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<p class="" style="margin-bottom:0.0001pt;text-align:center" align="center"><b style><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Declaration by the Peoples’ Health Movement of Latin
America and the Caribbean</span></b></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">We, the participants in the first
Latin American Peoples’ Health Assembly, from 19 countries in Latin America and
the Caribbean and 13 in other regions, gathered in Cuenca, Ecuador on 7-11
October 2013, in an ambience of fraternity and commitment, to debate our
struggle for the right to health in the midst of the crisis in capitalist
civilisation.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">A dispute between two major
directions for the future of humanity and the planet marked the context of the
Assembly.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">On the one hand, the dominant trend
in the world is seeking to restore the model of accumulation in a few hands,
with dire social and environmental costs, further dispossessing people through
irrational hyper-consumption, extractivism and the commoditisation of health,
violently imposed while criminalising social protest and resistance. </span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">On the other hand, there is the
emerging trend toward Living Well and guaranteeing the essential preconditions
for health, defending it as a fundamental human right.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Neoliberal prescriptions cannot
stanch this sweeping crisis. Instead, we must build grassroots and
country-level alternatives that tackle the roots of the capitalist system and
its manifestations in the economy and labour, forced migration, contamination
and climate change, ethics and health services.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Latin America and the Caribbean are
contributing concretely to this emancipatory trend, with its history of
resiliency and of fighting for social justice, with alternatives and ideas that
include the furtherance of indigenous wisdom, which teaches us that we must
seek a balance with nature and live in harmony; with the admirable example of
the Cuban people, who have been dealing with a criminal blockade for over half
a century; and in general, with the extensive solidarity and hope in our
region, from which spring alternative models to rebuild our utopian ideals.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">In light of the current discussions
over the post-2015 development agenda, we reaffirm the principles of the Peoples’
Health Movement in the Declaration of Alma Ata, reclaimed, updated and enriched
in our Peoples’ Charter for Health adopted in Bangladesh at our First Peoples’
Health Assembly in 2000, in the Declaration of Cuenca at the Second PHA in 2005
and in the Cape Town Call to Action at the Third PHA in 2012.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">We question the way international
agencies are proposing universal health coverage, centring on basic packages
and services limited by ability to pay. This reduces the problem to one of
access to health care services; although these are of course necessary, they
produce inequities if they are not comprehensive and are also insufficient if
they do not address the social determinants of health that are in the same
development model. Protection of people and of the environment should be at the
centre of public policies and international policy, and we should distance
ourselves from development focused on hyper-consumption and unsustainable,
untenable economic growth.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">We demand mechanisms for
environmental justice alongside social justice, including recognition of the
ecological debt and the differential liability of developed countries in
climate change and in the many other ways nature has been harmed.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">We question the move by several
governments in the region to criminalise and prosecute the legitimate social
mobilisation of the region’s peoples. We are also against their plans to ramp
up extractivist projects.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">We make a special call to the
government of Ecuador to desist in its plans to open the Yasuni Amazon reserve
to oil drilling and expand the extractive model, ignoring the cries of
Ecuadorans and the other peoples of the world who are following the path of
Sumak Kawsay—Living Well, a movement that begin in Ecuador itself. We also call
on Ecuador to not criminalise the social protest movement, but instead to
devise democratic mechanisms to deal with the differences between the
government and social movements.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Together, we commit ourselves to
restoring the health of ecosystems and combating new threats to commoditise
life. With urgency, we express our opposition to technological solutions that
attempt to gloss over social problems:</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">The use of genetically
modified seeds and species, because their genetic modifications have
unpredictable results, they bankrupt peasant farmers, take over large swaths of
land without consulting the people who live there, and turn communities into
laboratories at the service of transnational corporations that are encroaching
on national sovereignty. </span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">The production of
biofuels that increase pollution in order to power vehicles while millions
starve.</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Pesticide use by
large-scale agribusiness.</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">The focus on surgical
and technical procedures that are palliatives, yet mask the underlying
structural causes of disease, differential exposure and preventable premature
death.</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">A pharmaceutical
industry that puts profits before human rights, patents life to appropriate it
and is one of the main driving forces of the medical-industrial complex, which
exploits the results of collaborative research, with the complicity of a large
number of universities and governments.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">These so-called solutions are
creating more problems than the ones they claim to fight, upsetting the balance
in the ecosystem and causing disease, death, bacterial resistance and social
and health exclusion and inequity.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">In response, we call for: </span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">A different model of
society that rises above capitalism to found a new, truly human civilisation
based on solidarity and harmony with the environment, conditions for Living
Well.</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">The embodiment of
sovereignty in health, by building together the conditions that enable a
dignified life for human communities and the environment in which they live. We
want health to be in the hands of communities and the people, thus reclaiming
and appreciating the enormous wealth of knowledge, practices and experience
that the peoples of Latin America and the Caribbean have in protecting and
caring for health.</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Public, universal,
equitable health systems with social justice that are multicultural and include
promotion, prevention, treatment and supportive care, returning to the original
meaning of these terms, which go beyond lifestyle and refer to the integrality
of people and their context.</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Health worker training
institutions that break with the forced commoditisation of the way they
practice and educate from the perspective of the social determinants of health
and inequalities, social responsibility and direct engagement with their
communities.</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Public policy and
governance to lead these necessary changes.</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Broad social
participation based on strengthening social movements and building alliances
that enable communities to seize their rights and mobilise to develop and
defend fair policies that put the right to health and a balanced ecosystem
before the interests of the market, responding to this historic moment of
generalised crisis around us.</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-family:Symbol"><span style>·<span style="font:7pt "Times New Roman"">
</span></span></span><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Research, information
and communications systems free from spying, framed in personal and collective
rights, that allow for the flow of ideas to develop alternatives and make
knowledge freely available to society.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">We know that the ancient wisdom of
Living Well can save the planet. The emancipatory worldviews of indigenous
peoples are being revitalised and reconstituted and can provide the foundation
for the political intentions of the people, after 521 years of resistance. We
are moving towards peoples’ self-determination and autonomy, and along this
path the Peoples’ Health Movement seeks to contribute to building the health
sovereignty of our peoples.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">With our alegremia</span><a style href="#_ftn1" name="_ftnref1" title=""><span class=""><span style><span class=""><span style="font-size:11pt;font-family:Calibri">[1]</span></span></span></span></a><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB"> high, we call on ourselves to continue along the road to human
emancipation, to build health with dignity for the people and for our Mother
Earth.</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">Cuenca de Guapondelig</span></p>
<p class="" style="margin-bottom:0.0001pt"><span style="font-size:12pt;font-family:"Times New Roman"" lang="EN-GB">October 2013</span></p>
<p class="" style="margin-bottom:0.0001pt"> </p>
<div style><br clear="all">
<hr align="left" size="1" width="33%">
<div style id="ftn1">
<p class=""><a style href="#_ftnref1" name="_ftn1" title=""><span class=""><span style><span class=""><span style="font-size:10pt;font-family:Calibri">[1]</span></span></span></span></a><span class=""><span style> </span></span>
<span style="font-family:"Times New Roman"" lang="EN-GB">Alegremia: joy + -emia (blood
concentration) = the level of joy in the blood; a social construct, based on
hope, water, food, air, shelter, education, art and love, that involves a
profound social transformation towards a more dignified, freer and united
world.</span></p>
</div>
</div>
</div>