PHM-Exch> UFAL International Health Network: Dakar : The World Social Forum on Health to undertake major initiatives

[Claudio Schuftan]

   From:    sante-international at ufal.info


  Dakar : The World Social Forum on Health to undertake major initiatives
<http://ufal.info/blogs/santeinternationale/dakar-the-world-social-forum-on-health-to-undertake-major-initiatives-%e2%80%a8>

The 4th World Social Forum 
 on Health and Social Security just took place
February 3rd to 6th in Dakar, Senegal. This initiative occurs two months
after the 
1st World Conference for the Development of 
 Universal Social
Security Systems in Brasilia,
Brazil<http://conselho.saude.gov.br/web_confmundial/confmundial_fr.html>
.

In most countries of the world, save perhaps a handful, there are serious
set backs for the rights to prevention and access to high-level health care
for most people. All European and African countries are affected by this
decline.

*Several decisions were taken to fight back at this WSF on Health and Social
Security along the following lines :*

• To promote the principles of universality and solidarity for 
health
systems and high level of social protection for all is urgently needed.
Bernard Teper (UFAL) emphasized that “targeting policies” – which are
sometimes justified in cases of special emergencies-  should only be
tolerated if they respect the principles of universal systems and not be
targeting as charity, in violation of the need for universality and
solidarity1 <#12e1cd7f39a1975e_footnote_0_108>.

• To create a political laboratory to enable, on one hand, to better define
the words and the arguments used (health, social security, social protection
sphere, 
constitutional freedoms, equality, equity), 
 because it is clear
that the militants around the world use the same phrases with different
meanings, and, on the other hand, to identify possible leads, country by
country, to move towards universal systems with a high level of social
protection everywhere and for everyone
. These tracks will of course take
into account all parameters (demography, medical and paramedical health
facilities 
proximity and health structures of excellence, funding, 
social
and environmental determinants of health, etc.).

• Before the 2nd World Conference planned for 2013, to set up national and
regional health forums. Armando de Negri proposed a regional conference for
the Latin American region, accepted with enthusiasm by all
 South Americans
in attendance, including Colombian and Brazilian representatives.
Bernard Teper, on behalf of UFAL, proposed to experiment with the creation
of a North- South Francophone forum 
that would bring together Belgium,
France, Maghreb and Sub-Saharan African countries . This proposal was well
received by African countries representatives in attendance, especially in
the Morocco delegation composed of trade unionists, feminists and
associations for the Right to health, and from the Senegalese and 
Guineans
present, among whom many youth “boosted” by the Tunisian and Egyptian
example.

• An International Advisory Board would be created to 
put together
experiences, debates and decision making. On the sidelines of the plenary
sessions, discussions were held on the feasibility 
of public meetings,
popular education training courses and popular universities cycles 
in
African countries. Contacts have been made 
to evaluate the feasibility.

*Time for change. Nearly one hundred participants and delegates contributed
to this WSF on Health and Universal Systems which takes place at a time
when: *

- Neoliberal policies (deregulation, mounting unemployment or
under-employment) push more and more workers into the informal sector of the
economy2 <#12e1cd7f39a1975e_footnote_1_108>. This causes difficulties for
social contributions whether through taxes, or based on the social
contribution based on wage earners and employers (the French system) which
can only exist in the formal sector. This is very harmful because it is a
system of social protection funded by social contributions, which is most
resilient to economic crises (as long as the formal sector of the economy is
maintained) and a better sharing of wealth at the point of production is a
good rampart to attempts by companies to shift profits overseas.

- The tricky reforms setting with a mix of contribution caps and tax cuts
mean, in reality, that  the popular strata in the formal sector finance more
of its share than the affluent into the social security system contrary to
the principle of solidarity3 <#12e1cd7f39a1975e_footnote_2_108>.

- Financing through taxes and social contributions still insufficient, many
focus on the collection or setting up of international taxes. Without
denying the interest of international taxes, we should denounce the illusion
that they could replace the funding from national taxes and social
contributions.

The problem with present day fast turning financial capitalism is that
international assistance only represents a small portion of budgets in those
countries facing difficulties and that it is always accompanied by
compensatory anti social 
policies (structural adjustment plans imposed by
the multilateral organizations that are part 
of world governance) and the
discrepancies in  power relations are such  that any proceeds of such taxes.
instead of going to social protection -
 could well be used to help 
as
speculators in trouble as during 2008-2009.

By analyzing the participation in this 4th FSMS, we can estimate 
however
that the number of countries present was too low and much work must be done
to broaden participation  of social movements in World Social Forums on
Health, from a larger number of countries. 
 Researchers have their place in
the 
 FSMS, but they cannot replace trade unions and associations involved
in the
 struggle in these countries. 
 As for the tone of this 4th FSMS,
where different currents were 
represented, the anti-liberal left seemed 
to
represent the majority, while a minority seemed to think that we can count
on 
existing governments and institutions.

In conclusion: this 4th FSMS has beautiful potential, but needs much work.
Will it be able to rise to the challenge?

*by Bernard Teper,*
*Director of the Popular Education Section / UFAL*

   1. ‘Targeting policies’ have historically been associated with the World
   Bank approach to health in LMICs and their destructive aspects have been
   well documented by, among others, the former director of UNRISD, Dr Thandika
   Mkandawire. [↩ <#12e1cd7f39a1975e_identifier_0_108>]
   2. The concept of informal sector (or ‘un- structured’ sector) is defined
   by the International Labour Organisation (ILO). Such activities are beyond
   any kind of taxation, control or even just counting. They live on the
   margins of conventional production of goods and services and escape all
   regulation. They represent an indispensable complement to neoliberal
   policies, and the latter policies encourage its spread and use of
   low-skilled low paid ‘un-regulated’ labor force.
[↩<#12e1cd7f39a1975e_identifier_1_108>
   ]
   3. Simultanous settting of of safety nets for the very very poor or
   migrant – targeting policy- feed resentments among the working people and
   feeds into the extreme right populist movement, with the mistaken belief
   that the problem is the burden of these ‘other’ people rather than the
   burden of the tax exception and social charges cuts for the wealthy and
   corporate sector. [↩ <#12e1cd7f39a1975e_identifier_2_108>]
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