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<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
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<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Some more comments
received on the Bangkok Charter. <o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal><FONT face=Arial color=navy size=2><SPAN
style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p></o:p></SPAN></FONT></P>
<P><FONT face="Courier New" size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">I would recommend PHM not
endorsing this charter. Among dozens of points I will just highlight three:
those who are familiar with the arguments will only need to read the
titles in bold. Sorry to be so lengthy but I think it is important.
</SPAN></FONT><o:p></o:p></P>
<P><B><FONT face="Courier New" size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">1. The
repeated references to the private sector as "critical to the achievement of
health" or as a vital "partner" in health
promotion.</SPAN></FONT></B><o:p></o:p></P>
<P><FONT face="Courier New" size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">The reality is that the
private sector means TNCs, which have been clearly identified as major obstacles
to Health for All. It is time to state that explicitly and stop repeating these
mindless mantras about the importance of involving the private sector. What is
important is drastically curtailing the illegitimate influence and control in
ALL policy making and removing the private sector as partners (as they do not
share the same goals!!!) . </SPAN></FONT><o:p></o:p></P>
<P><FONT face="Courier New" size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">We have to clarify once and
for all some fundamental democratic principles. In this text (as in all othe
"lite" "humane" neoliberal texts) society consists of government, civil
society<I><SPAN style="FONT-STYLE: italic"> and the private sector.</SPAN></I>
Why ? Why not for example the public sector? Why not associations of health
workers? Why not the unions or peasant's federations?
</SPAN></FONT><o:p></o:p></P>
<P><FONT face="Courier New" size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">All citizens are involved
and concerned in health matters</SPAN></FONT><I><SPAN
style="FONT-STYLE: italic"> </SPAN></I><I><FONT face="Courier New" size=2><SPAN
style="FONT-SIZE: 10pt; FONT-STYLE: italic; FONT-FAMILY: 'Courier New'">as
individuals</SPAN></FONT></I><FONT face="Courier New" size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'"> but for reasons of conflict
of interest, various groups are explicitly excluded as partners in public policy
making. Note that TNC employees or their CEOs enjoy the same rights as any other
citizens but</SPAN></FONT><B><SPAN style="FONT-WEIGHT: bold">
</SPAN></B><B><FONT face="Courier New" size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">not as
representatives of the financial interests of their company.
</SPAN></FONT></B><o:p></o:p></P>
<P><FONT face="Courier New" size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">Interactions with the
private sector are important of course but they take place only under the
authority of the sovereign (the people) through their elected representatives
(leaving aside imperfections of our "democracies") and this would include
consultation to obtain needed information, certain expertise or to discuss
provision of services or goods to be delivered etc etc. Never in the formulation
of policy.</SPAN></FONT><o:p></o:p></P>
<P><FONT face="Courier New" size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">The private sector has a
legal obligation to make a profit for shareholders. This is certainly a critical
subject for law reform and perhaps we need to return to the idea of companies
having to show that they play a socially useful role and fulfil a public need in
order to have the right to operate.</SPAN></FONT><B><SPAN
style="FONT-WEIGHT: bold"> </SPAN></B><B><FONT face="Courier New" size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">However,
meanwhile, the private sector is subject to laws and regulations which need
urgently to be properly enforced. Legally binding restrictions apply to them as
do human rights obligations.</SPAN></FONT></B><FONT face="Courier New"
size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'"> Much new
legislation is required of course but even today, enforcing what exists would
enormously improve the situation of the poor. I would we need to solidly reject
the whole concept of social responsibility as a sort of voluntary mechanism and
"a plea to industy to be good and nice" and insist on legally binding measures
to societal actors who are emphatically NOT partners in public policy making.
</SPAN></FONT><o:p></o:p></P>
<P><B><FONT face="Courier New" size=2><SPAN
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">2. The
reversal of public health logic and history (again and again this
nonsense)</SPAN></FONT></B> <BR><FONT face="Courier New" size=2><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'">"Health determines
socioeconomic and political development". It simply does not! And this position
is promoted in order to avoid addressing structural poverty, inequality and
violence which are the direct causes of suffering on earth.
</SPAN></FONT><o:p></o:p></P>
<P><FONT face="Courier New" size=2><SPAN lang=EN-GB
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">The
relationship between health and poverty is two way but it
is</SPAN></FONT><I><SPAN lang=EN-GB
style="FONT-STYLE: italic; mso-ansi-language: EN-GB"> </SPAN></I><I><FONT
face="Courier New" size=2><SPAN lang=EN-GB
style="FONT-SIZE: 10pt; FONT-STYLE: italic; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">not
symmetric</SPAN></FONT></I><FONT face="Courier New" size=2><SPAN lang=EN-GB
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">.
Poverty is the single most important determinant of poor health. But poor health
is very far from being the single most important determinant of poverty. Poor
health</SPAN></FONT><I><SPAN lang=EN-GB
style="FONT-STYLE: italic; mso-ansi-language: EN-GB"> </SPAN></I><I><FONT
face="Courier New" size=2><SPAN lang=EN-GB
style="FONT-SIZE: 10pt; FONT-STYLE: italic; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">exacerbates
existing poverty.</SPAN></FONT></I><FONT face="Courier New" size=2><SPAN
lang=EN-GB
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">
Both the vicious cycle and the 'virtuous' cycle of health and poverty are
misleading images, as they imply equal weight of the two poles of health and
economic development. </SPAN></FONT><o:p></o:p></P>
<P><FONT face="Courier New" size=2><SPAN lang=EN-GB
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">No
amount of excellent medical interventions delivered to Haitians or Tanzanians
today are going to make them or their country prosperous tomorrow if the
national economy is strangled by debt, unfair terms of trade and the continued
pillage of natural resources and destabilized by uncontrolled financial
outflows, wildly fluctuating commodity prices and outside interference in
matters of national sovereignty. </SPAN></FONT><o:p></o:p></P>
<P><FONT face="Courier New" size=2><SPAN lang=EN-GB
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">Haitians
and Tanzanians receiving medical treatment today may survive where others die -
in very precarious conditions, allowing them to contribute valiantly for a
couple more months to gross national product (GNP) - until the next bout of
illness. Unless of course, while the medical technology is being delivered,
attention is being paid to the underlying causes of the population's poor health
status, such as miserable living conditions. </SPAN></FONT><o:p></o:p></P>
<P><B><FONT face="Courier New" size=2><SPAN lang=EN-GB
style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">3.
Completely absent from the analysis (if it can be termed as such) are actors,
causes and clashes of interests</SPAN></FONT></B><FONT face="Courier New"
size=2><SPAN lang=EN-GB
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">:
this text, like all the others emanating from establishment circles is
"apolitical" (but supporting the status quo so in fact highly political - just
not acknowledgeing it), ahistorical and amoral. The time has come for honest
political brokering in which we state our moral values and principles upfront
and the political action required to work towards that moral vision. (It used to
be called socialism and it needs to be reappropriated from the Blairs and
Schroders of this world). </SPAN></FONT><o:p></o:p></P>
<P><FONT face="Courier New" size=2><SPAN lang=EN-GB
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">
</SPAN></FONT><BR><FONT face="Courier New" size=2><SPAN lang=EN-GB
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Courier New'; mso-ansi-language: EN-GB">
</SPAN></FONT><o:p></o:p></P></DIV></BODY></HTML>