.

Nonetheless, countless people from the global to the local have helped to dispatch the serial objections. At one stage, the scholarship of Henry Shue and Asbjørn Eide was vital.1 At another, fresh thinking on indicators and benchmarks proved crucial.2 General Comments gave normative detail to vague treaty provisions. Special Rapporteurs, nongovernmental organizations (NGOs), and scholars (sometimes the same individuals sliding between these communities) applied these norms to specific issues in specific countries and found specific violations of economic, social, and cultural rights. New concepts and frameworks were devised, akin to making maps for new frontiers. The non-justiciability objection became unsustainable in light of the enormous growth of judicial decisions on economic, social, and cultural rights, reinforced by the General Assembly’s adoption of the Optional Protocol to International Covenant on Economic, Social, and Cultural Rights (ICESCR).3 Policy makers, practitioners, activists, and “ordinary people” demonstrated that these rights can make a difference and contribute to social change. Progressive states and dogged international officials made indispensable contributions. But the objections kept—and keep—coming.

This is the context of Ali Yamin’s terrific book. Moreover, Yamin addresses some of the recurring objections to economic, social, and cultural rights which “reveal certain limited assumptions about society, the obligations of the state, and the demands of justice.”4 Power, Suffering and the Struggle for Dignity has numerous commendable features. Here are a few of them.

First, the book is passionate, lucid, and accessible. Rich in scholarship and learning, it is neither manual nor textbook. It provides an exemplary interdisciplinary account of the transformative promise of what Yamin calls human rights frameworks for health. The book is laced with poignant stories and has a strong autobiographical quality. [End Page 1139]

Second, it not only deserves to be read by those working in, or thinking about, the intersection between human rights and health, it should also be studied by anyone interested in economic, social, and cultural rights. The...