The 2012 Global Family Planning Summit: Will Issues Be Adequately Addressed?

@RHRealityCheck

In mid-July, world leaders will gather in London to discuss a real and urgent need: increased funding for family planning. Over the past 15 years, the United States—one of the largest foreign aid donors in the world—has cut its funding level for family planning by at least 25 percent. Meanwhile, the demand for modern contraception and family planning information has only increased. By most accounts, an investment of approximately $6.7 billion is needed annually to meet current needs for family planning.

The summit documents, which is co-hosted by the Bill and Melinda Gates Foundation and the UK Department for International Development and supported by the US Agency for International Development and the UN Fund for Population Action, link the dearth of contraceptives and health services to poverty: women in “rich countries” have what they need, whereas women in “poor countries” don’t. This notion is supported by the fact that over 99 percent of maternal mortality happens in so-called developing countries.

This vision is not so much wrong as it is incomplete.

In early 2010, the medical journal The Lancet published new research on maternal mortality and morbidity. The research showed that improvements in maternal health — a good indicator for women’s access to health services overall — depend on 4 key factors, only one of which has to do with family planning: 1) lower fertility; 2) higher education levels for women and girls; 3) rising per capita income overall; and 4) access to skilled birth attendants.

Importantly, both the Global Family Planning Summit and research published in The Lancet potentially obscure the fact that adequate access to contraceptives and health services is a question of income rather than geography. To be blunt, a wealthy woman in a poor country is likely to have better access to care than a poor woman in a wealthy country.

Just as importantly, all four drivers of healthy motherhood depend on women’s ability to exercise their human rights, including the rights to quality health care, non-discrimination in education and health, and economic empowerment through job creation and protections for equality in the workplace.

But perhaps most to the point, the much-needed infusion of extra cash to development aid budgets for family planning is a means to an end. For the organizers of the London summit, that end is the provision of family planning services to poor women in the developing world. But even this very laudable objective is also a means to an end — or at least it should be.

Almost two decades ago the world’s governments for the first time promoted an understanding of individual empowerment as a vehicle for better policy outcomes on population growth, through the 1994 Cairo Declaration on Population and Development. The measures set out in this declaration supported the, at the time, radical notion that if individuals are empowered to make their own decisions about their family’s size and growth, these decisions, in the aggregate, will make for healthy and balanced societies. This notion departed from previous decades for population control through central planning and imposed government targets for fertility.

Of course a piece of paper is one thing. A real commitment to change is something else.  In the 18 years that have passed since the adoption of the Cairo declaration, few governments have shown a sustained commitment to actually empower all individuals, equally, to make decisions about their families.  

Some impose limits on family growth, punishing all women for wanting to have larger families than the government mandate. Others seek to limit the fertility of specific individuals within their population who for some reason or other are deemed unworthy parents, usually because of their color, class, family status, or gender identity. Still others force women to have larger families than that might have wanted through demonizing contraception, encouraging (or ignoring) early and forced marriage, and by perpetuating a culture where women without children are seen as somehow incomplete.

None of these situations promotes the kind of autonomy in family planning envisaged by the world community in 1994. And neither will merely stockpoling contraceptive methods.

The latter, however, will help. Here’s to hoping that the education, economic empowerment, and equality needed to ensure real family planning won’t be far behind.

Crime and Obesity: Let's Get to the Heart of the Problems

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There is something deceptively simple about New York City mayor Michael Bloomberg’s blanket initiatives. Whether it is giving the police unfettered discretion to stop and frisk anyone they think might look like a potential criminal because “it saves lives,” or banning the sale of large-container sodas because, well, that saves lives too, the initiatives promise easy fixes to complex problems.

They are, however, based on a blindness to prejudice that is compelling precisely because it is wrong.

In short, Mayor Bloomberg’s initiatives purport to be color- and class-blind. If the stop-and-frisk program affects mostly men of color, Bloomberg argues, this is purely coincidental. And if most of New York City’s overweight population lives in the poorest boroughs, that is also just by chance. Maybe, this line of argument implies, it is just that men of color and the resource-poor make appallingly bad decisions about their lives and health.

Incidentally, I am not arguing that our definitions of what should be subject to punitive measures and what constitutes a “normal” weight are perfect or even always good. The point I am making is about policy effectiveness. And in that sense, even a cursory look at correctional and obesity statistics in the United States reveals deep-seated disparities which knee-jerk reactions — in particular those that blatantly ignore color and class —cannot fix.

For example, 87 percent of those stopped and frisked in New York City in 2011 were either black or Latino and mostly male, even though drug possession and use — the ostensible reason for most stops — is equally prevalent among whites. And on health, compare the pricing of a Happy Meal and a pound of organic locally grown apples and you might have an idea of why the poor constitute the majority of the nation’s obese, and why many of them, at the same time, are malnourished.

Here’s a hint: It’s not because we don’t know better. 

Obesity, like being caught in the criminal justice system, is a condition disproportionately suffered by the poor and the relatively powerless. And it is self-perpetuating. Extra padding, much like a criminal record, is easier to acquire than to shed.

To articulate these truths is not to say that overweight individuals and those in conflict with the law are immoral, stupid, or devoid of agency and responsibility. It is not even to say that the decisions that led to the obesity and punishable behavior necessarily all are bad.

It is simply to acknowledge that all of us make decisions within our specific constraints, and that policy initiatives that seek to influence these decisions must look for ways to eliminate the constraints.

In the current case, our approach to crime and weight is better understood as wilfully ignored discrimination. The Supreme Court has pretty much systematically sidestepped and ignored racial profiling in the criminal justice system, resulting in continued discriminatory outcomes. And though discrimination against overweight individuals is prevalent in the workforce — in particular when it comes to obese women — only the state of Michigan and six cities ban this type of discrimination directly. This creates a vicious cycle of discrimination which perpetuates existing class and color disparities — a reality that policy initiatives to end both crime and obesity will have to contend with to be effective.

So why do politicians push for color- and class-blind initiatives? A key reason is that solutions to discrimination are more complex (and thus harder to sell to the public) than those which punish individual choice.

Take public school lunch. Many children depend on public schools almost entirely for their culinary development.  In New York City, for example, 62 percent of all children qualify for free school lunch, and many who don’t qualify still eat both breakfast and lunch at school. As a result, if food at school is overly fatty, salty, or sweet, this is what our children’s palates become accustomed to. The federal government has issued new guidelines to address this issue, but cooking healthier food in school cafeterias requires time, and time requires better benefits and higher salaries for cafeteria workers. Meanwhile, schools blame parents for not contributing, and increased money for school lunches is not high on the political agenda.

My point is: It should be.

Instead of spending money on policing serving sizes for sodas at the gas station, New York City Hall would do well to help instil healthy eating habits in children in the first place. And focusing on effective anti-obesity measures will probably save more lives than any amount of stopping and frisking. After all, heart disease has been the leading cause of death in New York City for at least the past decade.

Either way, there is no excuse for the discrimination that is inherent in current approaches to both crime and weight.

Spanking Your Child: The World Disagrees

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Opinion pieces for and against corporal punishment of children cycle around with tremendous regularity. Most are based on absolutely no data, and merely offer some variation on the theme of “I was (or I wasn’t) spanked as a child, and look how well I turned out.”

Many articles inexplicably extrapolate from these hyper-personal narratives to conclude not only that “what’s good enough for me is good enough for my children,” but moreover that whatever the other camp is proposing (to spank or not to spank) is inherently bad for the child with no reference to statistics or science. Most recently, a proponent of spanking argued that not to spank your child teaches her or him that “if life isn’t fair, then throw a fit and you’ll eventually get your way.”

Full disclosure: my parents did not hit or spank me and I have never thought it necessary, desirable, or expedient to hit or spank my child. I know for a fact that she is absolutely clear that throwing a fit won’t get her anywhere. And I also know for a fact that these personal experiences cannot be translated into a theory of child psychology for larger gain.

Instead, let me try to overcome some of the dearth of information on this topic, from the perspective of desired objectives and actual outcomes.

First of all, it might come as a surprise for readers in the United States that many countries have outlawed all forms of corporal punishment of children, including spanking, slapping, other forms of hitting, as well as kicking and shaking. Countries with full bans on corporal punishment include Austria, Denmark, Finland, Germany, New Zealand, Norway, Spain, and Sweden, as well as Bulgaria, Latvia, Lithuania, Macedonia, Moldova, Poland, South Sudan, and Ukraine. (For a full list, see here).

Sweden was the first country to pass a ban on corporal punishment in 1979, and quite aside from impressive child health and education indicators, it is clear that the country has not descended into anarchy as a result of this “lack of discipline.” It is noteworthy that Sweden’s standard of living has been described by economists as “enviable,” fuelled by a “skilled labor force” (including a substantial number of workers born after the absolute spanking ban). Moreover, the economic downturn that is engulfing all of Europe is projected to be relatively short-lived in Sweden. In other words: either it pays off to be throwing fits, or else the ban on spanking does not really produce lazy, fit-throwing adults after all.

To be clear, I am not suggesting that there is any direct causal link between bans on corporal punishment and a country’s economy. I am, however, suggesting that hitting children (whatever you choose to call it) is not something most people agree with. And not because I wasn’t spanked myself. Rather, every single country in the world except for the United States and Somalia, have agreed that spanking is wrong, at least in principle, through ratifying the universal treaty on children’s human rights, the Convention on the Rights of Child. (South Sudan also has not ratified this treaty, but banned corporal punishment of children in 2011).  

In other words, the vast majority of the world’s seven billion individuals live in countries that have, in principle, signed and ratified commitments to end violence against children in all its form, including corporal punishment in the home.

To be sure, the fact that governments from all over the world have come together to declare that spanking must stop is not going to convince those who believe in spanking as an effective method of discipline that, in fact, it is not. 

To this there is only one thing to say: they are wrong. 

It is a generally accepted notion that positive reinforcement brings about more lasting behavioral change than punishment both when it comes to animals and when it comes to people. A recent article in The Atlantic notes that theories on how to modify behavior through positive reinforcement form the backbone of successful programs such as Weight Watchers and AA, and provide the underlying structure of newer behavior modification applications for smart phones and computers. 

Indeed, observing children around me, it seems likely that what might produce “lazy fit-throwing” adults is not lack of corporal punishment but rather lack of clarity with regard to what constitutes acceptable behaviour in the first place. There are any number of ways to communicate this clarity, and violence—including spanking—is not one of them. Consistent quality education at home and at school would be a better place to start. 

Video Restrictions in India and the Growing Effort by Governments to Restrict Our Rights to Freedom of Information

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This week, several video-sharing websites were blocked by the two main internet service providers in India in response to a court order related to movie piracy. The company that had pushed for the court intervention said it hadn’t intended such a blanket block. The internet service providers said they merely did as told. The internet activist group Anonymous said it would shut down the website of the Indian Supreme Court in retaliation.

Meanwhile, over 3 million individuals had their right to exchange information and ideas summarily suspended.

India is not the only modern democracy where government institutions are pushing (and are being pushed) to facilitate blanket restrictions on internet use and flow of information to the detriment of human rights. In January this year, the US Congress considered bills that would have encouraged internet service providers to pre-emptively block sites that may be used by some individuals to share pirated content, the Stop Online Piracy Act (SOPA) and the Preventing Real Online Threats to Economic Creativity and Theft of Intellectual Property Act (PIPA). And the European Union is currently debating whether to sign onto an international treaty containing similar provisions: the Anti-Counterfeiting Trade Agreement (ACTA).

These developments are worrying. 

From a human rights perspective, blanket restrictions on specific means of communication should always raise red flags. On the most basic level, human rights guarantee the conditions we need to live with dignity. For centuries, philosophers have agreed that this includes the time and space for each and every one of us to develop, express, and share our unique beliefs and thoughts in peace, even if what we believe or think is offensive to others. When human rights were codified into law after the World War II, this notion was captured in very broad protections of the rights to freedom of expression and information.

Human rights law is particularly strict with regard to the limitations a government can legally impose on the exchange of information and opinions. This can only happen for certain specific purposes and only in the least restrictive manner possible. It is hard to imagine a situation where blanket restrictions on the exchange of information would constitute the “least restrictive manner” for the government to fulfil the purpose of the restriction, whatever this might be.

Of course, the purpose of many blanket restrictions on internet sites — including the stated purpose of the blocking of sites in India this week — is the protection of copyright. It is not only reasonable for governments to seek to protect these interests, it is, in fact, their job. Just as we have the right to freedom of expression, we have the right to government protection of our intellectual property. 

What we do not have the right to is the protection of our intellectual or other property at the expense of someone else’s right to freedom of expression. We wouldn’t, for example, want a government to impose a general curfew (violating freedom of movement for everyone) in order to prevent drunk driving, street crime, or other criminal behavior rightly or wrongly associated with the night time.  Yet this is precisely what blanket interventions of internet activity tend to do. Instead of the government imposing fines and blocking specific pirated content after fair and transparent judicial processes, internet service providers are pushed to pre-emptively block entire websites as soon as individual users of these websites are accused of violating copyrights. 

Some governments claim this is the only way to protect copyright where the internet is concerned. And it is certainly true that the more fluid and fast exchange of information that has come with the spread of the internet makes regulation more challenging. 

It is also true, however, that while the means of communication have changed over the years, our need, desire, and — yes — right to communicate freely has not. This is why the United Nations expert body charged with translating general human rights standards into concrete guidelines for implementation issued a statement last year spelling out the specifics of the right to freedom of expression in the age of the internet. This document is clear: generic bans on the operation of certain sites and systems are not allowed, whether these bans are imposed directly or through giving internet service providers strong incentives to take sites down. 

Sure, it is easier to do what the Indian internet service providers did this week, and what the supporters of the Anti-Counterfeiting Trade Agreement want to facilitate as a global standard: just block everyone from using sites that may or may not peddle pirated content. However, governments are not obliged to do that which is easier. Governments are obliged to protect our human rights. And that means targeting wrongdoers rather than facilitating or indeed imposing censorship in a blanket manner.

Are All Blacks Prejudiced Against All Gays? Beyond the Static View of Race, Sexual Orientation, and Otherness

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President Obama’s support for marriage equality came just one day after North Carolina voters banned same-sex marriage. Twitter storms followed each development, in which tweeters first declared that black people were homophobic as a group, then just as sweepingly that they were not. Somehow, the North Carolina defeat for marriage equality was seen as proof that all blacks hate all gays, whereas President Obama’s support was proof of the opposite.

This overgeneralization is somewhat similar to some of the commentary in the wake of the Trayvon Martin tragedy. We heard that “black violence” was somehow worse and more endemic than violence committed by non-black perpetrators. This idea was also the organizing principle behind the blog-post that got John Derbyshire fired from the National Review for advising his children to avoid contact with black people who are, Derbyshire argued, statistically more likely to be arbitrarily violent, especially toward whites.

It is not hard to see the racist undertones of all of these arguments, down to the very notion that everyone of a certain “race” has personal character traits that are inescapably and intrinsically linked to their skin color. It is also not hard to find information to disprove them: many blacks in North Carolina opposed the constitutional same-sex marriage ban.   And Justice Department statistics show that most violence is carried out within racial homogeneous communities, so that, for example, black-on-white homicides are a rare exception rather than the rule.

There are, of course, good reasons to pool and parse statistical information about any population using group criteria that may illustrate unequal policy outcomes for individuals associated with those groups. In fact, we expect governments to collect and separate statistics with a view to analysing policy effectiveness and equal access to benefits, rights, and care. Generalizations about groups can also be helpful in visualizing the underlying reasons for inequality and devising strategies to overcome it.

However, problems arise when our only understanding and interactions with specific people result in our treating them as part of a group and not as individuals. Whatever else may be true about George Zimmerman’s interaction with Trayvon Martin, it is clear from his phone comments to the police dispatcher that he had preconceived notions about Martin’s "dangerousness" even before he got out of the car — preconceptions that therefore only could be based on Martin’s appearance, including his sex, age, color, and apparel, and most likely the combination of all of them.

The corollary of this notion is that one way to overcome racism and homophobia and other “group-isms” is for people to relate to each other as individuals. While it is true that some people are able to reconcile a generalized negative feeling about certain groups (“all blacks are violent”) while nurturing positive sentiments about individuals from that group (“some of my best friends are black”), it is also true that most people start seeing a group differently when they know and love someone who belongs to it. A generally homophobic parent with a gay child may not feel compelled to campaign for marriage equality any more than they did before their child was “out.” However, most will at least start questioning negative portrayals of “all gays” in the media. This is why Derbyshire’s advice to his children to actively avoid contact with blacks is so insidious: it pushes a false notion of otherness that is purposefully static.

Even more serious problems arise when policies that should be informed by data and statistics instead are influenced by such Derbyshire-style perceptions of static and false otherness. The racial profiling of stop-and-frisk practices is one blatant example. Along those lines, Michelle Alexander has amassed examples of situations where police departments target predominantly black communities for aggressive interventions and arrests for drug-related crimes, even where data shows that in that specific state or city, the main users or sellers of drugs are not black. Many of the arguments voiced against marriage equality are equally based on false ideas that all gay people are promiscuous, sexually predatory, or bad parents.

And perhaps this is where the real issue lies. It is almost instinctual for us to organize information about the world around us based on visual cues and personal experiences. And it is equally human to use these cues and experiences to generate assumptions about what might happen and what we should do about it. It is when we confuse trends or, worse, preconceptions with reality that abuse, inequality, and discrimination can take hold.

More disturbingly, negative generalizations about what everyone in a given group wants, thinks, and does help to justify those who actually do. When we portray all black people as homophobic we exonerate individuals of color who feel prejudiced against gays. They are not responsible for their beliefs—their skin color made them do it.

I would not wish to be called homophobic just because quite of lot of individuals who happen to be white make anti-gay remarks. Even less would I want these individuals to be able to brush off their anti-gay sentiments as a natural part of their “whiteness.” Prejudice is prejudice, wherever it comes from and whatever form it takes. Respect dictates we treat it as such.