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GHW 7

Mobilizing for Health Justice: Global Health Watch 7

Since its first edition in 2005, Global Health Watch (GHW) – the flagship publication of the People’s Health Movement (PHM) – has been critically reporting on the state of the world’s health. Published every three or four years, it comments on developments in global health while focusing on continuities with past popular struggles.

As with previous editions, GHW7 comes to life with contributions from over one hundred activists around the world, sharing experiences and analysis on issues affecting people’s health in the contexts they live in and efforts to progress towards greater health justice. This process was energized by the fifth People’s Health Assembly (PHA5), the global gathering of PHM, that took place in Argentina in April 2024 under the motto “Making ‘Health for All’ our struggle for ‘Buen Vivir”.

 

Political contributions from Latin America are manifest in the first GHW7 section, dedicated to “The global political and economic architecture”, where an up-to-date analysis of current health crises is followed by contributions that frame them in an eco-feminist perspective, showing how alternatives can be rooted in ancestral wisdoms and the practice of ‘Buen Vivir’. The second section addresses old and new challenges for public and global health systems through the critical lenses of gender justice and decoloniality. The third section, “Beyond Healthcare,” addresses key social and environmental determinants of health, while the “Watching” section critically apprises the state of global governance for health with a focus on several key institutions. The final section, “Resistance, struggles and alternatives,” highlights areas of transformative change by health activists in a global context of increasing repression. The book ends with a chapter on PHA5, highlighting how collective action is the most powerful medicine against ill health and health inequality at the human and planetary levels.

 

On World Health Day, 2025, PHM launches the introductory chapter of the 7th edition of the Global Health Watch: From a Political Economy of Disease to a Political Economy for Wellbeing

Global Health Watch 7 will include the following chapters

A1. From a Political Economy of Disease to a Political Economy for Wellbeing
A2. Advancing an Eco-Feminist Political Economy for Health
A3. Ancestral and Popular Knowledge for Buen Vivir
B1. Privatization and Financialization of Health Systems: Challenges and Public Alternatives
B2. Artificial Intelligence, Digital Technologies, and Health
B3. Building Equitable Health Systems: A Transformative Proposal from an Intersectional Gender Perspective
B4. Abolition Medicine as a Tool for Health Justice
B5. Decolonizing Global Health
C1. War, Conflict and Displacement
C2. People on the Move
C3. Putting the Right to Health to Work
C4. Tax Justice: A Pathway to Better Health
C5. Commercial/Corporate Determination of Health
D1. WHO’s Compromised Role in Global Health Leadership
D2. Unpacking Our Pandemic Failures for Future Pandemic Prevention, Preparedness, and Response
D3. Financing Pandemic Recovery, Prevention, Preparedness and Response
E1. National Struggles for the Right to Health
E2. Taking Extractives to Court
E3. Fear and Hope in ‘Speaking Truth to Power’: Struggles for Health in Times of Repression and Shrinking Spaces
E4. 5th People’s Health Assembly: Advancing in the Struggle for Liberation and Against Capitalism

People’s Health Movement and the GHW7 co-producing organizations: ALAMES, Equinet, Health Poverty Action, Medact, Medico International, Sama, Third World Network, Viva Salud; Editorial committee members: Ron Labonte (Canada; PHM, coeditor of GHW7), Chiara Bodini (Italy; PHM, coeditor of GHW7), Rene Loewenson (Zimbabwe; TARSC, Equinet), Dave McCoy (Malaysia; UN university international institute for global health), Dian Blandina (Indonesia; PHM global health governance group), Devaki Nambiar (India; George institute for global health and PHM India), Matheus Falcao (Brazil; Brazilian Centre for Health Studies – Cebes and PHM Brazil), Lauren Paremoer (South Africa; PHM global health governance group), Penelope Milsom (UK; Medact), Ravi Ram (PHM Kenya), Hani Serag (PHM, Co-chair of Global Steering Council).

The 7th edition of the GHW will be published with Daraja Press, a not-for-profit publisher, based in Québec, Canada, that seeks to reclaim the past, contest the present and invent the future. Daraja is the KiSwahili word for ‘bridge’. As its name suggests, Daraja Press seeks to build bridges, especially bridges of solidarity between and amongst movements, intellectuals and those engaged in struggles for a just world.

 

Summary of chapters currently available for download

GHW_CH_A1: Chapter A1: From a Political Economy of Disease to a Political Economy for Wellbeing

This chapter critiques capitalism as the root cause of global crises, including inequality, environmental collapse, and mass displacement. It highlights how neoliberal and financialized capitalism exacerbate these issues, with wealth concentrated among a few while austerity measures burden the majority. The text explores alternatives like degrowth, which advocates reducing excessive consumption in wealthy nations, and the “wellbeing economy,” prioritizing equitable resource distribution within planetary limits. It also revisits the New International Economic Order (NIEO) as a framework for Global South solidarity. Despite challenges, the chapter calls for progressive taxation, labor rights, and ecosocialism to dismantle exploitative systems. Emphasizing activism and policy shifts, it underscores the urgency of transforming economic paradigms to achieve health justice and ecological sustainability. The chapter concludes with a Gramscian reflection on the struggle to birth a new, equitable world amid capitalist decline.

GHW_CH_A3: Chapter A3: “Ancestral and Popular Knowledge for Buen Vivir

This chapter advocates for Buen Vivir (Good Living), a holistic, biocentric paradigm rooted in Indigenous and ancestral knowledge, as an alternative to capitalist and colonial systems. Emphasizing harmony with nature, collective well-being, and health as a communal right, it critiques the medicalized, individualistic health models. The text highlights the role of women as custodians of ancestral practices, agroecology as a sustainable production model, and the resilience of Indigenous communities against dispossession and war. It calls for intercultural health systems that integrate traditional and modern medicine, recognizing the wisdom of healers and midwives. Challenges include decolonizing minds, advancing rights for nature, and fostering global solidarity. The chapter underscores *Buen Vivir* as a transformative political project, offering pathways to health justice and ecological balance.

GHW_CH_B1: Chapter B1: Privatization and Financialization of Health Systems: Challenges and Public Alternatives

This chapter examines the privatization, financialization, and corporatization of health systems, highlighting their detrimental impacts on global health equity. Privatization shifts healthcare from public to private control, often through active measures like outsourcing or passive underfunding of public systems, forcing reliance on costly private care. Financialization transforms healthcare into profit-driven assets, prioritizing investor returns over patient outcomes, as seen in International Finance Corporation (IFC) investments that exacerbate inequalities. Corporatization introduces profit-maximizing practices, leading to over-medicalization, neglect of primary care, and erosion of medical professionalism. Case studies from India, Ivory Coast, the US, and Canada illustrate how these processes inflate costs, reduce accessibility, and undermine public health systems. The chapter calls for stronger regulation, tax justice, and grassroots mobilization to reclaim healthcare as a public good, emphasizing human rights frameworks to ensure equitable, quality care for all. Resistance movements and policy reforms are urged to counter corporate dominance in healthcare.

GHW_CH_B2: Chapter B2: Artificial Intelligence, Digital Technologies, and Health

This chapter explores the role of artificial intelligence (AI) and digital technologies in global health, emphasizing both their potential benefits and risks. While AI can enhance diagnostics, drug discovery, and healthcare accessibility, it also raises concerns about data privacy, algorithmic bias, corporate dominance, and environmental impact. Key issues include:Data exploitation: Big Tech firms monopolize health data, undermining public control and privacy. AI bias: Skewed datasets perpetuate racial, gender, and socioeconomic disparities in healthcare. Labor impacts: “Uberization” of healthcare work erodes job security for professionals. Environmental costs: Energy-intensive AI infrastructure exacerbates climate change. Corporate power: Tech giants shape regulations, prioritizing profit over equitable health outcomes.  The chapter critiques data colonialism, where Global North corporations extract and control data from the Global South, and calls for stronger public governance, digital sovereignty, and rights-based regulations. It advocates for collective benefit-sharing models and grassroots resistance to ensure AI serves health justice, not corporate interests.

Chapter B3: Transformative Health Systems for Gender Equity

This chapter advocates for gender-transformative health systems that challenge structural inequalities and power dynamics perpetuating gender-based discrimination. It analyzes case studies from Nigeria, India, and Paraguay, highlighting systemic gaps in addressing gender-based violence (GBV) and reproductive health needs. Key findings reveal underfunded health systems, patriarchal norms, and disconnects between policy and practice, often exacerbating victimization. The chapter distinguishes between gender-blind, gender-sensitive, and gender-transformative policies, emphasizing the latter’s role in dismantling oppressive structures. Proposals include promoting women’s autonomy, equitable access to sexual and reproductive health services, and inter-institutional alliances. The chapter underscores the importance of social movements, continuous health worker training, and intersectional approaches to ensure empathetic, rights-based care. Ultimately, it calls for health systems to not only provide services but also empower marginalized groups, framing quality care as an enforceable right and a collective ethical obligation.

GHW_CH_B4: Chapter B4: Abolition Medicine as a Tool for Health Justice

This chapter explores “abolition medicine” as a framework for health justice, arguing that healthcare and criminal justice systems share intertwined histories of coercion and racialized control under capitalism. It critiques how biomedicine and policing have enforced racial hierarchies and disciplined labor, perpetuating carceral logics within healthcare, such as punitive treatment of marginalized groups (e.g., racialized women, people with addictions). Abolition medicine rejects these practices, advocating for no police in healthcare spaces, harm reduction, and community autonomy. Case studies highlight alternatives: Rojava’s decentralized, communal healthcare system in Kurdistan and Brazil’s Care Clinic, which address collective trauma from displacement through political, non-medicalized care. The chapter calls for solidarity between health justice and prison abolition movements, centering care over coercion and democratizing health systems. Ultimately, it envisions healthcare as anti-capitalist, autonomous, and rooted in transformative justice.

GHW_CH_B5: Chapter B5: Decolonizing Global Health

This chapter examines the intersection of colonialism and global health, highlighting how historical and contemporary colonial practices perpetuate inequities. It introduces a three-part framework for analysis: (1) Colonialism within global health, addressing power imbalances between Global North and South institutions, such as parachute research and marginalization of indigenous knowledge; (2) Colonization of global health, where governance systems are dominated by entities like the Bill & Melinda Gates Foundation, prioritizing privatized, technocratic solutions; and (3) Colonialism through global health, where healthcare systems enable wealth extraction, exemplified by pharmaceutical profiteering during COVID-19. The chapter critiques neocolonialism, emphasizing how financialized capitalism exacerbates global inequities. It calls for decolonizing actions, including democratizing global health governance, challenging exploitative practices, and centering grassroots voices. The goal is to align global health with justice, equity, and anti-colonial resistance, moving beyond Western-centric models toward pluralistic, inclusive approaches.

GHW_CH_C2: Chapter C2: Global Migration and Health Justice Challenges

This chapter examines global migration through an intersectional lens, emphasizing the health and human rights challenges faced by migrants. It highlights the rise in irregular migration and displacement due to conflict, environmental degradation, and economic inequality. Key themes include: 1. Dimensions of Migration: The chapter categorizes migrants (e.g., refugees, undocumented workers) and outlines systemic barriers they face, such as limited healthcare access and exploitation. 2. Drivers of Migration: Economic disparities, violence, and climate change are identified as primary causes, with examples like Syrian refugees and Inuit communities displaced by environmental shifts. 3. Structural Roots: Colonialism and neocolonial economic policies perpetuate global inequalities, forcing migration from the Global South to the Global North. 4. Health Access: Migrants often face healthcare barriers exacerbated by crises like COVID-19. Case studies from Brazil (migrant-led health advocacy) and Italy (health worker protests) illustrate grassroots efforts to address these gaps. 5. Policy Solutions: The chapter calls for universal health systems, migrant-centered policies, and addressing structural inequities to ensure health justice. The chapter underscores migration as a transnational issue requiring collective action grounded in equity and human rights.

GHW_CH_C3: Chapter C3: Putting the Right to Health to Work

This chapter explores the critical relationship between work and health, emphasizing how employment conditions act as a social determinant of health. It highlights the COVID-19 pandemic’s role in exposing disparities in workplace safety, particularly for essential and informal workers, and underscores the importance of decent work, unionization, and social dialogue. The text examines how capitalism exacerbates health risks through precarious employment, exploitation, and poor working conditions, with examples from industries like meatpacking, healthcare, and domestic work. It discusses global labor struggles, such as those by Kenyan health workers and Colombian domestic workers, which have secured rights and improved conditions. The document also outlines strategies to advance workers’ right to health, including enforcing safety standards, promoting social protection, and empowering worker organizations. Ultimately, it argues that collective action and inclusive policies are essential to achieving health equity in the workplace.

GHW_CH_C4: Chapter C4: Tax Justice: A Pathway to Better Health

This chapter explores how tax justice can significantly improve global health by addressing inequalities and funding public services. Taxes, described as society’s “superpower,” play a critical role in revenue generation, wealth redistribution, and discouraging harmful products. However, current tax systems are undermined by corporate tax avoidance, regressive policies, and international tax havens, disproportionately affecting low-income countries. The chapter highlights the 5Rs of tax justice—Revenue, Redistribution, Repricing, Representation, and Reparations—as key principles for reform. It critiques the OECD-dominated tax architecture and advocates for a UN-led Framework Convention on Tax to ensure fairness. Examples from Africa and Latin America illustrate the impact of tax reforms on health and climate resilience. The chapter calls for collective action to combat tax abuse, promote transparency, and ensure equitable health financing, emphasizing the need for progressive taxation and global solidarity to achieve health justice.

GHW_CH_C5: Chapter C5: Commercial/Corporate Determination of Health

This chapter highlights how transnational corporations (TNCs) and neoliberal policies prioritize profit over public health. Key harmful practices include aggressive marketing of unhealthy products (e.g., ultra-processed foods, fossil fuels), tax avoidance, lobbying to weaken regulations, and spreading health misinformation. Corporations exploit legal frameworks like intellectual property rights and investor-state dispute settlements (ISDS) to evade accountability, while voluntary codes (e.g., UN Global Compact) fail to enforce ethical standards. The chapter critiques corporate tactics such as “health washing,” astroturfing, and strategic lawsuits (SLAPPs) to silence critics. Solutions proposed include binding international treaties, progressive taxation, breaking up monopolies, and reversing privatization to reclaim public services. The chapter calls for systemic change—shifting from neoliberal capitalism to models like degrowth, circular economies, and worker cooperatives—to prioritize health and equity. Civil society, governments, and investigative journalists are urged to challenge corporate power and advocate for enforceable regulations. The People’s Health Movement demands a New International Economic Order (NIEO) to dismantle corporate dominance. (150 words)

GHW_CH_D1: WHO’s Compromised Role in Global Health Leadership

This chapter examines the declining leadership of the World Health Organization (WHO) in global health governance. It highlights how geopolitical tensions, ideological divides, and funding constraints have compromised WHO’s ability to fulfill its mandate. Key issues include the politicization of the World Health Assembly (WHA), where debates on gender and sexual health are often derailed by conservative governments, and the financial reliance on volatile voluntary contributions, which skews priorities toward donor interests. The chapter also critiques the shrinking space for civil society participation in WHO processes, contrasting it with the growing influence of private stakeholders and multistakeholder initiatives. The U.S. withdrawal from WHO under Trump’s administration exacerbates these challenges, threatening the organization’s financial stability and multilateral role. The chapter calls for reforms to democratize WHO, ensure flexible funding, and strengthen its capacity to address politically charged health determinants, such as conflict and reproductive rights, to restore its role as a leader in global health justice.

GHW_CH_D2 Chapter D2: Unpacking our Pandemic Failures for Future Pandemic Prevention, Preparedness and Response

This chapter examines the failures in global pandemic response during COVID-19 and efforts to reform future pandemic prevention, preparedness, and response (PPR) systems. While vaccine development was a biomedical success, inequitable distribution—termed “vaccine apartheid”—highlighted systemic flaws, particularly intellectual property (IP) barriers that restricted Global South access. Lockdowns exacerbated socioeconomic inequalities, disproportionately affecting marginalized groups. Revisions to the International Health Regulations (IHR) introduced equity principles, but the proposed Pandemic Accord (PA) struggles to address structural issues like IP monopolies, technology transfer, and health system strengthening. Negotiations reveal geopolitical tensions, with Global North countries resisting binding equity measures, such as the TRIPS waiver. The chapter critiques the reliance on public-private partnerships and market-driven solutions, advocating instead for a public goods approach to health. Despite recognition of inequities, reforms lack binding commitments to ensure equitable access to medical products or address gendered burdens of care, leaving future pandemic responses vulnerable to similar failures.

GHW_CH_D3 Chapter D3: Financing Pandemic Recovery, Prevention, Preparedness and Response

This chapter examines the financing of pandemic recovery, prevention, preparedness, and response (PPPR) in the context of recent U.S. actions, including its withdrawal from the WHO and freezing of international aid. It critiques the current financial architecture of PPPR, which is dominated by securitized, commodified, and market-driven approaches, often exacerbating inequities. The chapter highlights the historical role of Bretton Woods institutions in shaping global health financing through neoliberal policies, such as structural adjustment programs, and the growing influence of private actors like the Bill & Melinda Gates Foundation. It discusses the shortcomings of mechanisms like the World Bank’s Pandemic Fund and innovative financing tools, which prioritize profit over equity. The debt crisis in LMICs further strains health systems, diverting resources from essential services. The chapter calls for structural reforms, including debt relief, tax justice, and equitable governance, to ensure PPPR financing aligns with public health needs rather than corporate interests.

GHW_CH_E2 Chapter E2: Taking Extractives to Court

This chapter examines the rise of climate litigation as a tool to hold governments and corporations accountable for environmental and health harms. Highlighting cases like the Swiss elders’ victory against their government and Shell’s emissions reduction mandate, it showcases how courts are increasingly recognizing the right to a healthy environment. However, legal victories are often contested, as seen in Shell’s successful appeal. The chapter also explores challenges like investor-state dispute settlements (ISDS), which corporations use to sue governments over environmental regulations, and SLAPP lawsuits aimed at silencing activists. Examples from Panama, Ecuador, and El Salvador illustrate both successes and setbacks in grassroots legal battles. The text emphasizes strategic litigation as part of broader advocacy, including people’s tribunals that amplify marginalized voices. While court rulings alone won’t solve the climate crisis, they play a crucial role in advancing justice, especially for Indigenous and frontline communities disproportionately affected by environmental degradation.

Chapter E3: Fear and Hope in ‘Speaking Truth to Power’: Struggles for Health in Times of Repression and Shrinking Spaces

This chapter examines the global rise of repression against health activists and its impact on health justice. Drawing from cases in Turkey, Kenya, the Philippines, and South Africa, it highlights how authoritarian regimes, securitization, and neoliberal policies shrink civic spaces and target dissent. In Turkey, the Turkish Medical Association faced criminalization for advocating health rights. Kenya’s health activists endure police brutality and systemic corruption, exacerbating health inequities. The Philippines’ “red-tagging” campaigns have led to violence against health workers, while South Africa’s xenophobia undermines migrant access to healthcare. Despite repression, resistance persists through legal battles, international solidarity, and grassroots mobilization. The chapter underscores the need for broader alliances, political strategies, and community rebuilding to reclaim health as a collective right and counter systemic oppression. It calls for global health movements to bridge gaps between professional discourse and on-the-ground realities.

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