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AFRO-NETS> People's Health Movement in WHA in Geneva

  • Subject: AFRO-NETS> People's Health Movement in WHA in Geneva
  • From: Claudio Schuftan <aviva@netnam.vn>
  • Date: Mon, 9 Jun 2003 09:58:34 -0400 (EDT)

People's Health Movement in WHA in Geneva

People's Health Movement a force to reckon with in the WHA in Geneva!


Greetings from the People's Health Movement Secretariat (Global) at
CHC, Bangalore - India!

Thanks for the enthusiastic participation, dialogue, fellowship and
collective solidarity expressed during the last few days, we spent in
Geneva from 14th May till the end of WHA. It was a great learning ex-
perience for all of us and I am sure many of us would have grown in
our 'analytical' and 'advocacy; skills. Many people outside the PHM
including within WHO, personally conveyed to me their appreciation of
the seriousness, enthusiasm and collectivity of PHM that was symbol-
ized by all that we did in Geneva and at the WHA. Thanks once again
from the Secretariat.

Many of you volunteered to be rapporteurs; other documented events
with their own notes; some took photographs, and some prepared re-
ports for their own organization. We could be very grateful to get
email copies of most of these materials to circulate them in the Ex-
change and also to prepare a detailed communication of the proceed-

We enclose a first communication - Reporting from London and Geneva.
There may be some omissions, or details not mentioned correctly.
Please do point out any omissions, corrections or modifications, so
that report could be comprehensive and complete. We shall send out an
additional communication on 7th June.

There's lots to be done in the next few months as we celebrate the
Alma Ata Anniversary in our countries and prepare for the participa-
tory process before the next Assembly and the preparatory regional
meetings before that.

Please be in touch and if you would like to volunteer to support any
of the activities or initiatives mentioned in this communication,
then please do so at the earliest.

If you have prepared any audio visuals, published books and booklets
and prepared health education materials on PHM concerns and did not
give me a copy during WHA, then please do so at the earliest by post
or email at the earliest.

Another area where we need urgent support form all of you is the area
of funding. If you have any ideas or suggestions or contacts, who
would be interested to support the movement, please let us know of
them as soon as possible.

Looking forward to keeping in touch
With best wishes,
Your sincerely,
Ravi Narayan


Communication from PHM Secretariat

Reporting from London and Geneva, May 2003

In the last two weeks (from 9th May till 28th May 2003), a series of
important and significant initiatives have taken place in the context
of the evolution of PHM and this is a brief report of the key events,
the decisions and the relevant issues for the PHM Steering group as
well as all PHM members. A more detailed report with supporting docu-
mentation will be circulated as a consolidated file as well as a se-
ries of communications on the PHM Exchange in the next few weeks.


* A detailed evaluation of the PHA process before and during the As-
sembly and of the evolving PHM process after the assembly has just
been concluded by a small evaluation team led by Andrew Chetley (Ex-
change - UK) and three other participatory research consultants -
Roberto (Peru), Mwajuma (Tanzania) and Cecilia (Uruguay).

* The main findings of the evaluation were analyzed and discussed at
a three day Review meeting in London (9th to 12th May 2003), where a
few PHM participants representing different regions of the world
helped to contextualise the findings. The review was planned very
well and included sessions on:

a. Reflections on pre-PHA planning - how did it emerge? What worked
well? What was difficult? What was happening locally (in Latin Amer-
ica, in Asia, in Africa, in Europe, elsewhere)?

b. Reflections on the PHA -what was significant? What worked well?
What was less good? What would have made it better? Was anything

c. Reflections on the post-PHA period and the development of the PHM
- what are some of the significant achievements? What has not worked?
What needs to be improved? How strong are the roots of the movement?
(What's happening in local areas)

d. What others are saying?

e. What are the main conclusions we can see emerging? What are the
lessons that could be most valuable in strengthening the work of the
PHM in the future? What are the messages that we might want to commu-
nicate to a wider audience?

f. Would you do it again? What would you change? How would you do it
differently? What would you keep and build upon? Are there lesions
for the proposed assembly in 2004?

g. Recommendations and unresolved issues / questions.

* Over all, the 'evaluation' confirmed that the PHA had been a per-
sonally endorsing, inspiring and meaningful experience for all those
who participated in the 5 day meeting at GK Savar in December 2000.
Those who came linked to group or collective processes of mobiliza-
tions from different countries and regions, could build on the inspi-
ration 'of the global solidarity' evident at the Assembly and take
the process forward in their own countries after the Assembly.

* A large number of initiatives have taken place all over the world
and the main challenges for the evolving post PHA, movement is to es-
tablish interactive communications and an organizational framework
that enhances creativity and collectivity without too much centrali-
zation or limiting structures

* There were many lessons to be learnt as well for future assemblies
and for the ongoing communication and organizational challenges for
the movement (A more detailed report will be soon available on the
PHM Exchange and the website).


* Over 80 PHM delegates from 30 countries gathered in Geneva to at-
tend the PHM Geneva 2003 event, an Alma Ata Anniversary dialogue on
16th - 18th May at the World Council of Churches, facilitated by our
active PHM Geneva group. The four major thematic sessions were:

a. Primary Health Care and the Health for All campaigns and initia-
tives from all over the world.

b. Access to Affordable and Essential Drugs.

c. War, conflicts and Disasters - Health and humanitarian challenges
- which included reports from Iraq, Palestine, Philippines, Congo,
Sri Lanka and other conflict zones.

d. Global health and the diseases of Poverty, TB, HIV, Malaria. e. A
WEMOS facilitated workshop on the effects of GATS agreement on access
to Health Care and effects of WTO agreement on food and nutrition.

* The delegates included the following:

Fran Baum (Australia); Zafarullah, Nouman, Momtaz, Taznihar, Babul,
Abdul Zabbar, Zubair, Karnal Uddin Ahmed and Mohibubul Haque (Bangla-
desh); Armando (Brazil); Rosalie Bertell (Canada); Patricia Nickson
(Congo); Hani Serag (Egypt); Arturo Quizhpe (Ecuador); Margarite
Posada (El Salvador); Gopal Dabde, Barbara, Schimmer and Gaby Hetler
(Germany); Hugo Icu Peren (Guatemala); Sundararaman, Sudha, Amit,
Mira Shiva, Prem and Hari John and Johny Oomen (India); Mohd. Ali
Barzgar (Iran); Sunil, Savatore Anna and Maria Teresa (Italy); Samuel
Ochieng, Samuel Muwenda and Eva Ombaka (Kenya); Carmelita Canila (Ma-
laysia); Natalia, Cebotarenco (Moldavia); Marjan, Ellen, Patrick,
Melina, Jose, Preeti, Marianne, Annelies, Anke, Nina, Leontien (Neth-
erlands); Maria (Nicaragua); Ghassan (Palestine); Edelinda (Philip-
pines); Bala, Niranjan, Paranie, Thiru (Sri Lanka); David Sanders
(South Africa); Halfdan, Nance, Jean, Allison, David Woodward,
Eugenio, Andres, Monika, Manoj, Eric Ram, Anne Lindsay, Christine,
Manjith, Jourdan Genevieve, Michelle and others (Switzerland and some
France); Mwajuma (Tanzania); Pam, Mike, Andrew Chetley, David McCoy
(UK); Denise Zwahlen, Sarah, Eric, Charlotte (USA); Cecilia Muxi
(Uruguay); Lexi Bambas (Zambia), Ravi Narayan (PHM Secretariat), Un-
nikrishnan (India) and Satya Sivaraman (Thailand) - the PHM Media

* Some WHO team members also attended some of the session. They in-
cluded Dra Mirta Roses (Director of PAHO); Dr. Asamoah Baaha (Drugs
and Vaccine section); German Velasquez (Consultant, Essential Drugs
Unit); Eva Wallstam (Director, Civil Society Initiative) and Jose-
phine Matsumoto (Ext. Relations Officer).


Since the over 80 delegates included many of the steering group mem-
bers representing the 8 funding networks and the evolving 13 regions
of the world, a series of meetings were held from 16th to 18th May in
between and after the PHM Geneva 2003 dialogue to evolve strategies
and initiatives for the year. The key decisions and suggestions were
as follows (a more detailed minutes will be available soon):

* The organizational structure and framework evolved during the
steering group meeting at GK Savar (November 2002) was discussed and
circulated. These included structure of PHM - local, national, re-
gional geographical circles; issues circles; secretariat, Steering
group; general working principles of all these; responsibilities of
focal points and convenors; secretariat criteria; functions and sup-
port group.

* The list of 92 countries (which included 17 state teams from India)
classified by global regions and list of over 100 countries still to
be reached was circulated to encourage PHM members to help mobilize
contact persons from all over the world.

* Andrew Chetley reported the overview and key findings of the PHM
Evaluation; Unni presented an update on the Million signature cam-
paign; Maria,Armando, Amit and Unni reported from the World Social
Forum and Health Forum (Porto Alegre, January 2003).

* The News brief 9 focusing on shift of secretariat; Asia Social Fo-
rum; the November 2002 Steering Committee decisions; the Sri Lanka
HAI-AP meeting; the Human Rights Award for PHM by AIFO, Italy; the
media releases from the PHM media team and other news items was dis-
tributed at Geneva. The next News brief 10 will focus on the World
Social Forum, January 2003; and the PHM regional support tours to
East Africa and the USA regions and the PHM Geneva events.

* A position paper facilitated by David Sanders on Primary Health
Care in the context of the Alma Ata Anniversary initiatives was cir-
culated to many members for final comment and suggestions. This will
be ready for distribution by PHM, as a position paper by end of May.

* Melina presented the details of the launch of the Women's Access to
Health Campaign at the PHM Geneva dialogue and Lexi Bambas and David
McCoy presented the highlights of the PHM - GEGA Joint initiative in
evolving an 'alternative state of World's Health Report' as an evolv-
ing process to monitor global determinants of inequity and ill health
with a focus on international health players and global initiatives.
These were endorsed by the PHM delegates.

* In lieu of announcement of the next People's Health Assembly in
Porto Alegre (Brazil ) in July 2004 and the potential of organizing
another Health Forum before the World Social Forum in Mumbai (January
2004), a four member sub committee consisting of Maria, Amit, Armando
and Mwajuma met and evolved a framework for these events and the
process of evolution and planning. This was presented to the group. A
series of smaller follow up discussions were held during the whole
PHM Geneva phase based on these suggestions and a more detailed
schedule of potential events is outlined in section 5 (see later)


As one of the largest delegations to the WHA this year (over 80 dele-
gates from nearly 30 countries) the PHM contingent made its presence
felt and its enthusiastic and critical interventions were much appre-
ciated. The PHM had grown in strength as a delegation - from 6 in WHA
2001; 35 in WHA- 2002 and now 80+ this year. The key initiatives were
as follows:

* The presence of the PHM delegation at WHA was facilitated by PHM
partners which included World Council of Churches (Churches Action
for Health); Consumer International; Infact; and Save the Children,
UK. Our thanks for their solidarity.

* The PHM delegates were given an orientation to the process of advo-
cacy in the World Health Assembly, in two orientation sessions, which
included a role-play. These sessions were facilitated by Andrew, Ce-
cilia and Carmelita and this greatly enhanced the PHM interactions.
Carmelita was appointed the Advocacy coordinator and issues, events,
responsibilities were divided among the group and small groups of PHM
volunteers were seen actively in action throughout the 10 days.

* PHM participated in 6 NGO- related sessions in WHA which included:

a. Session on Public- Private Health Care on 19th May organized by
WCC and PHM. David Woodward (Geneva), Sundararaman (India) and Samuel
Ochieng (Kenya) were the panelists.

b. The NGO Forum for Health session on 20th May on the theme: The
Primary Health Care Movement after 25 years of Alma Ata: A Civil So-
ciety perspective.

The panelists included Maria (Nicaragua), Delen (Philippines), Eva
and Samuel (Kenya), Prem John (India), Nouman (Bangladesh), Natalia
(Alma Aty), Dr. Barzgar (Iran), Johny Oomen (India), Patricia Nickon

Dr. Raphael Bengoa of WHO also shared some of the key messages on
Primary Health Care from the recently completed WHO review which pro-
voked much discussion.

A book titled 'Poverty, Health and Development' - Health Cooperation
Papers, Issue No. 17, published by Italian Association amici di Raoul
Follereau (Organization for International Health Cooperation, re-
leased by Dr. Eric Ram, consisting a large number of papers which
were presented at the International Workshop on 'Poverty, Health and
Development. Many contributors are from the PHM and a note on the PHA
and Charter and also part of the publication.

c. A session on 'Medicine Prices - a new approach to Measurement' was
organized by Health Action International and WHO on 20th May, evening
which was very well attended.

d. On 21st May, there was an open seminar on National Capacity build-
ing for Health promotion: cooperation and partnership among govern-
ments, NGOs and WHO in overcoming risks to health: This was organized
by the NGO Adhoc Advisory Group on Health promotion.

e. On 21st May, there was a lunch time discussion on " Traditional
Medicine and Spiritual dimensions in Health" organized by the NGO Fo-
rum for Health and the NGO Committee on Spirituality, values and
Global concerns of CONGO in relationship with UN.

Ravi (PHM Secretariat) and Zafarulah (Bangladesh) made short presen-
tation and the animated discussion was supported by Prem and Hari
John, Bala, Mira, and others of PHM.

f. On 22nd May, Save the Childern, UK in collaboration with a WHO
Strategy unit organized a session on New Developments in pro-poor
health policy which was also well attended.

* The participation of PHM delegates in the WHO - process especially
on the agenda items of committee A was as follows.

a. The PHM delegates attended the NGO briefing by WHO on 19th May in
full strength. The four presentations on Policy for relations with
NGOs (Eva Wallstam); the Framework Convention for Tobacco Control
(Derek Yach); WHO and Millenium Development Goals (Andrew Cassels);
Intellectual Property rights, innovations and public health (Jonathan
Quick) were received with great enthusiasm and at least 5-6 PHM dele-
gates responded to each presentation, establishing the active, enthu-
siastic and critical presence of PHM at WHA at the beginning itself.

b. PHM delegates focused on Committee A agenda and attended the ses-
sions on

- Primary Health Care
- Framework Convention on Tobacco Consortium
- WHO contribution to MDGS
- Strategy for Child and adolescent Health and Development
- WHO and HIV / AIDS
- Intellectual Property Rights, innovation and Public Health
- Traditional Medicine
- Strengthening Health Systems in developing countries
- Policy for relations with NGOs
- Joint FAO/WHO evaluation of Codex Alimentarius Communication.

c. PHM made NGO statements in committee A on the following issues.

- Primary Health Care (Churches Action for Health and People's Health
- Concerns and suggestions on Policy for relations between WHO and
non-governmental organizations from a public (in collaboration with
CI, IBFAN and others)
- Joint NGO response to US proposal on IPRs, Innovation and Public
Health (in collaboration with MSF; Health GAP; HAI; ACT UP Paris;
Oxfam, Treatment Action Campaign; Canadian HIV / AIDS legal
network; stop AIDS now!; stop AIDS alliance)
- A draft PHM response to the Report of the Director General WHO -
- A note on IPR.

d. PHM Media team facilitated 7 press releases on the following
themes during the WHA:

War on Health is killing the dream of Health for All (16th May); To-
bacco today, Arms Trade tomorrow - PHM demands WHO target the World's
largest killer industry (20th May); Revive the spirit of Alma Ata -
More Action, Less words please (21st May); Hyper on SARS, Silent on
WARS - will the new WHO DG break the silence (22nd May); Stop attacks
on Palestine Medical Facilities! WHO is there in an emergency (22nd
May); Towards the next People's Health Assembly, Porto Alegre - July
2004 (26th May).

On 20th May, PHM also joined IPHC, Equinet, Medact, WEMOS, Save the
Children and World Development Movement in a joint Press statement
entitled "Health groups warn World Health Assembly, on new WTO threat
to Public Health.

e. Small PHM teams also participated in a few Press Conferences on
16th May, 20th May, and on Wars, Conflict and health; and Primary
Health Care and other issues of concern for PHM.

f. The highlight of the WHA interaction this year was the dialogue
with the new WHO-DG Dr. Lee, who met a 5 member PHM team on Thursday
22nd May and listened to PHM concerns and expectations of WHO. The
team included Ravi (Coordinator, PHM Global Secretariat); Maria (rep-
resenting Latin America); Mwajuma (representing Africa); Zafarullah
(representing Asia); and Ghassan (representing Middle East). The PHM
welcomed the expressed thrusts of the new DG including Primary Health
Care; Decentralization and focus on country offices and action; WHO
as a listening organization, and not only a guiding one. We shared
our willingness to work with the new DG as critical allies and
strengthening civil society voices in International Health decision-
making. We also invited him for the next PHA - 2 in July 2004 at
Porto Alegre (Brazil). The team also presented him with a set of PHM


* The II Peoples Health Assembly (also to be called the first World
Health Social Forum) will be held in Porto Alegre Brazil from 3rd to
7th of July 2004.

* The assembly will bring together living visions / testimonies from
the people and analytical perspectives on the global and local health
situation by specialists and scholars from all over the world commit-
ted to the Movement. It will generate a solid basis for action in a
political content for the next four years 2004-2005.

* It will build on a process of communication and empowerment, rein-
forcing the regional organization of the PHM and widening the coali-
tion of organizations associated with it.

* It will focus on the Struggle for the Universal and Equitable Right
to Health and the Globalization of solidarity; Health as an essential
human need, a right of citizenship, a duty of the state and the re-
sponsibility of the society and a public good.

* Some of the key themes will be Health as Human right; and the legal
expressions of it. Trade issues and health; Environmental destruction
and Health; Militarism, conflicts and Health; Right to access; Sci-
ence and technology and its advancements; Equity; State and Health
system reforms and the right to health and PHC and health promotion
in the context; Human resources for universal health; Economics of
universal health systems; Poverty and Health; Women and Childern's
rights. Other themes would include Food Security; Water and sanita-
tion, HIV/AIDS; Access to drugs; drugs and substance addiction and
mental health as social / economic issue; Mother and child care; en-
demic diseases; injuries and violence; chronic and degenerative dis-

* A core international committee consisting of the sub group already
formed (Maria, Amit, Armando and Mwajuma) and others who volunteer
from the regions will be formed to work on the mobilization process,
the funding and finances, the contents and programmes, the logistics
and the ongoing monitoring and evaluation.

* There will be at least three pre-Assembly events which will also
become focused as Regional activities in preparation for the PHA -

a. September 2003: The Alma Ata Anniversary Meeting hosted by the Is-
lamic Republic of Iran in collaboration with the People's Health
Movement in the second half of September 2003. This will also be a
regional preparatory meeting focusing on the Middle East and Africa
regions. Support from EMRO / SEARO is being explored. (Dates yet to
be confirmed).

b. January 2004: A two day health forum on 14th / 15th January will
be organized preceding the next World Social Forum to be hosted in
Mumbai, from 16th to 21st January. This forum also entitled the III
International Forum for Defense of People's Health will be focused as
a regional preparatory meeting for Asia - both South and South East.

c. March 2004: The ALAMES congress in Peru in March 2003 could become
a regional preparatory meeting for the America.

All these meetings will have to be planned in a participatory way
with democratic representations and process in countries and the re-
gion and the numbers at events will also depend realistically on the
funds / other resources mobilized in the regions and internationally.

* [The secretariat will initiate action to facilitate this process at
a more rapid and sustainable pace. A separate communication follows
on this important development].


The PHM Geneva events were a strategic opportunity to build coali-
tions and linkages with a wide variety of networks and global initia-
tives relevant to people's health concerns. The key linkages estab-
lished were:

a. The Global Forum for Health Research: A dialogue was held with
GFHR during the Geneva meeting, for PHM participation in Forum 7 in
Geneva from 2-5 December 2002. The PHM inputs by Zafarullah, David,
Thelma and Ravi at Forum 6 in Arusha, Tanzania were very much appre-
ciated. Areas and sessions where PHM participants could make signifi-
cant 'evidence based' inputs were identified. These included the ple-
nary on Poverty and Health Research; and the Parallel sessions on
Primary Health Care, Nutrition, Poverty and the life cycle; behav-
ioral and community based interventions and social, economic, cul-
tural and political determinants; Gender and Mental Health. David
Sanders, Convener of Research circle and Ravi (PHM Secretariat) will
follow up on this.

b. A circle on Food and Nutrition issues focusing on right to food;
Nutrition security; Junk foods; sugar issue etc. would be facilitated
by joining IBFAN and other networks like APPAN, which were set up by
the SCM - Nutrition meeting in Chennai in March 2003. Carmelita of
CI-ROAP would be the Convener and contact person. PHM plans to start
an advocacy circle with UNICEF on the Macdonald linkage and other is-
sues would be merged with this circle evolving in a much broader con-

c. Anti Tobacco Circle: While many PHM members have also been in-
volved with the Tobacco issue and the FCTC process and the Civil So-
ciety involvement in support of it, it was felt that IN FACT and
other anti-tobacco groups should be contacted and a circle to learn
from the experiences of the FCTC lobby process as well as monitoring
the post FCTC process at country level should be encouraged. It would
also be important to involve the anti-tobacco networks to organize
workshops on their experiences at WSF and PHA - II next year. A vol-
unteer convener would be identified for this circle.

d. Public-Private partnership Circle: In the context of the WEMOS
supported research process on Public - Private partnerships and the
presence of potential county level partners in Bolivia, India and
Kenya, it was felt that Jose Utrera could be requested to be the con-
tact point for a circle on this issue and that links with Judith
Richter and other networks working on he Global determinants of these
partnerships should be established.

e. PHM - GEGA partnership on Global Equity determinants: The links
with GEGA, MEDACT - UK and others in the collaborative project to
look at Global determinants of Equity and to evolve an evidence based
alternative report on Health situation and health initiatives at
Global level was endorsed. David McCoy and Lexi Bambas would circu-
late a comprehensive idea draft on this report and the process of its
evolution for identifying partners and collaborators.

f. A short dialogue was held with Dr. Bo Stenson of the GAVI Initia-
tive (Global Alliance for Vaccines and Immunization) and PHM concerns
about inadequate Health systems, Research in the GAVI initiative was

[This report brings together the key initiatives that the PHM secre-
tariat coordinator was kept informed off. A large number of smaller
group discussions and one to one meetings were held by PHM partici-
pants with WHA delegates and WHO units and others. This will be com-
piled and included in the next communication. All delegates are re-
quested to send us any contribution to the next communication par-
ticularly focusing on any omissions or any other initiatives or meet-
ings that have been omitted].
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