Blockchain Papers

Hemasree Akula

No abstract is available for this record.

Matthew M. Kavanagh, Luis Gil Abinader, Fatima Hassan, Eli A. Friedman

Scientific advances to fight infectious diseases have been remarkable. International law and global governance have sought, and often failed, to keep pace, secure equity, and stop outbreaks. We trace the law and governance model emerging from early failure in the AIDS response and identify four elements: use of law by national governments to compel sharing; decentralized generic manufacturing; mechanisms for voluntary sharing of patents and technology transfer; international funding. In combination, these created a remarkable new ecosystem. We find that when COVID-19 hit and mRNA vaccines were rapidly developed, global North governments opposed mobilizing this synergistic model. Instead, equity efforts focused on financing purchase of vaccines from originator companies with little use of law. Amidst monopolies and scarcity of doses, vaccine nationalism fatally undermined this effort. Whether more synergistic law and governance emerges from rapidly changing global health law will likely dictate the efficacy of future global infectious disease response.

Luke D. Graham

Internet access is a prerequisite for access to Web3. Consequently, Web3 and the benefits thereof are rendered inaccessible for those individuals who lack Internet access. Presently, rich discussion exists on the topic of a right to Internet access. The central purpose of this contribution is not to argue for the recognition of such a right. Rather, the central purpose of this contribution is to suggest that if a right to Internet access is to be recognised, then it can be grounded in Article 11 (1) of the International Covenant on Economic, Social and Cultural Rights (ICESCR). Examining the potential of a right to internet access to be derived from this provision facilitates an examination of the parameters of the right to an adequate standard of living. It is suggested that the right to an adequate standard of living is not fixed or static but is instead capable of capturing technological and societal advancements. The advantages of this approach are two-fold. First, grounding a right to internet access within the right to an adequate standard of living recognises a right to internet access both as a constituent part of the right to an adequate standard of living and as an independent right. After all, independent rights have been interpreted as deriving from Article 11 (1) ICESCR. Second, anchoring a right to Internet access in Article 11 (1) ICESCR allows the established legal framework of the ICESCR to be applied to delimiting the content of a right to internet access so understood.

Matthias Helble, Zulfiqar Ali, Jera Lego

To what extent do the World Health Organization, the World Trade Organization, and the World Bank remain central today and how much influence do they still wield in shaping the global agenda? While several studies have traced the development of various intergovernmental organizations (IGOs), charting their growth and influence in international affairs, and assessing their prospects, few if any have compared IGOs across various fields. This paper aims to fill this gap by taking a closer look at three different policy fields to better understand the current architecture of global governance, the centrality of IGOs, the role of new and other actors, as well as the strengths and weaknesses of this "new" architecture. The authors find that, first, the emergence of new private players has significantly eroded the centrality of IGOs such that the course of global governance in health, trade, and development finance has changed irreversibly. Second, regional arrangements have overtaken global ones and nonstate actors have assumed more prominent roles. Third, this multiplicity of powerful players has led to some positive outcomes but also greater inefficiencies and redundancies. Fourth, developed countries have been pivotal in eroding the centrality of IGOs, but developing countries are taking on a greater role in global governance. Fifth, the new architecture can be described as one of diversification in global health governance, fragmentation in global trade, and variation in multilateral development finance. Global governance in the 21st century is thus characterized by a proliferation of actors and a decentralization of authority, an erosion of IGO centrality accompanied by a greater role for nonstate actors, developing countries, and by increased regionalism. Depending on the sector of governance, its inherent aims, and the nature of the actors involved, the new architecture may be one of variation, fragmentation, or diversification. While this new architecture is complex and might possibly lead to inefficiencies and redundancies, it allows a greater number of actors to participate, making it more representative of the current world order and making it possible to mobilize more resources to promote development.

Henriques, Henriques José

The study analyzes the "International Law and the constitution of Mozambique: Consensus and dissent in the light of the Global Legal pluralism". This reflective analysis will converge in the problem of the internationalization of law in contemporary society, i.e., the interaction between International Law and the Constitutional Law in the light of the global legal pluralism. After reflecting on past political, economic and social changes, it is concluded that, on the one hand, constitutionalism is neither limited nor satisfied only with the structure of the state legal space (national) and its legal order. On the other hand, International Law is no longer limited to issues related to global international policy. The phenomenon of emerging globalization has created a challenge to the international law as to the idea of a pluralist synchronization and polycentric notion of Law that could respect the legal diversity or legal specificity, within the global Legal Pluralism. The older idea of International Law entered into crisis for not having achieved the unity and cohesion within the global legal system. This crisis driven by the polycentric force of globalization dictated the diversification and the expansion of international law. This diversification has imposed the constitution and strengthening of various autonomous international legal regimes, the multiplication of organs of international conflicts resolution and the emergence of a new normative configuration. With the emergence of new instances of international and global legal production, the debate on the internationalization of Law imposes itself as an urgent need, in the framework of the globalization process and the global legal pluralism. The great debate today, on this theme, departed from general International Law and is set in the context of the new global international legal order. The debate on the internationalization of law took two aspects: one on the protagonism of new instances of autonomous global and international legal production and its influence in the construction of the global international legal order. Another aspect is that of regional economic and political blocks and of organizations and institutions of humanitarian aid and development, under the same prism. This debate brings back the old or new problem of interaction between International Law and the Constitutional Law in the new global international legal order, i.e., the problem of internationalization of national law. In fact, some international rules emanating from autonomous international legal production organs, within the framework of hegemonic globalization, are imposed directly to citizens and States, sometimes without knowledge of such rules, or of its existence. The action of these organs or agents can be considered as a latching and destructive phenomenon within the national legal orders? These rules are imposed on citizens and States not only as strategies or means of operationalization of flows, for the success of the process of globalization and economic development, but also, sometimes, for unclear purposes and within wide range economic interests. With the introduction of the new international legal regimes, the relationship with National Law has decentralized, thus creating a polycentrism, where each regime seeks to draw to itself the protagonism. This phenomenon has created conflicts within National Law and between the various legal systems. It is noted that each legal regime has its specific rules of internationalization of law. The National Law, in the face of this diversity, must meet several distinct rules and sometimes contradictory. There are times when the same matter is subject to various internationalizations by different legal regimes and through distinct rules to that effect. The proliferation of various regimes and agents in the internationalization of Law has weakened the policies and measures of protection and rule production in peripheral States because of the overlap and complexity of the phenomenon. In this new global legal order, unfortunately, we are witnessing the phenomenon of international legislative hegemony led by the major powers with regard to the demands of globalisation. This unusual phenomenon, lived in the global society, is translated into anti-constitutional and anti-democratic practices in the creation and internationalization of law in peripheral countries. The study starts from the analysis of the relationship between international law and the constitution of Mozambique and returns to the debate on the problem of the relationship between International and National Law, in the framework of the new global international legal order.

Lauren Paremoer

In recent years, global governance institutions have operationalized their commitment to the right to health by advocating for universal health coverage (UHC) – particularly in the Global South. UHC aims to develop health systems that are efficient, well staffed, and capable of providing affordable and appropriate medical care and essential medicines to rich and poor alike (World Health Organisation, 2014). The political priority afforded to this goal is driven by an acknowledgement that people in wealthy and poor countries alike are priced out of the “market” for health care. This has caused concern because of the negative economic effects associated with inadequate access to care. Academic research and scholarly rhetoric often justifies UHC on the grounds that it will strengthen the economic position of households (particularly households living below or just above the poverty line) and contributes to the growth prospects of national economies (World Health Organisation Commission on Macroeconomics and Health, n.d.). UHC is thus framed as an investment in human capital: Healthier citizens are more productive citizens. They are more capable of investing in their own well-being, and that of their dependents, through participation in the labor market rather than relying on public assistance. Why is it problematic to justify UHC, and health promotion more generally, on the basis of its economic value, that is, on the basis of the contributions it makes to growing markets and improving economic productivity? Research on the reconfiguration of welfare regimes in the Global North suggests that globalization is undermining their social, political, and economic foundations. These countries – much like their counterparts in the Global South – are experiencing a rise in unemployment, coupled with an increase in flexible and precarious work. Globalization has also been associated with an increase in human migration from the Global South to the Global North and within the Global South. As a result, states are simultaneously faced with increased demands for welfare from the unemployed and the working poor, an erosion of their tax base, and increasingly heterogeneous societies. States are responding to these changes by adopting welfare policies that expand the influence of market actors and market logics on social welfare. Consequently, decisions about how to define and promote the public good are increasingly made in a decentralized fashion by private actors operating in households or markets rather than in democratic political institutions. For example, in many countries, access to public assistance is now contingent on welfare recipients' efforts to find employment (i.e., the shift from welfare to “workfare”) and pay for basic services, on private and public sector providers' ability to provide social services efficiently and cost effectively, and on the state's ability to efficiently coordinate interactions between citizen consumers and social services providers (Roche, 2002). Advocacy for UHC reflects these political and normative shifts. It de-emphasizes the importance of collective democratic decision-making about how the health needs of populations should be addressed. Instead, public institutions are primarily responsible for solving a “technical” problem: financing health consumption for all. As public institutions become more focused on policing health financing, they reduce the services they provide and, in so doing, strengthen the market power of private players (Global Health Watch, 2014). Private actors – philanthropic foundations and for-profit providers of medical services, health insurance, and medicines – now routinely constrain the ability of governments to decide the terms on which the right to health should be advanced. Their influence is legitimated by the World Bank and IMF austerity policies that frame debt repayment and economic growth as the direct and primary responsibilities of democratic governments. Although governments in the Global South are particularly vulnerable to these pressures, similar pressures are present in the Global North – as demonstrated by private sector opposition to Obamacare (Kirsch, 2013) and patent law reform in South Africa (De Wet, 2014). In contrast, these institutions frame the obligation to promote the social dimension of citizenship as something that can be outsourced to private actors and/or achieved through market logics. Additionally, the value of social policies is often justified in economic terms, for example, in terms of their ability to improve the productivity of worker citizens and the revenues of public and private sector service providers. This discourse de-emphasizes the intrinsic value of formal and substantive equality and meaningful participation in collective decision-making about the public good. Political institutions feature in it primarily as mechanisms that mediate the efficacy of investments in health care. Their significance is determined by their ability to maximize returns on investments in health (Jack and Lewis, 2009). What are some of the consequences of advancing the right to health in this manner? Research shows that the shift from universalistic welfare regimes to regimes that target “especially vulnerable” or “especially deserving” populations undermines social solidarity by stigmatizing welfare recipients as people who violate the liberal ethos of contemporary welfare states. Vulnerable populations (e.g., non-citizens, people of color, indigenous peoples, working class women, and able-bodied unemployed people) are stigmatized as being reluctant to (or incapable of) succeeding in market societies on their own “merit” and as unfairly benefiting from welfare policies that advance their particularistic group interests rather than overall well-being (Brown, 2003). The low social status of these groups obstructs their ability to access appropriate and effective medical care, even when it is available at no or little cost to patients (Bassett, 2015). Globalization is a politically and socially mediated process. The harmful effects of globalization on social inclusion, and the limits of the policy responses to these dynamics, point to the urgent need for collective action and research aimed at addressing the dimensions of globalization that undermine the social determinants of health by privatizing, stigmatizing, and instrumentalizing the management of health – and in some cases, life itself. Collective action is needed to democratize decision-making about health care at the local, national, and global levels in a meaningful way to foster social solidarity and address status inequalities that lead to disproportionate rates of illness and death among stigmatized social groups and to politicize the priority placed on economic growth, given its sometimes harmful effects on human and planetary health. Global Challenges is a journal that welcomes scholarly contributions on these tough issues and insightful commentary that points toward strategies for addressing them.

Peter Roderick, Allyson M Pollock

No abstract is available for this record.

Sam Halabi

The right to participation is the "the right of rights"--the basic right of people to have a say in how decisions that affect their lives are made. All legally binding international human rights treaties explicitly recognize the essential role of participation in realizing fundamental human rights. While the substance of the human right to health has been extensively developed, the right to participation as one of its components has remained largely unexplored. Should rights-based health advocacy focus on participation because there is a relationship between an individual's or a community's active involvement in health care decision-making and the highest attainable standard of health? In the context of the human right to health, does participation mean primarily political participation, or should we take the right to participation to mean more specifically the right of persons, individually and as a group, to shape health care policy for society and for themselves as patients? Decentralization of health care decision-making promises greater participation through citizen involvement in setting priorities, monitoring service provision, and finding new and creative ways to finance public health programs. Between 1999 and 2008, Indonesia decentralized health care funding and delivery to regional governments, resulting in substantial exclusion of its poor and uneducated citizens from the health care system while simultaneously expanding the opportunities for political participation for educated elites. This article explores the tension between the right to participation as an underlying determinant of health and as a political right by reviewing the experience of Indonesia ten years after its decision to decentralize health care provision. It is ultimately argued that rights-based advocates must be vigilant in retaining a unified perspective on human rights, resisting the persistent tendency to separate and prioritize the civil and political aspects of participation over its social component.

Ranjani K. Murthy

This paper examines the concept and practice of community participation in World Bank-supported health sector reforms in Asia, and how far such participation has strengthened accountability with regard to provision of sexual and reproductive health (SRH) services. It argues that the envisaged scope of community participation within a majority of reforms in Asia has been limited to programme management and service delivery, and it is occurring within the boundaries of priorities that are defined through non-participatory processes. Setting up of community health structures, decentralization and community financing are three important strategies used for promoting participation and accountability within reforms. The scant evidence on the impact of these strategies suggests that marginalized groups and sexual and reproductive rights based groups are poorly represented in the forums for participation, and that hierarchies of power between and amongst health personnel and the public play out in these forums. Community financing has not lead to enhanced service accountability. As a result of the above limitations, community participation in health sector reforms has rarely strengthened accountability with respect to provision of comprehensive SRH services. In this context, rights (including sexual and reproductive) based groups and researchers need to engage with design, monitoring and evaluation of health sector reforms, both from inside as participants and outside as pressure groups. Participation contracts enhancing powers of civil society representatives, quotas for participation (for women, other marginalized groups and rights-based organizations), and investment in capacity building of these stakeholders on leadership and sexual reproductive rights and health are pre-requisites if participation is to lead to health and SRH service accountability. Community participation and service accountability hence requires more and not less investment of resources by the state.