PHA-Exchange> People's Health Movement in WHA in Geneva

[claudio]

People's Health Movement a force to reckon with in the WHA in Geneva!

COMMUNICATION - VII      May 30, 2003


Greetings from the People's Health Movement Secretariat (Global) at CHC,
Bangalore - India!

Thanks for the enthusiastic participation, dialogue, fellowship and
collective solidarity expressed during the last few days, we spent in Geneva
from 14th May till the end of WHA. It was a great learning experience for
all of us and I am sure many of us would have grown in our 'analytical' and
'advocacy; skills. Many people outside the PHM including within WHO,
personally conveyed to me their appreciation of the seriousness, enthusiasm
and collectivity of PHM that was symbolized by all that we did in Geneva and
at the WHA. Thanks once again from the Secretariat.

Many of you volunteered to be rapporteurs; other documented events with
their own notes; some took photographs, and some prepared reports for their
own organization. We could be very grateful to get email copies of most of
these materials to circulate them in the Exchange and also to prepare a
detailed communication of the proceedings.

We enclose a first communication  - Reporting from London and Geneva. There
may be some omissions, or details not mentioned correctly. Please do point
out any omissions, corrections or modifications, so that report could be
comprehensive and complete. We shall send out an additional communication on
7th June.

There's lots to be done in the next few months as we celebrate the Alma Ata
Anniversary in our countries and prepare for the participatory process
before the next Assembly and the preparatory regional meetings before that.

Please be in touch and if you would like to volunteer to support any of the
activities or initiatives mentioned in this communication, then please do so
at the earliest.

If you have prepared any audio visuals, published books and booklets and
prepared health education materials on PHM concerns and did not give me a
copy during WHA, then please do so at the earliest by post or email at the
earliest.

Another area where we need urgent support form all of you is the area of
funding. If you have any ideas or suggestions or contacts, who would be
interested to support the movement, please let us know of them as soon as
possible.

Looking forward to keeping in touch
With best wishes,
Your sincerely,
Ravi Narayan

COMMUNICATION - VII      30 May, 2003

Communication from PHM Secretariat

Reporting from London and Geneva, May 2003

In the last two weeks (from 9th May till 28th May 2003), a series of
important and significant initiatives have taken place in the context of the
evolution of PHM and this is a brief report of the key events, the decisions
and the relevant issues for the PHM Steering group as well as all PHM
members. A more detailed report with supporting documentation will be
circulated as a consolidated file as well as a series of communications on
the PHM Exchange in the next few weeks.

1. EVALUATION OF PHM:

? A detailed evaluation of the PHA process before and during the Assembly
and of the evolving PHM process after the assembly has just been concluded
by a small evaluation team led by Andrew Chetley (Exchange - UK) and three
other participatory research consultants - Roberto (Peru), Mwajuma
(Tanzania) and Cecilia (Uruguay).

? The main findings of the evaluation were analyzed and discussed at a three
day  Review meeting in London (9th to 12th May 2003), where a few PHM
participants representing different regions of the world helped to
contextualise the findings. The review was planned very well and included
sessions on:

a. Reflections on pre-PHA planning - how did it emerge? What worked well?
What was difficult? What was happening locally (in Latin America, in Asia,
in Africa, in Europe, elsewhere)?
b. Reflections on the PHA -what was significant? What worked well? What was
less good? What would have made it better? Was anything missing?
c. Reflections on the post-PHA period and the development of the PHM - what
are some of the significant achievements? What has not worked? What needs to
be improved? How strong are the roots of the movement? (What's happening in
local areas)
d. What others are saying?
e. What are the main conclusions we can see emerging? What are the lessons
that could be most valuable in strengthening the work of the PHM in the
future? What are the messages that we might want to communicate to a wider
audience?
f. Would you do it again? What would you change? How would you do it
differently? What would you keep and build upon? Are there lesions for the
proposed assembly in 2004?
g. Recommendations and unresolved issues / questions.

? Over all, the 'evaluation' confirmed that the PHA had been a personally
endorsing, inspiring and meaningful experience for all those who
participated in the 5 day meeting at GK Savar in December 2000. Those who
came linked to group or collective processes of mobilizations from different
countries and regions, could build on the inspiration 'of the global
solidarity' evident at the Assembly and take the process forward in their
own countries after the Assembly.

? A large number of initiatives have taken place all over the world and the
main challenges for the evolving post PHA, movement is to establish
interactive communications and an organizational framework that enhances
creativity and collectivity without too much centralization or limiting
structures

? There were many lessons to be learnt as well for future assemblies and for
the ongoing communication and organizational challenges for the movement (A
more detailed report will be soon available on the PHM Exchange and the
website).

2. PHM GENEVA 2003:THE ALMA ATA ANNIVERSARY DIALOGUE

? Over 80 PHM delegates from 30 countries gathered in Geneva to attend the
PHM Geneva 2003 event, an Alma Ata Anniversary dialogue on 16th - 18th May
at the World Council of Churches, facilitated by our active PHM Geneva
group. The four major thematic sessions were:

a. Primary Health Care and the Health for All campaigns and initiatives from
all over the world.
b. Access to Affordable and Essential Drugs.
c. War, conflicts and Disasters - Health and humanitarian challenges - which
included reports from Iraq, Palestine, Philippines, Congo, Sri Lanka and
other conflict zones.
d. Global health and the diseases of Poverty, TB, HIV, Malaria.
e. A WEMOS facilitated workshop on the effects of GATS agreement on access
to Health Care and effects of WTO agreement on food and nutrition.

? The delegates included the following:

Fran Baum (Australia); Zafarullah, Nouman, Momtaz, Taznihar, Babul, Abdul
Zabbar, Zubair, Karnal Uddin Ahmed and Mohibubul Haque (Bangladesh); Armando
(Brazil); Rosalie Bertell (Canada); Patricia Nickson (Congo); Hani Serag
(Egypt); Arturo Quizhpe (Ecuador); Margarite Posada (El Salvador); Gopal
Dabde, Barbara, Schimmer and Gaby Hetler (Germany); Hugo Icu Peren
(Guatemala); Sundararaman, Sudha, Amit, Mira Shiva, Prem and Hari John and
Johny Oomen (India); Mohd. Ali Barzgar (Iran); Sunil, Savatore  Anna and
Maria Teresa (Italy); Samuel Ochieng, Samuel Muwenda and Eva Ombaka (Kenya);
Carmelita Canila (Malaysia); Natalia, Cebotarenco (Moldavia); Marjan, Ellen,
Patrick, Melina, Jose, Preeti, Marianne, Annelies, Anke, Nina, Leontien
(Netherlands); Maria (Nicaragua); Ghassan (Palestine); Edelinda
(Philippines); Bala, Niranjan, Paranie, Thiru (Sri Lanka); David Sanders
(South Africa); Halfdan, Nance, Jean, Allison, David Woodward, Eugenio,
Andres, Monika, Manoj, Eric Ram, Anne Lindsay, Christine, Manjith, Jourdan
Genevieve, Michelle and others (Switzerland and some France); Mwajuma
(Tanzania); Pam, Mike, Andrew Chetley, David McCoy (UK); Denise Zwahlen,
Sarah, Eric, Charlotte (USA); Cecilia Muxi (Uruguay); Lexi Bambas (Zambia),
Ravi Narayan (PHM Secretariat), Unnikrishnan (India) and Satya Sivaraman
(Thailand) - the PHM Media team.

? Some WHO team members also attended some of the session. They included Dra
Mirta Roses (Director of PAHO); Dr. Asamoah Baaha (Drugs and Vaccine
section); German Velasquez (Consultant, Essential Drugs Unit); Eva Wallstam
(Director, Civil Society Initiative) and Josephine Matsumoto (Ext. Relations
Officer).

3. PHM STEERING GROUP AND STRATEGY MEETINGS

 Since the over 80 delegates included many of the steering group members
representing the 8 funding networks and the evolving 13 regions of the
world, a series of meetings were held from 16th to 18th May in between and
after the PHM Geneva 2003 dialogue to evolve strategies and initiatives for
the year. The key decisions and suggestions were as follows (a more detailed
minutes will be available soon):

? The organizational structure and framework evolved during the steering
group meeting at GK Savar (November 2002) was discussed and circulated.
These included structure of PHM - local, national, regional geographical
circles; issues circles; secretariat, Steering group; general working
principles of all these; responsibilities of focal points and convenors;
secretariat criteria; functions and support group.

? The list of 92 countries (which included 17 state teams from India)
classified by global regions and list of over 100 countries still to be
reached was circulated to encourage PHM members to help mobilize contact
persons from all over the world.

? Andrew Chetley reported the overview and key findings of the PHM
Evaluation; Unni presented an update on the Million signature campaign;
Maria,Armando, Amit and Unni reported from the World Social Forum and Health
Forum (Porto Alegre, January 2003).

? The News brief 9 focusing on shift of secretariat; Asia Social Forum; the
November 2002 Steering Committee decisions; the Sri Lanka HAI-AP meeting;
the Human Rights Award for PHM by AIFO, Italy; the media releases from the
PHM media team and other news items was distributed at Geneva. The next News
brief 10 will focus on the World Social Forum, January 2003; and the PHM
regional support tours to East Africa and the USA regions and the PHM Geneva
events.

? A position paper facilitated by David Sanders on Primary Health Care in
the context of the Alma Ata Anniversary initiatives was circulated to many
members for final comment and suggestions. This will be ready for
distribution by PHM, as a position paper by end of May.

? Melina presented the details of the launch of the Women's Access to Health
Campaign at the PHM Geneva dialogue and Lexi Bambas and David McCoy
presented the highlights of the PHM - GEGA Joint initiative in evolving an
'alternative state of World's Health Report' as an evolving process to
monitor global determinants of inequity and ill health with a focus on
international health players and global initiatives. These were endorsed by
the PHM delegates.

? In lieu of announcement of the next People's Health Assembly in Porto
Alegre (Brazil ) in July 2004 and the potential of organizing another Health
Forum before the World Social Forum in Mumbai (January 2004),  a four member
sub committee consisting of Maria, Amit, Armando and Mwajuma met and evolved
a framework for these events and the process of evolution and planning. This
was presented to the group. A series of smaller follow up discussions were
held during the whole PHM Geneva phase based on these suggestions and a more
detailed schedule of potential events is outlined in section 5 (see later)

4. THE PHM PRESENCE IN THE WORLD HEALTH ASSEMBLY 2003

As one of the largest delegations to the WHA this year (over 80 delegates
from nearly 30 countries) the PHM contingent made its presence felt and its
enthusiastic and critical interventions were much appreciated. The PHM had
grown in strength as a delegation - from 6 in WHA 2001; 35 in WHA- 2002 and
now 80+ this year. The key initiatives were as follows:

? The presence of the PHM delegation at WHA was facilitated by PHM partners
which included World Council of Churches (Churches Action for Health);
Consumer International; Infact; and Save the Children, UK. Our thanks for
their solidarity.
? The PHM delegates were given an orientation to the process of advocacy in
the World Health Assembly, in two orientation sessions, which included a
role-play. These sessions were facilitated by Andrew, Cecilia and Carmelita
and this greatly enhanced the PHM interactions. Carmelita was appointed the
Advocacy coordinator and issues, events, responsibilities were divided among
the group and small groups of PHM volunteers were seen actively in action
throughout the 10 days.

? PHM participated in 6 NGO- related sessions in WHA which included:

a. Session on Public- Private Health Care on 19th May organized by WCC and
PHM . David Woodward (Geneva), Sundararaman (India) and Samuel Ochieng
(Kenya) were the panelists.
b. The NGO Forum for Health session on 20th May on the theme: The Primary
Health Care Movement after 25 years of Alma Ata: A Civil Society
perspective.

The panelists included Maria (Nicaragua), Delen (Philippines), Eva and
Samuel (Kenya), Prem John (India), Nouman (Bangladesh), Natalia (Alma Aty),
Dr. Barzgar (Iran), Johny Oomen (India), Patricia Nickon (Congo).

Dr. Raphael Bengoa of WHO also shared some of the key messages on Primary
Health Care from the recently completed WHO review which provoked much
discussion.

A book titled 'Poverty, Health and Development' - Health Cooperation Papers,
Issue No. 17, published by Italian Association amici di Raoul Follereau
(Organization for International Health Cooperation, released by Dr. Eric
Ram, consisting a large number of papers which were presented at the
International Workshop on 'Poverty, Health and Development. Many
contributors are from the PHM and a note on the PHA and Charter and also
part of the publication.

c. A session on 'Medicine Prices - a new approach to Measurement' was
organized by Health Action International and WHO on 20th May, evening which
was very well attended.
d. On 21st May, there was an open seminar on National Capacity building for
Health promotion: cooperation and partnership among governments, NGOs and
WHO in overcoming risks to health: This was organized by the NGO Adhoc
Advisory Group on Health promotion.
e. On 21st May, there was a lunch time discussion on " Traditional Medicine
and Spiritual dimensions in Health" organized by the NGO Forum for Health
and the NGO Committee on Spirituality, values and Global concerns of CONGO
in relationship with UN.

Ravi (PHM Secretariat) and Zafarulah (Bangladesh) made short presentation
and the animated discussion was supported by Prem and Hari John, Bala, Mira,
and others of PHM.

f. On 22nd May, Save the Childern, UK in collaboration with a WHO Strategy
unit organized a session on New Developments in pro-poor health policy which
was also well attended.

? The participation of PHM delegates in the WHO - process especially on the
agenda items of committee A was as follows.

a. The PHM delegates attended the NGO briefing by WHO on 19th May in full
strength. The four presentations on Policy for relations with NGOs (Eva
Wallstam); the Framework Convention for Tobacco Control (Derek Yach); WHO
and Millenium Development Goals (Andrew Cassels); Intellectual Property
rights, innovations and public health (Jonathan Quick) were received with
great enthusiasm and at least 5-6 PHM delegates responded to each
presentation, establishing the active, enthusiastic and critical presence of
PHM at WHA at the beginning itself.
b. PHM delegates focused on Committee A agenda and attended the sessions on

- Primary Health Care
- Framework Convention on Tobacco Consortium
- WHO contribution to MDGS
- Strategy for Child and adolescent Health and Development
- WHO and HIV / AIDS
- Intellectual Property Rights, innovation and Public Health
- Traditional Medicine
- Strengthening Health Systems in developing countries
- Policy for relations with NGOs
- Joint FAO/WHO evaluation of Codex Alimentarius Communication.

c. PHM made NGO statements in committee A on the following issues.

- Primary Health Care (Churches Action for Health and People's Health
Movement)
- Concerns and suggestions on Policy for relations between WHO and
non-governmental organizations from a public (in collaboration with CI,
IBFAN and others)
- Joint NGO response to US proposal on IPRs, Innovation and Public Health
(in collaboration with MSF; Health GAP; HAI; ACT UP Paris; Oxfam, Treatment
Action Campaign; Canadian HIV / AIDS legal network; stop AIDS now!; stop
AIDS alliance)
- A draft PHM response to the Report of the Director General WHO -
1998-2003.
- A note on IPR.

d. PHM Media team facilitated 7 press releases on the following themes
during the WHA:

War on Health is killing the dream of Health for All (16th May); Tobacco
today, Arms Trade tomorrow - PHM demands WHO target the World's largest
killer industry (20th May); Revive the spirit of Alma Ata  - More Action,
Less words please (21st May); Hyper on SARS, Silent on WARS - will the new
WHO DG break the silence (22nd May); Stop attacks on Palestine Medical
Facilities! WHO is there in an emergency (22nd May); Towards the next People
's Health Assembly, Porto Alegre - July 2004 (26th May).

On 20th May, PHM also joined IPHC, Equinet, Medact, WEMOS, Save the Children
and World Development Movement in a joint Press statement entitled "Health
groups warn World Health Assembly, on new WTO threat to Public Health.

e. Small PHM teams also participated in a few Press Conferences on 16th May,
20th May, and on Wars, Conflict and health; and Primary Health Care and
other issues of concern for PHM.
f. The highlight of the WHA interaction this year was the dialogue with the
new WHO-DG Dr. Lee, who met a 5 member PHM team on Thursday 22nd May and
listened to PHM concerns and expectations of WHO. The team included Ravi
(Coordinator, PHM Global Secretariat); Maria (representing Latin America);
Mwajuma (representing Afrcia); Zafarullah (representing Asia); and Ghassan
(representing Middle East). The PHM welcomed the expressed thrusts of the
new DG including Primary Health Care; Decentralization and focus on country
offices and action; WHO as a listening organization, and not only a guiding
one. We shared our willingness to work with the new DG as critical allies
and strengthening civil society voices in International Health
decision-making. We also invited him for the next PHA - 2 in July 2004 at
Porto Alegre (Brazil). The team also presented him with a set of PHM
publications.

5. THE SECOND PEOPLE'S HEALTH ASSEMBLY

? The II Peoples Health Assembly (also to be called the first World Health
Social Forum) will be held in Porto Alegre Brazil from 3rd to 7th of July
2004.

? The assembly will bring together living visions / testimonies from the
people and analytical perspectives on the global and local health situation
by specialists and scholars from all over the world committed to the
Movement. It will generate a solid basis for action in a political content
for the next four years 2004-2005.

? It will build on a process of communication and empowerment, reinforcing
the regional organization of the PHM and widening the coalition of
organizations associated with it.

? It will focus on the Struggle for the Universal and Equitable Right to
Health and the Globalization of solidarity; Health as an essential human
need, a right of citizenship, a duty of the state and the responsibility of
the society and a public good.

? Some of the key themes will be Health as Human right; and the legal
expressions of it. Trade issues and health; Environmental destruction and
Health; Militarism, conflicts and Health; Right to access; Science and
technology and its advancements; Equity; State and Health system reforms and
the right to health and PHC and health promotion in the context; Human
resources for universal health; Economics of universal health systems;
Poverty and Health; Women and Childern's rights. Other themes would include
Food Security; Water and sanitation, HIV/AIDS; Access to drugs; drugs and
substance addiction and mental health as social / economic issue; Mother and
child care; endemic diseases; injuries and violence; chronic and
degenerative diseases.

? A core international committee consisting of the sub group already formed
(Maria, Amit, Armando and Mwajuma) and others who volunteer from the regions
will be formed to work on the mobilization process, the funding and
finances, the contents and programmes, the logistics and the ongoing
monitoring and evaluation.
? There will be at least three pre-Assembly events which will also become
focused as Regional activities in preparation for the PHA - II.

a. September 2003: The Alma Ata Anniversary Meeting hosted by the Islamic
Republic of Iran in collaboration with the People's Health Movement in the
second half of September 2003. This will also be a regional preparatory
meeting focusing on the Middle East and Africa regions. Support from EMRO /
SEARO is being explored. (Dates yet to be confirmed).
b. January 2004: A two day health forum on 14th / 15th January will be
organized preceding the next World Social Forum to be hosted in Mumbai, from
16th to 21st January. This forum also entitled the III International Forum
for Defense of People's Health will be focused as a regional preparatory
meeting for Asia - both South and South East.
c. March 2004: The ALAMES congress in Peru in March 2003 could become a
regional preparatory meeting for the America.

All these meetings will have to be planned in a participatory way with
democratic representations and process in countries and the region and the
numbers at events will also depend realistically on the funds / other
resources mobilized in the regions and internationally.

? [The secretariat will initiate action to facilitate this process at a more
rapid and sustainable pace. A separate communication follows on this
important development].




6. BUILDING COALITIONS AND LINKAGES:

The PHM Geneva events were a strategic opportunity to build coalitions and
linkages with a wide variety of networks and global initiatives relevant to
people's health concerns. The key linkages established were:

a. The Global Forum for Health Research: A dialogue was held with GFHR
during the Geneva meeting, for PHM participation in Forum 7 in Geneva from
2-5 December 2002. The PHM inputs by Zafarullah, David, Thelma and Ravi at
Forum 6 in Arusha, Tanzania were very much appreciated. Areas and sessions
where PHM participants could make significant 'evidence based' inputs were
identified. These included the plenary on Poverty and Health Research; and
the Parallel sessions on Primary Health Care, Nutrition, Poverty and the
life cycle; behavioral and community based interventions and social,
economic, cultural and political determinants; Gender and Mental Health.
David Sanders, Convener of Research circle and Ravi (PHM Secretariat) will
follow up on this.

b. A circle on Food and Nutrition issues focusing on right to food;
Nutrition security;Junk foods; sugar issue etc would be facilitated by
joining IBFAN and other networks like APPAN, which were set up by the SCM -
Nutrition meeting in Chennai in March 2003. Carmelita of CI-ROAP would be
the Convener and contact person. PHM plans to start an advocacy circle with
UNICEF on the Macdonald linkage and other issues would be merged with this
circle evolving in a much broader context.

c. Anti Tobacco Circle: While many PHM members have also been involved with
the Tobacco issue and the FCTC process and the Civil Society involvement in
support of it, it was felt that IN FACT and other anti-tobacco groups should
be contacted and a circle to learn from the experiences of the FCTC lobby
process as well as monitoring the post FCTC process at country level should
be encouraged. It would also be important to involve the anti-tobacco
networks to organize workshops on their experiences at WSF and PHA - II next
year. A volunteer convener would be identified for this circle.

d. Public-Private partnership Circle: In the context of the WEMOS supported
research process on Public - Private partnerships and the presence of
potential county level partners in Bolivia, India and Kenya, it was felt
that Jose Utrera could be requested to be the contact point for a circle on
this issue and that links with Judith Richter and other networks working on
he Global determinants of these partnerships should be established.

e. PHM - GEGA partnership on Global Equity determinants: The links with
GEGA, MEDACT - UK and others in the collaborative project to look at Global
determinants of Equity and to evolve an evidence based alternative report on
Health situation and health initiatives at Global level was endorsed. David
McCoy and Lexi Bambas would circulate a comprehensive idea draft on this
report and the process of its evolution for identifying partners and
collaborators.

f. A short dialogue was held with Dr. Bo Stenson of the GAVI Initiative
(Global Alliance for Vaccines and Immunization) and PHM concerns about
inadequate Health systems, Research in the GAVI initiative was discussed.

[This report brings together the key initiatives that the PHM secretariat
coordinator was kept informed off. A large number of smaller group
discussions and one to one meetings were held by PHM participants with WHA
delegates and WHO units and others. This will be compiled and included in
the next communication. All delegates are requested to send us any
contribution to the next communication particularly focusing on any
omissions or any other initiatives or meetings that have been omitted].