Afghanistan: A Victory for Women – A Defeat of Democracy?

The Afghan Ministry of Justice has presented a revised version of a new law regulating marital affairs for the country’s Shi’ite minority. Many of its previous medieval provisions have been scrapped. No longer does it prescribe the frequency of sexual activity that Shi’ite women in Afghanistan would have had to observe, thus practically legalizing domestic rape; no longer does it allow men to prevent their wives from leaving the compounds where they live.

This is great news for Afghanistan’s Shi’ite women and for women living under repression, religious or otherwise, more generally. But the process also provides reason for concern.

US-installed Afghan President Karzai had in fact quietly signed the earlier version of the law, apparently hoping that it would win him the support of Shi’ite voters in the forthcoming presidential election in September. With women formally allowed to vote, Karzai did not seem overly concerned that while some Shi’ite men might have found their extended rights to subdue their wives appealing, most Shi’ite women might have retaliated by voting for other candidates.

In fact, at least in theory one could have expected a zero effect of this political move: male votes in favor canceled out by female votes against. This, of course, presumes that Afghan women vote in accordance with their preferences. More realistically, the President’s decision points to the continuing precarity of women in Afghanistan. Most of them illiterate, we must assume that a large percentage follows the political choices of their husbands. The photos depicting Afghan women ridding themselves of their burqas following the US-led invasion may not have been staged; yet they clearly do not represent the dire existence of most women who survived almost three decades of large-scale violence.

Of equal concern is the political dimension of this legislative revision. According to the BBC, Afghan “Justice Minister Sarwar Danesh said the changes had been made following complaints by human-rights groups.” The truth is that is was the international ‘community’ that reacted with outrage to the content of the initial version. US President Obama expressed deep concerns; NATO threatened with serious consequences, and numerous European heads of state intervened personally to prevent the law’s ratification and application.

This political pressure was surely justified on human rights-grounds. At the same time, it has added momentum to the widely held perception among Afghans that democracy is a system of government that opens the door for values and rules alien to what local traditions dictate. One might argue that in times of globalization, global norms and values must inform national laws and codes. Yet the Afghan President’s initial support of the repressive law as well as the angry demonstrations of conservative Shi’ites following the international protest seem to indicate that friction is unavoidable. In this case, Afghanistan’s dependence on international aid clearly overpowered local political deliberation. Put simply, the internationally induced revision of the law is a prime example of external social reengineering against the backdrop of a shallow democracy.

A new law governing family affairs for the Afghanistan’s Sunni majority is also in the making. It will be instructive to observe whose political motives and social values will prevail this time: Afghan or foreign.


What Makes Global Health Political?

Lawrence Gostin, in a recent scholarly op-ed in JAMA, has argued passionately that health inequality is deeply unethical. I fully agree. The question is how the current architecture of global health assistance can be changed so that it becomes more responsive to the unethical reality of global health disparities.

I just finished an essay for publication in which I am arguing that more money for global health is not necessarily going to have much of an impact on the global disease burden. Why? Because it is being spent on causes for which marginal returns have already been reached. Focusing on either the ‘classic’ neglected (tropical) diseases, on maternal and neonatal health or even the ‘new’ neglected diseases such as depression and obesity would be a much better way to invest in healthcare in developing countries.

Why is it not happening? Because donors follow the flock; one donor rarely deviates from what other donor agencies set their priorities on. And a significant mortality reduction over, say, a decade is more difficult to measure and attribute to a specific intervention that, for instance, the purchase of medical equipment or large training programs to halt the spread of HIV.

Can these dilemmas be solved? I think so. But it requires political action, and that is challenging because of the ongoing portrayal of international development as a field which, most of all, requires good intentions, strong partnerships and more money. This is a gigantic fallacy.

Development involves trade-offs. It is usually not the kind of win-win scheme as some prominent authors suggest. Understanding these trade-offs necessitates that political dimension is brought into global health care analysis and planning.

Susan Erikson recently argued [no full text version available] that health professionals need more training in political analysis and activism. To me, this sounds like a promising first step. But it will hardly be sufficient to nurture fundamental change. What is ultimately needed is agency–political activism, in other words–in recipient countries.

The current euphemistic talk about partnerships between donors and recipients, public and private sectors risks masking the fact that little progress has been made during the past decade in creating a more egalitarian playing field for developing nations in their negotiations with rich countries.

Where we have seen positive developments, these have originated in targeted South-South cooperation and grassroot organization, and not in more technical assistance and high-level donor conferences.

This, then, is the tall order to catalyze change: acknowledge that apolitical development is a fiction; engage constructively with the recipients so that they can really become ‘beneficiaries’; most of all, listen to local priorities rather than imposing international agendas.

Are these changes likely to happen anytime soon? No. Are they impossible to achieve? No.