People's Health Movement – organising for a health for all
Blog by Aneta, member of intal
4th People’s Health Assembly (PHA4) – a gathering of 1400 grass roots health activists, civil society organizations and academic institutions from around 73 countries took place in Savar, Dhaka, Bangladesh in November last year. Intal Globalize Solidarity and Viva Salud were actively present there.
While the official title of the Assembly was “Health for All Now”, the thematic topics raised at the plenary sessions and workshops tackled many elements from beyond the strict health sector, as key components of health problems. This was visible from the very first day of gathering when plenary session opened with tributes to assassinated health workers from all over the world, with solidarity statements with Palestinian struggle, Rohinya refugees hosted in Bangladesh and against continued occupation of Western Sahara.
Destroying impact of neoliberal capitalism
The subject of neoliberal effect on health was the main framework for discussions. At the opening plenary, panelists made it clear that the dominant economic model has developed new methods of oppression, especially by transnational companies. New and more restrictive Free Trade Agreements are being imposed on countries, more free tax and special economic zones established, new patents and intellectual property regimes implemented that lead in fact to the monopoly of transnational corporations.
Most of the Free Trade Agreements are being negotiated in secret, aiming to prevent governments from regulation corporate interests. Jane Kelsey at the first session explained that foreign investors have guaranteed protection if governments' actions substantially affect their profits or value. In those agreements the unlawful and harmful behaviour of multinational corporations is irrelevant. Only last year 65 new claims were laid against 48 countries with the sums claimed ranged between 15 million to 1,5 billion US dollars.
Thanks to the intersectional mobilisation of grass roots activists and movements against those agreements, governments were forced to disclose documents and conduct human rights and health impact assessments. National referenda have blocked their adoption and real alternatives were proposed. An example are the ongoing United Nations negotiations lead by Ecuador on a binding instrument imposing human rights obligations on transnational companies.
“The banks are to big to fail” we are being told, or “money needs to be safeguarded” but what about human life? It's a postal card of neoliberal capitalism – said Amir Sengupta. He emphasised that global government has been replaced by philantrocapitalism, where the billionaires are determining the current policies. As a consequence our health is for sale. We don't want billionaires charity – we want them to pay taxes. Without taxes, services disappear. There is a need to challenge corporations greed for profit and their policies of encouraging privatisation of public health that leads to high costs of hospitalisation, widespread medical corruption, unethical practices where public funds are fuelling irrational care and profits for the private sector, and overly expensive medicines among others. There is a need to address growing inequalities - even Chrisitne Lagarde (IMF Managing Director 2013) has described inequality as corrosive to growth and pointed into IMF's own role in it.
As recalled by Fran Baum – the wealth of the richest man in the world, Amazon's owner Jeff Bezos (net worth 150 billion dollars) is equivalent to that of 8,771, 930 Malawi or 382, 262 Bangladeshi people.
There is a need to implement strategies for justice, to shut down tax avoidance strategies, use progressive taxes to redistribute wealth, promote taxes necessary for public goods and services vital to health.
The struggle for the environment is a struggle for health
The health of millions of people across the world is already being significantly harmed by climate change. From driving up the number of people exposed to heat waves to increasing the risk of infectious diseases, such as dengue fever, climate change has had far-reaching effects on many aspects of human health in last few decades. It impacts human health directly and indirectly and no country is immune to its effects.
“One way to stop climate change is to acknowledge the right of the indigenous people to their land and stop extraction of oil” - said Gabriel Garcia when describing the impact of neoliberalism on indigenous people, including assassinations of human rights defenders and anti-fracking activists in Latin America. He shared examples of existing progressive autonomous systems based on integral conception of health and life, like permaculture in Europe and Sumak Kaway in Latin America. At the end, the health system is a by-product of the existing social system – so if it is capitalism, then our health if for profit.
Stopping refugees at any cost
Chiara Bodini addressed the topic of EU's policy towards refugees. In fact the majority of them is being kept outside Europe (e.g in detention camps in Libya). In 2017 due to its policies, Europe registered the lowest number of arrivals from sea since 2014. Those exact policies and arrangements with problematic partners (Turkey, Libya) are a direct threat to peoples life.
According to the United Nations, around thirty thousands people have died in Mediterranean Sea in the past 15 years (of which over five thousands people in 2016). Although most people are arriving to Spain, the most deadly routes are those towards Italy. Political responses were largely crafted on national rather than European level - refugees were viewed as unemployed migrants flocking into Europe to abuse our welfare system. Europe started to build long and high fences along its borders what pushed the refugees to change their routes and take even higher risk. The EU response has not only been inadequate to protect human rights, including right to health, it has put people at risk.
Practice of community organising
The most powerful and inspiring part of the Assembly were plenaries and workshops at which people from all over the world were sharing examples of successful campaigns and solidarity based alternative health systems. From Maharanja region in India where health workers built alliance of doctors for medical health proposing social regulations, through the Landless Workers Movement (MST) in Brasil organising alternative ways of trade and struggling for access to the land, to Thessaloniki in Greece where solidarity clinics were established to support people after the implementation of austerity policies by Troika. Solidarity based alternative socio-economic systems show that it's possible to challenge inequalities created by current neoliberal regime.
From Alma Ata to Astana
During 4 days of gathering, powerful discussions took place among participants on other subjects like militarisation and occupation, gender and health, food sovereignty and others, however the closing session of the Assembly was focused on two crucial documents that draw the lines for world governments in terms of actions on the right to health – Alma Ata (1978) and Astana (2018) declarations.
The Alma Ata declaration issued in 1978 is one of the most progressive documents addressing the complexity of all the components influencing people's health. The declaration not only declared health as human right but gave rights to those being under colonisation to restitution and compensations.
At the end of last year world leaders met in Astana and proclaimed new declaration to renew a commitment to primary healthcare and to achieve universal health coverage. David Sanders explained that in Astana last year global governments shifted their focus from the primary health care that involves ( in addition to the health sector) all related sectors and aspects of national and community development and relies at local and referral levels on health workers, to universal health coverage (UHC), financed by private insurance companies. So Astana declaration not only ignores the influence of multinational corporations and their role on the deterioration of health, not only ignores structural determinants of health but in fact encourages massive privatisation of health care.
Sanders pointed out that the biggest world institutions dealing with global health like WHO or UNICEF are money recipients from Bill Gates Foundation – the same one that is investing billions of dollars into tobacco, alcohol and junk food corporations.
Intersectionality and a struggle for health for all
Health is much more then access to health services. Almost sixty percent of improvement on health conditions comes from other sectors, therefore an intersectional action on social determinants of health is essential. The Sustainable Development Goals can't be achieved without a change in the current economic neoliberal paradigm. There is a need for social movements to act. We are a resource for ourselves and communities that we live in. The People's Health Assembly in Dhaka provided an important venue for exchange of ideas, consolidation of action plans and learning from each other experiences. It was a catalyst for the organisation of collective movements rooted in the local and connected on the global level.