History of the PHA5

The first PHA took place in 2000 in Bangladesh Savar, was preceded by months of global mobilisation and resulted in the People’s Charter for Health (PCH) and start of the People;s Health Movement. The PCH is the PHM founding document and still relevant today, 23 years after its conception. 

In 2005, the PHA2 was organised in Latin America for the first time. Hundreds of health activists gathered from around the world and adopted the Cuenca Declaration which provided a strategic vision for PHM.

Also read: Voices of the Earth From Savar to Cuenca

PHA3 took place in South Africa, Cape Town in 2012. The many health activists from over 70 countries developed an action orientated Cape Town Declaration focussing on the thematic areas of the Health for All campaign.

In 2018 in Bangladesh, Dhaka, the fourth assembly resulted in a renewed focus in building our movement, the importance of social mobilisation and strengthening thematic campaign. The Dhaka Declaration clearly emphasised the commitment of all present to Health for All.

The framework and outcomes of the Assemblies contained in the People's Charter for Health, the Cuenca Declaration , Cape Town Declaration and the Declaration of the Fourth World Health Assembly are more relevant than ever. The Fifth Assembly carries forward the commitments made in the PHA 4 Declaration.

The various discussions, exchanges and collective elaboration of analyses and strategies are expected to improve the organizational and mobilization capacity of the PHM in favor of health. It is expected that concrete actions and medium and long term plans in the main thematic and programmatic areas will emerge from the deliberations of the Assembly. 

The Assembly will be preceded by regional and local Assemblies and other forms of mobilization in different countries. Special attention will be given to supporting young activists to attend and participate in the Assembly and its pre-Assembly activities. 

PHA5 is expected to achieve
It is expected that the Assembly, through the various discussions, exchanges and collective strategizing, will enhance the capacity of the PHM to organize and mobilize for health and health determinants. It is expected that concrete actions in the main thematic and programmatic areas will emerge from the deliberations of the Assembly. According to what is expressed in the PHM Strategic Plan 2020 - 2025: "The vision of Movement Building is that more governments recognize the Right to Health as a constitutional right, and that the PHM contributes to a global movement towards an alternative economic paradigm: more egalitarian, without exploitation, towards Health for All".

The Assembly aims to advance the PHM goal of health for all people through deliberations focused on five thematic axes (see program). PHA5 will provide a critical space to deliberate on the specific objectives of each axis. 

Our objectives are 

• To analyze the global economic, political and social situation in relation to health policy. 
• To recognize and strengthen the diversity of approaches, struggles and resistances for the health of the people. 
• To articulate strategies that promote the solidarity of the health movement at the global, regional and local levels. 
• Strengthen movements towards health equity, social and gender justice, solidarity and good living, based on the diverse experiences of recent years.

Background and political context of the PHA5
Taken below described context, at the Fifth World People's Health Assembly (PHA5) we want to go a step further and go beyond this analysis, situating our struggles for the right to health from solidarity, empathy, equity and respect for biodiversity to safeguard human lives, nature and ecosystems that weave the relationship of life. 

Important changes in the global context over the past decade that have reworked health struggles include: the threat to comprehensive primary health care; the privatization of health services; increasing inequality and reduction of social assistance; the growing climate crisis; worsening wars, conflicts and displacement; the erosion of democratic structures and the positioning of authoritarian governments; the rise of right-wing political fundamentalism; the growing power of corporations, while the crisis and inequality and global economic domination deepen; the increase in unemployment; the increase in insecurity and loss of food sovereignty; and the general weakening of international human rights organizations, while at the same time old wars continue and new ones emerge that deepen the dynamics of forced internal and cross-border migration. All this disproportionately affects socio-economically vulnerable groups, especially in countries that have been under colonial rule, in the economic and political periphery, and which are characterized as middle and low income countries (LMICs). 

Corporations are indulging in the rampant destruction of ecosystems and biodiversity, generating enormous volumes of toxic waste, while endangering cultural identities and the diversity of life forms. The complexities of conflicts and wars, migration, the climate crisis and threats to democracy - to name but a few - pose new challenges every day. All of these, aided by unjust global and national economic and trade policies, are promoting a capitalist, patriarchal and colonialist development paradigm that is unsustainable and inequitable and creating a complex canvas of deterministic processes that are seriously impeding the realization of health for all. Furthermore, austerity measures in both the South and the North have further compromised access, often as a consequence of the dismantling of public systems and services and the increasing reliance on private health care provision under dynamics of commodification of the right to health. 

In the last three years, the world has experienced the most catastrophic health and humanitarian crisis in recent history, during the Covid19 pandemic. This crisis is a consequence of the prevailing global civilizational model and makes it urgent to change the cultural, social, political and economic paradigm. The anthropocentric logic that constitutes this model, which is based on the feeling of not belonging to Mother Earth, with the consequent destruction, exclusion, extinction and violence in all its manifestations, demands different ways of thinking and living education, production, politics, economy and health, present and re-existing in the ancestral wisdom and practices of the peoples themselves. 

The pandemic highlighted the long-standing structural processes of health inequalities that exist in a predominantly capitalist, neoliberal and corporate-controlled world. The great difference was not only limited to the inability of countries with fewer resources to ensure the availability of essential items such as personal protective equipment (PPE), diagnostics, drugs and vaccines, but also to their inability to stand up to the transnational corporations and the big pharmaceutical industry that profited, and continue to do so, in the wake of the pandemic. Many people have died because they did not have access to properly equipped Intensive Care Units, oxygen or even access to basic health services. Hundres of health workers have been affected by Covid19 not only because of the lack of Personal Protective Equipment, but also because of the worsening of precarious employment and working conditions, the extension of shifts and reduction of rest times, the extremely high emotional burden, delays in the payment of their salaries, among other conditions.

The abrupt and extremely harsh response to the Covid-19 pandemic in many countries, such as the closures, has exacerbated political deprivation and social and economic inequalities and has precipitated a public health crisis, as well as an economic crisis of mammoth proportions. Millions of people around the world have lost their livelihoods and incomes, particularly those who work and subsist in the informal economy. These consequences are disproportionately felt by social groups and individuals at the intersections of caste, race/ethnicity, disability, age, class, gender identity, sexual orientation, occupation, refugees, migrants and other historically marginalized social locations.

Gender-based violence, hunger and starvation, and gender-based work and care overload are among the many problems that have worsened in recent years. Stigma and violence, including racism against communities, migrants, refugees and patients, are phenomena in the COVID context that have also profoundly affected psychosocial well-being and exacerbated fears and consequences of inequalities, discrimination and intolerance. 

The distressing pandemic period has pushed us to reclaim the moment and to assert social justice, health and human rights through regional and global collaborative and solidarity actions. It is now essential to confront the deep flaws in the organization of our societies and worlds. It is a moment of reckoning, of reevaluating which and whose rights to health are essential and valued, including the rights of nature to which we belong. How to create solidarity societies capable of providing access to health services and guaranteeing the right to health, social protection and care, also impacting on those processes that determine the ways of living, getting sick and dying of people and collectives.