PHM-Exch> Buiding social participation in health El Salvador

[Claudio Schuftan]

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Declaration of the National Health Forum:

“Building Social Participation in Health”
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We, the almost three thousand leaders from around El Salvador constituting
the territorial expression

of the National Health Forum,
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BEARING IN MIND:
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That over the 20 years of rightwing government 1. the public health system
was systematically

dismantled for the malevolent purpose of the phased privatisation of health
services to satisfy

the exaggerated profit motive of businessmen tied to the ARENA party,
commodifying a

constitutional right of El Salvador’s citizens.

2. That neoliberal thinking, which is grounded in individualism,
selfishness, and commercialisation,

puts the interests of the marketplace above the human right to health. To
this end, rightwing

neoliberal governments instituted the misnamed “voluntary” fees, affecting
the poorest in

society and creating greater social exclusion, by shamelessly denying access
to health services.

3. That corruption has been the worst disease, infecting government
institutions to their core. The

Ministry of Health has not been immune from this disgraceful situation,
which has contributed

to the poor quality of health care that in turn has increased preventable
disease and death. A

reprehensible example of this obscene corruption was the purchase of tons of
expired drugs

that were then buried; as a result of this complicit deal between the
previous authorities and

pharmaceutical company brokers, the people were denied access to medicines
with impunity.

4. That citizen participation has traditionally been manipulated and turned
into volunteer work or

cheap labour for the Ministry. Similarly, the people have been excluded from
strategic decisionmaking

about health.
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CELEBRATE:
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1. That the new Ministry of Health authorities have demonstrated the
political will to exercise,

once and for all, the cancer of corruption, the commodification of health,
and the structure

of privileges through which a few have been profiting at the cost of the
health and life of our

people. This forward thinking has fostered the creation of opportunities for
citizen participation

and social auditing.

2. That the institution of this Forum marks the beginning of the
establishment of democratic

relations between the government and civil society, making it possible to
develop and strengthen

binding citizen participation processes for the design, implementation,
evaluation, and oversight

of public health policies at the local, regional, and national level.

*DEMAND:
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The dismantling of the mechanisms of corruption still embedded in the
government system, and

judgment and punishment for public officials tied to acts of corruption that
have caused the

death of many Salvadorans.

2. That the manifest openness of the new authorities be reflected in all
Ministry of Health officials,

because this is the only way to put into practice the model set forth in the
new health policy.

3. That during the entire term in office of President Funes, the promise be
kept to increase the

budget allocated to the Ministry of Health from the current 2.2% to 5% of
the Gross Domestic

Product (GDP).

4. That the transformations set forth in “Building Hope,” the new health
policy, be advanced,

to ensure the development and strengthening of a health system that
addresses the social

determinants of health and that approaches health from a comprehensive
perspective, and not

only as the absence of disease.

5. That the right to health be guaranteed for the entire population, fully
implementing the

comprehensive primary health care strategy as the best way to attaining this
right.

WE HEREBY PLEDGE:

1. To advance this reform process of the communities and for the
communities, with more

organisation and social participation that enable the progressive
empowerment of the people

to make their right to health a reality. We acknowledge the call and accept
the commitment.

We shall defend the gains that we will build together. We shall not step
back, not even to gain

momentum.

We hereby dedicate this National Health Forum to all the men and women who,
throughout history,

with their effort, dedication, and sacrifice, have made this groundbreaking
moment possible.
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San Salvador, May 010


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