PHA-Exch> PHM open letter to the members of WHO's Executive Board meeting today in Gva

[Claudio Schuftan]

 Jan 19, 2009.

Distinguished members of the Executive Board of WHO,

The *People's Health Movement* <http://www.phmovemenmt.org/> (PHM) is a
world wide movement of people's organizations, non-governmental
organizations, academic institutions and wide range of civil society
networks and social movements. The PHM was launched as a result of the
People's Health Assembly that was convened in December 2000 in Bangladesh.

We are aware that the Executive Board of the World Health Organization (WHO)
will soon discuss two resolutions on Primary Health Care (PHC) and Social
Determinants of Health (SDH) in preparation for submission to the World
Health Assembly.

The PHM is very keen to initiate a dialogue with the representatives of the
member countries of the WHO/EB to ensure that the expected resolutions will:

   - adopt health as a fundamental human right and an outcome of an
   interaction between political, economic, environmental and social
   determinants.
   - renew the commitment of governments, the WHO and the international
   community to achieving health for all as articulated in the Alma Ata
   Declaration, 1978.
   - build on the positive initiatives that have recently emerged,
   especially, the World Health Report 2008 (WHR-08) and the report of the
   Commission on Social Determinants of Health (CSDH);

To respond to these principles, we strongly believe that *the draft
resolution on **PHC** should:*

*request the member states to:*

   - examine their health policies to ensure they are based on the
   principles of the fundamental right to health and the social conditions that
   create health,
   - renew their commitment and responsibility to achieving the highest
   attainable level of health for their populations,
   - create effective channels through which people can participate in
   planning, implementing, monitoring and evaluating the system of health care
   provision,
   - ensure that their current health care systems are modified  to better
   respond to people's needs and the modified system has a clear process of
   continuously assessing people's health needs in a participatory manner.
   - ensure that their health care systems are adequately and publicly
   financed,
   - ensure universal and equal access (free at the point of use) to the
   whole range of preventive, curative, rehabilitative and promotive health
   services,
   - ensure proper investments in health-related research and industry
   within the public domain.
   - adopt public policies that are able to ensure sufficient and
   well-trained health care personnel and build the training of health care
   personnel on the principles of the right to health,

*request the WHO Director General to:*

   - renew the commitment of the WHO to "Health for ALL Now" and all actions
   and measures articulated in the Alma Ata Declaration,
   - take the necessary measures to re-focus the organization on its
   constitution and to ensure that it "*acts as the directing and
   co-ordinating authority on international health work**1**"*,
   - provide the political support and the technical assistance that are
   needed to implement PHC as articulated in the Alma Ata Declaration.
   - provide the member states with the necessary technical assistance to
   design a public health system based on values of universal access,
   comprehensive and integrated interventions and equity,
   - encourage and assist the member states to adopt health systems research
   as a tool to upgrade their health systems continuously,
   - ensure health systems  co-ordinate action on the SDH with other sectors
   - promote and enable dialogue among the different national and global
   stakeholders on the right to health
   - create and institutionalize channels for civil society and social
   movements at both national and global levels to participate in the health
   policy development and the health decision-making process.
   - organize an international conference on PHC and SDH to discuss and
   reinforce the importance of these two movements and integrate their key
   aspects and to commit to a declaration in which the fundamental right to
   health is central.

*request the international community to:*

   - ensure unconditional financial assistance to those countries developing
   comprehensive and integrated health systems on the basis of equity and
   universal access,
   - Support the WHO as a UN organization to implement its constitutional
   mandate through providing adequate resources.

*We believe that the draft resolution on **SDH** should*

*request the member states to:*

   - adopt the recommendations in the report of the Commission on SDH, and
   ensure adequate resource allocations to implement its recommendations

*direct the WHO Director General to:*

   - adopt the recommendations in the report of the Commission on Social
   Determinants of Health and ensure adequate budget is allocated to assist its
   implementation,
   - extend the activity of  the Commission on Social Determinants of Health
   as an independent coordinating body to monitor the implementation of the
   report recommendations, including the development of indicators to measure
   achievements on the country level,
   - form an intergovernmental working group on SDH in which civil society
   and social movements are represented
   - assist member states to implement the recommendations of the report of
   the Commission,
   - take all necessary measures to ensure that addressing the SDH and
   equity is a cross cutting theme in all units of the WHO.
   - provide the member states with the technical assistance needed to
   implement intersectoral action to address the SDH.
   - encourage and assist the developing country member states to use the
   flexibilities inherent in multi-lateral trade agreements (including the AoA,
   TRIPs, and GATS) in order to make these agreements supportive of the health
   of the populations in these countries .
   - adopt evaluation of the impact of different international agreements on
   people's health as one of the key actions of the WHO in informing global
   decision making.

*request the international community to:*

   - put health equity and addressing health disparities at the top of the
   international agenda – as an achievable international goal within a
   generation- and ensure adequate resources to achieve it,
   - support the WHO as a UN organization to implement its constitutional
   mandate through providing adequate resources.
   - review the available evidence which points to the failure of the
   currently dominant economic order to address the equity gap and promote
   health, and take all possible measures to facilitate the emergence of a new
   health and equity promoting new economic order.

 PHM Global Steering Council

(Represented at the EB by the Third World Network)
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