Health and slavery: what connects SDG 3 and SDG 8.7?

In Episode 1 of Series 5 Todd talks to Professor Luis da Costa Leão, Professor in the Department of Collective Health at the Federal University of Mato Grosso in Brazil, about the connections between the United Nations Sustainable Development Goals SDG 3 on good health and well being, and SDG 8.7 on modern slavery. 

0.48 – 3.17

The conversation begins with a discussion of the term Collective Health. The concept originated in Brazil at the end of the 1970s amid criticisms of the Brazilian health system while the country was under dictatorship. There is a distinction to be made between  medical approaches to health and collective health which takes a holistic view of the determinants of the health of the population, in particular the prevailing socio-economic conditions and how they impact upon health. Luis argues that there is a strong link between conditions of work and health.

3.17 – 6.55

The conversation moves on to discuss the state of public health in Brazil. Todd comments on the large income inequalities that exist within Brazilian society and asks how this is manifested within the public health field. The new constitution of 1988 enshrined health as a universal right and there is a system of universal access to healthcare. In Luis’ field there is increasing interest in the surveillance of working conditions. However, with the recent change of government, Luis notes that there is increasing pressure to privatise aspects of the public health system in Brazil, which could threaten the universal right to health.

6.55 – 11.50

Todd moves on to suggest a strong link between SDG 3 and Collective Health. Luis agrees and comments on the links between health, the work environment, SDG 3 and also SDG 8.7. He outlines his work on the surveillance of working conditions within commodity chains, for example coffee, which have strong historical links to transatlantic slavery. Using sugar as an example Luis describes how there is surveillance of working conditions at each stage of the labour process, and for a wide range of agricultural commodities, which is used to identify examples of modern slavery.

11.50 – 14.12

Todd asks Luis to describe how the authorities deal with reported cases of modern slavery. In Brazil all levels of government have obligations towards workers health and modern slavery and powers to deal with the problem. There are multiple stake holders and also the  private sector who are producing the commodities and this means that there is a need for co-ordination between different levels of government and working with the private sector. 

14.12 – 16.01

SDG 16 on governance is referenced and Todd refers to the corruption scandals at the highest levels of government and suggests that within the governance structure there is massive opportunity for corruption to obstruct the fight against modern slavery. Luis agrees and adds that corruption has impeded development in Brazil.

16.01- 20.31

In Brazil, modern slavery is officially defined by four conditions each of which is described. 

• Degrading conditions at work
• Exhausting working hours
• Servitude
• Forced Labour

Public health has neglected this area and linking public health and modern slavery is made difficult by a lack of reference to it. However, evidence taken from recently freed slaves shows that modern slavery is associated with the denial of acceptable working conditions, adequate shelter, and a healthy diet and this creates major health issues both mental and physical, which affect the both the individuals and the broader community. Not only is modern slavery the opposite of freedom it is also the opposite of a healthy society.

20.31 - end

Todd asks whether there are estimates of the numbers trapped in modern slavery in Brazil. Luis says that in the last 15 years more than 5000 people have been taken out of slavery as a result of the work of special teams of labour inspectors.

• Over 90% of those rescued were found in the agriculture sector. 
• 95% were young men with low levels of education. 

However, women appear to have been ignored in the definitions of modern slavery for example sex workers and victims of trafficking. These are areas yet to be addressed.

Useful links

• The genesis of collective health in Brazil.
• The field of Collective Health: definitions and debates on its constitution¹
• Combatting Forced Labour in Brazil  International Labour Organisation
• Fears for Brazil’s healthcare system Daily Telegraph November 2018