People's Health Assembly Demands Right to Health For All

Monday, August 1, 2005

By Lim Li Ching*

Opening Ceremony,
Ceremony of the Native Peoples of the World

The Second People’s Health Assembly (PHA) was held in Cuenca, Ecuador from July 17-22 2005, attracting about 1,300 people from 80 countries around the world. Its aim was to analyze global health problems and to develop strategies to promote “Health for All.”

The roots of the PHA can be traced back to 1978, when governments from 134 countries participated in an international conference organised by the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) at Alma Ata (now known as Almaty). There, they committed themselves to achieving an acceptable level of health for all people of the world by the year 2000 and this goal was enshrined in the Alma Ata Declaration.

However, this promise was never really taken very seriously and was subsequently marginalized in health policy discussions. To remind people of this forgotten commitment, the First PHA was held in Savar, Bangladesh in December 2000, drawing 1,500 participants from 75 countries.

Then, people’s movements and civil society organizations from all over the world came together to reiterate the pledge for “Health for All” and to force governments to take this promise seriously. PHA-1 also hoped to build global solidarity, and to bring together people’s movements and organizations working to advance people’s health in the context of globalization.

PHA-2 built on the progress made, continuing the debates from Bangladesh and consolidating the alliances for building a healthier world. It reaffirmed the importance of the People’s Charter for Health, a consensus document that arose out of PHA-1. The Charter is a statement of the shared vision, goals, principles, and calls for action that unites all the members of the People’s Health Movement (PHM), a growing coalition of people’s organizations, civil society organizations, NGOs, social activists, health professionals, academics, and researchers.

Two parallel plenary sessions were held every morning, followed by eight tracks of workshops in the afternoon. The plenaries focused on health as a fundamental human right, militarization and military occupation and its impacts on health, environmental degradation, and a final session which sought to bring together the recommendations from the various tracks and to chart out the role of the PHM over the next years.

A wide array of issues were also discussed and debated under various workshop themes: equity and people’s health, intercultural encounters on health, trade and health, health and the environment, gender, women and health sector reform, training and communication for health, the right to health for all in an inclusive society, and health in people’s hands. Testimonies were heard from people from all over the world. Particularly stirring were the testimonies of the brutal realities of the current situation in Iraq and Palestine, where war and occupation threaten people’s lives and health, including the lives of doctors and health workers. Doctors attending PHA-2 testified that over 100 doctors have been killed in violence against doctors and patients in Iraq during the past two years of U.S. occupation. In 2004 alone, 71 medical professors were killed or intimidated to leave the country. “There is complete insecurity in Iraqi hospitals that has resulted in many casualties,” said Dr. Salam Ismael, General Secretary of Doctors for Iraq, an independent association of medical professionals that was set up in 2003.

The victims of Agent Orange in Vietnam were not forgotten, as the horrifying effects of dioxin poisoning still show up today, 30 years after the Vietnam War ended. The resonance with Plan Colombia, where fumigations with herbicides intended to kill coca plants are carried out, was not lost. Participant after participant from Latin America denounced Plan Colombia, equating it to “biological warfare… currently waged against the peoples of Colombia, Ecuador, and Peru under the guise of drug control.” The human health and environmental impacts are immense and already evident.

Participants of the Global Children's Forum held in parallel with the second PHA joined the March for the Globalization of Solidarity and Dignity

The lack of access to medicines and healthcare due to the neo-liberal policies prescribed by the international financial institutions, particularly the intellectual property rights regime pushed via the World Trade Organisation (WTO) and Free Trade Agreements, was another major issue under discussion. Martin Khor, director of the Third World Network, placed these in the context of globalization, and urged the PHA to endorse the right to health as a fundamental human right. Other facets of globalization were also addressed, with scrutiny on how the corporate agenda has usurped control of the determinants of health, leading to environmental destruction, toxic pollution, and the denial of rights to water, food, and life itself. Privatization and inequitable trade regimes have denied people their right to health.

Environmental degradation also poses tremendous challenges to communities and their health. In particular, the extractive industries of mining and petroleum have not only fuelled bloodshed but have also increased militarization, cancers and other diseases, and toxic pollution of land and water. The use of pesticides in agriculture has resulted in untold damage to human and animal health and the environment.

Yet, there is a “mercenary epidemiology” at play. For example, some corporate-funded scientists and doctors have denied any links between the polluting effects of the petroleum industry and the increasing incidences of cancers in certain communities. PHA-2 thus urged that knowledge and science be reclaimed for public good and freed from corporate control, and that the precautionary principle be applied.

Furthermore, genetic engineering (whether genetically engineered crops, including those engineered to produce pharmaceuticals, or genetically engineered vaccines) poses risks to health and the environment. In addition, a proposal by an advisory committee of the World Health Organisation that would allow the genetic engineering of smallpox and dramatically expand research on the live virus carries serious public health, biosafety, and biological weapons risks. Other new technologies such as nanotechnology and non-lethal biochemicals (such as the gas used to suppress the Moscow theatre siege in 2003) also pose dangers. PHA-2 thus endorsed “a ban on patenting of life forms and processes, on release into the environment of GMOs and on development and use of all biochemical weapons."

PHA-2 saw the launching of the Global Health Watch Report 2005-2006. Also known as the Alternative World Health Report, it is a collaboration of public health experts, non-governmental organizations, community groups, health workers and academics. The report presents a hard-hitting assessment of inequalities in health and health care – and is aimed at challenging the major institutions, such as the World Health Organisation, that influence health.

Whilst the analyses of global health problems and their causes were incisive, PHA-2 also provided opportunities for discussion, reflection, and importantly, strategizing to address the wide range of issues.

The Cuenca Declaration, issued on the last day of the assembly, pledged to:

• establish the right to health in an era of hegemonic globalization

• advance the right to health for all in the context of gender and personal diversity

• protect the right to health in the context of environmental degradation

• ensure workers’ health in a globalized world

• defend the right to health in the face of war, militarization and violence

• struggle for comprehensive primary health care and sustainable, quality, local and national health systems

• support the growth of PHM p>To achieve these goals, several strategies were elaborated, including documenting, analyzing and disseminating research findings on key issues, creating awareness, working with grassroots organizations and communities, building partnerships and supporting activists in their struggle, building international solidarity with the oppressed and those affected by natural disasters and civil strife, and advocating with national governments, the United Nations, and other national and international agencies to influence decision-making.

PHA-2 closed with a call for peoples to demand and struggle towards a world in which health is a right, and to work towards another world, which includes health for all.

* Lim Li Ching, Senior Fellow at The Oakland Institute, works with the biosafety programme at Third World Network (TWN), an international NGO based in Malaysia. TWN is involved in efforts to bring about a greater articulation of the needs and rights of peoples in developing countries; a fair distribution of world resources; and forms of development which are ecologically sustainable and fulfill human needs.

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