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Declaration of the 2nd International Forum in Defense of the People's Health.

Health is a human right and a fundamental aspect of the right to life. Health is also a duty of the State, and it is the State's obligation to fulfill its international commitments. Health is a right in and of itself and not the means to promote poorly-termed "human capital." Neither can health be seen as a private good; it is a public resource.

Health is a comprehensive process that includes dignified living conditions; healthy employment in adequate conditions; access to basic services, such as potable water; civic education; adequate nutrition; a healthy environment, free from violence; and accessible health care services of high quality at all levels.

Health care workers play a fundamental role in the exercise of the right to health and access to adequate services. For this reason, it is important that they have adequate working conditions.

We denounce profound and long, ongoing deterioration of the living, health and working conditions of most peoples and in most countries, primarily poor nations but also some former socialist States that are losing the right to health (Great Britain, Germany, etc.) This deterioration is rooted in the conceptualization of health and life as goods and sources of profit and speculation and in the dominant model of care that is highly costly and promotes dependence.

Migration from the countryside to the city and from poor countries to others that are less poor is a daily fact of life for our people. In many countries, migrant workers provide the primary income for their families and their countries of origin through the income they send home. (It is the primary source of income in Ecuador, El Salvador, the Dominican Republic, Nicaragua, etc.) However, migration is accompanied by family disintegration and the loss of labor, social and civil rights of those who immigrate and who become pariahs in their new countries of residence.

The phenomenon of migration is used to justify and legitimate the privatization of services based on arguments that public administration is inefficient, that public resources are limited, and that the health care systems are imperfect, among others.

The so-called "reforms" or neoliberal "modernization" of the health sector --quite simply privatization in disguise--have sharpened inequities and lack of access to health care. There are various forms of privatization: one is the passing of responsibilities for service provision to private providers and insurance agencies, and another is the incorporation of the logic of the market in the public sector. Both damage the right to health. Nonetheless, in some countries, such as Brazil, the State is attempting democratic reforms that seek to improve health services as well as to increase civil participation and monitoring, with the accompanying success and difficulties.

We must break with the neoliberal dogma that insists, for example, that service provision and financing for health care cannot be separated or that the different levels of attention must be combined.

The International Monetary Fund, the World Bank and the regional banks such as the Inter-American Development Bank impose these concepts as conditions for countries to have access to their services. This generates inequality and decreased access and worsens living and health conditions.

At the same time, the World Health Organization's failure to take a stand for the health of all peoples in light of the subordination of nations to these conditions of the World Trade Organization and the transnational companies is remarkable.

We support decentralization as a form of strengthening the development of democracy, but we recognize that this alone is not enough; decentralization must take place within the context of national, state and local public systems because the local systems alone cannot shoulder the responsibilities of the national governments. Partial decentralization generates barriers in access and provokes greater inequity.

Wars such as the one being waged by the governments of the United States and the United Kingdom against Iraq or the government of Israel's occupation, systematic destruction and attempt to eradicate the ideal of nation and nationality of the Palestine people, are an aggression against the right to life and health of these peoples and of all people of the world.

The same occurs with the attempt to overthrow and de-legitimize Venezuela's legal government and the support for the on-going war in Colombia. Both conflicts seek to legitimize a hegemony motivated by the defense of the "freedom" of financial capital that attacks the autonomy and self-determination of the people.

We also call attention to the situation in Argentina where the application of the IMF's dictates have caused widespread poverty and an epidemic of hunger. At the same time, however, local levels of social and grassroots resistance have successfully limited, the implementation of IMF policies.

We salute the enormous and constant protests against the war in Iraq and against the war against the Palestine people; the resistance to the privatization of services, to the Free Trade Agreement of the Americas, and to the WTO's dictates and "free trade" agreements. We encourage the continuation and redoubling of these social and grassroots manifestations.

The 2nd International Forum in Defense of the People's Health at Porto Alegre has been one more step in the process of networking, resistance, alliance-building and combining of efforts to change these conceptions and to promote action through new forms of struggle and relationships with governments, institutions and organizations of civil society that has allowed us to renew our energy and our commitments.

At this event the Million Signature Campaign for Health Now was launched. This campaign demands accountability by governments and the WHO regarding the Alma-Ata Declaration, signed 25 years ago, which promised "Health For All by 2000."

In light of all of the above, we find that it is of utmost necessity that we develop a process to generate proposals and exchange ideas beginning at the community and grassroots levels, through the municipal, state, national and international levels to conclude in the 2nd People's Health Assembly and the 1st World Forum of the People's Health in July of 2004, bringing together the conclusions and designing new proposals that will facilitate the realization of concrete actions at all levels. Therefore, we call on all institutions, organizations and individuals committed to health and well-being to take part in this effort by organizing activities around this initiative, spreading with word, joining forces and realizing our dream of HEALTH FOR ALL, NOW.

Porto Alegre, January 2003.
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Title Annotation:Documents
Publication:Women's Health Journal
Date:Jan 1, 2003
Previous Article:People's Charter for Health.
Next Article:From Johannesburg.

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