PHA-Exch> PHM Newsbrief #21 Oct 2007

[Claudio Schuftan]

*PHM Newsbrief #21, Oct 2007*

* *

*Look to the Future?***

With great satisfaction, indeed with increasing hope, we mark the award of
the Nobel Prize for Peace this year. Though bowing to political expediency
in the past, notably Kissinger and Arafat received it, this Prize remains a
coveted one that focuses on peace and security of the community of nations.
Al Gore and the Inter-Governmental Group richly deserve this honour because
of the high profile and productive campaign that they carried on.  By
conferring the Prize, the Nobel Committee has squarely placed Global Warming
at the centre of international consciousness, if such a thing exists. This
is a wake up call for every nation, indeed for every citizen of the world to
keep global warming, rising sea levels, increasing ferocity of Atlantic
storms, floods, droughts, the shearing away of arctic ice caps and such
disasters in mind all the time. It is also an exhortation for reducing our
carbon footprints, for America to see why with 6% of the world's population
it uses 27% of the world's energy, for China and India to reduce their high
carbon emissions in the name of industrialization, for Brazil and Indonesia
to guard their forests. It also exhorts individuals to reduce their
individual carbon foot prints – switch off lights when not in use, don't let
the tap run while shaving, walk to the market instead of using the car, as
far as possible don't use air-conditioning, use air travel as little as
possible and such mundane every-day type of activities that contribute to
global warming.

The Prize also places in perspective the Chernobyl disaster that occurred 21
years ago and which continues to be a nightmare. A growing network of NGOs,
under the leadership of PHM points person Alison Katz, will launch a
long-lasting campaign "For an independent WHO",  a campaign that asks the
WHO to amend or repeal its binding treaty signed in 1959 with the
International Atomic Energy Agency (IAEA). According to this agreement,
public health research on radioactivity by the WHO must be agreed upon by
the IAEA. This agency has vetoed whose planned congresses on radioactivity
and public health in the past.

*[ Contd. Page-2 ]*

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A letter has been sent to the Director General of the WHO, Dr. Margaret
Chan, asking her to examine the 1959 agreement and to recover total
independence for the organization. Chapter II of WHO's constitution
describes the functions of the specialised agency. The first function is "to
act as the directing and coordinating authority on international health
work".

At Chernobyl and on battlefields, including Iraq and Afghanistan, where
depleted uranium has been used, the function for which the WHO was created
has not been respected, because of the agreement with the IAEA.

People, rich or poor alike, from New York or Nanjing, urban or rural, black
or white, will be or can be healthy only as long as our shared planet is
healthy. An illness in one part of our global village has the potential to
make the whole, sick.  If the planet itself is sick, then we have a problem.
Are we going to be part of the solution or be part of the problem?

This issue also carries the story of a festering sore from Egypt –
Privatisation of health care which is sure to be a disaster for the large
majority of Egyptians, the collusion between national and international
ruling structures and the role of international commerce in health. This is
a case study and a warning to other nations.

There are also reports of PHM involvement and activism in a wide range of
activities.

The point is to build coalitions of people not only to oppose anti-planet
activities but to take a proactive role, mainly in raising people's
consciousness like PHM is doing through the Global Health Watch. As Mahatma
Gandhi said, we are only as strong as the weakest link. Hence PHM's efforts
in building country and regional networks, especially in Africa. Be a part
of this on going struggle!



*Prem Chandran John *

*Editor*



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Privatisation in Egypt

* *

The Government of Egypt intends to pass a law on privatisation of health
services during the coming session of parliament sometimes around next
November. If this law is passed it will constitute a drastic set back to
people's right to equal access to health care services, as well as
eventually sell out the huge public infrastructure of health services built
by the sweat of the Egyptian people to the new international and national
private investors in health services including private providers and private
insurance companies.

Among the essential points that we oppose the new law are the following:

1. Its stipulation that in addition to the premium, people will have to
contribute 1/3 of the costs of any medical or surgical intervention or
drugs. This is out of the reach of the vast majority of people, particularly
in secondary and tertiary interventions or in medications for chronic
diseases and of course is completely out of reach of the poor.

2. The idea of providing different health insurance packages according to
the ability of people to pay.

3. The Prime Minister's decree of establishing a holding company which has
the right to sell out the facilities of the Public Health Insurance
Organization.

The Association for Health and Development in Egypt (AHED) which is the
hosting organisation for the PHM Global Secretariat and is an active part of
PHM Egypt has made a strident call to open a national dialogue with all
political parties, trade unions and syndicates, civil society organizations
during the coming year to develop an alternative reform which is committed
to equity and their right to health and not  the maximization of profit of
the private investors.

The World Bank, the USAID as well as the European Union are currently the
major supporters of this law since their businesses stand to benefit. We
call upon you to send letters and a petitions with the signatures of your
organizations to support us in the above demands.

The current law goes against all the human rights conventions which Egypt is
signatory to as well as to the constitution of Egypt which affirms people's
equal right to health services. (*Alaa Shukrallah, PHM Egypt**)*





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*What the Egyptians Have to Say against privatization*

* *

Statement from the National Egyptian conference for the rights to health and
against privatization of health services.



The right to health campaign in Egypt developed in 2005 through the
initiative of several Civil Society Organizations as a reaction to the
declared intentions and continuous actions from the Government of Egypt to
privatize the health care services and in its heart and as a first step the
Health Insurance Organization (HIO). The campaign was joined by many other
groups in the provinces and received much attention from several of the
press agencies both opposition and independent press.

In 2007, the "Egyptian National Right to Health Committee" was established
from a coalition of around 24 political parties and other civil society
organizations as a culmination of the first stage of the campaign and as a
direct reaction to the unconstitutional move from the side of the
Prime-Minister to establish a holding company for the HIO, which was viewed
as a first step direct and drastic step in its privatization.***

On Tuesday 2nd of October 2007, the first National Conference was held in
the Journalist Syndicate in Cairo. The conference came as a culmination of
the work of the committee and as a need to declare to the government of
Egypt and the world a statement from the majority of political parties and
civil society organizations in Egypt on its position from the newly proposed
"Health Reform Law" that the government intends to pass in the next
parliamentary rounds starting next November 2007.

Nearly Fifty political parties, syndicates and unions and other civil
society organizations (signed below) state their total and firm refusal to
the proposed law on the basis of:

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1.   The refusal of the discrimination between people in their right to
access appropriate health services; through providing different groups with
different packages of services according to their means and not their needs.
As an alternative we propose one package for all Egyptians according to
their real medical and health needs.

2.   The refusal of enforcing patients' contribution to a percentage of the
costs (without a ceiling) which can be and will be out of reach of the vast
majority of Egyptian people. As an alternative we propose a premium which is
related to the salary and income and a nominal contribution of a "fixed sum
and not a percentage" on receiving the service if necessary.

3.   The refusal of entitling the administrative bodies alone (whether
through the Minister of Health or Prim-minister) to change the contractual
basis between the HIO and the clients whether through changing the premium
or the packages offered. Any change in the relationship requires a change in
the law which does not take place except through the participation and
agreements of the clienteles.

4.   The refusal of the move towards running the major governmental and
health insurance services on the basis of profit and through for profit
sectors which puts the burdens of the profits on the patients and questions
its validity. We insist that the HIO and governmental services continue to
run on the basis of non-for profit. The private sector can have its
contribution as an additional complementary sector and not the major one
which is to inherit the public sector, the major provider of services to
date.

5.   Finally, we totally refuse the introduction of the law in the coming
parliamentary rounds on the basis that it was developed during the past two
years in complete darkness and in the lack of any transparency and
accordingly we demand that the law does not change without proper
consultation. We propose holding a process of a national dialogue during the
coming year through which an appropriate alternative could be developed with
all the different political parties, syndicates and unions and other civil
society organizations.

Built on the above we declare that the law in its current form is
non-constitutional in that it goes against the equal right of all citizens
to appropriate health care and that it goes also against all the human
rights conventions and treaties that Egypt is signatory to.

This declaration was signed by: 8 national political parties, 33 NGO
networks and NGOs, 4 large national-level trade unions20 October 2007

* *

**** Note: The HIO "currently services more than 50% of the Egyptian
people". The holding company has control over all assets and facilities of
the HIO and accordingly could dispense with them.1  It has been the
experience of selling out the public sector in all other spheres of life
that the establishment of the holding company is the first step in the
liquidation of the assets of the public sector and selling it for peanuts to
the new private investors.*

* *

*(Alaa Shukrallah, PHM Egypt)*

* *

* *

*WHO supports industrial lobbies at the cost of life on earth*



The best illustration of how far WHO has strayed from its mandate as the
international health authority is its response (or non-response) to the
catastrophe of Chernobyl.  Today, WHO stands accused of "twenty-one years of
silence, complicity and lies" (25). Since 1986, under pressure from private
interests, it has actively participated in a cover-up of the health
consequences of the world's most serious industrial accident.



It respects the infamous 1959 agreement with the International Atomic Energy
Agency (IAEA) which prevents it from investigating and reporting freely on
nuclear accidents (26).  The mandate of the IAEA, a UN agency which reports
to the Security Council, is to promote use of the atom. It is therefore,
quite simply, an industrial lobby. If the International Federation of
Pharmaceutical Manufacturers' Associations (the IFPMA) were a UN agency, it
would be no more absurd.

The WHO/IAEA agreement can be terminated by either party at any time (in the
case of WHO by a decision of the World Health Assembly).  The WHO has chosen
to honour a dishonourable agreement rather than provide care - on the basis
of reliable data - to the victims (those who are still alive), for their
numerous, horrifying and life threatening conditions (27).  Furthermore,
essential information for responsible decision-making relating to the
continuation of life on earth is denied by the very authority mandated to
inform the world's peoples on all matters relating to health.



In June 2007, the WHO, through its spokesperson, failed to tell the truth
and misled the public, (not for the first time) by claiming that the
proceedings of the International Conference on the Health Consequences of
Chernobyl, held in Geneva in 1995, were duly published. (28) This is not so.
*The proceedings of the **Geneva** (1995) and **Kiev** (2001) conference on
the same subject have never been published.*  The reason for this censorship
has been explained with admirable candour by the former Director-General of
WHO, Dr Hiroshi Nakajima, and recorded in a documentary made by Swiss
television (29) and a book by the film maker (30).



If the evidence presented at those two conferences had been made available
to the world's people and *if WHO had conducted responsible studies on the
health consequences of civil and military nuclear activities, from the time
of the Second World War and throughout the weapons testing era, use of the
atom would have been rejected as suicidal and/or genocidal.*  It is arguable
that the Chernobyl accident would never have happened because wide
dissemination of serious, scientific evidence 17 on the health consequences
of nuclear accidents/war would have made the construction of civil nuclear
reactors impossible.



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On the basis of hundreds of scientific studies published in the peer
reviewed literature, (see for example the bibliography of "*Chernobyl: the
Hidden Legacy*" 31), independent associations estimate that the accident has
caused more than a million deaths over 20 years, worldwide. At least two
billion Curies of radioactive substances were released from the reactor -
not 200 million Curie as claimed by the IAEA and the Soviet Union.  Between
600,000 and one million young men (the 'liquidators') were involved in
extinguishing the fire and then constructing the sarcophagus to seal the
reactor. They saved Europe. By 2001, according to the register of the
Minister of Health of the Russian Federation, 10% had already died, 30% were
invalid and practically all had health problems (30, pp. 28).  WHO and the
IAEA still claim today that there have been around 50 deaths and around 4000
cases of thyroid cancers. The dimensions of the untruth in relation to the
health of the local populations and especially the children, whose
vulnerability to contamination is acute, are similar.

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WHO's abdication of its responsibilities in radioprotection of populations
will be qualified as a crime against humanity.  If staff and directors of
the technical departments dealing with ionising radiation in WHO were
supported in their independence as international civil servants and *were
held accountable to the world's people for their interpretation of WHO's
mandate,* the cover up of the crime of Chernobyl (and the real health
consequences and crimes of Hiroshima, Nagasaki, weapons testing and the use
of depleted uranium in weapons today)  would have been revealed years ago,
many lives would have been saved and responsible decisions on energy options
for the future would be possible.



*Networking*

* *

*Report on the PHM Southeast **Asia** Visit*



>From July 27 to August 11 this year, Dr. Prem John, Co-Chair of the PHM
Steering Council and Dr. Delen De la Paz, PHM Coordinator for the
Philippines and Southeast Asia, visited key cities in Southeast Asia to
strengthen links with PHM members.  Initially, the plan also included Dr.
Hani Serag, PHM Coordinator, but unfortunately Hani could not join due to
some pressing issues that needed his attention in Cairo.



The first leg of the visit started in Bangkok, Thailand on July 27 with Prem
meeting with Dr. Ugrid, PHM Thailand Coordinator and several other NGOs who
are part of the initiating group in Bangkok for PHM.  Prem  gave an overview
of what the PHM is doing now and how PHM members in Bangkok can spread the
word and organize and strengthen the PHM network in Thailand.



On July 30, after concluding the meetings in Bangkok, Prem flew to
Manilaand met with Delen. A series of activities was lined up
including meetings
with medical students who are interested in pursuing global health courses
in the context of primary health care.  A forum was held at the College of
Medicine of the University of the Philippines in Manila attended by faculty
and students of the university, village health workers from the community
based health programs of the Council for Health and Development and the
Community Medicine Development Foundation, and some faculty members of the
nearby University of the City of Manila.  Prem spoke of the global crisis
and how health as a people's right is being affected.  He also spoke of how
the Philippine health care system is being affected especially with the out
migration of its health professionals.  Dr. Gene Nisperos, secretary general
of the Health Alliance for Democracy, a member of PHM Philippines, gave a
more detailed presentation on the impact of the global health crisis on the
Filipino people and the need to strengthen education and organizing efforts
among all sectors so that the people's voices and interests will prevail and
not those of foreign commercial interests in health.

A bigger forum was held in the University of the Philippines in Diliman
Quezon City campus in which  various sectors who are all members of the PHM
Philippines participated.  Notably present were the community health workers
who came all the way from Nueva Ecija, a town north of Manila, which was 6
hours away by bus.  There were also representatives of the urban poor
communities, Filipino migrant workers, women's groups, children's groups,
faculty and students from different health schools and universities, local
government units and the Department of Health.  Prem again presented the
global health in crisis and prospects of change being done with the People's
Health Movement.  In this forum, too, Mr. Sonny Africa, Deputy Director of
the IBON Data Bank which is a research group in the Philippines, gave an
extensive and in depth discussion on the economic and political impact of
current realities on people's lives particularly on health.  He presented
statistics based on their research which showed how trans-national
corporations are really raking in too much profit on health at the expense
of the people, mostly the poor.  Delen highlighted what PHM has been doing
with its ongoing campaigns in various countries.  She highlighted the
Campaign on the Right to Health and efforts to have WTO out of Health.  She
also spoke about the International People's Health University (IPHU.



The following day Prem and Delen went to Cebu City, a city south of
Manilawhich was one hour by plane, to speak in several forums
organised by the
Visayas Primary Health Care Services, also a member of PHM.  VPHCS organized
a forum in the College of Nursing of the University of Southern
Philippineswhich was attended by the Dean and administrators of the
College, all the
senior nursing students and their faculty members.  The topic was again on
the Global Crisis and its impact on the people's health, and the role of
People's Health Movement.  A similar forum was attended by members of
various sectors such as the farmers, workers, fisher folk, urban poor women,
professionals, etc. was held later in the evening. The following day there
was an exposure visit to the urban poor community along the port, which is
now being converted into an international port, causing displacement of a
lot of poor families.  The VPHCS is organizing a group of women to become
health workers and empowered members of the community, addressing their more
fundamental economic and political rights.



The Health Action Information Network (HAIN) remains the secretariat of the
PHM in the Philippines with Delen as the PHM focal point.



Next they went to Jakarta, Indonesia. Perdhaki, a PHM member and the
Catholic arm in health services, hosted Prem and Delen.  Meetings were held
with members of Muhammadiyah, the Moslem health arm, Pelkesi, the Protestant
health group and other NGOs involved in health.  Women's concerns,
environmental issues, nutrition and livelihood issues were presented in a
forum attended by various groups and organizations. FPKMI, the forum or the
coalition of the various faith based organizations in primary health care
has taken on the responsibility of promoting and expanding PHM membership
and organising PHM Indonesia with Perdhaki as the secretariat. Sri Rahayu
Wartomo is the focal point and Dr. Sudibyo Markus is the Chair of the FPKMI
or the Forum which will spearhead PHM activities in Indonesia.



Hanoi, Vietnam was the next city visited with Dr. Diem Hang organising the
program.  A meeting with the staff of the National Institute for
Occupational and Environmental Health (NIOEH), the Vietnam Red Cross, and
some nurses from different hospitals was held in the conference room of the
NIOEH.  A discussion of the Vietnam health situation in the context of the
global health crisis, and the role of PHM were again expounded by Prem and
Delen.  The participants then decided to build up PHM in Vietnam and Dr.
Nguyen Duy Bao of the NIOEH volunteered to chair the core group.  Ms Diem
Hang remains as the focal point for PHM Vietnam.



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A disappointment in the trip was the visit to Cambodia where unfortunately
our contact person was not able to organise a meeting.  A meeting with the
Coordinator of the Coordinating Council for Cambodian NGOs highlighted the
need to identify and forge links with more Cambodian NGOs with similar
thrusts as PHM.  for them to be the future core group of PHM Cambodia.  This
is the next challenge for us in Southeast Asia.



The entire two week trip across South East Asia was an exhausting venture
but a most rewarding one.  It was heartwarming to meet with the people who
are really involved with grassroots work trying to help educate and organise
the communities towards empowering them to assert their rights.  The
People's Charter for Health was presented to them as an analytical reference
and as an advocacy tool that they can use as they raise issues with their
government, the academic administrators, and even their colleagues.  South
East Asia has a lot of issues on health which are very much affected by the
global realities of neo-liberalism and globalisation.  We need to strengthen
our education, organising and networking thrusts at various levels so that
PHM will surely become a group that can push forward our desire to make
HEALTH FOR ALL a reality NOW. (*Dr. Edelina P. Dela Paz**)*



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*More from the World Health Assembly :  May 2007*

* *

The last News Brief 20 shared some of the events in which PHM members
participated especially the NGO forum sessions and the Round Table on
Primary Health Care in partnership with WCC. However, as always there were
many other interesting inputs as well in collaboration with many PHM
partners and some additional details.

a) A PHM Coordinating Council meeting took place on 13th May* * in Geneva
which was attended by Prem, Hani, Jihad, Arturo, Sarah, Alaa and Bridget
(for David Sanders)

b) PHM participated in the joint WHO NGO briefing on Saving lives and Saving
Money: Achieving rational use of medicines in health services on 15th May* *.
Dr. Ravi Narayan of PHM was the co-chair. The session was organized by
Health Action International (HAI) Ecumenical Pharmaceutical Network (EPN);
Action on Antibiotic Resistance (ReAct) and WHO.

c) The NGO Forum for Health and CETIM session organised with PHM and CMC
Action for Health on 15th May had Hani Serag, (PHM Global Coordinator);
Thelma Narayan ( PHM India) and Martin Khor ( Third World Network) as
panelists and Dr. Mirta Roses (PAHO Director )  and  Lida Lhotska ( IBFAN)
as co-chairs. 6 resolutions were presented for endorsement by the
participants to support WHO in keeping to its fundamental principles.

d) Thelma Narayan and Kumanan, (PHM New Zealand) attend an interactive
dialogue organized by the Health Systems and Services cluster with NGO and
Civil society representatives on 17th May* *

e) Armando (PHM Brazil) was a panelist on Human Resource Development at the
Save the Children Fund sponsored session on Social Insurance in Health on 17
th May.*  *

f) PHM participated actively in co-sponsoring an interactive round table
with CMC Action for Health and the WHO Task Force on Primary Health Care on
17th May in a session entitled "Civil Society Revisiting Primary Health
Care: from Policy to Action". 20 WHA delegates from 16 countries including
Australia, Brazil, Egypt, Ecuador, India, Iran, Iraq, Nigeria, Palestine,
sub Sahara and southern Africa participated.    **

g) On 18th May a PHM team consisting of Hani, Ravi, Mira, and Armando had a
short meeting with the new DG,  Dr. Margaret Chan and briefed her on the
movement and its concerns. The new DG also shared her views on partnerships
and engagement. **

h) PHM participated in a joint civil society statement on WHA establishing
fair framework for sharing of virus samples as well as vaccines and a draft
resolution on public health innovation and intellectual property rights.**

i) PHM released a press statement on Primary Health Care and protest letter
on the arrest of  the PHM related human rights health activist Dr. Binayak
Sen in India. **

j) On 18th May a PHM team had a dialogue with a small team from the WHO
cluster on Information Evidence and Research (IER) on the next World Health
Report 2008 (WHR 08) which would focus on primary health care.**

k) PHM members and partners released various books and news letter at WHA.
PHM publications, resource materials, and declaration were widely
distributed.**



*News from the European Region :*



*a) PHM Sweden:* Dag Hammerskjold Foundation, Uppsala hosted a informal
meeting of individuals and organizations on 12th June 2007 during the visit
of Dr. Ravi Narayan, as a Scholar in Residence. After listening to a
presentation on the development of PHM in India and Globally, the health
situation in Sweden and the process towards establishing a PHM country
circle was discussed. ( for further information contact (Kajsa Overgaard:
kajsa.Overgaard at dhf.uu.se.)

*b) PHM Germany*: A meeting  was hosted by Medico International on 22nd June
during the visit of Dr. Ravi and Thelma Narayan to Frankfurt to discuss the
development of the PHM country circle in Germany. Members from Buko
Pharmakampagne, Misereor , Diakonie, Universities of Berlin and
Frankfurt,  Medico
and other organizations attended. For further information contact (Andreas
Wulf:  wulf at medico.de).



*PHM engagement with the renewal of Primary Health Care by WHO*



As mentioned in an earlier News Brief, PHM had noted the commitment of the  new
DG to the renewal of Primary Health Care at the time of her appointment.
Since then various opportunities have been explored to be a pro active
partner in this renewal.



a) In the news brief 20 the PHM facilitation of the in house WHO seminar on
Primary Health Care in April 2007 and the round table on Primary Health Care
at WHA in May 2007 was mentioned.



b) PHM participated in the Buenos Aires conference organized by the Ministry
of Health, Argentina , PAHO and WHO on 13th to 17th Aug 2007. The theme was
'From Alma Ata to a Millennium Declaration'. Ravi Narayan was a resource
person in the panel discussion on Equity and Health and Financing and
participated in the evolution of the Buenos Aires declaration " Towards a
health strategy for equity based on Primary Health Care"
* * *Buenos Aires** Declaration – August 2007            (Extracts)*



*……* *We affirm that equity, solidarity and universality should govern
health and development system and policies.*

*…… The Primary Health Care strategy is based on values and principles that
remain relevant and which much guide the structure and operation of the
health systems at all levels and for all.*

*…… In order to achieve equity based health care it is imperative to strive
towards universal and comprehensive coverage. In doing so policies and
programmes need to be gender responsive, inclusive, non discriminatory and
prioritize vulnerable groups.*

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*…… Support rapid implementation of the above mentioned actions, in a frame
work of equity and social justice, to achieve the enjoyment of the highest
attainable standard of health, which is one of the fundamental rights of
every human being with out distinction to race, religion, political belief
or economical or social condition....*

*source: see website www.buenosaires30-15.gov.ar*



c) An informal discussion was held in Buenos Aires by the WHO cluster team
in charge of the World Health Report 2008 which would have primary health
care as its theme.  Ravi Narayan of PHM participated in it.



d) The World Health Report core team met in Bellagio, Italy from 10th to 14
th Sept 2007 along with some resource persons to plan out the perspectives
and issues to be covered by the report. Thelma Narayan, a PHM resource
person from  India , participated.



e) PHM is participating in a multi-continent study on comprehensive primary
health care facilitated by Ron Labonte , University of Ottawa, Canada and
David Sanders, University of Western Cape, South Africa. This study covers
most regions of the world and after a comprehensive literature review will
also evolve a training strategy to encourage young researchers and activists
to understand evidence and issues about comprehensive primary health care. (
a more detailed report of this study will be carried in the next news brief)




f) PHM is actively participating in the round table on Primary Health Care
organized at the Forum 11 of the Global Forum for Health Research in
Beijingfrom
30th Oct 2007 . (The panelists include David Sanders, (South Africa) Ron
Labonte ( Canada) Eduardo Espinoza (El Salvador) and Thelma Narayan (India)
among others.





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*1. News From **Argentina**  *

*  *

a)  A small core group in PHM Argentina organized a PHM Argentina conference
in Rosario on 11th and 12th  Aug 2007 on the theme of  " Right to Health
Care"

b) During Ravi Narayan's visit to Buenos Aires  see 3b above PHM Argentina
organized two sessions in Buenos Aires at the University of Lanus and at the
University of Buenos Aires on 17th and 18th of  August 2007 to share the
experience and concerns of PHM with local NGO's ; Academics, Researchers,
and  Networks. An interaction with local medical students and a visit to
their urban community health project was also organized. Halfdan Mahler a
PHM enthusiast and advisor also participated in these activities

(For further information contact Carmen Baez : carmenbaez at infovia.com.ar )



*2.* *PHM in mainstream Literature*:



*a) RENEWING PRIMARY HEALTH CARE IN AMERICA'S* *- *A position paper of the
Pan American Organisation / World Health Organisation ( PAHO- WHO) published
and released in 2007.


*"  Approaches  to Primary Health Care *

 *Health and Human Rights Approach: Stresses understanding health as a human
right and the necessity of tackling the broader social and political
determinants of health. It differs in its emphasis on the social and policy
implications of the **Alma** Ata declaration more than on the principles
themselves. It advocates that the social and political focus of PHC has
lagged behind disease – specific aspects and that development policies
should be more " inclusive, dynamic, transparent and supported by
legislation and financial commitments", if they are to achieve equitable
health improvements" (A philosophy permeating the health and social
sectors)" *

*" As the understanding of health has broadened so has the awareness of the
limitations of traditional health services to address all population health
needs. For many in the region there is the feeling that " Health is a
Social, economic and political issue and, above all, a fundamental right,
and inequality, poverty, exploitation, violence, and injustice are at the
root of ill-health and the death of poor and marginalized people"  *

*Quoting PHM Sources.*



*b) UNDERSTANDING PUBLIC HEALTH : *Open University series  in UK in
collaboration with London School of Hygiene and Tropical Medicine: Title In
the series : *'GLOBAL CHANGE AND HEALTH'  *edited by Kelly Lee and Jeff
Collin



*Globalisation and health – Civil Society Response: *

*From the chapter on Gender, globalisation and health*

* *

"*The People's Health Movement (PHM) is an 'international network of
organizations and individuals that came together in 2000 to re-ignite the
call for Health for All Now!" The goal of the PHM is 'to re-establish health
and equitable development as top priorities in local, national and
international policy –making, with comprehensive primary health care as the
strategy to achieve these priorities.' Its main aim is to begin with the
work done by people's health movements around the world to develop long-term
and sustainable solutions to health problems.*

*Towards this end, in December 2000 it held a People's Health Assembly
    (PHA)
in **Bangladesh**. The PHA was a unique gathering. Unlike the WHO Health
Assemblies this one involved people in village meetings, in district
meetings, in national events, and in regional workshops to prepare for the
global gathering in Bangladesh.The assembly took place in a Community health
center ( GK) in Bangladesh  where the accommodations were modest and where
people had a chance to talk about their concerns regarding health. Over
1,400 people from 92 countries attended.*

*The preamble of the People Charter for Health agreed in 2000, draws on the
*

*WHO UNICEF Declaration on Primary Health Care agreed at **Alma** Ata in
1978 to achieve Health for All. The Charter states: ' Health is a social,
economic and political issue and above all a fundamental human right.
Inequality, poverty, exploitation, violence, and injustice are at the root
of ill health and the deaths of poor and marginalized people. Health for All
means that powerful interests have to be  challenged, that globalization has
to be opposed, and that political and economic priorities have to be
drastically changed. This charter builds on perspectives of people whose
voices have rarely been heard before, if at all. It encourages people to
develop their own solutions and to hold accountable local authorities,
national governments, international organizations and corporations.'*

*( This is followed by further quotations from the People's charter )*

* *

*Activity 3.3 (pg.40) *

*How might a gender perspective be useful for understanding the challenges
of fulfilling the Charter's aim of achieving health for all?*

* *

*Global health goverance and the roles of Civil Society*.

>From the chapter on Health and an emerging global civil society :

Role 1 : Representing the voice of the People.

   11
 "*The establishment and growth of the People's Health Movement (PHM)
following the People's Health Assembly held in December 2000, is a good
example of an emerging player in global civil society. The PHM is a
transnational network, originally conceived of by a group of organizations
with membership spread across the world (including Consumers International,
Health Action, International Asia-Pacific and Women's Global Network on
Reproductive Rights) and which now has emerging regional bases in South
Asia, Latin America ,sub-Saharan Africa, Europe and North America. The
Movement's first assembly in Bangladesh was attended by over 1,400 people
from around 90 countries The Movement argues that urgent attention is
required to address both the underlying causes of ill-health, such as
poverty, and the need to create some more equitable and sustainable health
systems.*

*The PHM has broad and ambitious goals; first, to re-establish health and
equitable development as top priorities in local, national and international
policy making and second, to promote comprehensive primary health care as
the strategy to achieve these priorities. In order to do this it both draws
on the supports people's movements in their struggles to build long term and
sustainable solutions to health problems ( www.phmovement.org) The PHM
emphasizes increasing the participation of local people in global health
debates – on hearing the 'voices of the unheard' *

*The PHM is run by a global coordinating committee, made up primarily of
members of the founding CSO's  and, since the Assembly, of elected regional
representatives. On a day-today basis, the secretariat in Bangalore makes
administrative decisions and puts forward strategic campaigning priorities
such as the recent million –signature campaign for 'Health for All',
although anyone is welcome to do so".*

* *

*Activity 14.5*

*Use the information provided above to establish the core values and
interests that the PHM appears to represent. Has the PHM has undertaken
appropriate actions to ensure its legitimacy and accountability?*

* *
Feedback

   12
*There is evidence from the organizational composition of PHM ( it is
network of networks); from the widespread support for its first Assembly;
and from the developing regional infrastructure that the Movement has some
degree of accountability……*

*…… The complex structure of PHM governance highlights the extent to which
the movement has sought to reconcile tensions between the commitment to
democracy and the need for leadership and coordination. Organised around
interacting circles based on issue-  based representation as well as
secretarial support, this structure seeks to reflect the diversity within
PHM.*



*c) GLOBAL HEALTH - *an introductory text  book by Ann Lindstrand, Stafffan
Bergstrom, Hans Rosling, Birgitta Rubenson, Bo Stenson, Thorkid Tylleskar -
published by Studentlitteratur in 2007 in Sweden.



*From Chapter 1 What is development?  *

* *

*1.1 Definitions of Development *

*"Non governmental organizations, united in networks such as the People's
Health Movement, argue that the involvement of local communities in
development is a prerequisite for sustainability, effectiveness and the
achievement of self esteem and freedom, as well as for the other broader
objectives of development". *

* *

*1.8 Development strategies ( the last 50 years)*

* "In many low income and middle income countries in **Africa**,
**Asia**and the
**Middle East** opposition to the neo-liberal policy of the 1980's was not
dominated by the traditional political left, but by other movements. A
movement know as the Peoples Health Assembly' effectively voiced health
focused opposition. The People's Health Assembly is an international
grassroots network of organizations and individuals with thousands of
participants. It arose spontaneously in 2000 at a meeting in
**Bangladesh**. The participants defend public investment in the
health service and debt
relief for poor countries.*

* *

*1.9 Globalisation (the present)*

*A strong voice in the global health debate for free primary health care is
the people's health movement,** **which in** **2000,** **presented the
People's Health Charter (Box1.7). The charter argues strongly for a publicy
financed health services and for development policies that favour health.
The charter advocates strongly against the commercial aspects of
globalisation. This network presently led from **Bangalore** in **India**,
is a leading representative for NGO's in the global health debate. This
global network is itself  a new aspect of globalisation".*

*( A reference to website – www.phmovement.org is also provided)*

* *

*d)   GLOBALIZATION AND HEALTH* : Edited by Ichiro Kawachi and Sarah Wamala,
Oxford University Press, 2007



>From the chapter – Monitoring the impact of Globalisation on Health

" *There is an urgent need to widen capacity for producing knowledge that
can inform health impact assessment (HAI).  Fortunately as from 2005, the
People's Health Movement, the Global Equity Gauge Alliance (GEGA) and Medact
are planning a two yearly report on global health issues that will examine
the operation of organization such as the world bank*."



>From the chapter – What's Politics got to do with it?



Conclusion: The Politics and Ethics of Health Equity:



*"History suggests that such changes often demand radical forms of political
mobilization and action, although history has not yet encountered such a
demand on a global scale. No simple precedents exist, but several forms of
mobilization are already being pursued. These include, in no particular
order of importance".*



* *The increasing prominence of human rights discourse in national and
global frames of reference.*

* *The simultaneous rise of a global civil society movement pressing for
political actions to shift the rules of contemporary globalization  ( see eg
People's Health Movement et al, 2005) *

* *Direct actions by local, national, and regional grouping of actors
attempting,to hold their governments, and multinational enterprises
accountable for the impacts of their policies and practices on health and
human development.*

* *A growing web of linkages among labor, women's, environmental, and other
groups, both within and across borders, that may prevent elites whose
interests are threatened by economic and social justice or environmental
sustainability from engaging in divide- and – conquer tactics" .*



The above four books from main stream literature including two textbooks in
Sweden and UK mentioned the development of PHM as an important response of
Civil Society to tackling the problems of globalization and health. It is
heartening to see that we are being watched, reviewed and being written
about increasing our visibility, credibility but also encouraging us to be
more accountable and responsive. If any of you have come across any other
such references or descriptions in main stream literature please send
extracts and references to the PHM news brief editor at *(
prem_john at vsnl.net )*










Coordinator's Corner

­­

Dear Friends,



*    At the time of writing this note, the global secretariat is working
hard to support one of most vital processes for the PHM, namely the
International People's Health University (IPHU)

The IPHU was launched and conducted its first short course on political
economy of health and primary health care one week prior to the 2nd People's
Health Assembly in Cuenca, Ecuador – July 2005. Since then, the IPHU has
conducted three training modules for health activists: in Bhopal,
India(March 07);
Vancouver, Canada (June 07); and Atlanta, USA (July 07).

The IPHU jointly with the Gonoshasthaya Kendra (GK), Bangladesh and the PHM
global secretariat are preparing for the 5th IPHU short course "Struggling
for Health" in Bangladesh from the 12th to the 23rd of November 07. The
course's major themes are: globalization and political economy of health;
primary health care; social determinants of health; and environment and
health.

My personal enthusiasm about this course is due to:

*     This course will be hosted by the GK which witnessed the birth of the
movement and the launch of the People's Charter for Health" when hosting the
first people's Health Assembly in late 2000.

*     Over 50 participants from 23 countries are expected to join. Almost
one fourth of these participants will be from Africa which is the continent
of concern during the current PHM coordinatorship.





   14
*     The current course will be followed, for the first time, with a
fellowship program in which, around 10 participants will be enrolled in
different GK projects for three months as a practical application of the
course.

Believing in the IPHU process, I assume that this course will result in the
initiation or further strength of 23 country based circles. For further
information, please visit the PHM website.

The PHM global structures extend their solidarity and full support to all
national campaigners struggling for the right to health and against the
commercialization of health care in South Africa, Congo, Benin, India,
Egypt, Uruguay, Guatemala, Ecuador and many others. We urge all the health
activists to learn more about the PHM Right to Health Campaign and get
engaged with its process in many countries.

Hani Serag

PHM Global Coordinator





*A Report from PHM **USA***

This past June the first ever US Social Forum took over downtown Atlanta,
Georgia and brought together over 10,000 people to dream, plan, strategize,
and act toward a just society. Members of the People's Health Movement were
very involved in helping to organize Health Justice activities at the US
Social Forum. This was a great opportunity for building greater unity of
vision and strategy among US health and health care activist and
organizations through the exciting events on the right to health in the US.

PHM's primary contribution to the US Social Forum was to organize a
concurrent short course "Promoting Health for All" of the International
People's Health University. Designed to stimulate critical thinking in the
health and healthcare sector and to encourage action around the social
determinants of health, IPHU is an effort to direct attention at the ways in
which access to health is denied by structural inequalities, both in the US
and around the world. The IPHU was a great success and was attended by over
40 committed health activists from diverse backgrounds, ages, and nearly 20
states.

Each day of the IPHU included two hours of presentations by US and
international health activists and academics, followed by two hours of
discussion, activities and networking among the participants.

Participants in the IPHU looked at the health impacts of global warming,
militarism, the pharmaceutical industry, water privatization, racial, and
gender inequalities as barriers to health, and other issues, and
brainstormed about campaign strategies to bring about health equity.

   15
Meanwhile, groups involved with PHM, such as Doctors for Global Health, the
Poor People's Economic Human Rights Campaign, Partners in Health, and
Hesperian, held workshops on liberation medicine, environmental justice,
food sovereignty, and other crucial topics. The following are a sample of
the other workshops, discussions, and panels at the Social Forum that PHM
organized or contributed to:

Defending Our Water and Protecting Our Food: Bringing Family Farmers and
Water Rights Advocates Together

Our Bodies, Our Water: Our Right to Safe Water and Health

A human rights approach to health advocacy and activism

Health for All: a peoples vision for health and justice

Access to essential medicines advocating locally and globally

What Is Social Medicine?

A Peoples Healthcare Truth Hearing

We know that many who attended the USSF and especially those who attended
the IPHU and other PHM workshops have returned to their homes revitalized
with new knowledge, a stronger analysis of the problems we face, and
energized by the awareness that they are part of a worldwide movement for
positive change.  (*Sarah Shannon, Coordinator, PHM **USA*)
    PHM Right to Health Care Campaign

September 2007 Update



*In this email:*

*     If you want funding from the global

      campaign…

*     Local fundraising ideas

*     New financial support for the campaign

*     Campaign Assessment Guide Now Available

       in French

*     Discussion group "Together for Equity and

      Health"

*     Update on Campaign organizers

*     Sign up for the listserve

*     Country news



*If you want to receive funds*

We have funds to give to PHM country circles to carry out the campaign. To
receive these funds a country circle must meet certain criteria to ensure
that there is a structure in place to use the funds effectively and to
account for the use of the funds. These criteria are:

1. A PHM circle must be formed, if there isn't one in the country already.
The country circle is composed of individuals and organizations that endorse
the People's Charter for Health and operate under its principles. The
country circle can undertake any activities it wants to, one of the possible
activities being the Right to Health Care Campaign.

2. A committee to carry out the campaign must be formed.

3. The committee must have the participation of at least 3 different
organizations

   16
4. The committee must have at least 2 meetings in different parts of the
country to present the concept of the campaign and enlist participation from
groups and individuals.

5. The committee must select (through some kind of open process) one person
to be the main country contact for the campaign. The role of this person is
to facilitate communication between the global coordinators and the local
campaign and facilitate people to get involved.

6. The committee must select (through some kind of open process) one
organization that will serve as the fiscal sponsor for the campaign in that
country. This organization will receive and distribute the campaign funds
and be responsible for the accounting requirements we must maintain.

7. You must report to the global coordinating group what you have done; who
the participating organizations and individuals are; who the country contact
is (including full name, address, phone number and email); and which
organization will be the fiscal sponsor (including full name, address, phone
number, email, bank account information, and the names of the director and
contact person in that organization).



Funds will be distributed on a "first come, first served" basis - those
circles that meet the above criteria will receive funds until they are used
up. It is important to note that the amount given out will be small and that
each country will have to do some of its own fund raising in order to carry
out all the activities it would like to do. (Please see the "Local
fundraising" section below.) Participants should be aware that the first
amount of money will be given to carry out the initial mobilization and
assessment. We are reserving some funds to be distributed later for country
strategy meetings and Phase 2. If we receive more grants, we will have more
support to give.



All committees must meet these requirements to receive funds.
Well-established PHM circles are not exempt.



*Local Fundraising Ideas*

There are many ways local or national campaign committees may be able to
raise funds or stretch the funds they have. Some ideas:

*     Grant money may be available from national foundations. Some
international funders have interests in particular countries. You can find
out about these grantmakers by doing research on the internet. Let us know
if you need help with the research. Once potential funders have been
identified, we can help you write the grant if you need that kind of
assistance.

*     Ask for donations from sympathetic people who have some money to give
away to people doing good work. Not all people who have money are against
our goals. Don't be afraid - the worst they can say is "no".

*     Hold a benefit party or dance. You can charge admission, sell food and
drinks, and pass the hat after you tell the guests about the campaign.

*     Include the local offices of international health and human rights
organizations on the campaign committee. They may have resources they can
contribute such as meeting space, office supplies, and computers.



If your committee has a fundraising event that works well, please share it
with us.



*New funding awarded to the campaign*



We'd like to thank Diakonisches Werk / Bread for the World and Misereor for
their generous grant to PHM to launch the campaign in 4 Asian and 3 North
African/ Middle Eastern countries.

*Campaign Assessment Guide Now Available in French*

Thanks to the contributions of Aziz Rhali in Morocco, Cristianne Rocha in
Brazil, and Pacome Tometissi in Benin, the campaign assessment guide is now
available for download in French at
http://www.phmovement.org/en/campaigns/righttohealth. There are also
versions in English, Spanish, and Portuguese.



*Discussion Group "Together for Equity and Health"*

* *

Folks working on the campaign in Latin America should join this new
discussion group on Google that is going to serve as the central point of
support and coordination of the campaign in LA. It was formed as one of the
outcomes of a workshop at the Congreso Salvador 2007 organized by INICIATIVA
HONDUREÑA POR EL DERECHO A LA SALUD (IHDS), ASOCIACIÓN LATINOAMERICANA DE
MEDICINA SOCIAL (ALAMES), and SOCIEDAD INTERNACIONAL POR LA EQUIDAD EN SALUD
(ISEqH).



After pre-conference discussions and the workshop at the conference, the
participants agreed to support the campaign, along with other related
ongoing efforts, and many of them have returned to initiate the campaign in
their home countries. The group will help to find and share resources like
educational materials in Spanish and Portuguese, develop and share curricula
for training people on topics related to the campaign, share experiences of
how to utilize the guide, and help to coordinate later regional activities.



   17
To sign up go to http: //groups.google.com /group/
junto-asporlaequidadysalud/about. Click on "Send email  to  the owner"  to
send  an  email  asking  to be  subscribed. You  will  also  need  a  Google
account.



The global coordinators would like to thank the workshop and discussion
group organizers for the support they have offered us.



*Update on Campaign Organizers *



In previous communication about the campaign we have discussed the idea of
using campaign organizers to visit countries to support their campaign
efforts. Thanks to everyone who was interested and sent us all your
information. As the campaign has developed, particularly in Latin American,
we have reexamined this strategy. Via the discussion group described above,
campaign participants will be able to decide what kind of support they need
and how to get it. We will resolve these needs as they arise in a more
collective fashion within the region. We hope this new structure will
encourage  the  development  of  regional  leadership.



In Africa, several campaign leaders will be attending the upcoming
International People's Health University in Savar, Bangladesh (see
www.phmovement.org/iphu). At the IPHU we will discuss how to best support
the country level campaigns in Africa and what kind of regional support and
coordination mechanisms might be most effective. These leaders may be called
upon to travel to assist other countries' campaign organizing efforts in the
future, but we will make these decisions together with the regional campaign
participants. We will keep you updated on any developments. If you have any
suggestions please let us know.

   18


Stay in touch with PHM



To stay on top of what is going on in PHM and global health, sign up for the
main PHM listserve, the PHA-Exchange at
http://lists.kabissa.org/mailman/listinfo/pha-exchange. This is principally
an English language list.



For Spanish and Portuguese speakers, you can sign up for the
Redlatinoamericana at http://
mx.groups.yahoo.com/group/REDLATINOAMERICANASALUD/.



For RTHHC Campaign support in Latin America, join the Junt at s por la Equidad
y Salud discussion group at

http://groups.google.com/group/junto-asporlaequidadysalud/about. From there
send an email by clicking on "Send email to the owner". You will have to
sign up for a Google account.


Country news



Here are just a few examples of campaign activities going on around the
world. Send us photos and reports about your campaign and we will share them
via this newsletter and the website.



On August 11-12, 2007 PHM Argentina held its first national meeting. About
100 people attended and agreed to implement the campaign. PHM Argentina has
an email group at http: //ar.groups.yahoo.com/
group/saludelospueblosargentina/.



In Ecuador several RTH Campaign workshops are taking place in different
cities. Several committees are working on different items related to the
right to health in the context of the new draft constitution. A very
progressive statement has been included in the constitution draft proposal.



>From the *The **Cape** **Argus*, Cape Town, South Africa, September 09, 2007
:

Sporting placards reading "SA Health Crisis is bigger than Manto vs
Routledge", "Public Health before Private Wealth" and "Health for all NOW",
hundreds of people marched through Site C, Khayelitsha, on September
8, 2007to mark the launch of the People's Health Movement's Right to
Health
Campaign in South Africa. Leslie London, head of family health at the
University of Cape Town and one of the movement's organisers, said the
movement aimed to change current approaches to health and development in
poorer countries. "This is not just an organisation, it's a network. The
movement is a united front to fight the government for proper health-care
facilities, proper medication, more staff at health-care facilities and a
healthier living environment." London said South Africa needed a "strong,
local and independent" civil group to hold the government accountable for
their actions."There are policies in place, but they are nothing if we don't
understand them and if they are not implemented correctly," he said. The PHM
South Africa consists of local organisations including the Treatment Action
Campaign, The Girl Child Organisation, Cosatu, the South African Democratic
Nurses' Union and community churches

For more information about PHM in South Africa, see
http://www.phmsa.memberlodge.org/.



During the month of September the Uruguayan campaign has held over 15 local
meetings in different regions of the country and 1 regional health forum.
Over 630 people have participated and the events have been covered by local
media. The meeting begin discussions on themes that will be brought up to
the National Forum on Health in November: the right to health, the national
health system reform, sexual and reproductive health, and the environment
and health. Participants have engaged in a very high level of discussion and
often leave with a commitment to continue local organizing and to outreach
to other communities. A major concern is to improve the health system
characterized by inequity and inaccessibility, particularly in small rural
communities.



The global coordinators are actively following all leads from interested
groups in over 20 countries. We are encouraging local groups to go from
manifesting an interest to getting organized. The assessment phase of the
campaign is in full swing and we are ready to provide the needed support. We
encourage anyone interested to join by following the steps above. To those
already engaged, we pledge keeping up our support.















   19


*Global Health Watch*



The writing for Global Health Watch 2007/08 is almost complete and many of
the chapters look to be quite exciting! While there are a few chapters where
we are still waiting for the first draft, others are out for review at the
moment, and some are very close to being completed. All content has to be
completed by the end of November (written, reviewed and edited) when we will
be submitting the first draft to Zed books. We intend to launch Global
Health Watch 2007/08 in May 2008.



We continue to get good feedback about Global Health Watch 2005/06. After a
presentation at a conference in South Africa in October 2007, one of
panelists giving feedback said "a website that can keep me going well after
midnight has to have good content – I would suggest everyone reads this"! We
frequently hear about people quoting or referring to GHW.



We want to use the GHW report as a vehicle to revive and revitalise the
ethic of the Alma Ata, and to push for a progressive economic agenda which
promotes health and social justice more broadly. Out intention is for GHW to
be a tool that mobilises civil society and leads to advocacy and action,
rather than a book that sits unused on a bookshelf. To realise this, we need
support of PHM colleagues around the globe.





Please let us know if you are able to assist with any of the following:



* Advocacy;

* Launching GHW 2007/08 – please let us know if

  you can organise and support a launch in your

  country or region.

* Translation of key documents into other

  languages (French, Spanish and other

  languages);

* Fundraising

* Raising the profile of GHW;

* Referring to it in presentations and at meetings



GHW is run on a very small budget and with a very small secretariat pulling
it together. We are happy to have additional assistance from Emily Hansson,
an intern organised through Human Rights Internet who joined the GHW team at
the beginning of September.



If you are interested in becoming involved in Global Health Watch in any
way, please contact the secretariat on ghw at hst.org.za. If you are interested
in getting more information on GHW, please look at the website
www.ghwatch.org and you can subscribe to the newsletter by emailing
GHWatch-newsletter-subscribe at yahoogroups.com (*Bridget Lloyd, PHM South **
Africa*)





PHM Secretariat

(AHED),

17, Beirut St., Apt. #501, Heliopolis, Cairo, Egypt

Tel: ++202 2565613 / Fax : ++202 2565612

Email : hpsp at ahedegypt.org
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