PHA-Exchange> on PAHO's new PHC policy

[Claudio]

From: David Werner 


Dear Dr. Maria Magdalena Herrera,

Thank you for sending us the draft of the Primary Health Care Renewal statement drafted by the Pan American Health Organization. Overall I think it is excellent. It delights me to see PAHO taking action to restore and revitalize Primary Health Care, with emphasis on the Comprehensive rather than Selective approach, and with a stronger focus on Health as a Human Right. I am glad to see that stress is placed on the underlying "man made" causes of poor health which lie outside the health sector, including poverty, poorly regulated economic globalization, and lack of participatory democratic process. The undermining of the UN by the United States is surely another contributing factor.

I would, however, like to see more detailed analysis, and exploration of strategies for change, in relation to these sociopolitical and macro-economic causes of poor health, rather than talking in such vague (and therefore probably ineffective) terms. This "politically safe" shying away from detailed analysis and the need for regulatory measures with teeth on both the national and global scale, is one of the reasons that Comprehensive PHC never got off the ground. 

By the same token, in the PHC Renewal statement most of the talk of the need for "greater equity" is limited to health services. However the area where greater equity is most important for the health of the most vulnerable populations lies in the arena of global trade and macro-economic policies. Achieving greater equity in this area will requires strong international regulations, with a restructuring of the World Bank, IMF, and WTO so as to make these powerful bodies more responsive to human and environmental needs, and less beholden to the corporate "growth at all costs" agenda. These measures need to be spelled out clearly, with proposals of how "Health as a Human Right" can be used as a political tool to mobilize action for change -- i.e.the step by step transformation of our unhealthy and unsustainable macro-economic system.  Short of progress toward such far-reaching structural change, Primary Health Care Renewal, as well as the watered-down "Health for at least a few more" by the year 2015 (the MDGs), will go the way of Health for all by the Year 2000.

Good luck. You'll need it. It's an uphill battle! 

But the Primary Health Care Renewal statement is a good start. Have courage!

Sincerely,

David Werner  

The document in question is available from healthwrights
healthwrights at igc.org
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