Sandra Regina Martini, Germano Schwartz & Matteo Finco*
ABSTRACT: In BRICS’ context, how is it possible to approach such distant and different realities? In which way these differences can be decreased? The birth of the BRICS group is a bid on difference: how a new form of cooperation between countries could be realized? This research is set to identify how is possible to find “bridges” between these nations, especially about health. It used the Metatheory of Fraternal Law because, through this methodology, it is possible to identify how the model of health of each country may complement others. This, with the awareness that the right to health is a bridge through which make other social rights effective. Thus, precisely for integrating this group, composed by geographically distant and very different countries – that however are capable of a fraternal view (to see the other as another-me) – it is possible to visualize concrete possibilities of social transformation trough a new way of international cooperation. In fact these countries, beside the economic development, seems to be able to make human rights effective.
KEYWORDS: BRICS; Right to health; Metatheory of Fraternal Law; Fraternity
I. Introduction
“La solidarietà avvicina mondi mentre la solitudine vive di separazioni e di distanze.”1
The possibilities of building a BRICS group beyond the economic sphere must retake some overlooked concepts, such as fraternity and solidarity. In fact, as Resta says, solidarity has the capacity of approaching, while solitude separates, divides. Health care can be an important bridge towards the consolidation of several other social rights. Therefore, health conceived as a good of society implicates proximity, not division. If one opts to work with right to health while understanding that such right it is only given once its social determinants are effective, it is possible to conceive health as a bridge to citizenship and to imagine more solidary and fraternal forms of life in a cosmopolitan society. In such a society, the BRICS countries have many limitations (related to the social determinants): but every limitation can become a possibility.
What is intended in the present article is to pursue a way to encounter, in the BRICS, forms for fraternity, solidarity and hospitality: all of them are unlikely and anachronistic values and, precisely because of that, possible through the construction of bridges that allows the achievement of the different social rights respecting the cultural, geographical and political differences. We believe that these differences, present in the BRICS countries, are differences that do not separate but, instead, that brings them together. This is what it was clearly observed in the accounts of the summits of the BRICS. By the end of this article, it will be shown, through the example of the issue of HIV, how internal policies of each country can contribute with others.
II.The Place of Fraternity in the Contemporary Society
“L’umanità è come l’ecologia che non è fatta soltanto di fiumi incontaminati e di aria pulita ma anche del loro contrario: l’umanità, si diceva, si può minacciare soltanto da se stessa. Il suo paradosso sta tutto in questa sua dimensione ecologica; così i diritti inviolabili dell’umanità non possono che essere minacciati se non dall’umanità stessa. Luogo e soggetto di un’ambivalenza irrisolta, l’umanità si presenta come portatrice di una sua minaccia ma anche della sua neutralizzazione; lavora per la guerra come per la pace.2
Humanity can be threatened only by itself. Only by identifying this paradox we realize that the opportunity of a right world is only possible in this world. Furthermore, each determination of the world can only be realized in the society by itself. In the same way, the indetermination of the world means that it can be determined always in different ways: in the history, the world has been defined, measured, divided (nations, lands, etc.). But that history can be changed: we must conceive society as a place of social transformation. The differences are part of the modern society, where events occur simultaneously and are independent from individual and local desires, and yet directly influence our daily lives. Thus, the global threats can be solved only in their space where they rise; out of it, any solution may be inadequate. We do not have any doubt about the ambivalence of life in territories that present as many differences as in the BRICS countries, but those differences can somehow put us closer. Hence, public policies in each country and in the BRICS group should overcome this situation looking for new ways – building new bridges – where the right of health presents itself as central compared to the other social rights. It is not enough reaffirming the impotence of the established mechanisms; it is also necessary to transform this ambivalence into something positive. Bearing in mind that, in the evolutive process, antique paradoxes are unveiled by creating new ones, so resolving ambivalences creating new ones.
Many theories are available to the social analysis: some intend to solve humanity’s issues without realizing that while solving such issues it is also possible to consider “the other side of the form”3, accessing new issues. Other theoretical postures propose a revolution. The theoretical-methodological approach followed here is based on a specific anachronism because it proposes to rescue a fundamental concept of Enlightenment, which until now was not appropriately discussed. Fraternity, as stated by Resta, was the “broken promise” of the French Revolution4. This phenomenon has a strong justification, since discussing fraternity, from a scientific perspective, means seeing the other as “another self”. This is not an easy or comfortable posture because it is not easy to think about the necessary social transformation. However, remember this non-forgetting is the challenge that we propose here. It is a complex task that leads us to several restlessness (which will not be responded in this article, because they are part of a much larger process of reflection), starting with geopolitical context we analyze: the BRICS countries. What kind of group is this? Who are their members? Which ties they have? Who makes the rules? What are the limits of national health care systems? Can the right to health “be a bridge” to the realization of other social rights?
These questions will be answered through other questions, and the key for these question-answer-questions can be fraternity that, as Resta states, is the nodal notch to a critical established citizenship and sovereignty. Thus, fraternity has the function of constantly uncovering/unveil paradoxes. It is a term that historically relates to the idea of brotherhood, the experience of being part of a sharing experience, of identity and community. Resta let us think about the role of science in the last years:
The social sciences of the last 20 years did not do anything but strive to show the existence of non-rational components of rational action, interweaving between motives and action of their cognitive dissonance, bounded frame of reference the ex post justifications continuum of effects and motivations, highlighting the strong disposal between action and its world of possibilities excluded, but not eliminated.5
The meta-theoretical methodology used relates directly to the process of social transformation. Meta, etymologically, means transformation and succession in time6. Also, theory means the action of observing. Based on the understanding that the meta-theoretical research results in the meta-theory itself7, it is necessary to analyze concepts and terms that allows understanding how the observer is located within the observation itself: there is no separation between subject and object. This is an idea deeply discussed by N. Luhmann.8
Indeed, it is worth noting the close ties between legal meta-theory and legal epistemology. See, for example, that the legal epistemology builds itself as a theory that studies the application of legal knowledge (and the knowledge related to it) and that, with the advancing of the construction of a science of law, eventually specializes fields of knowledge. The production of knowledge about a particular theme enables the differentiation of thematic fields and the consequent critical production about what was produced. Therefore, this production process creates a “theory about a theory”, a “theory of legal science” or a “legal meta-theory”. These meta-theories seek to address the problems related to legal scientificity, given that legal science becomes verifiable. The differentiating factor of the meta-theory of legal epistemology is how meta-theory surpasses the epistemological processes of understanding the nature and the justification of scientific knowledge. Furthermore, a meta-theory attempts to reconstruct the scientific activity and to understand what results from it. There is a close connection between what is theoretically produced and what is possible to relate and verify empirically.
Eligio Resta, conceiving his theory as a meta-theory, shows the need of aggregating multiple assumptions for the analysis of social complexity. Nowadays, we see the importance of the return of Weber’s ideas. For example, when one proposes to capture the subjective meaning of social actions through an objective method, although built in a subjective manner, i.e., the Ideal Type. Resta, proposing the meta-theory of Fraternal Law, revives several authors and theories using many conceptions of systemic theory. He also works – among others – with Habermas’ theory, with concepts taken from psychoanalysis and philosophy. From this construction/deconstruction, the main points of this meta-theory it could be presented as follows: fraternity is conceived as the possibility and the necessity of seeing the other as another self; it consists in pacts, established among peers, where there is no place for a sovereign; is the need to overcome the dogma of state sovereignty; it includes nonviolence and a limitless inclusion, even though we often have inclusions that are given through exclusion9. Therefore, the meta-theory of Fraternal Law presents itself as an anachrony and, at the same time, as a bet for social transformation. In this process, the right to health is an issue that transcends boundaries of all kinds because the idea of the other as a brother does not support territorial boundaries or other boundaries. For Resta, the fraternity promoted by the Enlightenment Revolution remains unheard and unresolved in relation to equality and liberty; but now it returns linked to the idea of globalization and to the necessity to overcome boundaries, because the condition of dependency of everything and everyone by others is day by day more evident. Thus, while there is a growing feeling that everything could be different from what it is, little can be effectively done to make the different occur. Also, as Resta stated, our time lives a decisive re-articulation of the idea of spazi politici (political spaces). This is exactly what imposes a reconsideration of concepts such as fraternity, which remained silent for a long time, but is now presented with more force, albeit it has an anachronistic look.
The meta-theory of Fraternal Law presupposes the unveiling of paradoxes, i.e.: how is it possible in a cosmopolitan society still have impassable borders? Are they insurmountable? What is the function of fraternity in this game?10 There is a lot to ponder about this, but it is critical to understand what Fraternal Law means, as well as its possibilities and limitation. The fraternity, long forgotten by many, is enshrined in the Universal Declaration of Human Rights11 and in the International Labor Organization, and also in various modern constitutions. Even so, fraternity is the least discussed and most complex concept to be make effective.
The proposal of meta-theory of Fraternal Law is to understand how this conception of Enlightenment revolution can be implemented and analyzed in the present day, although not by its presence but by its absence. It is exactly the anachronism of fraternity which allows the in-depth analysis of the social complexity. Today several theories dealing with social complexity are available; here we chose the meta-theory of Fraternal Law as a possible one. We do not deny the importance of other theories; to the contrary, we make a “meta-theoretical” proposal, based on the analysis of theories through themselves, where traditional separation between subject and object disappears, taking place the analysis related to the social transformation process.
This theoretical proposal explains itself and becomes even more complex through the founding conceptions of the meta-theory presented by Eligio Resta: taking an oath together or, as Resta says12; a law free of obsession, free of an identity that legitimate; pondering about the traditional concept of citizenship, founded on friendship, nonviolence and on the universal inclusion in a cosmopolitan society.
III.Health as A “Bridge To Citizenship” in BRICS
When dealing with health as a “bridge” for citizenship13we do not ignor the complexity that surrounds the realization of the right to health. Thus the contributions of Ferrajoli in this aspect are relevant. The author emphasizes that the right to health is expensive, but is much more valuable to the State to propitiate him than neglect it, because this neglect creates an exclusion. This is what the author says about the “complexity” of the right to health in relation to its scope:
“Il diritto alla salute si configura peraltro come un diritto tipicamente molecolare. Esso include da un lato un diritto negativo di immunità, garantito dal divieto di lesioni: che l’aria e l’acqua non vengono inquinate, che non si mettano in commercio cibi adulterati, in breve che non si rechino danni alla salute; dall’altro, esso include un diritto positivo, tipicamente sociale, all’erogazione di prestazioni sanitarie”.14
The proposal of the Welfare State was to “incorporate” social issues: to take the opportunity to face claims and question coming from society, proposing interventions, actions, tools, solutions, policies.
The constitutionalization of the right to health, where it occurred, represents an attempt to reduce complexity, because to the extent that a right becomes positive – at least in theory – it complies with the social demand for complexity reduction. At the same time, when a right is make positive, it will increase complexity because it make possible a range of actions that constitute an obligation for the State; so it creates different rights. With the positivization15 of the right to health, as well as any other rights, it is necessary to build a structure capable of accounting for the realization of this right and the possibility of claiming it in court. That is, things become even more complex.16 This analysis does not exclude other possibilities of observation, for example, the importance of social movements and the democratization process in the countries.
Although, at first, the BRICS countries were identified only by economic development and political power in their respective regions. Nowadays, indeed, maintaining the economic identity is no longer sufficient: so topics like protection and realization of human rights become unavoidable and should become a priority in agendas of these countries. So, as Cintra suggests:
“In an increasingly interdependent world, peace, prosperity and human dignity does not only depend on actions. A wide and international cooperation for development between nations is the key to the establishment of a more just and peaceful international order”.17
Then we can ask: BRICS countries are willing to promote an agenda that establishes conditions for economic development that take into account the protection of human rights? If we look at the official meetings of this group, we can say that yes, there are provisions for this and possibly this represents the differential in relation to other groups, such as Mercosur and the European Union. For this reason, in the next section we will analyze the results of the meetings of the BRICS countries.
IV.The Summit of the BRICS: the Paths to the Realization of Social Rights
We will describe the summits, highlighting how these meetings “open” ways to build “bridges” to the realization of rights. The group of countries that form the BRICS, until now, had nine summits. In each of these meetings the representatives of each country signed statements. It should be noted that the first summit took place in Russia on June 16, 2009; the second summit took place in Brazil, in April 15, 2010; the third summit, held in China in April 14, 2011, featured the entry of South Africa into BRICS;18 the fourth took place in India on March 29, 2012; the fifth in South Africa, on March 27, 2013. The sixth summit took place in Brazil on July 15, 2014. The seventh was in Russia, on July 9, 2015); the eighth took place again in India, on 16 October, 2016; the ninth was held in China on September 4, 2017.
At the first summit was clearly expressed the will of the BRICS countries to seek reform of international financial institutions, to reflect the changes in the world economy. This was the main concern in 2009. In regard to human rights, the BRICS condemns terrorism and reaffirms its commitment to increase cooperation between countries in areas of social concern and to strengthen efforts to provide international humanitarian assistance and reduce the risk of natural disasters.19
At the second summit, it was underlines the necessity of matching the global governance in all relevant areas of transformations, but without identifying the areas where intervene nor solutions. Also it was reaffirmed the need for a comprehensive reform of the UN, with a view to make it more effective, efficient and representative, so that it could deal more effectively with contemporary global challenges. With this, the BRICS countries underlined their support for a multipolar, equitable and democratic world order based on international law, equality, mutual respect, cooperation, coordinated action and collective decision-making of all States.20
In addition, they claim that the global economic situation improved and attached to emerging economies an important role in the resumption of economic growth. This shows that BRICS countries believed to be able to play an even larger and more active role, working together to reduce imbalances in global economic development and promote social inclusion. To do so, they called upon reforming the financial architecture and argued that the IMF and the World Bank urgently need to address their legitimacy deficits.21
Importantly, in 2010, the BRICS statement devotes a part of the development in social context, highlighting the Millennium Declaration of the United Nations and the need to achieve the Millennium Development Goals (MDGs).22In that occasion States started to show more clearly the topics of development, social rights, reducing inequality, solidarity and some concrete measures such as technical cooperation and financial support, as a way of contributing to the achievement of sustainable social development, with social protection, full employment and decent work policies and programs, and a special attention to vulnerable groups such as poors, women, youth, migrants and people with disabilities.23
Therefore, it is from the second summit that it is possible to talk about an agenda of cooperation that also seeks to make social rights effective. In this sense, it was also the first time that sectoral initiatives were taken to strength cooperation. For example the I Exchange Program for Magistrates and Judges of the BRICS countries, held in March 2010 in Brazil, after signing, in 2009, the Protocol of Intentions between the Supreme Courts of the BRIC countries. The protocol – signed by Brazilian Supreme Federal Court, the Russian Federation Supreme Court, the Supreme Court of India and the Supreme People’s Court of China – aims to establish mutual cooperation through the exchange of information and the disclosure of activities in within their respective powers.24
This agreement represents an important step towards cooperation on the protection of human rights, since it provided for holding conferences, seminars and other technical and academic meetings on judicial practice, human rights, the promotion of access to justice, the use of alternative dispute resolution methods, settlement and protection of minors, in addition to the rapprochement between their magistrates.25
In the third summit, the discourse aimed to strengthen cooperation ties for the BRIC as a group that plays an important role on the world stage. They declared that: “It is the strong shared desire for peace, security, development and cooperation that united the BRIC countries, with a population of about 3 billion people from different continents. The BRICS aims at contributing to the development of humanity and establishing a more just and equitable world”26. However, the commitment was not restricted to this group: at the same time, States claimed that cooperation is inclusive, opening to engagement and cooperation with third-countries.
Under international law, they expressed concern about terrorist threats and the turmoil in the Middle East, North and West Africa. Thereby reinforcing the principle that the use of force should be avoided as well, “that the independence, sovereignty, unity and territorial integrity of each nation should be respected”.27However, at no time the statement makes explicit mention of human rights. It only mentions that:
“We believe that growth and development are essential to fighting poverty and achieving the Millennium Development Goals. Eradicate extreme poverty and hunger is a moral imperative, social, political and economic development of humanity and one of the biggest global challenges the world faces today, especially the least developed countries in Africa and other continents”.28
This demonstrates that the BRICS believe in the premise that only a growing and developed country is capable of addressing issues related to human rights. By the third summit, for the first time, was presented an action plan, which lays the foundation for cooperation within the BRICS.
For the objective proposed in this paper, we present two actions: first, one linked to the field of human rights stands, included in the action plan proposed by the BRICS declaration in 2011, which is the objective of “Implementing the Protocol intent between the Supreme Courts of the BRICS”,29 signed in 2009, during the second summit.
Well, the first conference arising from this Protocol took place in March 2011 and lasted twelve days. Nevertheless, specifically regarding human rights, the schedule of activities devoted only a day in the theme, with the aim of identifying the areas in which they could develop actions of human rights, as well as programs and mechanisms for information sharing and cooperation between the Supreme Courts of the BRICS.
However, beyond the discussions at the BRICS Summits, in these countries the civil society show – especially through social movements – clear claims about human and social rights.
The second action concerns the right to health issue. Specifically, the year 2011 was a highlight, because was the first time that the term “public health” appeared in the statements, in the following manner: “We underline our firm commitment to strengthen dialogue and cooperation in the fields of social protection, decent work, gender equality, youth and public health, including the fight against HIV / AIDS”. In addition, in 2011, the following events were held: Meeting of BRICS Ministers of Health (Beijing, July 11); Meeting of BRICS Ministers of Health, on the sidelines of the 64th World Health Assembly (Geneva, May 17); Meeting of BRICS Ministers of Health on prevention and control of non-communicable diseases, alongside the “UN High Level Meeting on Non-communicable Diseases” (New York, September 20); Meeting of the BRICS WG on Access to Medicines on the banks of the 29th Meeting of the Committee-manager UNAIDS (Geneva, December 13).30
With respect to the Fourth Summit, held in New Delhi (India), on March 29, 2012, we can say that the discourse remained basically the same of 2011. Thus, it was used to demonstrate the importance of group: in fact that these countries represent 43% of the world population. With this, they reiterated the claim on the broadening of representation of these countries in global governance institutions, especially in the Security Council of the UN and the IMF. In addition, reinforcing this new global scenario especially in the peripheral countries, the block said that while the BRICS have recovered the international crisis relatively quickly, the prospects for growth around the world have been affected by market instability, especially in the euro zone.31
It was the fourth summit which first considered the possibility of establishing a new Development Bank aimed to mobilize resources for infrastructure projects and sustainable development in the BRICS countries and other emerging economies and developing countries. Regarding the issue of human rights in International Law, countries expressed concern about the current situation in Syria and called for the immediate end to all violence and human rights violations in that country, for the support to Afghanistan, the recognition of Iran’s right to peaceful use of nuclear energy and the commitment to the alleviation of the humanitarian crisis that still affected millions of people in the Horn of Africa.32In terms of concrete initiatives, the fourth summit highlights the concern for the Right to Health.
“Most countries of the BRICS confront many similar challenges in the field of public health, including universal access to health services, access to health technologies, including medicines, the costs are increasing, and the rise of the costs with transmitted and non-transmitted diseases. We recommend that the meetings of Ministers of Health of BRICS, which first took place in Beijing in July 2011, are from now on, institutionalized in order to face these common challenges more efficiently in terms of cost, more equitable and sustainable way”.33
Also that year there were the following events: the Informal meeting of BRICS during the 130th Session of the Executive Board of the World Health Organization (Geneva, January 19); the Meeting of BRICS Ministers of Health, at the margins of the 65th World Health Assembly (Geneva, May 22).34
The fifth summit, held in 2013, completes the first cycle of Summits BRICS, reiterating many issues addressed in previous summits on more equitable development and a more inclusive global growth. Thereby, this statement brought numerous issues concerning the world economy, as well as a critique of political actions adopted in Europe, USA and Japan, for they produce negative side effects on other economies. On the other hand, stated that the BRICS were satisfied with the finding that the establishment of a new Development Bank was feasible and viable.35 The instruction for a feasibility study were held were given to the finance ministers of BRICS, as already mentioned, during the Fourth Summit, held in 2012, in the Plan of Action of New Delhi, which referred to the need for “meeting of Experts on the New Development Bank”.
The agreement was finally signed in 2014, with this new Development Bank for the purpose of mobilizing resources for infrastructure projects and sustainable development, either in the BRICS and other emerging economies:
“11. BRICS, as well as other EMDCs, continue to face significant financing constraints to address infrastructure gaps and sustainable development needs. With this in mind, we are pleased to announce the signing of the Agreement establishing the New Development Bank (NDB), with the purpose of mobilizing resources for infrastructure and sustainable development projects in BRICS and other emerging and developing economies (….)”.36
Still, on the issues of human rights, the report of the fifth summit contains the concern over the deteriorating security and humanitarian situation in Syria and the condemnation of increased violations of human rights and international humanitarian law, as a result of continued violence. In addition, countries call upon the international community to help Israel and Palestine to work toward a two-state solution and present again issues as the commitment to Afghanistan and the nuclear issue in Iran, the concern over the deteriorating humanitarian issues in Mali, with the ongoing instability in the Democratic Republic of Congo. Finally they reaffirm the commitment to work together to achieve the millennium goals. Still, the year 2013 was held the meeting of “senior health officials”, prior to the ministerial meeting (New Delhi, January 10) and the Second Meeting of Ministers of Health (New Delhi, January 11).37
With regard to the sixth summit just held in Brazil, we can say that was marked by a new way of agreement between countries institution, especially when dealing with the creation of the Development Bank of the BRICS.38The unfolding of this proposal falls mainly on countries whose latent social inequalities reverberate in political and diplomatic level. One could cite the work on the development of social policies aimed at combating drugs, reduction of gender inequalities, smooth of economic and social inequalities from the enforcement of human rights, whose implementation has been further complicated from the recognition of new/old rights and the consequent institutional swelling inherent to population growth and the extension of life expectancy. Such questions are very related to matters of public health policies, certainly one of the main points of progress made since the first summit.
This new perspective is critical, especially in health. We give an example to facilitate the understanding. It is estimated that 46% of incidents related to people affected by tuberculosis happened in countries belonging to the bloc and about 40% of the mortality from this disease occurs in these countries.39Unlike other countries, Brazilian policy of treating this disease allows greater control of the substances used in the treatment, as accentuates the Bulletin of the World Health Organization, since the drugs are free and treatment policy decreases the risk of incomplete treatment. However, we can observe that countries like China and India, who long ignored the recommendations of international organizations, achieved a series of breakthroughs. As an example, we refer to the fact that China has deployed more than 3,000 centers for the monitoring of incidents related to tuberculosis, according to the Bulletin, and India implemented a system of electronic notification of disease that allows a greater capacity for government action and geographic visualization of the demands. Although each country has different points to be clashes, it is the whole confrontation that stands out. The Development Bank, that will allow other emerging countries, also receive resources, transmutes into a new possibility to foster the reduction of poverty and expand the capacity of investment in public policy, given that the “development” is not restricted to economic and structural, but advances linked to the full implementation of the rights related to social determinants. This means moving towards the realization of the rights. Furthermore, from the statements of the domes we can observe, even if narrowly, that the BRICS countries are willing to commit to an agenda for human rights protection. However, the vast majority of issues related to human rights concerns violations witnessed in countries outside the BRICS, and very little is said about the guarantee of these rights at the national level in each country.40
In 2015 were strongly emphasized “the importance to strengthen BRICS solidarity and cooperation, and decided to further enhance our strategic partnership on the basis of principles of openness, solidarity, equality and mutual understanding, inclusiveness and mutually beneficial cooperation”.41That year countries “reaffirm the right of every person, without any distinction, to the highest attainable standard of physical and mental health and to the quality of life that is necessary to maintain his or her own health and well-being and the health and well-being of his or her family”. Mostly important, they express concern for “growing and diversifying global threats posed by communicable and non-communicable diseases” and the consequent negative impact on economic and social development. For this reason, they called for the “implementation of universal and equitable access to health services”, also seeking “enhanced partnerships by the international community and other stakeholders from both the public and private sectors, including the civil society and academia to improve health for all”.42
In 2016 human rights were addressed related to security and terrorism and also to ICT. About the Information and Communications Technologies, countries called for the respect of “fundamental freedoms, including the right to privacy” as “of paramount importance in order to ensure a peaceful, secure and open and cooperative use of ICTs”. Reference were also made to “gender equality and empowerment of all women and girls”. About global health challenges, they emphasised the importance of cooperation among them “in promoting research and development of medicines and diagnostic tools to end epidemics and to facilitate access to safe, effective, quality and affordable essential medicines”.43
Finally, in 2017, economic cooperation, development and innovation, security, fighting terrorism, ITC remained at the center of interest.44Anyway, the final document contains a paragraph about the “People-to-People Exchanges”, in order to promote in many areas – including health – development and “enhancing mutual understanding, friendship and cooperation among BRICS peoples”. The States also claimed to “enhance BRICS role in global health governance, especially in the context of the World Health Organization and UN agencies, and foster the development and improve the availability of innovative medical products”. Very interesting is the reference to the promotion of mutual learning between traditional medicines of the countries, in order to “pass them down to future generations”.45
V.Right to Health in the BRICS
It is hard to speak of a “natural affinity” between the countries that composes the BRICS, but all of them have undeniable achievements in several fields – being, for instance, social or economic – that could be object of cooperation.46 It must be understood that each country, in its singularity, has very different and complex cultural, economic, political and religious issues. However, we identify in the right to health some issues that might shorten the distances between local realities and fortify the process to make human rights effective through caring and attending to health that, despite presenting peculiar local questions, may overcome many differences. To speak of health implies to speak of life, and the presuppositions of life have common aspects to every country in their individual forms.
Certainly, through health – the right to health – it is possible to advance the consolidation of what has been searched since the first summit: dialog and cooperation. In this sense, there has been at least ten reunions made by the BRICS since 2006 – among multiple international events – to have a discussion between Heads of States or Ministers of Health of each country, regarding precisely themes related to health.
BRICS acknowledged, in several manifestations as a group, that cooperation might contribute to a better development and social protection for their own subject population. Right to health, in its turn, amongst social rights, gains space in the cooperation agenda of BRICS fundamentally since 2010 and therefore presents itself as a possibility for searching a new model of cooperation that contributes to make human rights effective.
This has been materializes in a few actions towards effecting this right through cooperation, as it was stated in the records of the BRICS’s Ministers of Health Reunions. An example of that is the account of the meetings occurred in Beijing, in 2011, that points towards the necessity of fortifying the political systems of health as a way to secure the social and economic development.
Furthermore, the subject has gained attention in the agenda of cooperation of the BRICS especially since the declaration of the 5th Summit of BRICS in Durban, occurred in March 2013 in South Africa. In this occasion the countries highlighted their concerns with non-transmissible diseases and their global threat and acknowledged the necessity of more research regarding the socioeconomic determinants that cause such diseases in the states members of the BRICS. Plus, the ministers also renewed the efforts of facing the continuous challenge brought by the HIV virus. It must be noted – being relevant to this work – the fact that the BRICS renewed their compromise with enforcing the international cooperation in the sector of health.
Another important aspect to be noted is the position assumed by the ministers in the defense of having a reform in WHO, with the purpose of stablishing a new global health governance, stablishing new priorities and programs, as well as effectuating new managing reforms. In its turn, regarding the effective results, there is a compromise of countries with the promotion with the access to quality, effective, safe and fair priced medication and vaccines along with the compromise signed to permit the transfer of technology and capacitation of people who work in the field of health.47
We can see, for example, the case of progressive expansion of HIV treatment, especially the encouragement of new antiretroviral therapies, a proposed debated in the Encounter of BRICS’s ministers of Health (Beijing, 2011), representing a tendency of investments in the fields of prevention and treatment. It is estimated that the countries that belong to the block have invested 120% more, in comparison to the previous year, in policies related to HIV, contributing for that, only in 2011, 1,4 million people, or about 20% more.48 had access to the apparatus responsible for treatment and prevention. In this case, preceding the expansion of access is the expansion of financial availability and of capacity of investing. Although Brazil foments its own action in the treatment of the virus, its signature in pacts of the United Nations enrolled it to raise HIV related investments which, if properly added the other countries contributions, should totalize about 25 billion dollars until 2015: it reveals that HIV/AIDS is more than a acknowledged problems in the current world, becoming a problem to be contained.
However, the perspectives deriving from the compromise with extension of investment does not mean an excessive weakening of public finances, if they are accompanied by a directive attaining to the simplification of the access to treatment. The formation of new agreements foreseeing the industrial production of medications related to the struggle against HIV, adopted in 2011, represents an important example of that. The Brazilian state, while making possible the production of certain medicaments in Brazil, ends saving a substantial amount of resources that, later, can be invested in other social policies. In this specific example, Brazil saved about 650 millions of reals in buying medications related to the HIV treatment. More than that, it made possible for the movement of capital to reach about 400 million reals.49In the perspective of the pacts related to the BRICS this is important because, having in sight that it goes beyond providing a greater possibility of the population accessing its rights, such attitudes mean fortifying the internal economy of the very country, which is one of the main goals linked to the block.
On the other hand, it is noticeable that the agenda still lacks actions focusing the integral development of health care systems, more specifically, retrieving the focus from diseases and adopting the extended concept of health that, by its turn, demands social and economical developments.50 This is considered one of the main challenges of the group, in the sense that is required to public health programs focuses on the community and not only individuals, because it is a right acknowledge for all. As Scaffardi wrote:
“The force with which events are occurring within the BRICS is probably the result of the approach adopted. It has not set up a radical group whose goal is to revolutionise or overturn global governance; instead a legal network has been created. Having identified a need for reform, it tackles the status quo in a gradual way and on several fronts. The process has been sketched out from a virtuous angle, although the distances to be covered to achieve progressive implementation targets remain considerable.”51
Furthermore, overcoming this challenge require long term actions, especially given the facing of social determinants and the necessity of cross-sectoral actions. In short, it is through public policies that become possible the social conditions for effecting the right to health. Such right, in its turn, runs through social determinants which facing can be boosted by a fraternity-based cooperation. In this sense, we defend the necessity of fomenting the acquaintanceship considering and promoting several dimensions involving society, in which the economy cannot occupy the core of this cooperation. It is believed that the fact of health integrating the cooperation agenda of BRICS can be the link between countries through fraternity, taking human rights seriously.52
VI.Conclusion
“La singolare forza di quanto si sta svolgendo nel BRICS deriva probabilmente dal modus operandi che si è scelto di percorrere.”53
In this article, we have worked with the possibility of the assumption of fraternity being a link between countries in the context of BRICS. We observe that the bond more frequent, when it comes to a group of countries, is the economic one; but, just as the BRICS present meaningful differences with other forms of organization, we believe that they can overcome the impositions laid by the economic system. Obviously we acknowledge the difficulties for implementing such assumption, because fraternity puts in question the form of operation of the various social systems. We also know, as says Eligio Resta, that humanity can only be threatened by humanity itself; or, if until today we have worked “for War”, we can also work “for peace”. Lucia Scaffardi is right when she states that these singular “forces” acting in the development of the BRICS are forces not for war, but for peace. A more fraternal living, which certainly can be observed in the acts and actions we are promoting, and that we will promote in the future, regards the goal to make the right to health effective. As we have seen, from BRICS’s summits declarations, it could be identified an essentially political discourse. The countries see themselves as a group intending to contribute to the development of humanity and for the establishment of a fairer, more egalitarian world. So, it is possible to say that the BRICS countries conceive the establishment of a more egalitarian world in the sense that they desire a greater participation and a stronger voice in the international community. In this sense, it is clearly observed that the discourse is directed to the United Nations and, mainly, to the reform of the UN’s Security Council and the global financial architecture, when stating that these countries have contributed in a relevant way for world peace, security and stability through reinforcing multilateralism and promoting a greater democratization of international relations.
In this way, the promotion of the right to health is directly linked to the promotion of the other human rights. Therefore health is complemented by these rights and vice-versa: it is a cross-sectoral and transdisciplinary right. So, from the right to health, it could be possible to create a “bridge” to make human rights effective.
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* Sandra Regina Martini is the Coordinator of the Master’s in Human Rights at Ritter dos Reis University Centre (Uniritter, Porto Alegre). She teaches there and at the Federal University of Rio Grande do Sul. As Pesquisadora Produtividade CNPq, she graduated in Social Sciences (University of Vale do Rio dos Sinos, 1983), earned a Master’s Degree in Education (Pontifical Catholic University of Rio Grande do Sul, 1997), a PhD in Evoluzione dei Sistemi Giuridici e Nuovi Diritti (Università degli Studi di Lecce, 2001) and completed two postdocs (Roma Tre University, 2006; Salerno University, 2010). She is Evaluator at Ministry of Education and Culture, National Institute for Educational Studies and Research "Anísio Teixeira", CNPq, CAPES. Previously she taught at University of Vale do Rio dos Sinos, International Doctoral School Tullio Ascarelli (Roma) and Salerno University. She was Director of the Public Health School of Rio Grande do Sul (2007-2011) and member of the High Council of the Foundation for Research Support of the State of Rio Grande do Sul (FAPERGS).
Germano Scharz is Rector of Ritter dos Reis University Centre (Uniritter). He is also Secretary of Research Committe of Sociology of Law (RCSL), Second Vice-President of Associação Brasileira dos Pesquisadores em Sociologia do Direito (ABRASD), Vice-Scientific Director of World Complexity Science Academy, Member of: International Institute of the Sociology of Law - Oñati (Spain), Executive Committee of World Consortium of Law and Society, Collaborative Research Network on Law and Health of Law and Society Association, Ibero American Network of Health Law. He is also Evaluator of Ministry of Education and Culture, National Institute for Educational Studies and Research "Anísio Teixeira”.
Matteo Finco is Post-doc researcher at Ritter dos Reis University Centre (Uniritter, Porto Alegre). He studied Sociology and Journalism at University of Urbino and had his PhD in 2017 at University of Macerata. A first version of the present article was published with the title Right to Health in the BRICS’ context: distances and proximities. Available at: http://www.comparazionedirittocivile.it/prova/files/martini_health.pdf. Accessed 04/03/2018.
1 Resta Eligio. “Solidarity place worlds near while solitude is made of separations and distances”, Il diritto fraterno. (Roma-Bari: Laterza, 2002), p. 9.
2 “Humanity is like ecology, that is not only made of pure rivers and clean air but also of their opposite: humanity, we said, can only be threatened by itself. Its paradox lay on its ecological dimension; thus the inviolable rights of humanity can only be threatened by humanity itself. Place and subject of an unresolved ambivalence, the humanity presents itself as a bearer of its threat but even also of its neutralization; he works for war as for peace”: Id., p. 29.
3 About the concept of “form” see, among others, Luhmann, Niklas; De Giorgi Raffaele. Teoria della Società. (Milano: Franco Angeli, 1996).
4 See Resta Eligio. Il diritto fraterno. (Roma-Bari: Laterza, 2002).
5 Resta Eligio. Routes of Identity jusphilosophical one approach. Trans. Douglas Cesar Lucas, (Ijuí: Ed. Unijuí, 2014), p. 108.
6 On this, see the English vocabulary Merriam-Webster: <https://www.merriam-webster.com/dictionary/meta-> Accessed 04/03/2017.
7 Timely see the definition presented on: André-Jean Arnaud et al. Encyclopedic Dictionary of theory and sociology of law. Trans. Patrice Charles, F. X. Willaume. (Rio De Janeiro: Renovar, 1999), pp. 493-495. It is important to note that the concept of metatheory is presented through: Philosophy of Science; Philosophy of Law, Cultural Roots of speech; Metatheory and legal theories and scientific theories.
8 About this, see LUHMANN, Niklas; DE GIORGI, Raffaele. Teoria della Società. (Milano: Franco Angeli, 1996), especially in the first chapter, where the authors show the difficulty of realizing the theoretical project itself, since the object of the research is the social system of modern society, in which the relation to the object is circular: “[...] However you want to define the object, the definition itself is already one of the operation of the object. That completes the description of what is described: the description, when is made, must describe itself” (“comunque si voglia definire l’oggetto, la definizione stessa è già una delle operazioni dell’oggetto. La descrizione compie ciò che viene descritto: la descrizione, nel momento in cui si effettua, deve descrivere anche se stessa.”), p. 9. In other words, system theory states that it has no more sense to talk about this separation, but of a distinction: “The refusal of the concept of object allows us not only to emphasize the distances with the respect to the implications of the use of diagrams related to that concept, but also to avoid, by denying them from the outset, any conceptual space, those substantial assumptions on which is supported the sociological analysis, even when it was made at highly formals levels.” (“Il rifiuto del concetto di oggetto ci permette non solo di rimarcare la distanza rispetto alle implicazioni connesse all’uso di schemi correlate a quell concetto, ma anche di evitare, negando ad essi fin dall’inizio qualsiasi spazio concettuale, quei pressuposti di tipo sostanzialistico sui quali si è sorretta l’analisi sociologica, anche quando si sia svolta a livelli altamente formali.”), Id., p. 16.
9 About a non-trivial conception of inclusion and exclusion (that is, the form inclusion/exclusion), see, among others, Luhmann Niklas; De Girgi, Raffaele. Teoria della Società. (Milano: Franco Angeli, 1996) and Dutra Roberto; Bachur João Paulo (Orgs.). Dossiê Niklas Luhmann. (Belo Horizonte: UFMG, 2013).
10 Here it is worth to recall Luhmann and his conception of “functions”. On this see, among others, Luhmann Niklas. Organizzazione e decisione. Trans. Giancarlo Corsi. (Milano: Bruno Mondadori, 2005) (Organisation und Entscheidung.(Opladen/Wiesbaden: Westdeutscher Verlag GmbH, 2000).
11 ARTICLE 1.º: All human beings are born free and equal in dignity and rights. Endowed with reason and conscience and should act towards another in a spirit of fraternity.
12 See Resta Eligio. Il diritto fraterno. (Roma-Bari: Laterza, 2002).
13 In Brazil, especially at the University of São Paulo by the Prof. Sueli Dallari, the right to health is analyzed such as a “bridge” for citizenship in BRICS’ countries. This right can be useful to make others fundamental rights effective (see…). In the context of BRICS this kind of approach is important in relation of the differences and peculiarities about economic, politic and social plans of each country.
14 Ferrajoli Luigi. Principia iuris. Teoria del diritto e della democrazia. Teoria della democrazia. v. 2, (Editori Laterza: Roma- Bari, 2007). p. 409. “The right to health takes shape as a typical molecular right. This includes, on one side, a negative right of immunity, provided by the prohibition of injuries: that the air and water are not polluted, that adulterated food won’t be put on the market, in short that damages to health will be not caused; on the other side, this includes a positive typically social right, to the health care provision”.
15 About the process of the “positivization of Law”, see Luhmann Niklas. Law as a Social System. Trans. Klaus A. Ziegert. (Oxford: Oxford University Press, 2004).
16 For an analysis of the relationship between Health, Law and modern society, see: Schwartz Germano. Tempo e direito na construção da saúde. In: Revista de Direito Sanitário, vol. 15, n. 3, (Usp, São Paulo, nov. 2014/ feb. 2015), pp. 68-84; O tratamento do risco no direito à saúde. (Porto Alegre: Livraria do Advogado Editora, 2004); A autopoiese do sistema sanitário. In: Revista de Direito Sanitário, vol. 4, n. 1, (Usp, São Paulo, 2003), pp. 50-59; A saúde na pós-modernidade. In: Revista de Direito Sanitário, vol. 3, n. 1, (Usp, São Paulo, 2002), pp. 29-37.
17 CINTRA, Marco Antônio Macedo (Org.). Cooperação brasileira para o desenvolvimento internacional: 2005-2009. Brasília, DF: Instituto de Pesquisa Econômica Aplicada: Agência Brasileira de Cooperação, 2010, p. 7.
18 In 2011, South Africa joined the group after the agreement between Brazil, Russia, India and China. This ensured greater geographic representation of the group and reinforced the need for financial change and democratization of global governance.
19 BRASIL et al. I BRIC Summit Joint Statement. Yekaterinburg, 2009. Available at: <http://www.itamaraty.gov.br/temas-mais-informacoes/saiba-mais-bric/documentos-emitidos-pelos-chefes-de-estado-e-de-governo-pelos-chanceleres/i-bric-summit-joint-statement/>. Accessed 21/07/2013.
20 BRASIL et al. II Cúpula de Chefes de Estado e de Governo do BRIC - Comunicado Conjunto. Nota n. 212. Brasília, DF, 15 abr. 2010. Available at: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/2010/04/15/ii-cupula-de-chefes-de-estado-e-de-governo-do-bric/>. Accessed 01/08/2014.
21 Id., ibid.
22 In September 2000, 189 nations signed a commitment to fight extreme poverty and other societal ills. This promise ended up materializing in the Eight Millennium Development Goals (MDGs) to be achieved by 2015. In September 2010, the world renewed commitment to accelerate progress towards the achievement of these goals. They are some of the eight UN goals presented in the Millennium Declaration: reducing extreme poverty and hunger, promoting gender equality, eradicate diseases that kill millions of people and foster new foundation for the sustainable development. See Programa das Nações Unidas para o Desenvolvimento (PNDUD). Os objetivos de desenvolvimento do milênio. Brasília, DF, 2012. Available at: <http://www.pnud.org.br/ODM.aspx>. Accessed 21/07/2013.
23 BRASIL et al. II Cúpula de Chefes de Estado e de Governo do BRIC - Comunicado Conjunto. Nota n. 212. Brasília, DF, 15 abr. 2010. Available at: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/2010/04/15/ii-cupula-de-chefes-de-estado-e-de-governo-do-bric/>. Accessed 01/08/2014.
24 BRASIL. Supremo Tribunal Federal. Cortes supremas dos BRICS. Brasília, DF, [2012]. Available at: <http://www2.stf.jus.br/portalStfInternacional/cms/verConteudo.php?sigla=portalStfCooperacao_pt_br&idConteudo=159618>. Accessed 01/08/2014.
25 Id., ibid.
26 BRASIL et al. Terceira cúpula dos BRICS – declaração de sanya. Nota n. 155. Sanya, China, 14 abr. 2011. Available at: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/declaracao-de-sanya-2013-reuniao-de-lideres-do-brics-sanya-china-14-de-abril-de-2011>. Accessed 01/08/2014.
27 BRASIL et al. Terceira cúpula dos BRICS – declaração de sanya. Nota n. 155. Sanya, China, 14 abr. 2011. Available at: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/declaracao-de-sanya-2013-reuniao-de-lideres-do-brics-sanya-china-14-de-abril-de-2011>. Accessed 01/08/2014.
28 SANYA DECLARATION. BRICS Leaders Meeting, Sanya, Hainan, China, 14 April 2011). Available at: <https://www.brics2017.org/English/AboutBRICS/DOPS/201701/t20170114_1116.html>. Accessed 04/03/2018.
29 BRASIL et al. Terceira cúpula dos BRICS – declaração de sanya. Nota n. 155. Sanya, China, 14 abr. 2011. Available at: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/declaracao-de-sanya-2013-reuniao-de-lideres-do-brics-sanya-china-14-de-abril-de-2011>. Accessed 01/08/2012.
30 BRASIL et al. Terceira cúpula dos BRICS – declaração de sanya. Nota n. 155. Sanya, China, 14 abr. 2011. Available at: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/declaracao-de-sanya-2013-reuniao-de-lideres-do-brics-sanya-china-14-de-abril-de-2011>. Accessed 01/08/2014.
31 BRASIL et al. Terceira cúpula dos BRICS – declaração de sanya. Nota n. 155. Sanya, China, 14 abr. 2011. Available at: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/declaracao-de-sanya-2013-reuniao-de-lideres-do-brics-sanya-china-14-de-abril-de-2011>. Accessed 01/08/2014.
32 BRASIL et al. Quarta cúpula dos BRICS. Nova Delhi, 29 de março de 2012. Parceria dos BRICS para a Estabilidade, Segurança e Prosperidade - Declaração de Nova Delhi. Nota n. 77. Nova Delhi, 29 mar. 2012. Available at: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/quarta-cupula-dos-brics-nova-delhi-29-de-marco-de-2012-parceria-dos-brics-para-a-estabilidade-seguranca-e-prosperidade-declaracao-de-nova-delhi/?searchterm=IV%20C%C3%BApula%20do%20BRICS>. Accessed 01/08/2014.
33 Id., ibid.
34 Id., ibid.
35 BRASIL et al. V BRICS Summit - Brics and Africa: Partnership for Development, Integration and Industrialisation. Durban, 2013. Disponível em: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/v-cupula-do-brics-durban-27-de-marco-de-2013-declaracao-de-ethekwini>. Accessed 01/08/2014.
36 BRASIL et al. Nota nº 153. VI Cúpula BRICS – Declaração de Fortaleza. Available at: http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/vi-cupula-brics-declaracao-de-fortaleza. Accessed 01/09/2014.
37 BRASIL et al. V BRICS Summit - Brics and Africa: Partnership for Development, Integration and Industrialisation. Durban, 2013. Available at: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/v-cupula-do-brics-durban-27-de-marco-de-2013-declaracao-de-ethekwini>. Accessed 01/08/2014.
38 BRASIL et al. VI Cúpula dos BRICS - Declaração de Fortaleza. Available at: <http://www.itamaraty.gov.br/sala-de-imprensa/notas-a-imprensa/vi-cupula-brics-declaracao-de-fortaleza>. Accessed 02/09/2014.
39 World Health Organization. Tuberculosis in BRICS: challenges and opportunities for leadership within the post-2015 agenda. Available at: <http://www.who.int/bulletin/volumes/92/6/13-133116/en/>. Accessed 09/09/2014.
40 In 2014, however, the topic was “Inclusive Growth: Sustainable Solutions”. The goal was to “to address challenges to humankind posed by the need to simultaneously achieve growth, inclusiveness, protection and preservation”. Social inclusion and equality were objectives affirmed together with economic stability, sustainable development and mutually beneficial cooperation with all countries. The challenges of poverty and inequality were strongly addressed, as well as sustainable peace. About health, was expressed concern for “the world drug problem, which continues to threaten public health, safety and well-being and to undermine social, economic and political stability and sustainable development” and were reaffirmed the “determination to ensure sexual and reproductive health and reproductive rights for all”. See BRICS. VI BRICS Summit. Fortaleza Declaration. Available at: <https://www.brics2017.org/English/AboutBRICS/DOPS/201701/t20170114_1121.html>. Accessed 04/03/2018.
41 BRICS. VII BRICS Summit Ufa Declaration. Available at: <https://www.brics2017.org/English/Documents/Summit/201701/t20170125_1409.html>. Accessed 04/03/2018.
42 They also declared: “we will work together in such areas as: -Management of risks related to emerging infections with pandemic potential; -Compliance with commitments to stop the spread of, and eradicate, communicable diseases that hamper development (HIV/AIDS, tuberculosis, malaria, “neglected” tropical diseases, poliomyelitis, measles); -Research, development, production and supply of medicines aimed at providing increased access to prevention and treatment of communicable diseases”. Concern were also expressed for the Ebola virus disease (EVD) in Guinea, Liberia and Sierra Leone: Id., ibid.
43 BRICS. VIII BRICS Summit. Goa Declaration. Available at: <https://www.brics2017.org/English/AboutBRICS/DOPS/201701/t20170114_1127.html>. Accessed 04/03/2018.
44 BRICS. BRICS Leaders Xiamen Declaration: Available at: <https://www.brics2017.org/English/Headlines/201709/t20170908_2020.html>. Accessed 04/03/2018.
45 Id., ibid.
46 See the archives of Fundação Alexandre Gusmão, Mesa-redonda: o Brasil, os BRICS e a agenda internacional. Apresentação do Embaixador José Vicente de Sá Pimentel. (Brasília: FUNAG, 2012). Available at: <http://www.funag.gov.br/biblioteca/dmdocuments/OBrasileosBrics.pdf>. Accessed 23/09/2014.
47 BRASIL et al. BRICS Health Ministers’ Meeting: Beijing Declaration. Beijing, 2011. Available at: http://www.brics.utoronto.ca/docs/110711-health.html. Accessed 17/08/2013.
48 ONU. Programa das Nações Unidas para o Desenvolvimento (PNUD). Available at: http://www.pnud.org.br/Noticia.aspx?id=3631.
49 Check more information in: Lígia Formenti. O Estado de São Paulo. Generic of Tenofocir will have a Brazilian version. Available at: <http:// www.estadao.com.br/noticias/geral,generico-do-tenofovir-tera-versao-brasileira-imp-,677615>. Accessed 09/09/2014.
50 This attitudine did not to seem to change recently. In the 2016, Health Ministers’ of BRICS met in New Delhi. They agreed, for example, “to constitute a working group, to work on strengthening regulatory systems, sharing of information, appropriate regulatory approaches in case of international and national health emergencies and provide recommendations for the promotion of research and development of innovative medical products”. But there are not any reference to an integral development of health care systems. See BRICS. 6th BRICS Health Ministers’ Meet Delhi Communiqué. Available at: <http://www.brics.utoronto.ca/docs/161216-health.html>. Accessed 04/03/2018. Even in 2017, the main interest remain to respond to infectious diseases (HIV, tuberculosis, malaria): see BRICS. Tianjin Communiqué of BRICS Health Ministers Meeting. Available at: <http://brics.itamaraty.gov.br/images/documentos2017/Tianjin-Communiqu-of-BRICS-Health-Ministers-Meeting.pdf>. Accessed 04/03/2018.
51 “The characteristic strength of what is taking place in the BRICS probably derives from the modus operandi that was choose to follow”. Scaffardi Lucia. BRICS, a Multi-Centre “Legal Network”?. In: Beijing Law Review, 2014, v.5, p. 145. Available at: <http://file.scirp.org/Html/4-3300253_47127.htm>. Accessed 04/03/2018.
52 About this commitment, see Dworkin Ronald. Taking Rights Seriously. (Cambrigde (Mass.): Harvard University Press), 1977.
53 Scaffardi Lucia. Pensare l’im-possibile: BRICS, tra miraggio e realtà. In: BRICS: Paesi emergenti nel prisma del diritto comparato. (Torino: Giappichelli Editore, 2012). p. 169.