“Health care reform is no longer an unmet promise. It is the law of the land.”

I can’t tell you what a thrill it was to hear President Obama speak those words, a few hours ago, after signing the Patient Protection and Affordable Care Act. Around me listening to the President were advocates who have worked hard for many months – and in some cases, for many decades – to bring this moment about, and colleague foundations whose years of steady investment laid the groundwork that we have built upon.

For Atlantic, this moment is the culmination of a campaign that we supported with a substantial, game-changing, ground-seeding investment to Health Care for America Now! (HCAN), the broad coalition working for comprehensive reform, in early 2008, before there was any Presidential nominee or new administration. The hard-won result, many believe, is the greatest advance for the U.S. social contract since Medicare 45 years ago. It will have an impact on the real lives of millions of real people.

For let us not forget, with all the deserved kudos to the toughness and vision of political leaders like President Obama and Speaker Nancy Pelosi, that it was the voices of ordinary people – those most affected by the broken health care system and those who need reform most urgently – that played the critical role in this historic victory. In a note Sunday night to the Center for Community Change, an Atlantic grantee, one such “insurance victim” who had campaigned with the Center wrote: “I am elated. I sit here with a glass of champagne and I weep that this didn't happen in time to save my son. But I kept my promise to him. I helped to pass this bill with all of you dear people and so many more.”

This is the real story of the health care victory – that movement and mobilisation made and made the most of the moment. The largest progressive organising effort in history for health care set the table for President Obama's leadership once elected, supported and pushed him once he was in office, and kept hope alive during many rough patches. HCAN worked to sustain grassroots organizing for nearly two years in key districts throughout the United States and in Washington to get health care on the agenda and to keep pushing it forward. The work of Atlantic’s other grantees – children’s advocates in protecting children’s health gains, Planned Parenthood in fighting anti-choice provisions – all affected the final bill.

I want to pay special tribute to the role of the Atlantic board and our founder, Chuck Feeney. They made a huge bet that few other foundation boards – maybe no other board – would have made, certainly not as boldly. When things looked rough last December, they made an additional grant to HCAN to keep going, on top of what was already, at $25 million, the largest advocacy grant ever made by a foundation. Despite ups and downs, the board stuck with its bold commitment, and it is my hope that this story of philanthropic courage and tenacity will be noted, studied and echoed in the work of many other funders.

We backed HCAN because we believed the moment was right in the United States, but what may have seemed a bold departure for Atlantic was strongly influenced by our experience in the other countries in which we work. We understand from these commitments and campaigns that only with increased public responsibility and expenditure is there any chance of meeting and sustaining the health needs of the most marginalised people. We learned from our colleagues from Dublin to Johannesburg the power of organising to put an issue on the agenda and keep it there.

From the Republic of Ireland, we took lessons from the Older & Bolder campaign. The campaign, a collaborative initiative of five organisations that had not previously worked together, funded evidence-based research, mounted an advertising campaign to counter stereotypes about older adults, and ran a systematic awareness-raising and education effort across the spectrum of politicians, public officials and the general public. Not only did the campaign successfully help to put the ageing issue into the platform of all the major parties, but the elected government created a new ministry focused on health matters and issues of social inclusion. When in the wake of the Irish economic crisis the government proposed to cut medical cards for people over seventy, Older & Bolder took to the streets and reversed the decision in days.

And we were moved to support HCAN by our experience in South Africa. More than three-quarters of AIDS-related deaths occur in sub-Saharan Africa, and South Africa is the country with the highest prevalence of HIV in the world, according to a United Nations report released in November 2007. The South African Government estimates that about 12 per cent of South Africans are infected with HIV, and the economic and developmental impact of the epidemic threatens to undo many achievements of South Africa’s new democracy. Atlantic has long funded the Treatment Action Campaign, which has mobilised a grassroots movement of people with HIV, mostly in poor communities, to advocate for better care and work through the courts to pressure the government to deliver antiretroviral (ARV) medications to people with HIV/AIDS.

What we have learned in our work around the globe is that there is no sustainable social progress without social movements – without ordinary citizens, those who need the change the most, taking the lead on their own behalf. There would be no ageing ministry in Ireland without the mobilised voices of older adults. There would be no ARV access in South Africa without the courageous and often in-your-face activism of the Treatment Action Campaign. And there would be no health care reform in the United States without the tenacious advocacy of HCAN and its allies.

In the months to come, we will keep our sleeves rolled up. Not only to fight rear-guard actions to repeal the landmark health care bill or block it in court, but to assure its thorough and fair implementation, particularly for children and older adults, the focus of two key Atlantic programmes.

But today, we celebrate.

Gara LaMarche

gara@atlanticphilanthropies.org

Links to organisations mentioned in this column:

• Center for Community Change
• Health Care for America Now! (HCAN)
• Older & Bolder campaign
• Treatment Action Campaign

This Sunday, I will join 100,000 other supporters of comprehensive immigration reform in the United States – a cause to which Atlantic has been deeply committed since 2004 – in a march on Washington to demand that the U.S. Congress act this year. I hope you will join me, and here are the details.

My Atlantic colleagues and I will be marching because, like the advocates we fund, we feel a sense of urgency that demands our presence and our voices. Yes, Congress has many other pressing issues on its agenda, like health care (which I’ll talk more about below) and financial reform, which are also important Atlantic priorities in the United States. But immigration reform – a path to citizenship for more than 11 million people who live, work and contribute as members of their families and communities without recognition, basic rights or security – is a matter of fundamental justice. The wait has already been much too long, particularly as the Obama Administration’s harsh immigration enforcement efforts have angered and destabilised immigrant communities. If Congress does not move before the fall election cycle, there will be no immigration reform until next year at the earliest. The time for action is now.

For some months, particularly since the Massachusetts special Senate election led many pundits and politicians to see a shift in the political winds, the prospects for immigration reform seemed increasingly bleak. Traditionally a bipartisan issue, the broad political coalition seemed to have fallen victim to the toxic polarisation of Washington. Senator John McCain, long a leader for immigration reform, is nowhere to be seen this time around, and among Republicans only Senator Lindsey Graham has yet stepped forward to work with Senator Charles Schumer and other Democrats for a sensible solution to a broken immigration system. Despite the growing political power of Latino voters, and the consistent experience in Congressional elections that anti-immigrant “wedge” campaigns fall flat at the polls, far too many politicians fear the racist attacks they know will come their way if they do the right thing and vote for reform. We came very close to achieving immigration reform in 2007 only to have it fail at the last moment in a wave of xenophobic fervor.

After that setback, Atlantic provided funds for the key advocacy groups we support – including the Center for Community Change, National Council of La Raza, National Immigration Forum and Asian American Justice Center – to regroup and come back with a proposal for strengthening their efforts next time. The result was Reform Immigration for America (RIFA), a strong coalition with resources provided by Atlantic (through a $3.5 million grant in January) and other funders that have enabled the movement to field an unprecedented campaign. Advocacy groups in Washington have worked with grassroots groups on the ground in applying advanced communications, research and lobbying tools and co-ordinating action to influence policy and the media debate.

The value of this investment was starkly demonstrated last week when President Obama, under fire by immigrant advocates for failing to make good on his campaign promises for reform – devoting just a scant line to it in his State of the Union speech – met at the White House for an hour and fifteen minutes with campaign advocates, including seven of RIFA’s steering committee members. The meeting, and the President’s recommitment to action, was a pivotal turning point. Under a headline citing “new life” for immigration reform, the Los Angeles Times wrote: “Participants in the White House gathering also pointed to an immigration rally set for March 21 in Washington as a way to spotlight the issue and build needed momentum.”

The President’s own March 11 statement said he “heard from a diverse group of grassroots leaders from around the country about the growing coalition that is working to build momentum for this critical issue. I am optimistic that their efforts will contribute to a favorable climate for moving forward. I told both the Senators and the community leaders that my commitment to comprehensive immigration reform is unwavering, and that I will continue to be their partner in this important effort.”

There is still a long way to go to achieve comprehensive immigration reform. The White House meeting, spurred by the prospect of many thousands of people descending on the Capitol to demand action, is an important step, but you can expect RIFA and other advocates to keep the heat on until the job is done. We learn from this turnaround that patience has its limits, and the best way to hold a well-intended leader to his or her commitments is to demand accountability and action, and speak up when it is late or lacking.

In the same week, Congress seems to be poised to vote on health care reform. After a year of ups and downs, there is a very strong chance that the greatest social advance in the U.S. since Medicare will be enacted into law, expanding coverage to 31 million Americans, increasing consumer protections and affordability, and expanding government authority to regulate insurance premiums. As you know, this too has been a key Atlantic priority, and we are proud of the role that our grantee, Health Care for America NOW! (HCAN) played in creating the climate for action and keeping the pressure on during the past year. Whatever happens with the vote, I’ll have more to say about the health care reform drive in a future column. But for now, with an extremely close vote looming, Congress needs to hear that reform can’t wait. Visit HCAN’s website for information on what you can do as the critical moment nears.

Immigration and health care are two issues where the possibility of positive action and reform was ushered in with the Obama Administration last year, but which have thrown into sharp relief the relationships between inside and outside strategies, movements and government. I reflected on these tensions in a recent talk at the Hudson Institute in D.C., and the text of my remarks can be found here.

Gara LaMarche

gara@atlanticphilanthropies.org

Links to organisations mentioned in this column:

• Asian American Justice Center
• Center for Community Change
• Health Care for America NOW! (HCAN)
• National Council of La Raza
• National Immigration Forum
• Reform Immigration for America (RIFA)

From time to time, Atlantic Currents is written by my colleagues at Atlantic. This week Martin O’Brien, Programme Director for Atlantic’s Reconciliation & Human Rights Programme and a veteran human rights advocate in Northern Ireland, gives us an update on recent developments with the new devolved power sharing government and its impact on peacebuilding.
-- Gara LaMarche

Northern Ireland was a different place when Atlantic first began making grants there in the early 1990s. The violent conflict had claimed thousands of lives and had deeply divided communities. Atlantic was drawn to the country by Atlantic Founder, Chuck Feeney, who himself played an important role in helping to secure the ceasefires in Northern Ireland and the historic Belfast/Good Friday Agreement in 1998.

Our grant making has evolved over time but our work in Northern Ireland has always had a focus on peace building. This has been alongside early investments in higher education and the voluntary sector and our current work in respect of older people, children and reconciliation and human rights.

The Belfast Agreement heralded an end to the conflict in Northern Ireland and laid out the framework for a new devolved power sharing government. But since its signing more than a decade ago, the devolved government has lurched from one crisis to the next and was suspended on a number of occasions due to difficulties between the main parties.

Most recently, the failure to agree on a date and process for transferring responsibility for policing and criminal justice from the Westminster Parliament to the devolved Northern Ireland Assembly threatened to collapse the power sharing Executive and Assembly and lead to new elections.

This brought public frustration to a fever pitch with many criticizing the “stop/start” nature of the political process and the failure of politicians to tackle key issues affecting the lives of people in Northern Ireland. Amidst this public pressure, and after almost two weeks of intensive negotiations involving the British and Irish Prime Ministers and US government representatives, the Democratic Unionist Party and Sinn Fein, the two largest local political parties, finally reached an agreement on 5th February 2010.

The Agreement includes a commitment by the parties to work together to deliver a better society for all based on mutual respect and equality. This commitment to work as a team is what has been missing to date and is essential to preventing a new crisis in the next five or six months. The Agreement also importantly notes that the parties will work to move ahead on the long list of policy decisions which have been stalled as a result of the political tensions within the government. The Agreement also sets 12th April as the date for the devolution of criminal justice and policing from the British Government to the devolved Assembly.

The move to devolution is linked to the parties reaching agreement on a new mechanism to deal with decision making on controversial parades by one section of the community through neighbourhoods where the other community predominates. These parades have been the focus for much community tension over the years. Failure to reach agreement on this issue could still derail the process.

UK Prime Minister Gordon Brown described the recent agreement as “closing a final chapter” on the Northern Ireland peace process. While it would be wonderful if that proves to be the case, the process to date suggests that further difficulties may crop up again in the months ahead. The encouraging news is that difficulties can be overcome and new structures and processes have been established to resolve emerging problems.

While incidents of dissident paramilitary violence may continue, going back to the sustained violence which brought so many deaths and injuries to Northern Ireland is not an option. Lasting peace however depends on ensuring that communities which suffered during the worst of the violence see some benefits from the peace process. That means that there must be a steady focus on implementing the range of laws and policies which have been enacted over the years to deliver a fairer society for everyone in Northern Ireland.

Northern Ireland has some of the most progressive equality and rights infrastructure in the world and the challenge now is to make that infrastructure deliver to those that need it most. Accountability and transparency around how core public services such as education, health, criminal justice and investment are delivered are critical to moving Northern Ireland forward and to cementing peace and strengthening democracy. Atlantic supports a range of grantees working to this end including the Committee on the Administration of Justice; the Northern Ireland Law Centre; the Integrated Education Fund; Include Youth; The Age Sector Platform and the Participation and Practice of Rights Project.

In that vein, it’s vital that the investment conference which U.S. Secretary of State Hilary Clinton has agreed to sponsor later this year works to ensure that investment goes to the areas of greatest need and does not simply perpetuate past patterns of inequality. Expectations are high amongst communities most in need and delivery is the new watch word. Similarly, progress still has to be made to secure a strong Bill of Rights. Such a Bill presents an opportunity to provide Northern Ireland with a framework and vision of a just and equal society that protects the rights of all and which can also provide a model from which others can learn.

Martin O'Brien

Director, Reconciliation & Human Rights Programme, Country Representative, Northern Ireland (UK)

gara@atlanticphilanthropies.org

Links to organisations mentioned in this column:

• Committee on the Administration of Justice
• Northern Ireland Law Centre
• Integrated Education Fund
• Include Youth
• The Age Sector Platform
• Participation and Practice of Rights Project