<div class="gmail_quote">From: <b class="gmail_sendername"></b> <span dir="ltr"><<a href="mailto:access@imaxi.org">access@imaxi.org</a>></span><br><br><br>
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<h1>Counter Austerity! Vote for Bottom-Up Democracy
in Health<br>
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<p>The time has come to invite the millions of people living
with life-threatening diseases to join the movement for the
Right to Health. Yet, surprisingly, there is some opposition
to this invitation.</p>
<p>Within many Global Health 'silos' - the individual disease
programs such as TB, HIV, and Malaria, a handful of civil
society organizations have succeeded in gaining a place at
the board table of the policy makers. In other 'silos',
including those of the non-communicable diseases, the
handful is actually just a finger-full, and participation is
far too limited to the mega multi-national NGOs. They all
speak of 'community' and of the 'voices of those in need',
and often bring selected photogenic patients to meetings to
make their demands for still more resources 'look good', but
this is not meaningful involvement.</p>
<p>In some of the global health institutions (WHO, UNAIDS,
UNITAID, Stop TB Partnership, etc) 'delegations' have been
established and run by big NGOs, with 'representatives'
selected by the inner-circle. Little if any effort has been
made to open the system of representation up to wider
participation, and many have resisted attempts to do so.
Gatekeepers assure that mostly the same usual suspects can
attend high level meetings, and they often 'represent'
people living with the diseases in several institutions -
but without any real mandate. This also assures that the
genuine and unfiltered voices of people with 'serious'
diseases are not heard, and that they can't participate in
the decisions that may be of life or death importance to
them. Although there are some very good and sincere people
involved, the systems of representation are exclusive, and
institutionalize elitism and nepotism. Conflicts of interest
are hidden from view, and the lack of civil society
accountability is a green light to governments to allow
corruption to go unchecked on the ground. With no watch-dogs
on the streets, those above can 'alley-cat' without fear.</p>
<p>The coming years of hard times for health financing will
impact hardest on those at the bottom - poor sick people in
hundreds of thousands of districts around the world. Too
many suffer and die needlessly already due to lack of access
to basic essential medicines and care, and the projections
for the future are deathly dreadful. Clearly, urgent action
is needed to mobilize a greater participation in health
issues from more of the population, and to harness these
human resources to bring pressure on governments and global
institutions to keep promises, deliver better services and
to increase their support for the Right to Health for all,
the underlying obligation of all governments that are
members of the United Nations, and all organizations working
in health. The present system of unaccountable
representation must be reformed.</p>
<p>Recent advances in mobile technology and social media now
allow for greater participation via SMS (FrontlineSMS for
example) and simple messaging across social networks in any
language. Twitter, for example, can be used on any non-smart
phone in many low income countries, enabling almost anyone
to learn more and to 'have a say'. A growing number of
innovative 'mobile-activists' around the globe have been
developing systems for SMS based information exchanges and
even voting in referendums on local issues. m4HealthDev
projects and products, by and for the community, are gaining
ground each day, and now need to be scaled-up and
replicated.</p>
<p>Today, some sixty million very poor people are sick and
suffering, and must be allowed to participate in decisions
that are about them. Democracy is a great tool for
accountability and transparency, and is now the key tool for
mobilizing widely so that 'austerity' isn't fatal to many
millions already at risk. The time is now to begin the
process of developing mPowered patients, who can build their
own systems of democratic representation, from the
bottom-up. Now, we must demand that those in power act to
reform bad practices, and support the march for the Right to
Health by the voiceless. From the bottom to the top - the
short message is "Democracy Now!" <br>
-<br>
<a href="http://www.imaxi.org/content/counter-austerity-vote-bottom-democracy-health" target="_blank">http://www.imaxi.org/content/counter-austerity-vote-bottom-democracy-health</a><br>
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<p>Celina & Case, Coordinators<br>
IMAXI Cooperative Trust (Kerala, IN)<br>
<a href="http://www.imaxi.org" target="_blank">http://www.imaxi.org</a>
<br>
tweet: @IMAXIcoop<br>
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