[corp-focus] The People's Health

[Robert Weissman]

The People's Health
By Russell Mokhiber and Robert Weissman

Savar, Bangladesh -- More than two decades ago, the nations of the world
issued a call for "Health for all the people of the world by the year
2000," in the Alma Alta Declaration, the product of a World Health
Organization-UNICEF conference.

In 1978, at the time of the Declaration, that goal seemed achievable.
There was serious talk of a New International Economic Order, to begin to
remedy the wealth and technology gap between the global North and South.
Primary healthcare was held "the key to attaining th[e] target" of health
for all.

Now, with 2000 upon us, it is evident that the world failed to turn the
vision into reality.

Earlier this month, approximately 1,500 public health activists from 93
countries gathered at the spirited and historic People's Health Assembly
(PHA) in Bangladesh to assess this state of affairs, and to map the way
forward so that health for all is in fact achieved.

The emerging PHA diagnosis, which focused primarily on healthcare failures
in developing countries, was multifaceted: Governments have failed to
invest sufficient resources and empower localities to assure adequate
nutrition, clean water, maternal and child health care and other
components of primary health care. This governmental failure is rooted in
many internal problems, but especially reflects the budgetary and policy
squeeze imposed by the International Monetary Fund and the World Bank and
foreign debt repayments, as well as the World Trade Organization.
Meanwhile, multinational corporations are pushing a privatization agenda
for healthcare which removes control of crucial health decisions and
delivery systems from the public sphere, where it is subject to popular
influence, and often removes access to healthcare altogether from poor
people.

The delegates had an opportunity to passionately denounce the institutions
of corporate globalization when a World Bank representative attended a
session labeled "The World Bank Faces the People." Led by the Indian
delegation, PHA attendees hooted and booed the Bank, chanting "Down, Down,
World Bank, Down Down." They spoke with raw emotion of Bank projects which
have displaced people from longstanding communities, destabilizing both
societies and public health, and of Bank lending programs that pushed
national healthcare systems in the direction of a corporate-dominated
model.

Primary healthcare remains a top priority, the PHA concluded, but it was
unlikely to be achieved broadly in the absence of fundamental
transformations in the global political economy.

A "People's Charter for Health" issued by the PHA (see
http://www.pha2000.org/pch8Dec.htm) asserted that health is a human right
and that "health and human rights should prevail over economic and
political concerns," and it called for the provision of "universal and
comprehensive primary health care, irrespective of people's ability to
pay."

But the Charter also called for the cancellation of the Third World debt,
major changes at the IMF, World Bank and WTO, effective regulation to
control the activities of multinational corporations and controls on
speculative international capital flows. It also includes provisions on
the environment, war and violence.

The imperative of achieving macro-level transformations did not depress
the delegates. There were more community health workers than professional
policy advocates at the conference, and delegates from developing
countries vastly outnumbered those from industrialized nations.

These delegates were able to relate their own successes to illustrate what
can be achieved, despite enormous obstacles, with determination and
organization.

A. Chintamani, a health worker from a low caste in India, explained how
she learned to wear shoes to prevent hookworm -- despite an expectation
that people in her caste would go barefooted -- and then became empowered
to deliver care even to upper caste persons, who were forced to turn to
her, because she offered the best available care.

Delegates from Cuba related the island's stunning public health
achievements -- with many national health indicators, such as infant
mortality levels, comparable to those in the United States -- in the face
of the U.S. trade embargo. The international audience cheered long and
loud for the Cuban delegates -- in appreciation of Cuba's accomplishments
and in solidarity for its resistance to U.S. aggression.

Most heartening, perhaps, was the example provided by the PHA hosts. The
meeting was held on the campus of Gonoshasthaya Kendra (GK), a Bangladesh
NGO that has constructed a hospital, university and generic drug factory.
Putting the concept of primary healthcare into effect, GK has trained
countless health workers -- mostly women -- to raise health standards in
surrounding villages. It leads the way in supplying care in the wake of
floods and other national emergencies in Bangladesh. GK pharmaceuticals,
and its support for Bangladesh's progressive national drug program --
which has weathered relentless attacks from multinational drug firms --
have made essential medicines available to consumers throughout the
country.

What GK and other success stories conveyed at the PHA reveal is that it is
not for lack of resources or knowledge that the world has failed to
deliver on the promise of the Alma Alta declaration.

What is lacking is political will, from the village to international
level.

"While governments have the primary responsibility for promoting a more
equitable approach to health and human rights," the People's Health
Charter concludes, it will require people's organizations to force them to
meet this responsibility.


Russell Mokhiber is editor of the Washington, D.C.-based Corporate Crime
Reporter. Robert Weissman is editor of the Washington, D.C.-based
Multinational Monitor. They are co-authors of Corporate Predators: The
Hunt for MegaProfits and the Attack on Democracy (Monroe, Maine: Common
Courage Press, 1999).

(c) Russell Mokhiber and Robert Weissman