Activists want health on top of agenda

Savar (Bangladesh), 4 Dec 2000 (IPS) -- An international conference organised by health activists, the People’s Health Assembly, started off here Monday, with hundreds of delegates from around the world vowing to pressure policy-makers to put primary health care back on top of the development agenda.

“We are deeply disturbed at what is happening,” said Denmark’s Halftone Mailer, who was Director General of the World Health Organisation (WHO) when the United Nations body pledged “Health for All by 2000” at an international conference in Alma Aba, Kazakhstan in 1978.

Mailer lamented that the whole UN system had forgotten the struggle of humanity against injustice, which includes the lack of services and access to health and growing gaps between countries despite major improvements in many health indicators in the last 50 years.

“The struggle against injustice is a struggle against forgetfulness,” he told delegates from 92 countries gathered around him here in this small town some 40 km from Bangladesh’s capital Dhaka.

Qasem Chowdhury of Bangladesh, coordinator of the PHA Secretariat, said there was a need for people-centred healthcare as opposed to a health industry increasingly driven by profit-oriented concerns.

India’s N H Antia, chair of the inaugural session, said health activists and experts were gathered at a time when globalisation has undercut many health structures and systems around the world, including the aims of “Health for All.”

Globalisation, liberalisation and privatisation would also be “the death knell of the planet if we don’t take adequate corrective measures at this stage,” he added.

Mailer, who was among hundreds of slogan-shouting delegates who made a symbolic 2-km march Sunday to the Jyotir Sriti Soud, Bangladesh’s national monument, said comprehensive primary health care (PHC) as envisioned at Alma Aba - an unaccomplished goal - was the only viable path to health and health care. He challenged those who would now abandon the declaration to spell out an alternative.

Meanwhile, the participants were not worried that their vigorous show of solidarity in this obscure town would be lost to the world. “What matters is that all this is part of the globalisation of people’s movements,” said Alexis Benos from Greece, representing the International Association of Health Policy.

Said Edlyn Jimenez, who teaches humanities at the University of the Philippines: “A struggle like this does not end with this. I expect people in other countries to be inspired by what we are doing here,” she said.

“This is a reminder to governments around the world of the importance of health and that they cannot abdicate the responsibility entrusted to them by the people,” said Li Enlin, general secretary of the Amity Foundation, a volunteer group based in Nanjing, China.

Monday, the first of five days of deliberations toward a People’s Charter for Health, was structured around testimonies and stories from the field to depict real problems and people-oriented solutions to them.

The draft of the charter says “inequality, poverty, exploitation, violence and hunger are at the root of ill health and excess deaths of poor and marginalised people.”

Public health services are not fulfilling the needs of people not because of cuts in governments’ social budgets, activists here say.  Instead, health services have become less accessible, more unevenly and badly distributed and more inappropriate while expensive private medical care is available only to a few, the draft document points out.

To change this, “powerful interests have to be challenged, political and economic policies redirected and priorities changed,” it adds.

Concurrent sessions on Monday examined the PHA’s main issue - the political economy of the “assault on health.” The discussions were led by Mohan Rao of the Jawaharlal Nehru University (JNU) in New Delhi and Rene Loewenson of the South African Network on Equity and Health.

One session examined the failures of the pharmaceutical industry, foundations and governments, the availability of essential drugs and emerging issues such as the dissemination of misinformation as documented on behalf of the drug industry over the Internet.

“The inclusion of industry representatives in critical WHO policy committees, especially drug pricing, vaccine production, health care costing and the selection of essential drugs lists, is rightly viewed with suspicion and the organisation’s partnership with transnational corporations needs to be re-examined,” said Zafrullah Chowdhury, Bangladesh’s leading expert on the subject.

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