PEOPLE'S CHARTER FOR HEALTH
As amended and approved at the People’s Health
Assembly, Savar, Bangladesh, December 2000
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 globalization 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 ample 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
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. 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. 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.
The participation of people and
people's organisations is essential to the formulation,
implementation and evaluation of all health and
social policies and programmes.
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,
communal, 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:
Support all attempts to implement
the right to health.
Demand that governments and international
organisations reformulate, implement and enforce
policies and practices which respect the right
to health.
Build broad-based popular movements
to pressure governments to incorporate health
and human rights into national constitutions and
legislation.
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 globalization 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:
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.
Demand the cancellation of Third
World debt.
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.
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.
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.
Demand that national governments
act to protect public health rights in intellectual
property laws.
Demand the control and taxation
of speculative international capital flows.
Insist that all economic policies
be subject to health, equity, gender and environmental
impact assessments and include enforceable regulatory
measures to ensure compliance.
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 globalization 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 organizations 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:
Demand and support the development
and implementation of comprehensive social policies
with full participation of people.
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.
Pressure governments to introduce
and enforce legislation to protect and promote
the physical, mental and spiritual health and
human rights of marginalised groups.
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.
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.
Condemn and seek the reversal of
any policies, which result in the forced displacement
of people from their lands, homes or jobs. Oppose
fundamentalist forces that threaten
the rights and liberties of individuals, particularly
the lives of women, children and minorities.
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:
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.
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).
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.
Oppose the shifting of hazardous
industries and toxic and radioactive waste to
poorer countries and marginalised communities
and encourage solutions that minimise waste production.
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.
Demand measures to ensure occupational
health and safety, including worker-centred monitoring
of working conditions.
Demand measures to prevent accidents
and injuries in the workplace, the community and
in homes.
Reject patents on life and oppose
bio-piracy of traditional and indigenous knowledge
and resources.
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:
Support campaigns and movements
for peace and disarmament.
Support campaigns against aggression,
and the research, production, testing and use
of weapons of mass destruction and other arms,
including all types of landmines.
Support people's initiatives to
achieve a just and lasting peace, especially in
countries with experiences of civil war and genocide.
Condemn the use of child soldiers,
and the abuse and rape, torture and killing of
women and children.
Demand the end of occupation as
one of the most destructive tools to human dignity.
Oppose the militarisation of humanitarian
relief interventions.
Demand the radical transformation
of the UN Security Council so that it functions
democratically.
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.
Encourage independent, people-based
initiatives to declare neighbourhoods, communities
and cities areas of peace and zones free of weapons.
Support actions and campaigns for
the prevention and reduction of aggressive and
violent behaviour, especially in men, and the
fostering of peaceful coexistence.
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:
Oppose international and national
policies that privatise health care and turn it
into a commodity.
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.
Pressure governments to adopt, implement
and enforce national health and drugs policies.
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.
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.
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.
Support, recognise and promote traditional
and holistic healing systems and practitioners
and their integration into Primary Health Care.
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.
Demystify medical and health technologies
(including medicines) and demand that they be
subordinated to the health needs of the people.
Demand that research in health,
including genetic research and the development
of medicine and reproductive technologies, be
carried out in a participatory, needs-based manner
by accountable institutions. It should be people-
and public health-oriented, respecting universal
ethical principles.
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:
Build and strengthen people's organisations
to create a basis for analysis and action.
Promote, support and engage in actions
that encourage people's involvement indecision-making
in public services at all levels.
Demand that people's organisations
be represented in local, national and international
forums that are relevant to health.
Support local initiatives towards
participatory democracy through the establishment
of people-centred solidarity networks across the
world.
End of Document
