Empowerment of citizens: a global challenge Ilona Kickbusch European Health Forum Gastein Forum 3 5 th October 2005

What drives global citizenship? Normative claim: how we should act Existential claim: what is the case in the world Aspirational claim:what the future should be like Nigel Dower 2003 A new global ethics: “Implicit in the idea of “globalization” ….is the idea that we are moving beyond the era of growing ties between nations and are beginning to contemplate something beyond the existing conception of the nation state” Concept: One World Peter Singer 2002

Health as a human right The move towards a new public health: peoples control over their health and its determinants EMPOWERMENT PUBLIC POLICY

Empowerment means to exercise Agency Empowerment means having the rights, capabilities, resources, and opportunities to make strategic choices and decisions These are ensured by law and enabled by public policy Development as freedom (Sen, Nussbaum, Rawls)

What constitutes active global citizenship Identifying/Defining oneself as part of a global community Acting with others through organizations that advance causes Citizen means public action that takes place in a public space

..From elites to ordinary people The very nature of politics has changed: Globalization has provided opportunities for women, lesbians and gay men, disabled persons, indigenous people to mobilize to a degree that was generally unavailable to them in …territorial politics. (Scholte 1999)

Why now? States individually and collectively are no longer able to protect “the common good”

1. The increasing chasm between what we know and what we do What we DO What we know Political Commitment gap

A new political space Global “interhuman” Ethics: Make poverty history

2. The privatization of health Commercialization and Privatization (water and health) Structural adjustment Trade in health services WTO agreements TRIPS Foreign direct investment Mobility of health workers

Health is a global public good

3. the “globalization” of everyday life Cognitive Spatial temporal DETERRITORIALIZATION

Direct lifestyle impacts

How to govern a fragmented POLITICAL ECOSYSTEM BONO CLINTON MSF 150 PPPH WEF PHA World Bank Global health summit

What driving ideology? Threat Risk justice Market

Two policy principles: Ensure a global public goods and human rights approach The global public goods produced for economic globalization (World Trade Agreements) need to be complemented by global public goods that address the other dimensions of globalization Mechanisms need to be created that ensure the responsibility of other global actors for human rights

Required shifts in thinking From nation state to Multi actor accountability From national to international and global accountability From focus on civil and political rights to economic, social and cultural rights From punative to positive ethos (name and shame) From multi party to inclusive models of democracy From poverty eradication as a development goal to poverty eradication as social justice (UNDP 2000)

Global Ethics: From charity to entitlements and citizenship “the very values of an enlightened and civilized society demand that privilege be replaced by generalized entitlements – if not ultimately by world citizenship then by citizens rights for all human beings of the world” Ralf Dahrendorf

The goal: a global health treaty