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<DIV><B>From:</B> <A title=healthwrights@igc.org
href="mailto:healthwrights@igc.org">David Werner</A> </DIV>
<DIV style="FONT: 10pt arial"><SPAN><FONT face=Arial color=#0000ff size=2><SPAN
class=804464504-15092005></SPAN></FONT></SPAN><SPAN><FONT face=Arial
color=#0000ff size=2><SPAN
class=804464504-15092005></SPAN></FONT></SPAN> </DIV>
<DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2>Dear Dr. Maria Magdalena
Herrera,</FONT></SPAN></DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2>Thank you for sending us the
draft of the Primary Health Care Renewal statement drafted by the Pan American
Health Organization. Overall I think it is excellent. It delights me to see
PAHO taking action to restore and revitalize Primary Health Care, with emphasis
on the Comprehensive rather than Selective approach, and with
a stronger focus on Health as a Human Right. I am glad to see that
stress is placed on the underlying "man made" causes of poor health which lie
outside the health sector, including poverty, poorly regulated economic
globalization, and lack of participatory democratic process. The
undermining of the UN by the United States is surely another contributing
factor.</FONT></SPAN></DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2>I would, however, like to see
more detailed analysis, and exploration of strategies for change, in
relation to these sociopolitical and macro-economic causes of poor health,
rather than talking in such vague (and therefore probably ineffective) terms.
This "politically safe" shying away from detailed analysis and the need for
regulatory measures with teeth on both the national and global scale, is
one of the reasons that Comprehensive PHC never got off the ground.
</FONT></SPAN></DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2>By the same token, in the PHC
Renewal statement most of the talk of the need for "greater equity" is
limited to health services. However the area where greater equity is most
important for the health of the most vulnerable populations lies in the arena of
global trade and macro-economic policies. Achieving greater equity in this
area will requires strong international regulations, with a
restructuring of the World Bank, IMF, and WTO so as to make these powerful
bodies more responsive to human and environmental needs, and less beholden
to the corporate "growth at all costs" agenda. These measures need to be spelled
out clearly, with proposals of how "Health as a Human Right" can be used as a
political tool to mobilize action for change -- i.e.the step by step
transformation of our unhealthy and unsustainable macro-economic
system. Short of progress toward such far-reaching structural change,
Primary Health Care Renewal, as well as the watered-down "Health for at least a
few more" by the year 2015 (the MDGs), will go the way of Health for all by
the Year 2000.</FONT></SPAN></DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2>Good luck. You'll need it.
It's an uphill battle! </FONT></SPAN></DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2>But the Primary Health Care
Renewal statement is a good start. Have courage!</FONT></SPAN></DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2>Sincerely,</FONT></SPAN></DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2></FONT></SPAN> </DIV>
<DIV><SPAN><FONT face=Arial color=#0000ff size=2>David Werner
</FONT></SPAN></DIV></DIV>
<DIV class=OutlookMessageHeader dir=ltr align=left><FONT face=Arial size=2><SPAN
style="FONT-SIZE: 12pt"></SPAN></FONT> </DIV>
<DIV class=OutlookMessageHeader dir=ltr align=left><FONT face=Arial size=2><SPAN
style="FONT-SIZE: 12pt">The document in question is available from
healthwrights</SPAN></FONT></DIV>
<DIV class=OutlookMessageHeader dir=ltr align=left><FONT size=2><SPAN
style="FONT-SIZE: 12pt"><A
href="mailto:healthwrights@igc.org">healthwrights@igc.org</A></SPAN></FONT></DIV></BODY></HTML>