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Executive Summary: Working Group on Health Promotion

Coordinators

Eric Ram (World Vision International) & Ann Lindsay (NGO Forum on Health / CONGO)

Reporters

Manjit Dosanjh (CERN) & Alison Katz

Assistance

Virginia Rose (Mandat International)

Health as a human right emerged as the unifying theme of the seven working groups on health (see below). It was agreed that poverty, inequality, exploitation, violence and injustice are the root of poor health and deaths of poor, marginalized and vulnerable people. The neglect of economic and social rights among the five indivisible human rights (social, economic, political, civil and cultural) prevents any meaningful implementation of the right to health. The major determinants of health lie outside the health sector and are often beyond the control of people and their communities.

A second unifying theme was poverty as the greatest, single determinant of illness and death and its eradication as the starting point for long term, meaningful action. In short, as the People's Health Movement asserts, poverty is the disease. This is the perspective of WHO's Alma Ata Declaration on Primary Health Care of 1978. But it is a very different perspective from that of today's international health community, which has been heavily influenced by neoliberal doctrine and agenda.

A key recommendation 25 years on from Alma Ata, was for civil society to press WHO to set up a Poverty and Health Commission to pursue work on these issues and to return to its role as a strong advocate for the poor in the struggle for a fair, rational, international economic order.

In relation to the above, private sector involvement in health policy and delivery requires careful scrutiny. Public-private partnerships are strongly promoted despite the fact that no evidence is available to show that they have any positive effects on the health status of people nor on their access to medicines. Moreover, the private sector and the international economic and financial policies on public services have together contributed to the dismantling of already fragile infrastructures, including national health care delivery systems.

Civil society participation in health work cannot be assessed unless and until a distinction is made between business interest NGOs (BINGOs) and public interest NGOs (PINGOs). BINGOs are in fact the political lobby of industry. Particularly problematic is the fact that in the 1997 UN reform, corporations were included as civil society partners with a role as 'shapers of policy' on an equal footing with NGOs and academic and research institutions.

Inequality in health is exemplified by what is known as the 10/90 gap, referring to the fact that only 10% of health research worldwide is devoted to 90% of the world's health problems. The Global Forum for Health Research has been set up to address this gap. Even a small shift in the proportion would help significantly.

For vulnerable groups, such as children (especially girls), women, the disabled, old people, refugees and migrants, war victims and indigenous peoples, health as a human right is especially critical and must override short sighted, economic concerns. Providing health must not be seen as a stepping-stone to economic development but as a right in itself. In the case of indigenous peoples, traditional foods and medicines are being replaced by "Western" foods and medicines with disastrous effects, malnutrition, poor health and reduced life expectancy. Land is their health and their life and must not be taken away from them.

Conclusions and recommendations

Health and human rights

To promote health as a basic human right for all.
To promote the Right to Health as inseparable from the Right to Life.
The right to life and health is universal "health for all".

Health and development: a question of poverty

To bring evidence to the Forum on Health Research that inequality, poverty, exploitation, violence and injustice cause ill health.
To request the World Health Organization to set up a Poverty and Health commission.
To strive for equity and equitable distribution.
To make distribution economics rather than growth economics the basis for health policy.

The private sector and health: access to medicine

To call for a moratorium on the creation of new "global funds".
To promote local production of generics (use of developing regions).
To strengthen infrastructure for delivering even donated drugs.
To ensure that private and public funding empowers local producers.

Vulnerable populations and their access to health and medicine

To gather and present evidence of the effects of national and international policies on the health of vulnerable people.
To adopt a holistic approach to health related issues, such as nutrition.
To promote health as a human right irrespective of gender, race, age, disability, and political situation.
To raise awareness, especially in women, for equal rights for girls.

Indigenous peoples and access to health

To ensure that traditional medicine is exploited for the benefit of people and not for patenting by industry.
To examine and address patent issues for traditional medicines with the World Intellectual Property Organization, World Trade Organization, World Health Organization.
To address superior attitude of western medicine systems.

The role of cultural factors in health

To promote beneficial cultural practices and discourage or stop harmful ones.
To promote health education and awareness for all.
To define health, taking into account community and spiritual values.
To make the girl child the priority, as she is responsible for family unity and health.

The role of civil society organisations in health

To work for a UN that is free from the influence of transnational corporations.
To insist that the UN distinguishes between real non-profit NGOs and commercial NGOs.
To address the ”10/90 gap” in health research and help the 90% who are excluded.
To allow NGOs (public interest) to speak at the World Health Assembly.
To hold the World Civil Society Forum in a southern state.