Declaration of the National Health Forum: “Building Social Participation in Health”

We, the almost three thousand leaders from around El Salvador constituting the territorial expression of the National Health Forum,

BEARING IN MIND:

1. That over the 20 years of rightwing government the public health system was systematically dismantled for the malevolent purpose of the phased privatisation of health services to satisfy the exaggerated profit motive of businessmen tied to the ARENA party, commodifying a constitutional right of El Salvador’s citizens.
2. That neoliberal thinking, which is grounded in individualism, selfishness, and commercialisation, puts the interests of the marketplace above the human right to health.  To this end, rightwing neoliberal governments instituted the misnamed “voluntary” fees, affecting the poorest in society and creating greater social exclusion, by shamelessly denying access to health services.
3. That corruption has been the worst disease, infecting government institutions to their core.  The Ministry of Health has not been immune from this disgraceful situation, which has contributed to the poor quality of health care that in turn has increased preventable disease and death.  A reprehensible example of this obscene corruption was the purchase of tons of expired drugs that were then buried; as a result of this complicit deal between the previous authorities and pharmaceutical company brokers, the people were denied access to medicines with impunity.
4. That citizen participation has traditionally been manipulated and turned into volunteer work or cheap labour for the Ministry.  Similarly, the people have been excluded from strategic decision-making about health.

CELEBRATING:

1. That the new Ministry of Health authorities have demonstrated the political will to excise, once and for all, the cancer of corruption, the commodification of health, and the structure of privileges through which a few have been profiting at the cost of the health and life of our people.  This forward thinking has fostered the creation of opportunities for citizen participation and social auditing.
2. That the institution of this Forum marks the beginning of the establishment of democratic relations between the government and civil society, making it possible to develop and strengthen binding citizen participation processes for the design, implementation, evaluation, and oversight of public health policies at the local, regional, and national level.

DEMANDING:

1. Dismantling of the mechanisms of corruption still embedded in the government system, and judgment and punishment for public officials tied to acts of corruption that have caused the death of many Salvadorans.
2. That the manifest openness of the new authorities be reflected in all Ministry of Health officials, because this is the only way to put into practice the model set forth in the new health policy.
3. That during the entire term in office of President Funes, the promise be kept to increase the budget allocated to the Ministry of Health from the current 2.2% to 5% of the Gross Domestic Product (GDP).
4. That the transformations set forth in “Building Hope,” the new health policy, be advanced, to ensure the development and strengthening of a health system that addresses the social determinants of health and that approaches health from a comprehensive perspective, and not only as the absence of disease.
5. That the right to health be guaranteed for the entire population, fully implementing the comprehensive primary health care strategy as the best way to attaining this right.

WE HEREBY PLEDGE:

1. To advance this reform process of the communities and for the communities, with more organisation and social participation that enable the progressive empowerment of the people to make their right to health a reality.  We acknowledge the call and accept the commitment.  We shall defend the gains that we will build together.  We shall not step back, not even to gain momentum.

We hereby dedicate this National Health Forum to all the men and women who, throughout history, with their effort, dedication, and sacrifice, have made this groundbreaking moment possible.

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