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People’s Charter for Health
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PREAMBLE
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.
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
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.
PRINCIPLES OF THE PEOPLE'S CHARTER FOR HEALTH
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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 orientation or class.
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The principles of
universal, comprehensive Primary Health Care (PHC), envisioned in the
1978 Alma Ata Declaration, should be the basis for formulating policies
related to health. Now more than ever an equitable, participatory and
intersectoral approach to health and health care is needed.
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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.
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The participation of
people and people's organisations is essential to the formulation,
implementation and evaluation of all health and social policies and
programmes.
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Health is primarily
determined by the political, economic, social and physical environment
and should, along with equity and sustainable development, be a top
priority in local, national and international 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 action.
HEALTH AS A HUMAN RIGHT
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:
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Support all attempts to
implement the right to health.
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Demand that governments
and international organisations reformulate, implement and enforce
policies and practices which respect the right to health.
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Build broad-based popular
movements to pressure governments to incorporate health and human rights
into national constitutions and legislation.
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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 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:
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Demand transformation of
the World Trade Organisation and the global trading system so that it
ceases to violate social, environmental, economic and health rights of
people and begins to discriminate 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 Intellectual Property Rights (TRIPS) agreement.
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Demand the cancellation
of Third World debt.
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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.
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Demand effective
regulation to ensure that TNCs do not have negative effects on people's
health, exploit their workforce, degrade the environment or impinge on
national sovereignty.
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Ensure that governments
implement agricultural policies attuned to people's needs and not to the
demands of the market, thereby guaranteeing food security and equitable
access to food.
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Demand that national
governments act to protect public health rights in intellectual property
laws.
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Demand the control and
taxation of speculative international capital flows.
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Insist that all economic
policies be subject to health, equity, gender and environmental impact
assessments and include enforceable regulatory measures to ensure
compliance.
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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 labour, 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
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:
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Demand and support the
development and implementation of comprehensive social policies with
full participation of people.
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Ensure that all women and
all men have equal rights to work, livelihoods, to freedom of
expression, to political participation, to exercise religious choice, to
education and to freedom from violence.
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Pressure governments to
introduce and enforce legislation to protect and promote the physical,
mental and spiritual health and human rights of marginalised groups.
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Demand that education and
health are placed at the top of the political 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.
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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.
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Condemn and seek the
reversal of any policies, which result in the forced displacement of
people from their lands, homes or jobs.
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Oppose fundamentalist
forces that threaten the rights and liberties of individuals,
particularly the lives of women, children and minorities.
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Oppose sex tourism and
the global traffic of women and children.
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:
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Hold transnational and
national corporations, public institutions and the military accountable
for their destructive and hazardous activities that impact on the
environment and people's health.
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Demand that all
development projects be evaluated against health and environmental
criteria and that caution and restraint be applied whenever technologies
or policies pose potential threats to health and the environment (the
precautionary principle).
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Demand that governments
rapidly commit themselves to reductions of greenhouse gases from their
own territories far stricter than those set out in the international
climate change agreement, without resorting to hazardous or
inappropriate technologies and practices.
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Oppose the shifting of
hazardous industries and toxic and radioactive waste to poorer countries
and marginalised communities and encourage solutions that minimise waste
production.
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Reduce over-consumption
and non-sustainable lifestyles - both in the North and the South.
Pressure wealthy industrialised countries to reduce their consumption
and pollution by 90 per cent.
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Demand measures to ensure
occupational health and safety, including worker-centred monitoring of
working conditions.
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Demand measures to
prevent accidents and injuries in the workplace, the community and in
homes.
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Reject patents on life
and oppose bio-piracy of traditional and indigenous knowledge and
resources.
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Develop people-centred,
community-based indicators of environmental and social progress, and to
press for the development and adoption of regular audits that measure
environmental degradation and the health status of the population.
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:
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Support campaigns and
movements for peace and disarmament.
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Support campaigns against
aggression, and the research, production, testing and use of weapons of
mass destruction and other arms, including all types of landmines.
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Support people's
initiatives to achieve a just and lasting peace, especially in countries
with experiences of civil war and genocide.
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Condemn the use of child
soldiers, and the abuse and rape, torture and killing of women and
children.
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Demand the end of
occupation as one of the most destructive tools to human dignity.
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Oppose the militarisation
of humanitarian relief interventions.
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Demand the radical
transformation of the UN Security Council so that it functions
democratically.
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Demand that the United
Nations and individual states end all kinds of sanctions used as an
instrument of aggression which can damage the health of civilian
populations.
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Encourage independent,
people-based initiatives to declare neighbourhoods, communities and
cities areas of peace and zones free of weapons.
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Support actions and
campaigns for the prevention and reduction of aggressive and violent
behaviour, especially in men, and the fostering of peaceful coexistence.
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Support actions and
campaigns for the prevention of natural disasters and the reduction of
subsequent human suffering.
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:
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Oppose international and
national policies that privatise health care and turn it into a
commodity.
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Demand that governments
promote, finance and provide comprehensive Primary Health Care as the
most effective way of addressing health problems and organising public
health services so as to ensure free and universal access.
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Pressure governments to
adopt, implement and enforce national health and drugs policies.
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Demand that governments
oppose the privatisation of public health services and ensure effective
regulation of the private medical sector, including charitable and NGO
medical services.
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Demand a radical
transformation of the World Health Organization (WHO) so that it
responds to health challenges in a manner which benefits the poor,
avoids vertical approaches, ensures intersectoral work, involves
people's organisations in the World Health Assembly, and ensures
independence from corporate interests.
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Promote, support and
engage in actions that encourage people’s power and control in
decision-making in health at all levels, including patient and consumer
rights.
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Support, recognise and
promote traditional and holistic healing systems and practitioners and
their integration into Primary Health Care.
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Demand changes in the
training of health personnel so that they become more problem-oriented
and practice-based, understand better the impact of global issues in
their communities, and are encouraged to work with and respect the
community and its diversities.
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Demystify medical and
health technologies (including medicines) and demand that they be
subordinated to the health needs of the people.
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Demand that research in
health, including genetic research and the development of medicines and
reproductive technologies, is carried out in a participatory,
needs-based manner by accountable institutions. It should be people- and
public health-oriented, respecting universal ethical principles.
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Support people’s rights
to reproductive and sexual self-determination and oppose all coercive
measures in population and family planning policies. This support
includes the right to the full range of safe and effective methods of
fertility regulation.
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:
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Build and strengthen
people’s organisations to create a basis for analysis and action.
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Promote, support and
engage in actions that encourage people’s involvement in
decision-making in public services at all levels.
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Demand that people’s
organisations be represented in local, national and international fora
that are relevant to health.
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Support local initiatives
towards participatory democracy through the establishment of people-centred
solidarity networks across the world.
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