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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 illhealth
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 biopiracy
of traditional and indigenous knowledge and resources.
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Develop people-centred, communitybased
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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