Development:
Health Care Needs Shot in the Arm, Activists Say - Media Coverage
Development:
Health Care Needs Shot in the Arm, Activists Say
By Ranjit Devraj
SAVAR, Bangladesh, Dec 8 (IPS) - Primary health care must
be put back up on the global agenda, immunising it from damage caused by economic
liberalisation and the privatisation of health services, activists said at the end of the
People's Health Assembly (PHA) here Friday.
Meeting in this remote setting 40 km outside Bangladesh's capital Dhaka, the activists
demanded the restoration of the primary health care approach adopted at a 1978
international health conference in Alma Ata, Kazakhstan.
The demand is the cornerstone of a ''People's Charter for Health-2000,'' endorsed at the
end of four days of deliberations and testimonies by more than 900 delegates gathered here
from 92 countries.
Although the charter reflected the Alma Ata Declaration in many ways, it sought to remedy
setbacks suffered by the global health sector caused by the more recent processes of
liberalisation, globalisation and privatisation pushed by the World Bank and the
International Monetary Fund (IMF).
''Unlike the World Health Organisation (WHO), the World Bank and the IMF are Bretton Woods
institutions and not true U.N. bodies,'' said Halfdan Mahler, who served as WHO
director-general for 15 years and played a key role in discussions here this week.
Mahler blamed the ''hijacking'' of the global health agenda from WHO by the World Bank
after 1993 and its emphasis on market-driven policies for deteriorating health services
around the world, the main concern of the PHA.
''Governments have a fundamental responsibility to ensure universal access to quality
health care, education and other social services according to the people's needs, not
according to their ability to pay,'' the charter laid down as a basic principle.
''You can't reverse globalisation, but you can stop people from suffering its consequences
- if large numbers come forward and protest,'' said Prem John, Asia coordinator of PHA and
director of the Asian Community Health Action Network.
Indeed, activists said public pressure had a role to play in changing the priorities of
global institutions like the World Bank.
Asked how the just-finished PHA can change the Bank, Zafrullah Chowdhury, programme
cooridnator of Gonashasthaya Kendra, the assembly's host organisation, said the mood
created by people's movements encourages their politicians to put pressure on the World
Bank and the ''mafia'' which now runs it behind closed doors.
''Our aim is to make it (the Bank) democratic so that every country has one vote,'' he
added.
Olle Nordberg of the Dag Hammarskjold Foundation, major donor and supporter of PHA, said:
''The PHA has wider implcations than health. It helps people build up their own strategies
and provide an important balance.''
The World Bank and the World Trade Organisation (WTO) took a beating from experts and
activists at the PHA 2000 for ''arrogating unto themselves'' the right to set the world
health agenda on hard- nosed business principles rather than as a people-oriented service.
The charter pointedly said health was ''primarily determined by the political, economic,
social and physical environment and should, along with equity and sustainable development
be a top priority in local, national and international policy-making.''
''Health should find a prime place. No one has the right to commodify it,'' Abdul Matim
Khasru, Bangladesh's minister for law, justice and parliamentary affairs declared at one
of the sessions this week.
Heeding demands set out by the charter was one asking for ''transformation of the global
trading system so that it ceases to violate social, environmental, economic and health
rights of people and begins to discriminate positively in favour of countries of the
South.''
Reforms, the charter demanded, should include intellectual property regimes such as
patents and the Trade Related Aspects of the Intellectual Property Rights (TRIPS)
agreement.
It also asked for firm commitment in the WTO framework to support measures to protect
public health, which Mike Rowson, an economist with the United Kingdom-based activist
group Medact, explained to the delegates are missing.
''While WTO gives individual governments rights to adopt or enforce measures to protect
human, animal or plant life or health, these are not defined, leaving it open to the
danger of prioritising the interests of trade and restrict definitions considered
necessary for public health measures,'' Rowson said.
Rowson said TRIPS particularly affected the rational use of drugs, and threatened to put
essential drugs out of the reach of ordinary people. ''Disputes have already risen over
the leeway given through compulsory licensing and parallel imports,'' he added.
Activists from South Asia, such as Zafar Mirza from Pakistan and Mira Shiva from India,
said the 20-year window given for pharmaceutical companies to determine global prices for
new drugs threatened to affect the control of diseases such as malaria and hepatitis.
The charter called for radical transformation of the World Bank and the International
Monetary Fund (IMF) so that these institutions reflect and actively promote the rights and
interests of developing countries, and demanded a reining in of transnational corporations
(TNCs).
On social and political challenges, the charter commented that economic globalisation and
privatisation have ''profoundly disrupted communities, families and cultures.''
''Public institutions have been undermined and weakened. Many of their responsibilities
have been trasnferred to the private sector, particulary corporations or to other national
and international institutions which are rarely accountable to people,'' it said.
The charter itself was honed by a special committee of experts communicating with one
other over the Internet for at least two years, but each section was put before the
delegates to the PHA over the week.
At a special session Thursday, members of the committee heard and accommodated demands by
delegates asking, for example, for a ban on the use of sanctions for military purposes
since it affects the health and social development of civilian populations.
The charter came down hard on militarist tendencies. ''Increased arms procurement and an
aggressive and corrupt international arms trade undermine social, political and eocnomic
stability and the allocation of resources to the social sector,'' it said.
The charter also took note of environmental challenges such as water and air pollution,
rapid climate change, ozone layer depletion, nuclear energy and waste toxic chemicals and
pesticides, loss of biodiversity, deforestation, and soil erosion, all of which affect the
health of people.
But most of all, it called for a people-centred health sector and the provision of
universal and comprehensive primary health care, irrespective of people's ability to pay.
''Health services must be democratic and accountable with suffcient resources to achieve
this,'' it stated.
Finally, activists closed the health assembly with a view to persisting with their
campaign after the meeting and said the PHA plans to function over the Internet and plans
to meet again in two or three years.
Said John: ''It took fifteen years to collect funds (1.7 million U.S. dollars) for this
one but there is momentum now.'' (END/IPS/ap-wd-he/rdr/js/00) .
