Latin America: The Spirit of Constitutionalism under Attack

By Maxwell Cameron*

Venezuela constitition

A participant in a march in Venezuela holds up the country’s constitution. / TeleSURtv / Flickr / Creative Commons

Recent events in Paraguay and Venezuela raise yet again the issue of whether political leaders are capable of deliberating and acting in ways that show an appreciation for constitutional essentials, or whether they choose instead to perform their roles and offices in ways that continuously test constitutional principles and, over time, contribute to their erosion.  The principles of re-election and term limits are important in every presidential democracy, the product of historical circumstance.  In the case of Paraguay, a dictatorship under strongman Alfredo Stroessner from 1954 to 1989, sensitivity to the idea of a president serving for too long is strong.  Venezuela’s elimination of term limits a few years ago set a dangerous precedent.  Other constitutions limit incumbents to one term (Mexico, Paraguay) or two terms (United States, Colombia); in some constitutions, presidents cannot be re-elected immediately but can run later after a term has elapsed (Peru, Uruguay).

  • More important than the constitutionality of term limits is that the re-election issue be settled in a way that commands the assent of all parties – within a certain spirit of constitutionalism. Paraguayan President Horacio Cartes’s error was to think that he could change the constitution by means that violated this spirit, even if the public would arguably support a modification of the re-election rule if pursued in the right way.  (Since the fall of Stroessner, the Partido Colorado, the pillar of his rule, has won every election except in 2008, when Catholic priest Fernando Lugo was elected.  Lugo was deposed in 2012.)  The President of the Senate, Roberto Acevedo, opposed the change and was outraged by the way it was adopted: the Senate voted in a special session held behind closed doors.  In that session, 25 Senators approved the measure, bypassing the opposition Partido Liberal Radical Auténtico.

The showdown in Venezuela over President Maduro’s effort to shut down the congress was another undemocratic blunder.  A decision by the Tribunal Supremo de Justicia (TSJ), Venezuela’s supreme court, to arrogate legislative functions to itself or delegate them to other branches or agencies was unconstitutional.  (The TSJ has the power only to declare a law invalid or that another branch of government is operating outside the law.)  When the Fiscal General de la República, Venezuela’s equivalent of attorney general, Luisa Ortega Díaz argued that the TSJ’s decision was unconstitutional, she gave herself political cover by expressing loyalty to the Constitution of 1999 – the legitimacy of which has long been undermined by the fact that it is a document made to measure for chavismo.  As a result of this and significant domestic and international pressure, the government backed down – a rare event.  The attorney general’s insistence that the constitution not be violated indicates that a spirit of constitutionalism among chavistas is not completely dead, but it also shows that it remains a mechanism for coordinating the actions of agents within the government.  Her position also raises the possibility of a split between constitutionalists and hardline militarists within the regime.

Democracy is not just a system of rules.  It requires politicians to acknowledge and respect the essential constitutional agreements that have to underpin the struggle for power in a self-governing community.  The crises in Paraguay and Venezuela both forewarn of the dangers of excessive partisanship and the risks of playing fast and loose with constitutional rules.  Something similar seems to be playing out in Ecuador, where allegations of fraud have been made by the opposition.  If spurious, they are condemnable; if supported by evidence, they are deeply disturbing.  Either way, they reflect mistrust in institutions after a decade of rule by Rafael Correa (Likewise, U.S. Senate Republicans’ threats to use of the “nuclear option” to confirm Judge Gorsuch threatens to deepen the politicization of the U.S. Supreme Court.)  The cost of the failure of politicians and citizens to cultivate a spirit of constitutionalism is very heavy.  In Paraguay, it has resulted in deadly protests and resignations by top officials; in Venezuela it has taken the country to the brink of civil war; in Ecuador, there is a real prospect of debilitating governance problems as Lenín Moreno of Alianza PAIS takes office; and in the United States we are starting to see the kinds of governance problems that have long been associated with the “politicized states” (to use Douglas Chalmers’s phrase) of Latin America.

April 5, 2017

* Maxwell A. Cameron is Director of the Centre for the Study of Democratic Institutions at the University of British Columbia.

How are the Americas Faring in an Era of Lower Oil Prices?

By Thomas Andrew O’Keefe*

Gas Station Guatemala

Photo Credit: Josué Goge / Flickr / Creative Commons

The sharp drop in global oil prices – caused by a combination of a slowing Chinese economy hurting commodities sales and efforts by Saudi Arabia to retain market share – has both downsides and advantages for Latin America and the Caribbean.  By keeping production levels steady, despite decreased demand, so that a barrel of crude remains below US$40, the Saudis’ hope is to put U.S. shale oil producers and Canadian tar sands producers out of business.  The drop in oil prices has had a varied impact elsewhere in the Americas:

  • The effect in Venezuela, already reeling from over a decade of economic mismanagement, has been catastrophic. The ripple effect is being felt in those Caribbean and Central American countries that grew to depend on PetroCaribe’s generous repayment terms for oil imports that allowed savings to be used for other needs.  In 2015, for example, this alternative funding mechanism in Belize was slashed in half from the previous year.  The threat of interest rate hikes on money that must eventually be repaid for oil imports also pushed the Dominican Republic and Jamaica to use funds raised on international capital markets to reduce their debt overhang with Venezuela.  (For those weening themselves off PetroCaribe dependency, however, the lower prices are a silver lining.)
  • Low oil prices have also knocked the wind out of Mexico’s heady plans to overhaul its petroleum sector by encouraging more domestic and foreign private-sector investment.
  • In South America, the decline has undermined Rafael Correa’s popularity in Ecuador because the government has been forced to implement austerity measures. The Colombian state petroleum company, Ecopetrol, will likely have to declare a loss for 2015, the first time since the public trading of its shares began nine years ago.  In Brazil, heavily indebted Petrobras has seen share prices plummet 90 percent since 2008, although that is as much the result of the company being at the center of a massive corruption scandal that has discredited the country’s political class.
  • On the other hand, lower petroleum prices have benefitted net energy importers such as Chile, Costa Rica, Paraguay, and Uruguay.

The one major oil producer in the Americas that has not cut back on production and new investment is Argentina – in part because consumers are subsidizing production and investment by the state petroleum firm YPF, which was renationalized in 2012 and now dominates domestic end sales of petroleum products.  Prices at the pump remain well above real market values.  While successive Argentine governments froze energy prices following the 2001-02 implosion of the Argentine economy, this time policy is keeping some energy prices high.  This encourages conservation and efficiency and spurs greater use of renewable alternatives, but it becomes unsustainable during a prolonged dip because it will, among other things, make the country’s manufacturers uncompetitive.  The Argentine example underscores that predictions of a pendulum shift in Latin America in favor of private-sector investment in the hydrocarbons sector over state oil production are still premature.

The lower prices do not appear likely to harm the region’s continuing substitution of natural gas for coal and oil as a transitional fossil fuel to greener sources of energy.  Natural gas prices remain at their lowest levels in over a decade, and the expansion of liquefied natural gas plants allows for easier transport of natural gas to markets around the world.  They are also unlikely to dent the global shift to greater reliance on renewable energy resources driven by the international consensus that climate change can no longer be ignored and something must be done to address it.  At the UN climate change talks in Paris last December, for example, countries agreed to keep temperature increases “well below” 2 degrees centigrade above pre-industrial levels and made a specific commitment “to pursue efforts” to achieve the much more ambitious target of limiting warming to no more than 1.5 degrees centigrade.  The year 2015 was the second consecutive year in which energy-related carbon emissions remained flat in spite of 3 percent economic growth in both years. 

March 24, 2016

*The author is the President of San Francisco-based Mercosur Consulting Group, Ltd.  He chaired the Western Hemisphere Area Studies program at the U.S. State Department’s Foreign Service Institute between July 2011 and November 2015.

Ignoring MERCOSUR and UNASUR at Your Peril

By Thomas Andrew O’Keefe*

Mercosur map

Participating countries in MERCOSUR. Image Credit: Immanuel Giel (modified) / Wikimedia / Creative Commons

Pundits who dismiss MERCOSUR and the Union of South American Nations (UNASUR) as failed attempts at Latin American economic integration should look again.  MERCOSUR has presided over an explosion in intra-regional trade among its four original member states (Argentina, Brazil, Paraguay, and Uruguay) from just over US$ 5 billion at its launch in 1991 to US$ 43 billion by 2014.  UNASUR, for its part, is credited with thwarting a coup attempt against Evo Morales in 2008 and putting a damper on continental arms races.

  • MERCOSUR and UNASUR member countries have taken additional important steps toward convergence since 2014, when MERCOSUR’s highest governing body adopted “CMC Decision 32,” which allows initiatives pursued by either collective to be binding on both if they arise from a set of goals and objectives common to both. The document reaffirms the UNASUR founding treaty stipulation that “South American integration shall be achieved through an innovative process that includes all of the achievements and advances by the processes of MERCOSUR and CAN [Andean Community].”  Chile has spearheaded this effort as a means of reducing duplication of efforts, and is also attempting to bridge ideological differences between the Pacific Alliance (Chile, Colombia, Mexico, and Peru) and MERCOSUR to further build Latin American unity.

Given the relentless negative assessment of both integration projects, multinational pharmaceutical companies were caught off guard when MERCOSUR and UNASUR forced them late last year to make substantial price cuts for public-sector purchases of Darunavir, an antiretroviral to combat HIV-AIDS, as well as Sofosbuvir, used with other medications to treat Hepatitis C.  Both drugs are on the World Health Organization’s List of Essential Medicines.  As a result of CMC Decision 32/14, the Ministers of Health of all the South American nations met in Montevideo on September 11, 2015, and launched a joint MERCOSUR/UNASUR committee to negotiate with multinational pharmaceutical companies on the prices for bulk purchases of certain high-priced drugs.  The committee, made up of representatives from each government’s agency responsible for purchasing medicines, won major price cuts last November – a steep reduction for Darunavir from Hetero Labs as well as lower prices with Gilead for Sofosbuvir.  The new costs were premised on the lowest amount charged to any one of the member governments, and enabled Chile’s Ministry of Health to pay 90 percent less than what it previously paid for Darunavir.  The South American governments as a whole are expected to save US$ 20 million in 2016 on purchases of this anti-retroviral.  A proposed 14 percent reduction in the cost of the combination Sofosbuvir-Ledispaver drug for Hepatitis C – if accepted by the MERCOSUR/UNASUR committee – would enable further savings.

The South American governments have their eyes set on several additional high-priced medications, with a particular focus on drugs used to treat cancer.  In order to aid the committee’s work, UNASUR is creating a data bank of the prices charged by the multinationals for specified medicines purchased by the public health sector in each member state.  The fact that the purchases are made jointly through the Pan American Health Organization’s already existing Strategic Fund opens the possibility that countries in Central America and the Caribbean can benefit as well.  It also means that all these countries can access the Fund’s capital account and do not need to have the cash in hand to acquire medications required to address public health emergencies.  MERCOSUR and UNASUR – often dismissed as ineffective – are demonstrating that integration produces tangible results.

February 11, 2016

* Thomas Andrew O’Keefe is President of San Francisco-based Mercosur Consulting Group, Ltd. and is former chair of Western Hemisphere Area Studies at the U.S. State Department’s Foreign Service Institute (2011-15).

Correction: Due to an editing error, an earlier version of this post mistakenly stated that “a 14 percent reduction in the cost of its combination Sofosbuvir-Ledispaver drug for Hepatitis C will enable Chile’s Ministry of Health to pay 90 percent less than what it previously paid for Darunavir.”  The outcomes of the cost negotiations for the two medications are unconnected.

Pope Francis’s Pastoral Mission

By Alexander Wilde*

Photo Credit: Ministério da Defesa / Flickr / Creative Commons

Photo Credit: Ministério da Defesa / Flickr / Creative Commons

The primary purpose of Pope Francis’s trip to Latin America – like all papal visits since Pope Paul VI made the first in 1968 before the historic meeting of Latin American bishops in Medellín, Colombia – is pastoral.  The media are grasping for the implications of his visiting Ecuador, Bolivia, and Paraguay this week, looking for a theme, for example, in the common factors of their poverty, indigenous populations, and environmental conflicts.  Others wonder if this Argentine pope, well acquainted with Peronism, carries a political message about the dangers of left-wing populism.  Yet others posit this trip in terms of religious “competition” to recapture market share from Evangelicals.

This visit and this extraordinary pope, however, are focused on his broader pastoral message – conveying to the faithful his deepest beliefs about what their faith demands of him and of them.  Francis, in contrast to his immediate predecessors, has given a strongly social orientation to this pastoral ministry, while reinforcing its spiritual foundation in personal faith.  In doing this, he has embraced the renewal wrought by the Second Vatican Council (1962-65) and what he apparently judges the positive insights of liberation theology.  Christians must live their faith in the world and their times, and that includes engaging with other “men and women of good will” to realize God’s purposes for humanity.  Pope Francis repeats that phrase, taken from Pope John XXIII, in his new environmental encyclical Laudato Si’.  Visiting these three countries – in which conflicts over land, oil, forests, and water have mobilized social protests – presents clear opportunities to speak out about how the encyclical’s analysis and moral judgments may apply in concrete settings.

Pope Francis brings to his pastoral visit a belief that he and the Catholic Church should “meet people where they are.”  During 15 years as Archbishop of Buenos Aires, that meant being an active presence among the poor in the villas miserias.  Now he links that pastoral injunction to global issues of poverty, development, and the environment.  He appears to feel a deep responsibility to spur action but at the same time a strong grasp of the intractability of the larger processes, political and natural, involved.  He has said more than once that he expects his papacy to be brief, suggesting that he may view this trip within a God-given responsibility to use his limited time and moral authority to help us confront the most fundamental problems of our future together in this world.  Latin Americans have shown growing awareness of these problems.  Their response to this trip is probably not best judged by Mass attendance but rather by whether they can take concrete steps to link, as Francis does, the “cry of the poor” and the “cry of the earth” in their societies. 

July 7, 2015

* Alexander Wilde is editor of Religious Responses to Violence: Human Rights in Latin America Past and Present (University of Notre Dame Press, forthcoming December 2015). 

The Impact of Falling Oil Prices on the Western Hemisphere

By Thomas Andrew O’Keefe*

L.C. Nøttaasen / Flickr / CC BY-NC 2.0

L.C. Nøttaasen / Flickr / CC BY-NC 2.0

The sharp drop in the benchmark Brent crude price of oil from just under US$115 per barrel in June 2014 to its current perch around US$50 has important ramifications for the Western Hemisphere.  For Venezuela, which earns some 95 percent of its foreign exchange from petroleum exports, it is a potential disaster.  Underlying political tensions will be exacerbated if there is no money to continue funding social welfare programs or heavily subsidizing gasoline.  It probably also spells the end of PetroCaribe’s generous repayment holidays and what are in essence below-market interest loans for Caribbean and Central American nations.  Sharply lower oil prices also put at risk major energy projects such as the development of Brazil’s pre-salt reserves, which require a minimum price of $50 to $55 to be economically viable.  Equally tenuous are Argentine efforts to regain energy self-sufficiency by exploiting its vast shale oil and gas reserves and Mexican plans to attract foreign investors to participate in deep-water oil exploration and drilling.  The minimum price for a barrel of oil below which new investment projects in Canada’s oil sands are no longer attractive is around $65.  Shale oil producers in the United States are also being squeezed by low petroleum prices.

On the other hand, net energy importers such as Chile, Paraguay and Uruguay benefit from sharply lower oil prices.  Although being weaned off  PetroCaribe will be painful for the Caribbean and Central America in the short term, they will be able to seek oil at the lower prices elsewhere.  The pressure on the Obama administration to lift the ban on U.S. crude oil exports, in response to a glut of domestic shale oil production, could also redound in favor of the Caribbean and Central America by lowering international oil prices further through increased global supply.  Already, 2015 began with U.S. companies authorized to export an ultralight crude called condensate.

In hopes of rallying OPEC to stabilize oil prices, Venezuelan President Maduro last weekend rushed off to lobby Saudi Arabia, which just two months ago refused to decrease production in order to raise prices, but oil industry sources say there’s little chance of a policy change.  Meanwhile, the environment may turn out to be among the biggest beneficiaries of lower oil prices.  Less investment in shale oil production reduces the risk of leaks of methane, a potent greenhouse gas, as well as decreases flaring.  Similarly, slowing down oil sands production in Alberta and Saskatchewan means that the very high levels of greenhouse gas emissions associated with extracting crude oil from bitumen (not to mention the negative impact on water resources) is diminished.  Although lower fossil fuel prices traditionally have undermined incentives to move to greater reliance on renewable and non-traditional energy resources, this may no longer be true.  For one thing many governments around the world are now embarked on ambitious efforts to reduce carbon emissions by, among other things, raising the costs associated with petroleum usage through cap and trade regimes that force companies to buy government-issued pollution permits.  Still others have enacted outright carbon taxes on utilities and large factories per metric ton of carbon dioxide emissions.  In addition, the heavy initial capital investment that was previously associated with things like wind, solar and geothermal power are falling.  For example, a combination of technological advances and Chinese overproduction have resulted in much lower prices for solar panels so that the cost of generation from a large photovoltaic solar plant is now almost 80 percent less than five years ago.  Geothermal energy may be the renewable that most benefits as drilling rigs idled by lower oil prices are now available at a lower cost for geothermal projects.  

*Thomas Andrew O’Keefe is President of San Francisco-based Mercosur Consulting Group, Ltd. and teaches at the Villanova University School of Law.

January 13, 2015

UNASUR Looking for Leadership and Direction

By Andrés Serbin

unasur meetingThe seventh UNASUR head of state summit, held in Suriname in August, failed to give the organization the shot in the arm that it needed to continue developing as an effective voice for South America. Despite grandiloquent declarations that it was a “historic event” for the region, the summit was in danger of being overshadowed by several incidents. The son of Suriname´s President and summit host, Desi Bouterse, (who himself has a checkered past) was detained in Panama the day before the summit and extradited to the United States, where he faced drug- and arms-trafficking charges.  (The son was subsequently charged with “attempting to support a terrorist organization” as well.)  Moreover, four of the 12 UNASUR heads of state didn´t attend the Summit, and bilateral tensions between some of the participants got the meeting off to a rough start:  Bolivia was irritated that Brazil gave asylum to a senator accused of corruption; Uruguay’s decision to expand a paper plant on the Paraná River peeved Argentina; Chile and Argentina were in a row regarding the Chilean airline LAN’s use of facilities in Buenos Aires; Chile and Peru continue a battle in the Hague about a territorial dispute; and Paraguay was still in limbo after being suspended from UNASUR (and MERCOSUR) after President Lugo’s removal last year by the Congress.

Even as the dust settled, however, UNASUR was unable to take on the most important task of the summit – appointing a new Secretary General for the organization.  Despite their contrasting styles – sometimes complementary and sometimes in open competition – Presidents Chávez and Lula de Silva had driven the creation and consolidation of UNASUR after the end of the FTAA project during the Mar del Plata Summit of the Americas in 2005, but that strong leadership is not there anymore.  Their absence laid bare the weak political will of most other South American leaders to consolidate the organization and to build a strong institutional basis for its development.  No one, except perhaps former (and controversial) Paraguayan President Lugo has expressed interest in the job of Secretary General.  It was no surprise, moreover, that the Summit was not able to advance other crucial decisions, such as the creation of the long expected Banco del Sur. A resolution condemning U.S. initiatives regarding Syria was one of the few relevant and consensual results of the Summit.

UNASUR started out as a political endeavor based on regional, instead of national, interests, and much of its earlier momentum was driven by rejection of earlier “neoliberal” attempts at regional integration and of the role of the United States in the region. Members’ new focus is clearly state-centric and political, as regional market and trade issues have been superseded by a new agenda focusing on infrastructure and communications development, energy and security agreements, global financial impact and environmental concerns. The absence of new leadership to move forward a regional agenda poses a series of challenges to this process.   In the meantime, other processes continue.  Paradoxically, some of the member countries are deeply involved in the creation of a new initiative – the Pacific Alliance (Alianza del Pacífico), clearly oriented towards free trade.

Replicating the U.S. Shale Gas Revolution in Latin America

By Thomas Andrew O’Keefe*

Photo credit: Energy Information Administration / Foter.com / Public domain

World Shale Gas Map / Photo credit: Energy Information Administration / Foter.com / Public domain

The shale gas revolution in the United States promises not only to soon make the country energy self- sufficient but also serve as the catalyst for a major revival of manufacturing.  Similar high hopes have been raised for Latin America, where some of the planet’s largest reserves of shale gas are found.  According to U.S. Energy Information Administration estimates, Argentina is said to have the world’s second largest reserves of technically recoverable shale gas (China is first).  The United States is currently in fourth place, followed by Canada and Mexico.  Brazil is in tenth place, with Chile and Paraguay not far behind.  The possibility that Latin America can pursue a successful shale gas strategy, however, is tempered by a number of important legal and/or geological differences that can serve as important bottlenecks.  In addition, the region’s tumultuous politics often get in the way of implementing policies that boost investment and encourage a highly productive energy sector.

The most important legal difference is that subsoil rights belong to the above ground property owner in the United States, while everywhere else in the Western Hemisphere the government (national, state or provincial) is the owner.  Developers have had an easier time purchasing access to shale gas deposits from individual landowners throughout the United States.  This explains, in great measure, why Canada’s significant shale gas reserves have not been as extensively exploited as in the United States, despite a hydrocarbons regime receptive to private-sector investment.  In addition, environmental protection legislation that impacts the shale gas industry is fractured among Federal, state, and local government authorities in the U.S.  That has facilitated developers extracting waivers and more lenient treatment in the United States that would be harder to obtain in most Latin American nations, where environmental protection is the exclusive or predominant prerogative of the central government.  Furthermore, current technology for extracting natural gas from shale reserves demands huge amounts of water, a resource that is scarce in those regions of Mexico, for example, where most of its extensive shale gas reserves are located.

Political realities are the most crucial (and often overlooked) factor that can easily undermine any effort to develop Latin America’s extensive shale gas reserves.  On paper, Argentina should be a regional energy powerhouse, supplying not only its own energy needs but those of its neighbors. However, the country has for years pursued policies that have scared off private-sector investment, heightened Argentine dependence on foreign energy imports, and led to a steady hemorrhaging of hard currency reserves.  To outsiders these policies appear illogical, but they make perfect sense to Argentine political leaders trying to consolidate their power base.  Mexico is an example of a country constrained by its Constitution from developing its extensive off-shore hydrocarbon resources.  Any political party that tries to make major amendments to those constitutional provisions, however, risks annihilation at the polls.  Brazil’s recent adoption of nationalistic legislation to encourage the domestic manufacturing of hydrocarbon-related technology could well impede exploiting its shale gas reserves if similar mandates are created for the highly specialized and capital-intensive hydrofracking equipment the industry utilizes.  In fact the only Latin American country where the stars seem aligned to repeat the U.S. shale gas success story is investor-friendly, politically-stable, energy-starved, and free-market oriented Chile, whose shale gas reserves are concentrated in the remote, under populated (and very wet) far south of the country that desperately seeks new opportunities to promote local economic development.  

*Thomas Andrew O’Keefe is the President of San Francisco based Mercosur Consulting Group, Ltd. and teaches at Stanford University.

Latin America’s Emerging Burden of Chronic Non-Communicable Diseases

By Fernando De Maio*

Photo credit: FLICKR.com/diapositivasmentales / Foter.com / CC BY

Photo credit: FLICKR.com/diapositivasmentales / Foter.com / CC BY

Despite significant improvements over the past 30 years in some of the most crucial health indicators – including increases in life expectancy and decreases in infant mortality – Latin America faces an impending epidemic of chronic non-communicable diseases such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes.  The region has avoided the worst effects of the HIV/AIDS epidemic.  Brazil, for example, is now widely accepted by health policy analysts as offering the world valuable lessons for combating the spread of HIV and in ensuring access to life-saving antiretroviral medicine.  But chronic non-communicable diseases are now stretching under-funded and fragmented health care systems, revealing deep lines of social inequality.

The World Health Organization (WHO) has warned of an impending epidemic of such ailments, which are already the leading causes of death in all areas of the world except for sub-Saharan Africa.  In Latin America, chronic diseases account for more than 60 percent of deaths, with some variance between countries (more than 70 percent in Uruguay, more than 60 percent in Argentina and Chile, but less than 40 percent in Bolivia and Paraguay).  The latest data indicate that this burden is growing across the region, driven by increases in some of the most important risk factors (physical inactivity and obesity in particular).  Surveys in the region allow us to disaggregate national data, revealing the social inequalities underlying the problem.

In Argentina, we have used the National Risk Factor Surveys from 2005 and 2009 to examine how social gradients are changing:

  • Physical inactivity – an important risk factor for cardiovascular disease – has increased substantially (from 46 to 55 percent).  The further down we go in the socioeconomic hierarchy, the more this important risk factor seems to be increasing.
  • Obesity has also increased in this four-year period (from 14 to 18 percent), with a steepening social gradient for women.
  • Data on diabetes from these surveys are mixed.  The percentage of the adult population told they have diabetes or high blood sugar has risen (8.4 to 9.6 percent), but experts believe the increase reflects both increases in diabetes in the population and an in access to health care resulting in more cases being detected.
  • Some good news may be found in preventive cancer screening: rates of mammograms and pap smears have increased, and social gradients for mammograms are decreasing, raising the hope of diminished inequalities in cancer mortality in the future.

The WHO’s Commission on the Social Determinants of Health recently concluded that “reducing health inequalities is… an ethical imperative.  Social injustice is killing people on a grand scale.”  Among its recommendations is a call for the routine monitoring of health inequalities.  The growing body of data documents the linkage between inequality and the occurrence of chronic non-communicable diseases – demonstrating that, fundamentally, it is a question of social justice.  Social inequalities in physical inactivity, obesity, diabetes – and, crucially, tobacco consumption – are not natural but socially and politically produced.  Empirical research in the coming years will need not only to document the rise of chronic non-communicable diseases in aggregate terms, but also to closely monitor the inequalities embedded in national figures.  Policy analysis will likewise need to examine not just the national-level effects of new initiatives, such as new taxes on tobacco products or new standards for salt consumption, but, at a disaggregated level of analysis, examine how new initiatives affect people across the socioeconomic spectrum.

* Dr. De Maio is a professor in the Department of Sociology at DePaul University.

 

Revitalization of the OAS: More than an act of Congress

By Carlos Portales*

OAS logoU.S. Congressional passage in late September of the “Organization of American States Revitalization and Reform Act of 2013” could either help revitalize the troubled body or contribute to its irrelevance. By directing the U.S. Secretary of State to develop and drive OAS reform options, the bill seeks to give much higher priority in the OAS and Summit of the Americas to promoting and consolidating democracy in the hemisphere – “with due respect for the principle of nonintervention” – while recognizing that “key OAS strengths” are also in strengthening peace and security, assisting and monitoring elections, and fostering economic growth. Reducing “mandates” – ongoing programs that tend to get institutionalized – is another priority. The new law also requires Secretary Kerry to devise a strategy for a new fee structure in which no member state would pay more than 50 percent of OAS’s assessed yearly fees. (The U.S. Library of Congress reports that the United States, the organization’s largest donor, contributed an estimated $67.5 million in fiscal year 2012 – nearly 43 percent of the total 2012 budget.)

The reforms parallel ideas presented by OAS Secretary General Insulza in his “Strategic Vision of the OAS” on December 2011 (updated in March 2013) striving for concentration on four main pillars: democracy and conflict resolution; human rights; development (in association with the Inter-American Development Bank); and security (mainly against drugs and organized crime). He also advocated limiting a single state contribution to 49 percent without reducing the OAS’s total budget. The Secretary General embraced similar reforms when the legislation was first introduced by then-Senator Kerry in the previous Congress.

Agreement that the OAS needs reform is nearly universal, but any strategic transformation will have to take into account important developments among the Latin American international organizations. The OAS handily accommodated the creation of subregional organizations such as SICA and CARICOM in the past.  But new bodies – such as UNASUR, CELAC and ALBA – have posed new challenges to the organization’s relevance and effectiveness. Differences among the organizations have emerged over trade, democracy (different value attributed to the independence of powers and to press freedom, as well as of handling of crises in Venezuela, Honduras, and Paraguay), security (withdrawal of five countries from the Inter-American Treaty of Reciprocal Assistance), the strategy against drugs, and relations with the United States.  The organizations have also created new arenas for leaders to meet, at times taxing governments’ ability to keep up. From 1990 to 2012 there have been 272 Latin American regional and subregional summits, including eight Summits of the Americas.  When Secretary Kerry delivers his plan, it will be difficult for him to strike a balance between bringing the OAS more in line with Washington priorities, as laid out in the legislation, and seeking a bigger tent that addresses some of the concerns that gave rise to the plethora of competing organizations.

*Carlos Portales is the Director of the Program on International Organizations, Law and Diplomacy at WCL, American University. He was Ambassador of Chile to the OAS between 1997 to 2000.”

ALBA’s Future: Continuity or Break Down?

By Marcela Torres

ALBA Emblem | public domain

ALBA Emblem | public domain

The death of Hugo Chávez last March and the increasingly severe economic dislocations inside Venezuela have raised serious questions about the sustainability of the Bolivarian Alliance for the Peoples of the Americas (or ALBA).  Born out of an agreement between the Venezuelan and Cuban governments in 2004, the alliance was intended as a response to the U.S. goal of a Free Trade Area of the Americas (FTAA), as well as a vehicle for Chávez to project his Bolivarian vision for Latin American solidarity around a socialist project.  The regional bloc won its first symbolic battle at the Fourth Summit of the Americas in 2005, where Argentina, Brazil, Uruguay, and Paraguay definitively halted negotiations led by U.S. allies to create a single hemispheric free trade area (excluding Cuba, of course).  Over time, ALBA and its oil-based extension, Petrocaribe, have had a significant impact on economies in the region, providing crucial underpinning for presidents who signed on to Chávez’s vision for ideological or pragmatic reasons.  Among the greatest beneficiaries have been the Castro government in Cuba and the Ortega government in Nicaragua, which have received petroleum in exchange for food, in the case of Nicaragua, and doctors and teachers, in the case of Cuba. Ecuador and Bolivia, along with several states in the greater Caribbean, have also become key players in the ALBA network.

Venezuela’s leadership of ALBA, frequently described as “petro diplomacy,” has repeatedly come under fire from the country’s political opposition and from government critics in other ALBA-friendly nations.  The critiques in Venezuela rarely acknowledge the degree to which petro diplomacy has been a recurring feature of that country’s foreign policy, most notably during the governments of Carlos Andrés Pérez in the 1970s and 1980s.  Critics inside Venezuela and beyond frequently accused Chávez of building dependent clientelistic networks with countries desperate for energy resources. However, ALBA activities have transcended ideological divides, a fact demonstrated by Misión Milagro in Colombia, where Cuban doctors indirectly supported by Venezuela provide medical services in conflict zones.  If Chavez’s oil and charisma initially defined ALBA’s possibilities, the alliance has also fostered economic ties and investments among member countries, independent from Venezuela.

Though the election of Nicolás Maduro as Chávez’s successor might appear to guarantee political continuity, lacking Chávez’s charisma, Maduro might not be able to continue Chávez’s level of oil-fueled investment in ALBA.  Public spending in Venezuela continues to increase dramatically, with the fiscal deficit at 9-12 percent, inflation exceeding 40 percent, and the scarcity of dollars contributing to shortages of basic consumer goods.  To sustain its financial backing for ALBA, Maduro will have to stabilize the economy at home lest he lose the  popular legitimacy — no simple challenge.  Following the Twelfth Presidential Summit of ALBA in July, the presidents of Ecuador, Bolivia and Nicaragua joined Maduro in reaffirming their shared commitment to a socialist project in the region and a desire to maintain the international exchanges initiated by Chávez, suggesting that the alliance will not disappear at least in rhetoric in the medium term.  It is possible, however, that Maduro’s leadership will be challenged.  After the airplane in which Bolivian President Evo Morales was traveling was not allowed to land in France and Portugal this summer,  he proposed creating an ALBA army and convening another anti-imperialist summit.  Recently re-elected Rafael Correa of Ecuador has also hinted he might want to lead ALBA.  Without Venezuelan oil and sweeteners like Petrocaribe, it’s hard to see how ALBA will amount to more than a platform for personalistic agendas.