Connecting the right to health and anti-extractivism globally

Abstract

Natural resources are essential to health and are global commons. Recognizing the devastating damage posed by extraction to health and the environment, as well as the erosion of the sovereignty of our governments that have increasingly conceded people’s health in the interest of profit and development, is important in framing our resistance. Our communities experience growing displacement, the loss of social services, of land, water and livelihood, heightened militarization, violence and repression, and increased incidence of communicable diseases and health problems resulting from exposure to toxics. All of these are linked to an extractivist project driven by global financial capital promoting an unsustainable and inequitable development model that threatens people’s health and the health of the planet. Is it compatible with the right to health to finance national health systems with revenues of activities that intrinsically destroy life? The essay portrays the inconsistency of development policies that fund health/right to health with extractivism and depicts examples of resistance to extractive industries tied to the People’s Health Movement (Canada,Turkey, India and Ecuador) in different types of governments. The need to strengthen the link between the right to health struggles and anti-extractive resistance is highlighted.

How and why buy-in for health in all policies was facilitated in Ecuador: a realist case study of Plan Nacional para el Buen Vivir

“…Additional caveats regarding the overall health equity benefits of PNBV come from sustained Indigenous and civil society opposition to the imposition of resource extraction projects held necessary to fund social spending [ 37 ]. The Correa government became notorious for criminalizing and demeaning such voices, which had previously helped bring it to power [ 38 ].…”

“…One qualitative study [ 40 ] identified a group of stakeholders outside of the public sector and not involved in the implementation of PNBV who were more critical of the implementation of PNBV. For example, one stakeholder was critical of Correa’s turn towards extractivism in 2012, which is echoed in other articles that highlight his government's aggressive promotion of mining, oil and gas extraction, and agroindustry [ 16 , 37 ]. In another interview, a government stakeholder argued that extractivism in the short term was necessary to finance a reduction in poverty [ 40 ], echoing a common narrative in Correa’s public service (and public speeches) that helped to dismiss resistance to resource extraction as ‘infantile’ or insufficiently informed by science [ 38 ].…”

“…Such observations, coupled with the numerous negative health equity implications of petroleum extraction, mining and large-scale agroindustry – all aggressively promoted by the Correa government as sources of funds to finance PNBV – suggest a need to look beyond traditional socially-oriented sectors such as health and education in attempting to achieve health in all policies [ 37 ]. They also bring into focus a range of possible contexts that could have strengthened the health equity approach in Ecuador.…”

“…The federal government also could have included specific objectives related to health inequities to strengthen the likelihood that action on social determinants of health would have benefited the well-being of marginalized populations. More fundamentally, the model of development that underlay PNBV could have been less reliant on financing from taxes on industries that have a conflict of interest with health equity [ 37 ].…”

“…Recent studies have also demonstrated continued inequities in Ecuador based on ethnicity, income, occupational class, education, and region [34][35][36]. In addition, numerous voices have critiqued the ways in which the social programs implemented by PNBV followed an 'extractivist' development model based primarily on increased resource extraction to fund poverty reduction and social spending [37]. While the Correa government did introduce some progressive taxation measures redistributing wealth, these were not nearly enough to fund the social programs mandated by PNBV, which instead were financed by a combination of historically high commodity (e.g., oil) prices and borrowing, especially and increasingly from China -backed by commitments of future mining and petroleum exports to Chinese creditors, thereby 'locking in' the extractivist development model [38].…”