AFRO-NETS> People's Charter for Health, December 2000

[Claudio Schuftan <aviva@netnam.vn>]

People's Charter for Health, December 2000
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Part 1 of 2

PREAMBLE

Health is a social, economic and political issue and above all a fun-
damental human right. Inequality, poverty, exploitation, violence and 
injustice are at the root of ill-health and the deaths of poor and 
marginalised people. Health for all means that powerful interests 
have to be challenged, that globalisation has to be opposed, and that 
political and economic priorities have to be drastically changed.

This Charter builds on perspectives of people whose voices have 
rarely been heard before, if at all. It encourages people to develop 
their own solutions and to hold accountable local authorities, na-
tional governments, international organisations and corporations.

VISION 

Equity, ecologically-sustainable development and peace are at the 
heart of our vision of a better world - a world in which a healthy 
life for all is a reality; a world that respects, appreciates and 
celebrates all life and diversity; a world that enables the flowering 
of people's talents and abilities to enrich each other; a world in 
which people's voices guide the decisions that shape our lives.

There are more than enough resources to achieve this vision.


THE HEALTH CRISIS 

"Illness and death every day anger us. Not because there are people 
who get sick or because there are people who die. We are angry be-
cause many illnesses and deaths have their roots in the economic and 
social policies that are imposed on us." (A voice from Central Amer-
ica)

In recent decades, economic changes world-wide have profoundly af-
fected people's health and their access to health care and other so-
cial services. Despite unprecedented levels of wealth in the world, 
poverty and hunger are increasing. The gap between rich and poor na-
tions has widened, as have inequalities within countries, between so-
cial classes, between men and women and between young and old. A 
large proportion of the world's population still lacks access to 
food, education, safe drinking water, sanitation, shelter, land and 
its resources, employment and health care services. Discrimination 
continues to prevail. It affects both the occurrence of disease and 
access to health care. The planet's natural resources are being de-
pleted at an alarming rate. The resulting degradation of the environ-
ment threatens everyone's health, especially the health of the poor. 
There has been an upsurge of new conflicts while weapons of mass de-
struction still pose a grave threat. The world's resources are 
increasingly concentrated in the hands of a few who strive to 
maximise their private profit. Neoliberal political and economic 
policies are made by a small group of powerful governments, and by 
international institutions such as the World Bank, the International 
Monetary Fund and the World Trade Organisation. These policies, 
together with the unregulated activities of transnational 
corporations, have had severe effects on the lives and livelihoods, 
health and well-being of people in both North and South. Public 
services are not fulfilling people's needs, not least because they 
have deteriorated as a result of cuts in governments' social budgets. 
Health services have become less accessible, more unevenly 
distributed and more inappropriate. Privatisation threatens to 
undermine access to health care still further and to compromise the 
essential principle of equity. The persistence of preventable ill 
health, the resurgence of diseases such as tuberculosis and malaria, 
and the emergence and spread of new diseases such as HIV/AIDS are a 
stark reminder of our world's lack of commitment to principles of eq-
uity and justice.


PRINCIPLES OF THE PEOPLE'S CHARTER FOR HEALTH

* The attainment of the highest possible level of health and well-
  being is a fundamental human right, regardless of a person's colour, 
  ethnic background, religion, gender, age, abilities, sexual orienta-
  tion or class.

* The principles of universal, comprehensive Primary Health Care 
  (PHC), envisioned in the 1978 Alma Ata Declaration, should be the ba-
  sis for formulating policies related to health. Now more than ever an 
  equitable, participatory and intersectoral approach to health and 
  health care is needed.

* Governments have a fundamental responsibility to ensure universal 
  access to quality health care, education and other social services 
  according to people's needs, not according to their ability to pay. 

* The participation of people and people's organisations is essential 
  to the formulation, implementation and evaluation of all health and 
  social policies and programmes.

* Health is primarily determined by the political, economic, social 
  and physical environment and should, along with equity and sustain-
  able development, be a top priority in local, national and interna-
  tional policy-making.


A CALL FOR ACTION 

To combat the global health crisis, we need to take action at all 
levels - individual, community, national, regional and global - and 
in all sectors. The demands presented below provide a basis for ac-
tion.


HEALTH AS A HUMAN RIGHT 

Health is a reflection of a society's commitment to equity and jus-
tice. Health and human rights should prevail over economic and po-
litical concerns. This Charter calls on people of the world to:

* Support all attempts to implement the right to health.
* Demand that governments and international organisations reformu-
  late, implement and enforce policies and practices which respect the 
  right to health.
* Build broad-based popular movements to pressure governments to in-
  corporate health and human rights into national constitutions and 
  legislation.
* Fight the exploitation of people's health needs for purposes of 
  profit.


TACKLING THE BROADER DETERMINANTS OF HEALTH 

Economic challenges 
The economy has a profound influence on people's health. Economic 
policies that prioritise equity, health and social well-being can im-
prove the health of the people as well as the economy. Political, fi-
nancial, agricultural and industrial policies, which respond primar-
ily to capitalist needs, imposed by national governments and interna-
tional organisations, alienate people from their lives and liveli-
hoods. The processes of economic globalisation and liberalisation 
have increased inequalities between and within nations. Many coun-
tries of the world and especially the most powerful ones are using 
their resources, including economic sanctions and military interven-
tions, to consolidate and expand their positions, with devastating 
effects on people's lives.

This Charter calls on people of the world to:

* Demand radical transformation of the World Trade Organisation and 
  the global trading system so that it ceases to violate social, envi-
  ronmental, economic and health rights of people and begins to dis-
  criminate positively in favour of countries of the South. In order to 
  protect public health, such transformation must include intellectual 
  property regimes such as patents and the Trade Related aspects of In-
  tellectual Property Rights (TRIPS) agreement.

* Demand the cancellation of Third World debt.

* Demand radical transformation of the World Bank and International 
  Monetary Fund so that these institutions reflect and actively promote 
  the rights and interests of developing countries.

* Demand effective regulation to ensure that TNCs do not have nega-
  tive effects on people's health, exploit their workforce, degrade the 
  environment or impinge on national sovereignty.

* Ensure that governments implement agricultural policies attuned to 
  people's needs and not to the demands of the market, thereby guaran-
  teeing food security and equitable access to food.

* Demand that national governments act to protect public health 
  rights in intellectual property laws.

* Demand the control and taxation of speculative international capi-
  tal flows.

* Insist that all economic policies be subject to health, equity, 
  gender and environmental impact assessments and include enforceable 
  regulatory measures to ensure compliance.

* Challenge growth-centred economic theories and replace them with 
  alternatives that create humane and sustainable societies. Economic 
  theories should recognise environmental constraints, the fundamental 
  importance of equity and health, and the contribution of unpaid la-
  bour, especially the unrecognised work of women.

Social and political challenges
Comprehensive social policies have positive effects on people's lives 
and livelihoods. Economic globalisation and privatisation have pro-
foundly disrupted communities, families and cultures. Women are es-
sential to sustaining the social fabric of societies everywhere, yet 
their basic needs are often ignored or denied, and their rights and 
persons violated. Public institutions have been undermined and weak-
ened. Many of their responsibilities have been transferred to the 
private sector, particularly corporations, or to other national and 
international institutions, which are rarely accountable to the peo-
ple. Furthermore, the power of political parties and trade unions has 
been severely curtailed, while conservative and fundamentalist forces 
are on the rise. Participatory democracy in political organisations 
and civic structures should thrive. There is an urgent need to foster 
and ensure transparency and accountability.

This Charter calls on people of the world to:

* Demand and support the development and implementation of comprehen-
  sive social policies with full participation of people.

* Ensure that all women and all men have equal rights to work, live-
  lihoods, to freedom of expression, to political participation, to ex-
  ercise religious choice, to education and to freedom from violence.

* Pressure governments to introduce and enforce legislation to pro-
  tect and promote the physical, mental and spiritual health and human 
  rights of marginalised groups.

* Demand that education and health are placed at the top of the po-
  litical agenda. This calls for free and compulsory quality education 
  for all children and adults, particularly girl children and women, 
  and for quality early childhood education and care.

* Demand that the activities of public institutions, such as child-
  care services, food distribution systems, and housing provisions, 
  benefit the health of individuals and communities.

* Condemn and seek the reversal of any policies, which result in the 
  forced displacement of people from their lands, homes or jobs.

* Oppose fundamentalist forces that threaten the rights and liberties 
  of individuals, particularly the lives of women, children and minori-
  ties.

* Oppose sex tourism and the global traffic of women and children.

(to be continued) 

--
Claudio Schuftan
Hanoi, Vietnam
mailto:aviva@netnam.vn

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