The Cuenca Declaration

THE CUENCA DECLARATION

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Defend the right to health in the face of war, militarization and violence

• PHM calls on the people of the world to oppose war and militarization as the most blatant attacks on people’s health, especially the health of women and the poor. While the terror attacks in New York, Madrid and London caused unjustifiable damage, the US-led “war on terror” has generated an even more terrible, unjustifiable and endless war on defenseless populations in order to control their natural resources. At the same time, wars that have claimed millions of lives are unacknowledged as the UN system and our governments allow them to continue unabated.
• PHM will continue to participate in the global movement to end the US occupation of Iraq and Afghanistan. Foreign troops should be removed immediately and reparations paid for damage caused by the US-led war.
• PHM calls for an investigation into the use of torture by US soldiers and medical personnel at Guantanamo Bay, in Iraq and Afghanistan, and an immediate end to the detention of foreign nationals held without trial at Guantanamo Bay.
• We demand that medical personnel refuse to participate in illegal detention and torture. The US and its allies must be charged with violations of the Geneva Conventions for their attacks on civilian populations, particularly medical personnel and institutions in Iraq.
• PHM calls upon the United Nations and humanitarian agencies to intervene effectively in the “hidden wars” in the Congo, Sudan, Chechnya and many other places to foster lasting peace through political reconciliation and economic and social development programs that transform the social and economic conditions that give rise to these wars.
• PHM opposes the Israeli occupation of Palestine and the efforts to isolate and ghettoize the Palestinian people behind the illegal separation wall. Denial of Palestinian health rights on the West Bank and Gaza has reached emergency proportions.
• PHM supports the steps toward democracy and self-determination made by the indigenous people of southern Mexico, and calls for an end to the low-intensity conflict waged against them by the Mexican government.
• PHM denounces the biological warfare called Plan Colombia currently being waged against the peoples of Colombia, Ecuador and Peru under the guise of drug control. These actions contravene international conventions, and irreversibly damage environmental and human health in the region.
• PHM calls upon the United States to take responsibility for and compensate victims of Agent Orange in Vietnam, and the toxic contamination left by US military bases in the Philippines and elsewhere.

Struggle for comprehensive primary health care and sustainable, quality, local and national health systems

PHM recognises that neo-liberal policies have resulted in disinvestments in public sector health services; the promotion of a limited number of mostly curative technical interventions selected solely on the basis of a very narrow and often inappropriate application of cost effectiveness analysis, the corresponding neglect of broader environmental actions; the accelerated migration of health workers from public to private sectors and thence to wealthy countries; and the continuing spread of HIV/AIDS especially in Africa, with the collapse of public health services in many countries.

PHM calls upon governments to:

• Implement comprehensive community-based Primary Health Care initiatives that enroll or involve relevant sectors and are supported by legislation.
• Provide healthy living and working environments in order to respect and guarantee the health rights of all.

• Establish and fully implement universal health care financing mechanisms at national level in all countries (public health expenditure being at least 15% of the overall budget, especially in African countries) in order to provide protection for the whole population. 
• Address the crisis of human resources for health (HRH) by: improving working conditions, training, support and supervision for health workers; implementing an International code of practice on ethical recruitment, financial compensation to exporting countries, return and reorientation of health workers in the diaspora through incentives, and establishing a global fund for HRH.
• Ensure widespread knowledge on HIV status; access to opportunities for voluntary testing; equitable, and sustainable access to ARVs with emphasis on prevention; comprehensive home-based care including health and social services.

PHM calls upon the WHO to support and promote the above as national government responsibilities and to advocate for the removal of economic and political obstacles at global, regional and national levels, that adversely affect national governments' social policies. 

PHM will continue to raise awareness among communities on policies, policy-making processes and financial issues to enable them to monitor government performance, increase accountability and address health equity issues. PHM commits to gathering from within its movement, positive experiences of comprehensive PHC to build up the evidence base that supports such an approach, and to undertake concerted advocacy for its revitalization.

Finally, PHM salutes and supports the strong social justice approach to health in Venezuela and Cuba which inspires and encourages us towards Health for All.

Support the growth of PHM

The People’s Health Movement is both a network and a movement that takes as its mission the strengthening of the much wider movement of individuals and organisations around the world fighting for the Right to Health. PHM is bound by a commitment to the People’s Charter for Health and includes country circles, issue circles and affiliates, which are actively involved in advancing the work of the PHM.  Beyond this core of PHM activists are the friends of PHM and organisational partners at all levels.

Another world is possible – these are our strategies to achieve it!

This declaration urges health activists around the world to organise, influence, advocate, analyse and educate to advance global people’s health.

The People’s Health Movement -

- Will pursue work on the human right to health that includes both individual and community rights.

- Will continue to struggle for improved ways of working by strengthening its regional as well as its global coordination.  It will continue to develop participatory and transparent decision making so that activists at all levels know that their views are valued. 

- Celebrates the inauguration of the International People’s Health University, a university for health activists with courses presented in association with local PHMs and selected universities around the world.    

- Will engage with formal training institutions and challenge the dominance of the biomedical paradigm of health care.  It will incorporate diverse strategies for reorienting health worker education to comprehensive PHC, keeping people in communities at the centre.

- Will become a forum within which intellectuals can support local activists in their action and struggle.

- Will challenge the media to disseminate its perspectives and publicize its activities.

- Will strengthen its communications strategy to reach communities at the grassroots.

- Will translate as many of its communications as possible into two or more languages; will establish a mix of central and regional/national websites; the PHM newsletter will continue quarterly publication and will be translated into other languages.

As a summary of PHM´s strategy for the next three years:

-PHM will be linking the local, the national and the global by passing on and giving guidance to its geographical circles on the issues on which to concentrate tactically.

-PHM will document, analyze and disseminate research findings on key issues pertaining to the principles in its Charter, including gathering, analyzing and disseminating key evidence for its constituency of the efficacy and sustainability of initiatives in comprehensive primary health care.

-PHM will create awareness about the burning health issues of the day and will delegitimize and demystify false claims, prescriptions and slogans used by the Establishment.

-PHM will work with grassroots organizations and communities trying to understand their issues, building partnerships and supporting their activists in their struggle.

-PHM will adopt an approach of strengthening rights, and will support initiatives to achieve the Right to Health and Health Care at the local, national and international levels

-PHM will work tirelessly to build international solidarity with the oppressed and with those affected by natural disasters and civil strife,

- PHM will confront powerful forces of oppression in the struggle for economic justice, in particular  through support for cancellation of debt, the end of economic conditionalities and the establishment of a fair international tax regime.

-PHM will incorporate cultural and spiritual practices in all aspects of its work.

-PHM will advocate with national governments, UN and other national and international agencies to influence their decision-making.

The power of the People’s Health Movement can change the world. Another World, which includes Health for All, is possible. We must all demand and struggle towards a world in which health is a right, and is not subject to the forces of neo-liberalism.

SUPPORT and sign on to the People’s Health Charter and the Million Signature Campaign which is demanding Health for All Now, JOIN your local PHM group and support the new campaigns and activities being initiated.       www.phmovement.org

                                                                                                                Cuenca, Ecuador

                                                                                                                22 July 2005

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