Suchergebnisse

ABSTRACTDespite broad international agreement on the importance of addressing global health inequalities on grounds of both social justice and health security, there is little accord on how this should be done. The Debate that follows interrogates the role that capital and corporate institutions have assumed in defining and implementing global healthcare reforms. The contributors to the Debate do not agree on the legitimacy of the classic oppositions in design of healthcare — state vs market or public vs private. Nor do they concur on the (in)compatibility between pragmatic collaboration with corporate institutions and realization of norms of social justice in health. Yet all do agree that unequal access to healthcare is only one of the structural determinants of inequalities in global health. Global capital is implicated in structural patterns of investment that have made jobs, wages and land‐based livelihoods insecure and unhealthy, fouled air and water and profited from spiralling costs of drugs and treatment. On such an economically and politically conflictual terrain, it is unlikely that collaboration with corporate institutions is consistent with structural assault on the social determinants of global inequalities in health.

There is now agreement in HIV/AIDS prevention that biomedical and behavioural interventions do not sufficiently address the structural causes of the epidemic, but structural prevention is understood in different ways. The social drivers approach models pathways that link structural constraints to individuals at risk and then devises intervention to affect these pathways. An alternative political economy approach that begins with the bio-social whole provides a better basis for understanding the structural causes of HIV/AIDS. It demands that HIV/AIDS prevention in southern Africa should not be a set of discrete technical interventions but a sustained political as well as scientific project.

Writing about the life of Olive Schreiner, Ruth First hoped that biography could capture the dilemmas of a white South African woman and writer at the turn of the twentieth century, caught in a world that made her, but in which she could not bear to live as it was. Ruth First too struggled her entire life against the injustices of race and class in southern Africa, but she did so with a confidence, joy and energy that Schreiner never achieved. Written on the basis of conversations with Ruth First in Mozambique in the last period of her life, this paper explores the possibilities and dilemmas posed by her commitment to a disciplined collective revolutionary project embedded in strong nationalist movements.

ABSTRACTThe current concern with corporate social responsibility must be seen in the context of major shifts in the functioning of the market, the state and civil society, and of the boundaries between them, and in the ways that we envision them. Capitalism has been reconfigured as an ethical order in which transnational corporations can, indeed must, be accountable for the global well‐being of citizens be they rich or poor, capitalists or workers. This ethical commitment to global justice is to be promoted by the mobilization of civil society, governing with integrity both large corporations and a somewhat marginalized regulatory state. In short, regulation is being privatized. Contributors to the debate which follows vary in the extent to which they accept this vision of how capital is to be governed. There are three principal grounds for scepticism. First, in a world so marked by sharp inequalities of both income and conditions of life, how can corporate initiatives be both profitable and consistent with the interests of the poor? Second, how can global civil society, which is itself structured by relation of power and class, be counted on to regulate corporations in the interest of the poor? Third, do limited corporate reforms undercut alternative transformative projects? Those with greater sympathy for civil society involvement in governing corporate capital point out that transformative projects grow out of everyday experiences of progressive change, not out of defeatist visions of an untransformable hegemonic capital. Readers — please decide.

ABSTRACTFeminist research has convincingly shown that an increase in household income does not necessarily lead to improvement in the well‐being of all members of the household. More questionable is the policy conclusion often drawn from this research for rural Africa: redressing gender imbalance in control of productive resources will significantly reduce poverty. This contribution argues that the evidence and analysis presented by two studies repeatedly cited to show that gender inequality is inefficient are problematic. It is mythical to suggest that tinkering with women's market position by exchanging unequal collective rights to productive resources for individual ones will decisively reduce rural poverty in Africa. That will depend on the restructuring of long‐term and deeply unequal processes of integration in the market, not on a firmer insertion of women within existing patterns of individualization and commodification of productive resources.