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<h1><span style="color:#4f81bd">THE PEOPLE´S HEALTH MOVEMENT <br></span></h1>
<p class="MsoNormal"><span style="font-family:Arial"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">The
evaluation was conducted from January to June 2011, by a team consisting of six
members residing in India, Mexico, South
Africa, Switzerland,
Sweden, and Thailand.
The evaluation was conducted through document review (global docs, evaluations,
report, publications, etc), interviews and electronic survey questionnaires
with the Steering Council, country focal points, IPHU alumni and faculty </span></p>
<h1><span style="color:#4f81bd">Evaluation findings </span></h1>
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<p class="MsoNormal"><b><i style><span style="font-size:11.0pt;font-family:Arial">1. Do the current strategic
objectives respond to the movement’s mission articulated by the People´s
Charter for Health and other strategic documents? </span></i></b><b><span style="font-size:11.0pt;font-family:Arial"></span></b></p>
<p class="MsoCommentText"><span style="font-size:11.0pt;font-family:Arial">PHM
has over the years increased its reach and visibility and become a unifying
movement around the ‘Right to Health’ and contributed to the renewal of
thinking around ‘Health for All’ including social determinants to health. The
People’s Charter for Health sets out an alternative set of values to the
neo-liberal view of the world and calls on action on many fronts – it carries a
strong symbolic value. Some would like to see PHM taking on more / different
issues and some <span style>PHM activists don’t
feel their voice is sufficiently heard at the global level, Not everyone puts
effort into the global level advocacy. Local and global PHM advocacy
initiatives could have more interconnectedness. </span></span></p>
<p class="MsoNormal"> </p>
<p class="MsoNormal"><b><i><span style="font-size:11.0pt;font-family:Arial">2. To
which extent have the current PHM global programs, thematic circles, and other
activities achieved the strategic objectives and responded to the PHM mission? </span></i></b><span style="font-size:11.0pt;font-family:Arial"></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">The
movement has a number of global campaigns and programmes, the Right to Health
Campaign (RTHC), the International People´s Health University (IPHU), the
Global Health Watch (GHW), and WHO Watch. These have raised the profile and
visibility of PHM. The RTHC and IPHU have reached out to new people and groups
and been strong vehicles for dissemination of knowledge and building capacity
of young and new activists. There is however a need for long-term planning and
follow-up for those interested in PHM. The GHW receives strong appreciation
from international activists, academics and government officials. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">Thematic
circles have functioned less well although some have gone through adjustments
and are now considered global programmes, like the WHO Watch. PHM also partners
with the World Social Forum in the vision that ‘another world is possible’.
Communication tools like PHM-Exchange and the websites play an important role
in sharing information and supporting networking. Most global programmes
incorporate some gender analysis, but many would like to see this come out
stronger. </span></p>
<p class="MsoNormal"> </p>
<p class="MsoNormal"> </p>
<p class="MsoNormal"><b><i><span style="font-size:11.0pt;font-family:Arial">3. To
which extent has the current governance structure (including management system
and financial controls) enabled the movement to achieve reasonable levels of
inclusiveness and transparency? </span></i></b><span style="font-size:11.0pt;font-family:Arial"></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">A small
group of committed individuals, most of them volunteers, has put in enormous
efforts over the years to support the movement. These individuals, from diverse
backgrounds and regions, are united by the core values of the PHM. <span style>There is overall agreement within the
Steering Council that it is not functioning optimally in terms of </span>accountability
and that the SC needs a term limit for members. Limited communication within
the SC and between the SC and the Coordinating Committee (CoCo),
as well as with the rest of the PHM (including Country Focal Persons) has led
to misunderstandings, under-appreciation and a perception of lack of
transparency. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">There is
recognition of a generation gap and a need to include more women and
marginalized groups in leadership. It is thus crucial that the action plan for
a new governance structure is implemented as planned leading up to the People’s
Health Assembly (PHA3). Further discussions on how to actively involve women
and marginalized groups in leadership is needed. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">The current
three Global Secretariats (Cape Town, Cairo and Delhi)
are well coordinated and many within PHM appreciate the new structure. Latin America has raised they would like to see the
Global Secretariat being hosted in their region. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">Financial
controls and transparency have greatly improved in recent years </span></p>
<p class="MsoNormal" style><span style="font-family:Arial"><span style> </span></span></p>
<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:Arial">4. How
effective are the current PHM strategies for managing the sustainability of
human and financial resources? </span></b><span style="font-size:11.0pt;font-family:Arial"></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">PHM is very
effective in piggybacking on other events and in its use of limited resources.
The number of paid staff is kept to a minimum. However, the lack of regional
administrative coordinators is making management less than optimal. Most
programmes, as well as the PHM-Exchange depend heavily on one or two people,
which is a risk factor and a lost opportunity to get more PHM members involved.
</span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">The IPHU
has been one of PHM´s most important activities in the last years, but the lack
of follow-up of alumni, as well as more concrete opportunities for them to get
involved in limit its potential in recruiting active members. A notable exception
is the African region which has employed a part time person to coordinate
follow-up activities. Similar results are expected in other regions if
resources were available. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">There is a
need for more clarity in terms of who raises funds for what. At both regional
and national levels there are expectations, as well as uncertainties, over the
role of fundraising from global. Although there is strong appreciation for
volunteer work and it is considered normal that members of the movement
contribute, the lack of funding is considered a challenge across the board.
Changes in donor priorities and economic crises which decrease the availability
of development funds pose real threats to the longer term financial
sustainability of PHM. </span></p>
<p class="MsoNormal" style><span style="font-family:Arial"> </span></p>
<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:Arial">5. Is
the current geographical spread pertinent to carrying out the PHM mission? </span></b><span style="font-size:11.0pt;font-family:Arial"></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">PHM has a
presence in all regions of the world. Many of those active in PHM work at the
grassroots and PHM is therefore able to represent grassroots community health
movements. There is, however, still potential to develop more global links with
these grassroots health movements. PHM’s ‘presence’ in countries is not always
at grassroots, but can also be concentrated on academics. Regional coordination
is lacking in most regions resulting in a lack of planning. Language forms an
obstacle for communications between regions, between countries and within
countries. The digital divide is an important consideration when aiming to
bring out the voices of the poor and marginalized, especially since much of PHM’s
work relies heavily on online communications. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">India</span><span style="font-size:11.0pt;font-family:Arial"> and Latin America seem to be the strongest regions,
although a decline in activities has been reported from India. Latin
America has functioned more independently from PHM in other
regions and from PHM global. The movement in Africa
is young and less established, but growing. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">In other
regions, the Movement is patchy and is often represented by a few dedicated
individuals who have direct contact with the global level. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> </span></p>
<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:Arial">6. To
which extent is the PHM recognized as a global actor for change? </span></b><span style="font-size:11.0pt;font-family:Arial"></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">PHM has a genuinely good reputation globally where it is active</span><span style="font-size:11.0pt;font-family:Arial">. PHM messages ‘resonate’. PHM is
known for its influence on the WHO Commission on Social Determinants of Health
and has a visible presence at the World Health Assemblies. The Global Health
Watch is well recognized by WHO, NGOs and some governments. Various other PHM
publications, as well as articles in publications like the Lancet, contribute
to the visibility of PHM and to the promotion of the message of ‘Health for
All’. PHM’s analysis and health activism is increasingly incorporated into
medical and health education and taken up by lecturers and students. However,
global activities are not always grounded at the local level and the balance
between ‘global’ and ‘local’ (or grassroots) needs to be better managed.</span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> </span></p>
<h1><span style="color:#4f81bd">Suggestions and recommendations </span></h1>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial">The
following are suggestions and recommendations from the evaluation team with the
aim of strengthening PHM´s impact as a global actor for change and from within
the movement.<span style> </span></span></p>
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<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> <b>To
increase the breadth and depth of PHM as a movement and to strengthen its
internal diversity. </b>To embrace diversity is essential for ensuring
credibility and sustainability. Globally, PHM should identify and apply better
ways to represent the diversity of the movement in its governance structures,
priorities, campaigns and working groups. In the regions, this will involve
increasing outreach to other movements, activists and academics who share PHM’s
core values and vision --and who can develop activities which are not current
priorities of PHM. Concrete activities that bring together different countries
and regions will naturally bring different strands of PHM together. It is
important to consciously guard against sectarianism and exclusivism. IPHUs have
a great potential to support movement building by running courses focusing on
collective activism and advocacy. </span></p>
<p class="MsoNormal"> </p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> <b>The
governance structures --from the Steering Council (SC) to the national and
sub-national coordination committees should be reviewed. </b>It is essential to
keep the current global secretariat functions and to ensure its capacity for
strategic fundraising. However, the governance processes and representation
should be made more inclusive and transparent. A system of ‘mentoring’ or
‘coaching’ could provide opportunities for newer and younger PHM members to
become more active. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> <b>The
Gender Committee that that was established in 2010 by the SC should develop an
action plan towards strengthening gendered perspectives and the inclusion of
marginalized issues and concerns. </b>While some of this is happening, there
should be a stock taking of PHM initiatives that provide spaces for this and
alternative new pathways. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> <b>To
strengthen participatory strategic development and planning. </b>Prioritizing
strategies and actions (campaigns, programmes, IPHUs, etc) at national and
regional level, along with processes to decide if and what role PHM can play in
campaigns. Interested IPHU alumni and PHM activists need to be offered concrete
projects and/or campaigns to get involved in so as to make their participation
in PHM active, meaningful and enduring. The African region has positive
experiences of such involvement. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> <b>Regional
SC representatives need to be (s)elected and have support </b><span style>to<b> </b></span>work on outreach, networking
and communication to support planning and activities including fundraising. A
system is underway to make the (s)election of Regional SC representatives more
participatory, inclusive and transparent. Organizing Regional PHAs could
contribute to Movement building and solidarity. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> <b>Environment
and health</b>: PHM is well placed to carry out in-depth, far-reaching
research, awareness-building, campaigning, advocacy and social mobilising to
curb the devastating effects on the health of people, on communities and
climate change, as well as open pit mining and other transnational ‘mega
projects’.</span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> <b>Communication
strategies for improved transparency. </b>Regular summarized meeting minutes
from CoCo and from the SC should be made
available with the possibility for anyone to add their ideas and opinions.
Information about the PHM<span style> </span>(Charter,
principles, activities, structure, functioning, etc.) should be disseminated
widely and made available both electronically and in other ways. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> <b>Communication
strategies for improved networking. </b>In order to improve PHM communications
within the network and with interested ‘outsiders’, a list serve could be
established in which people can select their areas of interest. Thematic
discussions could be initiated through separate email groups, small skype
sessions or internet discussion fora. It is recommended to create a PHM Global
Communications Committee hosted in Latin America
which, in collaboration with the existing web team, could enhance coordination
regionally and in PHM globally through technological and electronic means. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> <b>Develop
local strategies that can influence WHO and global health governance. </b>The
WHO Watch initiative is promising. PHM should increase its emphasis on country
circles (in its broadest definition) to better lobby WHO country
representatives, as well as ministries of health. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:Arial"><b style> A</b> p<b>ermanent PHM presence in Geneva would greatly
facilitate WHO lobbying.</b> PHM is primarily reactive in most policy debates;
while Primary Health Care and ‘Health for All’ were radical and proactive
issues. It is thus recommended that PHM establishes some kind of “think tank”
as a permanent observer of selected priority policy themes. This should be
considered a long term goal given the current financial situation of PHM. </span></p>
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<p class="MsoNormal"> </p>
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