In 1978, at the Alma-Ata Conference, ministers from 134 countries in association with WHO and UNICEF called for 'Health for All by the Year 2000' and selected Primary Health Care as the best tool to achieve it.
Unfortunately, that dream never came true. The health status of Third World populations has not improved. In many cases it has deteriorated further. Currently, we are facing a global health crisis, characterised by growing inequalities within and between countries. New threats to health are continually emerging. This is compounded by negative forces of globalisation which prevent the equitable distribution of resources necessary for people's health, particularly the poor.
Within the health sector, failure to implement the principles of primary health, care as set out in the Alma-Ata declaration, has significantly aggravated the global health crisis. Governments and the international community are fully responsible for this failure.
It is now essential to build a concerted international effort to put the goal of Health for All in its rightful place on the development agenda. Genuine, people-centred initiatives must be strengthened to increase pressure on decision makers, governments and the private sector to ensure that the vision of Alma-Ata becomes a reality.
Several international organisations and civil society movements, non-governmental organisations (NGOs) and women's groups decided to work together towards this objective. This group, together with others committed to the principles of primary health care and people's perspectives organised the People’s Health Assembly, which took place form 4-8 December 2000 in Bangladesh, at Savar. 1453 participants from 92 countries came to the Assembly which was the culmination of 18 months of preparatory action around the globe. The preparatory process elicited unprecedented enthusiasm and participation of a broad cross section of people who have been involved in thousands of village meetings, district level workshops and national gatherings.
At the Assembly, they reviewed their problems and difficulties, shared their experiences and plans, and formulated and endorsed the People’s Charter for Health. The Charter is now the common tool of a worldwide citizen's movement committed to making the Alma-Ata dream a reality. We encourage and invite everyone who shares our concerns and aims to join us by endorsing the Charter.
Health is a social, economic and political issue and above all a fundamental 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, national governments, international organisations and corporations.
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.
”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 because many illnesses and deaths have their roots in the economic and social policies that are imposed on us.”
(A voice from Central America)
In recent decades, economic changes world-wide have profoundly affected people’s health and their access to health care and other social services.
Despite unprecedented levels of wealth in the world, poverty and hunger are increasing. The gap between rich and poor nations has widened, as have inequalities within countries, between social 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 depleted at an alarming rate. The resulting degradation of the environment threatens everyone’s health, especially the health of the poor. There has been an upsurge of new conflicts while weapons of mass destruction 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 equity and justice.
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 action.
Health is a reflection of a society’s commitment to equity and justice. Health and human rights should prevail over economic and political concerns.
This Charter calls on people of the world to:
Economic challenges
The economy has a profound influence on people’s health. Economic policies that prioritise equity, health and social well-being can improve the health of the people as well as the economy.
Political, financial, agricultural and industrial policies which respond primarily to capitalist needs, imposed by national governments and international organisations, alienate people from their lives and livelihoods. The processes of economic globalisation and liberalisation have increased inequalities between and within nations.
Many countries of the world and especially the most powerful ones are using their resources, including economic sanctions and military interventions, to consolidate and expand their positions, with devastating effects on people’s lives.
This Charter calls on people of the world to:
Social and political challenges
Comprehensive social policies have positive effects on people’s lives and livelihoods. Economic globalisation and privatisation have profoundly disrupted communities, families and cultures. Women are essential 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 weakened. 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 people. 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:
Environmental challenges
Water and air pollution, rapid climate change, ozone layer depletion, nuclear energy and waste, toxic chemicals and pesticides, loss of biodiversity, deforestation and soil erosion have far-reaching effects on people’s health. The root causes of this destruction include the unsustainable exploitation of natural resources, the absence of a long-term holistic vision, the spread of individualistic and profit-maximising behaviours, and over-consumption by the rich. This destruction must be confronted and reversed immediately and effectively.
This Charter calls on people of the world to:
War, violence, conflict and natural disasters
War, violence, conflict and natural disasters devastate communities and destroy human dignity. They have a severe impact on the physical and mental health of their members, especially women and children. Increased arms procurement and an aggressive and corrupt international arms trade undermine social, political and economic stability and the allocation of resources to the social sector.
This Charter calls on people of the world to:
A People-Centered Health Sector
This Charter calls for the provision of universal and comprehensive primary health care, irrespective of people’s ability to pay. Health services must be democratic and accountable with sufficient resources to achieve this.
This Charter calls on people of the world to:
People's Participation for a Healthy World
Strong people’s organisations and movements are fundamental to more democratic, transparent and accountable decision-making processes. It is essential that people’s civil, political, economic, social and cultural rights are ensured. While governments have the primary responsibility for promoting a more equitable approach to health and human rights, a wide range of civil society groups and movements, and the media have an important role to play in ensuring people's power and control in policy development and in the monitoring of its implementation.
This Charter calls on people of the world to:
Source: People's Health Movement, http://phmovement.org