The idea of health care as a human right is widely debated, but Joia Mukherjee, who has been at the forefront of the fight against the HIV and AIDS epidemic as chief medical officer of Partners in Health, said that it is a basic necessity.
Mukherjee discussed her work with Partners in Health, an international medical nonprofit, at Rider University on March 28. Mukherjee has been part of a social movement that calls for long-term treatment — not just education and prevention — to fight AIDS, tuberculosis and other epidemics in the world’s poorest nations.
“Most of you are American, but but when I give lectures in Africa at elementary schools all throughout the continent, teachers will say to young kids as young as first grade, ‘Prevention is what?’ And the kids say, ‘Prevention is better than cure.’ They’re trained to say that from a very young age,” she said. “My kid is not trained to say that, because if he’s sick, he expects to go to a hospital. When he had cancer, I expected him to get treatment. But these kids are brainwashed from the beginning.”
But in Mukherjee’s field, finding a cure is often a means of prevention. “They’re really kind of inseparable,” she said.
The idea that prevention is better than finding a cure, according to Mukherjee, is a “false dichotomy” that was put in place to solve the real problem: a lack of resources.
From a human rights perspective, health care is basic right, Mukherjee said.
“We don’t say, ‘well you’re too poor, you don’t have this right,'” she said. “It is our right. It’s been marginalized because of the dynamic of the Cold War.”
Part of the disparity in health care for the poor and the wealthy comes from changes in the United Nations’ Declaration of Human Rights, she said. During the Cold War, it was split into two different treaties: the Covenant on Political and Civil Rights, and the Covenant on Social, Economic and Cultural Rights. The U.S. has only signed the treaty on political and civil rights, but not the latter.
“For poor people, these rights are paramount,” she said. “Some people even call them ‘poor people’s rights,’ because if you don’t have a full belly, who cares if you get to vote?”
Mukherjee said even in the 2000s, impoverished countries’ interest on their national debt exceeded their public service budgets, so most poor nations “only have $5 per capita for health.” This leads to severe inaccessibility to health care, causing people to seek alternatives such as seeing a traditional healer or even stealing money. Hospitals lack drugs and have few staff members — and the existing ones do not get paid for months at a time. “We, as Partners in Health, end up paying the electricity bill of our partners,” she said.
While serving at Pleebo, a small hospital in Liberia, she was devastated when she saw its run-down conditions. One delivery room had a hole in the ceiling.
“It was right over a delivery table, and I said to the nurse, what do you do if there’s a delivery?” she said. “And she tells me, ‘oh, we have an umbrella.’ That was her solution. This is not dignified. This is untenable.”
Meanwhile, while working in a Haitian village, Mukherjee made another alarming discovery: doctors were unable to make diagnoses of diseases because of their lack of resources — in particular, access to drugs and an adequate-sized staff. In the early 2000s, she expected to diagnose 137 cases of tuberculosis based on the city’s population of 55,000. But local doctors had only made nine diagnoses, she said.
“How they even diagnosed nine is a miracle,” she said. “There’s no staff, no drugs, no microscope.”
Partners in Health has been leading the way in helping people in the most destitute corners of the world access the care they need. “We showed that you could take these drugs, use them effectively and save these lives, and that created massive funds for global health,” she said.
“Activists get it,” she said. “All over the world, people living with HIV and their allies said, ‘we demand treatment.’ Whole communities get wiped out in the 1990s, but people still say prevention is better than cure,” she said. “Teach people not to have sex. But we’re all a product of sex. The idea that we can roll out this massive campaign of abstinence around the world is completely folkloric — and I love condoms. I’ve given out more condoms than any other person of Asian descent. But it’s not enough. It’s too late for prevention when you already have the disease. We have to treat the sick.”
Gabriel Gonzales, a junior health care management major at Rider, said he walked away inspired by Mukherjee’s words, and even more motivated to stay in the health field.
“There is so much that can be done, it’s just a matter of actually taking the first step,” Gonzales said. “It might take a long time to see the result, but it takes a lot of different people to accomplish one goal.”
Senior political science major Chris Scales, a former member of the Hamilton Board of Education, said he felt affected by Mukherjee’s message of social justice.
“Activism leads to social change,” Scales said. “It’s important for all of us to remember that we are global citizens. It’s our responsibility to care for one another.”
Mukherjee expressed a sense of optimism for the millennial generation. “I heart millennial,s” she said to the students in the room. “A tiny group of people can change anything. AIDS activists were a small group. And look at the Parkland students, millions of people get out there. Don’t take the bait that there’s one story. The story of justice is people working together to a common good and fighting the good fight.”