Date: Mon, 5 Sep 2005 16:22:33 +0700
From: "Claudio" <[log in to unmask]>
Subject: People's Health Movement : The Cuenca Decaration
PEOPLE'S HEALTH MOVEMENT
SECOND PEOPLE'S HEALTH ASSEMBLY
CUENCA DECLARATION
Coming from 82 countries around the world, 1492 people met
at the Second People's Health Assembly in Cuenca, Ecuador
from 17th to 22nd July 2005, to analyse global health
problems and to develop strategies to promote Health for all.
Overwhelmingly we reaffirmed the continuing importance of
the People's Charter for Health (2000) and saw it as a
rallying document for the ongoing struggles of the People's
Health Movement globally and within countries.
The vision endorsed at PHA2 is for a socially and
economically just world in which peace prevails; a world in
which all people, whatever their social and economic
condition, gender, cultural identity and ability, are
respected, are able to claim their right to health and
celebrate life, nature, and diversity.
Solidarity with struggles in Ecuador
Here in the heart of the Andes we have learned much from the
hospitality, living cultural heritage, and current struggles
of our Ecuadoran sisters and brothers. We join them in
solidarity to oppose the signing of the Free Trade Agreement
imposed by the government of the United States and the
international financial institutions. This agreement will
increase corporate profits, impoverish the workers,
campesinos and indigenous peoples of the Andes, negatively
influence their living and working conditions and impede
their access to health care and enjoyment of health. We also
join our Andean partners in opposing Plan Colombia, the name
for the biological warfare carried out against them by the
United States, which is poisoning their land and water, and
militarizing their border regions.
The global health reality
We deplore the worsening conditions of health experienced by
many of the world's people and we denounce their cause -
neo-liberalism. Neo-liberal polices imposed by the G8,
transfer wealth from the South to the North, from the poor
to the rich, and from the public to the private sector.
Corporate profits increase while poor people, indigenous
peoples and the victims of war and occupation, suffer.
Economically and politically generated health inequalities
have increased, yet these root causes of avoidable disease
and death are not effectively addressed by current policies
or programs. The spirit of Alma Ata has been betrayed by
most official health systems, though it has been kept alive
in the face of adversity by health activists and health
workers in community projects all over the world.
Comprehensive primary health care is implemented in very few
places, and the provision of health services is rarely seen
as a collective social responsibility. Under neo-liberalism
there is no right to health, racism is nurtured, women's
oppression deepens, social exclusion increases,
environmental degradation becomes the norm, workers' rights
are non-existent, and war serves the profit seeking of big
corporations. Governments, IFIs, WHO, multilateral and
bilateral agencies are strongly influenced by the agendas of
these corporations.
Establish the Right to health in an era of hegemonic
globalization
PHM calls on the peoples of the world to mobilize against
the denial of the Right to Health. The global economic
framework of neo-liberalism, privatization and "free trade,"
made operational through the WTO and international financial
institutions, has played a determinant role in the transfer
to the corporate sector of the control of the determinants
of health. This leads to environmental destruction, toxic
pollution, denial of rights to water, food, and life itself.
The human right to health and health care must take
precedence over the profits of corporations, especially the
profiteering of pharmaceutical companies. The WTO operates
as a de facto world government even though it is unelected,
unrepresentative and unaccountable. Responsibility for
international trade and development must be returned to the
people through reappropriation of relevant UN bodies such as
UNCTAD. Unless it is massively reformed to operate
democratically, the WTO must be dismantled as it is a major
source of massive human rights violations and injustice and
a key mechanism of corporate control of life on earth.
The right to health will be achieved through large scale
popular mobilization. PHM will initiate or support struggles
related to the right to water, food security and food
sovereignty, a healthy environment, dignified work, safe
housing, universal education and gender equity, since
people's health depends on the fulfillment of these basic
rights. PHM will launch a comprehensive campaign to achieve
the "Global Right to Health and Health Care" at the local,
national and international levels, to defend health and
social security (including health care) systems, and to
document and oppose health inequities and denial of the
right to health. PHM will defend health workers in their
opposition to the privatization of health services by
building broad multi-sectoral alliances.
PHM will campaign to end TRIPS, remove it from the WTO, and
oppose bilateral Free Trade Agreements and TRIPS+. We call
upon governments to use the Doha agreement to provide people
with affordable generic drugs. We oppose public-private
partnerships because the private sector has no place in
public health policy making. PHM will continue to monitor
and provide inputs for the WHO Commission on the Social
Determinants of Health to ensure that it effectively
addresses the political and socio-economic causes of
poverty, ill health and health inequity and engages in
meaningful dialogue with civil society as much as possible.
PHM will work with allied movements to coordinate common
international actions against privatization and inequitable
trade regimes.
Promote health in an intercultural context
PHM recognises that interculturality is a fundamental
element to promote social equity and build a fair health
system. Equity in access to health information is a
fundamental human right. It is essential in the struggle for
indigenous people's health. People's knowledge should be
incorporated into the development of culturally based
equitable health services; culturally sensitive prevention
programs; the training of health workers in intercultural
skills; achieving fair conditions of work; food security;
and a healthy ecosystem. PHM will incorporate key issues
such as the struggle against trade agreements, land reform
and indigenous people's land restoration, protection against
piracy of traditional knowledge as a fundamental defence of
social security, cultural identity and nutritional security.
The many useful aspects of traditional medicine and culture
must be valued and included as part of a people-oriented
society and health system.
Advance the right to health for all in the context of gender
and personal diversity
The health of women, men and people of diverse sexual
orientation is severely damaged by the dominance of a
patriarchal culture with social and gender inequities and
discrimination that affects their integrity. The social,
health, sexual and reproductive rights of women are often
denied. PHM commits to mainstreaming gender and feminist
perspectives in all its work and action plans. Men and women
of PHM commit themselves to deconstruct patriarchal
relations in private and public life. This Assembly demands
the dismantling of neoliberal policies that have increased
gender inequality. To do so it will support international,
regional and local campaigns for sexual and reproductive
rights; strengthen communication and work relations with
networks and other movements; and work to ensure safe
abortion for all women and girls. PHM firmly denounces all
forms of violence including that against women, such as
femicide, and demands government action to prevent it, to
prosecute perpetrators and to provide all necessary support
for people affected by violence.
People with disabilities and older people should be treated
with respect and their right to appropriate health care
should be ensured. PHM supports a new UN convention
protecting and promoting the rights of persons with
disabilities, promotes rehabilitation services as part of
PHC, and urges the Commission on Social Determinants of
Health to develop more focus on people with disabilities.
PHM argues for the inclusion of people with disabilities in
all aspects of life, and recommends that disability be
addressed in a similar way as gender among donor agencies so
that inclusive development is ensured.
Protect the right to health in the context of environmental
degradation
PHM calls upon the people of the world to support action to
end imperialist control of the earth's natural resources and
create and maintain a healthy environment for all. Natural
resources essential to health are global commons. We call
for a worldwide campaign for a UN Treaty on the Right to
Water, ensuring that commodification and privatization of
this vital resource - life itself - is both reversed and
prevented. Guided by evidence of devastating damage and by
the precautionary principle, we demand a moratorium on
extractive mining and petroleum exploration/extraction, a
ban on patenting of life forms and processes, research on
nanotechnology, release into the environment of GMOs, and on
development and use of all biochemical weapons. Governments
are accountable to people not transnational corporations and
must guarantee rights relating to health and the environment
through enforceable laws and regulations. Governments, IFIs
and the WHO must cease to be accomplices to TNCs and
imperialism. Dow, Monsanto and other companies must be
forced to provide reparations to the thousands of
uncompensated victims of disasters such as Bhopal and Agent
Orange. Knowledge and science must be reclaimed for the
public good and freed from corporate control.
Ensure workers' health and safety by defending and extending
existing rights
PHM calls upon the people of the world to demand the
implementation of international treaties that protect
workers' health and safety, recognize workers' health as a
universal human right and a responsibility of the state,
involve workers in the decision and policy-making process on
working and health conditions and ban child labour. We
support social arrangements to ensure the right to regular,
meaningful and adequately remunerated work, with equal pay
for equal work for men and women; protection of historical
achievements attained by trade unions in the formal sector,
renewal and strengthening of trade union, workers' and
anti-globalization movements and their links to other
movements; protection of the health of informal sector
workers and migrants as they are more exposed to
occupational health hazards; and universal health coverage
through national health systems and insurance.
Defend the right to health in the face of war,
militarization and violence
PHM calls on the people of the world to oppose war and
militarization as the most blatant attacks on people's
health, especially the health of women and the poor. While
the terror attacks in New York, Madrid and London caused
unjustifiable damage, the US-led "war on terror" has
generated an even more terrible, unjustifiable and endless
war on defenseless populations in order to control their
natural resources. At the same time, wars that have claimed
millions of lives are unacknowledged as the UN system and
our governments allow them to continue unabated.
PHM will continue to participate in the global movement to
end the US occupation of Iraq and Afghanistan. Foreign
troops should be removed immediately and reparations paid
for damage caused by the US-led war. PHM calls for an
investigation into the use of torture by US soldiers and
medical personnel at Guantanamo Bay, in Iraq and
Afghanistan, and an immediate end to the detention of
foreign nationals held without trial at Guantanamo Bay. We
demand that medical personnel refuse to participate in
illegal detention and torture. The US and its allies must be
charged with violations of the Geneva Conventions for their
attacks on civilian populations, particularly medical
personnel and institutions in Iraq.
PHM calls upon the United Nations and humanitarian agencies
to intervene effectively in the "hidden wars" in the Congo,
Sudan, Chechnya and many other places to foster lasting
peace through political reconciliation and economic and
social development programs that transform the social and
economic conditions that give rise to these wars.
PHM opposes the Israeli occupation of Palestine and the
efforts to isolate and ghettoize the Palestinian people
behind the illegal separation wall. Denial of Palestinian
health rights on the West Bank and Gaza has reached
emergency proportions.
PHM supports the steps toward democracy and
self-determination made by the indigenous people of southern
Mexico, and calls for an end to the low-intensity conflict
waged against them by the Mexican government.
PHM denounces the biological warfare called Plan Colombia
currently being waged against the peoples of Colombia,
Ecuador and Peru under the guise of drug control. These
actions contravene international conventions, and
irreversibly damage environmental and human health in the
region.
PHM calls upon the United States to take responsibility for
and compensate victims of Agent Orange in Vietnam, and the
toxic contamination left by US military bases in the
Philippines and elsewhere.
Struggle for comprehensive primary health care and
sustainable, quality, local and national health systems
PHM recognises that neo-liberal policies have resulted in
disinvestments in public sector health services; the
promotion of a limited number of mostly curative technical
interventions selected solely on the basis of a very narrow
and often inappropriate application of cost effectiveness
analysis,
the corresponding neglect of broader environmental actions;
the accelerated migration of health workers from public to
private sectors and thence to wealthy countries; and the
continuing spread of HIV/AIDS especially in Africa, with the
collapse of public health services in many countries.
PHM calls upon governments to:
a.. Implement comprehensive community-based Primary
Health Care initiatives that enroll or involve relevant
sectors and are supported by legislation.
b.. Provide healthy living and working environments in
order to respect and guarantee the health
rights of all.
a.. Establish and fully implement universal health care
financing mechanisms at national level in all countries
(public health expenditure being at least 15% of the overall
budget, especially in African countries) in order to provide
protection for the whole population.
b.. Address the crisis of human resources for health
(HRH) by: improving working conditions, training, support
and supervision for health workers; implementing an
International code of practice on ethical recruitment,
financial compensation to exporting countries, return and
reorientation of health workers in the diaspora through
incentives, and establishing a global fund for HRH.
c.. Ensure widespread knowledge on HIV status; access to
opportunities for voluntary testing; equitable, and
sustainable access to ARVs with emphasis on prevention;
comprehensive home-based care including health and social
services.
PHM calls upon the WHO to support and promote the above as
national government responsibilities and to advocate for the
removal of economic and political obstacles at global,
regional and national levels, that adversely affect national
governments' social policies.
PHM will continue to raise awareness among communities on
policies, policy-making processes and financial issues to
enable them to monitor government performance, increase
accountability and address health equity issues. PHM commits
to gathering from within its movement, positive experiences
of comprehensive PHC to build up the evidence base that
supports such an approach, and to undertake concerted
advocacy for its revitalization.
Finally, PHM salutes and supports the strong social justice
approach to health in Venezuela and Cuba which inspires and
encourages us towards Health for All.
Support the growth of PHM
The People's Health Movement is both a network and a
movement that takes as its mission the strengthening of the
much wider movement of individuals and organisations around
the world fighting for the Right to Health. PHM is bound by
a commitment to the People's Charter for Health and includes
country circles, issue circles and affiliates which are
actively involved in advancing the work of the PHM. Beyond
this core of PHM activists are the friends of PHM and
organisational partners at all levels.
Another world is possible - these are our strategies to
achieve it!
This declaration urges health activists around the world to
organise, influence, advocate, analyse and educate to
advance global people's health.
The People's Health Movement -
- will pursue work on the human right to health that
includes both individual and community rights.
- will continue to struggle for improved ways of working by
strengthening its regional as well as its global
coordination. It will continue to develop participatory and
transparent decision making so that activists at all levels
know that their views are valued.
- celebrates the inauguration of the International People's
Health University, a university for health activists with
courses presented in association with local PHMs and
selected universities around the world.
- will engage with formal training institutions and
challenge the dominance of the biomedical paradigm of health
care. It will incorporate diverse strategies for
reorienting health worker education to comprehensive PHC,
keeping people in communities at the centre.
- will become a forum within which intellectuals can support
local activists in their action and struggle.
- will challenge the media to disseminate its perspectives
and publicize its activities.
- will strengthen its communications strategy to reach
communities at the grassroots.
- will translate as many of its communications as possible
into two or more languages; will establish a mix of central
and regional/national websites; the PHM newsletter will
continue quarterly publication and will be translated into
other languages.
As a summary of PHM´s strategy for the next three years:
-PHM will be linking the local, the national and the global
by passing on and giving guidance to its geographical
circles on the issues on which to concentrate tactically.
-PHM will document, analyze and disseminate research
findings on key issues pertaining to the principles in its
Charter, including gathering, analyzing and disseminating
key evidence for its constituency of the efficacy and
sustainability of initiatives in comprehensive primary
health care.
-PHM will create awareness about the burning health issues
of the day and will delegitimize and demystify false claims,
prescriptions and slogans used by the Establishment.
-PHM will work with grassroots organizations and communities
trying to understand their issues, building partnerships and
supporting their activists in their struggle.
-PHM will adopt an approach of strengthening rights, and
will support initiatives to achieve the Right to Health and
Health Care at the local, national and international levels
-PHM will work tirelessly to build international solidarity
with the oppressed and with those affected by natural
disasters and civil strife,
- PHM will confront powerful forces of oppression in the
struggle for economic justice, in particular through
support for cancellation of debt, the end of economic
conditionalities and the establishment of a fair
international tax regime.
-PHM will incorporate cultural and spiritual practices in
all aspects of its work.
-PHM will advocate with national governments, UN and other
national and international agencies to influence their
decision-making.
The power of the People's Health Movement can change the
world. Another World, which includes Health for All, is
possible. We must all demand and struggle towards a world in
which health is a right, and is not subject to the forces of
neo-liberalism.
SUPPORT and sign on to the People's Health Charter and the
Million Signature Campaign which is demanding Health for All
Now, JOIN your local PHM group and support the new campaigns
and activities being initiated. www.phmovement.org
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