PHM-Exch> Post 2015 Development Agenda on the topic of Health: Indigenous and Afro-Communities demands

[Claudio Schuftan]

*Results of the Consultation with Representatives of Local Governments,
Indigenous Communities, Afro-Communities, and Civil Society Organizations
about the *

*Post 2015 Development Agenda **on the topic of Health *

*Antigua Guatemala, 12 to 14 February 2013*





The commitment toward achieving universal coverage understood as access to
quality, individualized healthcare for all, in a human rights framework,
has been profiled as the Goal of the Post 2015 Development Agenda on the
topic of Health.



For this reason, the Pan American Health Organization proposed a
consultation of the key social actors in this process and to hear their
voices.  The present document summarizes the debate and the agreements
assumed by the representatives of civil society organizations, municipal
authorities or mayors, indigenous authorities, afro descendants, and other
civil society representatives.



We have maintained a profound debate with the participants with respect to
the five themes and we have jointly concluded and agreed on the following
points:



*1- The Millennium Development Goals *must be redrawn and analyzed from the
perspective of their achievements and shortcomings at the subnational
level, and not only using national averages.  For this reason, a new agenda
cannot be planned without giving continuity and resolution to these
commitments.  It is necessary to undertake an evaluation with the
participation of different actors to provide an explanation for the
investments and results.



*2- The guarantee of the right to health* should be materialized through
the creation of a unique universal public health system that has the
components of equity, quality, interculturality, cultural and linguistic
belonging, integrality, gratuity, opportunity, humanity and accessibility
and incorporates criteria of differential focus.



The actions of the States should not be limited to the personal health
services. They should also cover the focus of the social determinants of
health, strengthen the actions of promotion and prevention under the
concept of Primary Health Service.


In relation to the present call referred to as Universal Health Coverage
and Post 2015 MDG, we consider that it should not be based on criteria of
assurance because it does not guarantee equity, integrality, universality,
or the respect of rights.


A special emphasis is placed on the fact that gender should be present in
all components of services.

 *3- Social Participation*: Another urgent consideration is citizen
participation, of indigenous communities and afro descendants should
participate in decision-making throughout the entire health policy cycle,
its participation should be binding and the governments should give it a
legal framework that guarantees said participation in the perspective of
creating unique public and universal health systems.

*4. Financial Aspect:
*
The states are guarantors of the rights; therefore, they should guarantee
public funding through equitable and progressive tax systems (“those that
have more should pay more”) and regular payments with defined, stable,
results-driven flows.



In order for all of this to be possible it is fundamental that there be a
system of alliances between different levels of the State, the local space
being of special relevance, social organizations, indigenous communities
and communities of afro descendants.



*5.  **In relation to the ruling model of development* that international
agencies and some States sell, we propose a development model for life
under the paradigm of Live Well or Good Life that is contrary to
competition and advocates a decent life of complementarity and solidarity.


*
The attending members of this consultation:*

*
**Recommend: *

·       Democratizing the debate for a new development agenda, opening all
of the spaces of analysis and possible discussions for the adoption of
goals post 2015 with the main participation of villages (faces, voices, and
wisdom), avoiding said process from solely representing the interests and
outlooks of technical, bureaucratic, and economic groups.

·       Working with the interior of countries to influence national
governments so that its communities’ and villages’ positioning and outlooks
are reflected at the international level.

·       Promoting alliances with local governments, communities, indigenous
communities, and civil society organizations to achieve the necessary
leaderships with the goal of demanding of the central government what is
necessary to ensure the right to health.

·       We are calling to the universities to redraw educational/training
curricula for health workers to orient them toward the right to health,
transcending the concept of health through goods and biomedicine.

·       Driving the process of administrative decentralization and the
competitions to the local governments with the transfer of resources, under
the responsibility and rectory of the national government through component
ministries.

·       Strengthening the rectory and regulation of the State, establishing
its responsibility, above all of the healthcare system, avoiding the
commercialization of health and of life.



Antigua Guatemala, 13 February 2013
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