THE PEOPLE’S HEALTH MOVEMENT
By now you know I have, for long, been very involved in the People’s Health Movement (PHM). I am one of the two dozens or so that founded it in a process that went from early 1999 to mid 2001 –before and after our successful People’s Health Assembly 1 (PHA1) held in Bangladesh in 2000.
It is time, I thought, I share with you the serious concerns we at PHM address as an active social movement. But first, let me bring you in on my experience of having been part of launching and of helping to run this social movement, and the energy and sense of purpose –plus the deep satisfaction– this has brought and brings me. PHM is all about people working together and I have been part of making this work with a clear vision for a better future. And you know what? It works…
If I could transport you back to the year 2000 and share with you the exhilaration we all felt in an Assembly that brought together close to 1500 participants from over 80 countries, most of them from small grassroots organisations that had either been active, outspoken and vocal in saying “we are not going to take it anymore” [that is, the neglect the health care delivery systems had fallen into as part of structural adjustment policies (wiki)], or had given up on the state to fix the health system and had taken community health into their own hands. Both had something important to share. The atmosphere was charged with an incredible energy; a truly sense of planetary camaraderie burst out of every pore. The Assembly included the sharing of people’s voices and testimonies about the many distortions the application of Primary Health Care had undergone and about how governments and international agencies had, for all practical purposes, sidelined the “Health for All by the year 2000” promise. Participants met in the various events, shared their success stories, best practices and lessons learned, revealed new and innovative social mobilisation methods and openly manifested their commitment to network across borders.
The collective and interactive dialogue in PHA1 led to the finalisation and endorsement of PHM’s People’s Charter for Health, which became the still valid manifesto of the nascent People’s Health Movement. (www.phmovement.org) The leading idea that emerged was that we needed to join forces with community health-oriented organisations the world over to lobby and put pressure on governments and international organisations.
At the Assembly, participants reviewed their problems and difficulties, shared their experiences and plans, discussed inequity, the human right to health, ecologically-sustainable development and peace, all at the heart of the Charter’s vision of a better world –a world in which people’s voices guide the decisions that shape their lives. The Charter (translated into over 40 languages) is now the common tool of a worldwide citizens movement committed to making the Alma-Ata dream a reality.
Alma Ata, 1978. People’s Health Assembly 1, Bangladesh.
Not surprisingly, Halfdan Mahler, during whose tenure as Director General of WHO the Alma Ata Declaration evolved, attended the Assembly as a spiritual pilgrimage and was strongly inspired by the gathering of Primary Health Care activists supportin the creation of a movement. He has remained one of the strongest friends, philosopher and guide of our movement.
To paraphrase Winston Churchill: PHA1 was not the end, nor was it the beginning of the end. It was the end of the beginning. A beginning that has now gone for 13 years plus fostering bottom-up leadership and setting up health and human rights issue-based coalitions, always pushing government to act. PHM makes sure governments know that there is a groundswell pushing for changes in health.
In short, PHM works towards the revitalisation of Primary Health Care, as described in the Alma-Ata Declaration of 1978, as well as to address the social determination of health, in particular, the growing inequity within and between nations mostly due to the unfair economic structures which lock so many people into poverty and poor health. PHM opposes the privatisation of health services and advocates for tax-based public health care services. It regularly and effectively lobbies WHO; it runs a Health For All Campaign, and that is just the tip of the iceberg for you to get an idea. The website given above is, of course, more explicit.
PHM and WPHNA have common, shared interests but, as you can guess by now, not (yet) the same strategies and tactics.
Our successful WPHNA Rio meeting was one such an occasion for convergence. Several PHM and WPHNA members participated and gave important inputs to the topics discussed. You can see me in the picture with PHM colleagues attending the meeting. Together with Fabio Gomez, I ran a workshop on the responsibilities for action of civil society organisations in public health nutrition.
Staying with Rio, a few months later, in October 2011, the WHO global meeting to follow up on actions for the application of its Social Determinants of Health Report (wiki) brought me and quite a few PHM and WPHNA members to Rio again. We intensely lobbied WHO member states’ representatives to influence the political declaration that came out of that global meeting. Not that we succeeded in having a striking declaration come out but, as much as me, you know that this is the nature of global declarations: watered down, vague, non-binding. Our moment of glory came when, at the last minute, one of our founding members, David Sanders (also a WPHNA member) was added to a plenary panel. He had a chance to vividly expose the ways in which unfair trade relationships have played a key role in creating the massive health and nutrition inequities between rich and poor countries especially in Africa. The house burst into applause. You have got to watch this 4 minutes video of his panel participation: http://www.youtube.com/watch?v=H8DYy67nhc4
But now we are in 2014 and you may wonder what PHM is up to. First and foremost it is up to strengthen its grassroots at national level; a monumental task given that PHM has a presence in so many countries; regional coordination is the matching concomitant challenge. On the global stage PHM continues to actively lobby WHO every year on its World Health Assembly every month of May. Moreover, PHM has actively engaged in influencing the post 2015 development agenda. It has taken strong positions on what health and nutrition should be after 2015. So, you see?, we do not (yet) have the same strategies and tactics.
What I mean is that the challenge for our association also is to connect with and influence what activists at grassroots are doing around the world. As an association, we also ought to have a vision for what nutrition ought to be post 2015. Am I asking something impossible? Apparently not. Many, and I mean many, of our members are active in the above fronts. So, this should trickle up the ladder in our Association. Some of it is being hinted in our website and in WN. But is this enough? Any ideas how we can proceed?
I hope this has given you an idea where I draw my longstanding enthusiasm and commitment from. I have let you in into a small window of my motivation. My emphasis, all the time, is on working together and setting up combative social movements.