Development Channel

Emerging Voices features contributions from scholars and practitioners highlighting new research, thinking, and approaches to development challenges. This article is from Nema Milaninia, a legal officer in the Office of the Prosecutor at the International Criminal Tribunal for the Former Yugoslavia (ICTY). The views expressed are those of the author alone and do not necessarily reflect the views of the United Nations or the ICTY. This piece is part of an ongoing Development Channel series on global justice and development. In 1994, the international community reacted to brutal crimes committed in Rwanda and the former Yugoslavia by establishing tribunals mandated to bring those most responsible to justice. The thinking was that justice would help restore and maintain peace in those regions struggling to recover from divisive tragedies. But today, the relationship between justice, peace, and political stability faces serious scrutiny. How governments and international organizations choose to view that relationship has huge implications for how individuals responsible for mass atrocities will be held accountable. The recent prosecution of Kenyan leaders in the International Criminal Court (ICC) sheds light on the tenuous balance between stability and justice. In October 2013, leaders of the African Union (AU) passed a resolution requesting that the ICC defer its trials against Kenyan President Uhuru Kenyatta and his deputy William Ruto – both charged with organizing post-electoral violence in Kenya that resulted in the deaths of over 1,000 civilians and the displacement of another 250,000 or more people. The resolution argued that the ICC cases could “undermine [Kenya’s] sovereignty, stability, and peace.”  In 2009, the AU passed a similar resolution concerning ICC proceedings against Sudanese President Omar Hassan Ahmad al Bashir, out of fear that his genocide case could “undermine the ongoing efforts aimed at facilitating the early resolution of the conflict in Darfur.” Both of these cases currently face serious obstacles: in Kenya, witnesses have withdrawn, likely due to bribery, pressure, and a climate of hostility. And al Bashir continues to evade extradition to The Hague. Resistance to the ICC is not unique to Africa. Just last year, the Russian government stated that referring the ongoing conflict in Syria to the ICC would be “ill-timed and counterproductive” to peace efforts. Some argue that in conflict or post-conflict situations, the emphasis should be on ensuring security, encouraging economic development, rebuilding key institutions, and disarming belligerent groups. In this view, justice is placed in juxtaposition with peace, and other factors usually weigh against holding leaders accountable. For example, the perpetrators of an atrocity, or their chosen successors, often retain or come into power after a conflict ends. In other cases, both sides of the conflict commit abuses and there is a fear that the quest for justice might undermine reconciliation. Increasingly, however, studies show that the justice or peace dichotomy is false. Instead of being at odds, there is an important and fundamental link between justice, stability, and economic development. In 2010, the International Institute on Higher Criminal Studies (IIHCS) published a survey of world conflicts that took place from 1945 to 2008. The study found that of the over 300 conflicts that took place during that period, nearly all were of a non-international or internal character and were largely concentrated in developing countries in Asia and Africa. The conflicts themselves were usually caused by poverty, exploitation, corruption, and other factors relating to economic, social, and political grievances. Furthermore, the survey found that those who promoted conflict in poor countries were often motivated by personal greed and were willing to surrender their states to the interests of foreign governments (such as in the Cold War) or foreign corporations. In the vast majority of cases, perpetrators of crimes escaped accountability. More often than not, justice was sacrificed for short-term political expediency. However, as the IIHCS study revealed, stability, security, and democracy are actually strengthened by a post-conflict commitment to accountability. Openly facing past violence is essential to prevent future violence. It is for these reasons that Kenya’s key aid donors and senior Washington officials support the ICC process, viewing impunity for state corruption and political violence as a threat to Kenya’s long-term stability.  There is also indication that international prosecutions helped prevent another outbreak of election-related violence when Kenyans voted for a new president in 2013. Of course, balancing political and economic development with accountability will always be a case-by-case determination. Just as conflicts arise from distinct issues and involve different types of violence, post-conflict resolutions must also be context-specific. There is no one-size-fits-all approach to ensuring justice and stability following major conflicts. But there is at least strong indication and growing international consensus that justice and stability are collaborative and not mutually exclusive concepts. Despite this finding, international justice institutions like the ICC continue to suffer from budgetary restraints and limited state cooperation, particularly from the most powerful countries in the world. Without more resources and support, the prospect of realizing both justice and peace risks being reduced to an aspiration instead of a reality.

This guest post is from Yanzhong Huang, senior fellow for Global Health at the Council on Foreign Relations, and CFR Research Associate Jay T. Chittooran. Global momentum is building for universal health care (UHC). In January 2012, health ministers from around the world gathered in Bangkok and committed themselves to raising “universal health coverage on the national, regional and global agendas.” Within a year, the United Nations General Assembly adopted a resolution on UHC, encouraging national governments worldwide to “plan or pursue the transition towards universal access to affordable and quality health-care services.” Since then, the World Health Organization and the World Bank have worked together to encourage global action on instituting UHC. Over seventy countries have enacted UHC or similar programs within their borders. But even with growing political commitment, difficult decisions remain regarding what health services will be covered by UHC, given that resources for health are finite and demand is seemingly limitless. This is especially true in low- and middle-income countries (LMICs), which typically face tough budget constraints. In setting priorities about what to cover, policymakers have to address some thorny questions, such as: how can evidence and social values be systematically incorporated into the design of health plans?  How do you ensure a proper balance between promotive and preventive care on the one hand, and curative and rehabilitative care on the other? Which types of patients receive what interventions, when, and at what cost? Very often, the selection of services and technologies to be covered is based on cost effectiveness with respect to health outcomes. But any UHC plan should also take equity, financial protection, and social values into account. Unfortunately, health care coverage in many LMICs is associated with general inefficiency, wasted money, and needless illness and death. For example, in India, even though only 44 percent of children under two years old are fully vaccinated, open-heart surgery is subsidized in national public hospitals. Similarly, in Colombia, only 58 percent of children are fully vaccinated, but public monies are used to subsidize a breast cancer treatment considered ineffective and unsafe in the United States. In both cases, expensive and potentially wasteful services are prioritized over cost effective and equity-enhancing health interventions. In order to correct this problem, countries should ensure that they have an adequate amount of certain affordable drugs that satisfy the health care needs of their population, consult health insurance priority lists, and incorporate technology-related policy-making in health care to encourage the use of cost-effective health care tools. This requires building capacities to produce quality data and developing evidence-based decision-making. Fortunately, in many LMICs, data, methods, and evidence on the costs, effectiveness, and equity of health interventions are increasingly available. But health care resources and interventions remain skewed in favor of the privileged and politically-connected. As UHC generates more demand for better health care, in turn putting financial pressure on governments, public spending will respond even more to interest groups and wealthy populations. This makes it imperative that countries invest in independent institutions to overcome the inherent biases of participatory politics, which tends to favor the loudest, best connected, and most articulate, but not always those most in need of care.