Julio Monsalvo, PHM Argentina Circle: A History of Struggle

"Who said all is lost?
I've come to offer my heart"
Fito Paez

With a militant and committed spirit, with the energy to contribute to the strengthening of the PHM in Latin America and the world, also recognizing the difficulties we are going through and the necessary wait for appropriate resolutions and decisions, we believe it is politically strategic to advance in the organization of the Fifth People's Health World Assembly in the territory of "Abya Yala" (Latin America). We believe that this will be an opportune occasion to promote dialogue and political ties and solidarity already in place, to address new challenges and to review our practices and structures. Therefore, the circle of the PHM Argentina assumes the challenge of hosting the Assembly in the city of Mar del Plata, from April 7 to 11, 2024.

The realization of the 5th People's Health Assembly in Argentina will allow to expand the dissemination and international recognition of the collective health process in all its expressions and the great diversity that the South American country enjoys; it will visualize the experiences of dialogue of knowledge between academia and social movements; it will promote the exchange of knowledge and concrete experiences of struggle and resistance from around the world; it will build collective global strategies from the grassroots, expanding the influence, articulation, protagonism and leadership of the Argentine movement at the international level.

At the moment, Latin America is one of the largest spaces of confrontation between progressive forces, extreme right and resistance to neoliberalism. The region has regained hope after large mobilizations and elections of several progressive and leftist governments. Among them, Mexico, Argentina, Bolivia, Colombia, Cuba, Chile, Honduras and, more recently, Brazil and Guatemala. This new moment is marked by the need to build alternatives for the future from the progressive and popular forces, without ignoring the stalking and emergence of ultra-right forces that will generate new struggles and resistance.

The celebration of PHA5 in Argentina will have a fundamental role for the region. In the field of health, several issues require dialogue, articulation and regional action. Some examples are health system reforms and the construction of universal systems; the difficulty of reversing mercantilization in segmented and fragmented systems; the discussion of interculturality and the decolonization of health policies; the need for greater regional integration to build sovereignty in health; the need for joint strategies to face the consequences of the climate crisis, environmental degradation and the advance of extractivism, in addition to pandemics and health crises. And, no less important, the construction of a new international political, economic and social order that guarantees social justice, democracy, the right to health and life.

The PHA5 is a unique opportunity to strengthen the articulation of social health movements in the region and to take an organizational leap in their collective action. In addition to the discussion between governments and academia, it is necessary that the popular forces build articulation and international solidarity to intervene in the collective agendas from the movements, workers and civil society, from the territories to the international forums.

The road traveled

Argentina, a member country of the PHM Southern Sub-Region of Latin America "Julio Monsalvo", has been present in the PHM since the origins of the Movement when the pediatrician, activist and thinker for the right to health, Julio Monsalvo, participated in the First World Assembly in Bangladesh in 2000.

From then on, Julio began a militancy of permanent commitment to the founding Charter of the PHM, sharing it with grassroots organizations such as the National Health Movement (LAICRIMPO), the Association of General Medicine of the Province of Buenos Aires and the Argentine Federation of General Medicine Associations (FAMG). Subsequently, the return to the country of Carmen Baez (also a PHM founding activist) to the region brought a new dynamism.

At the 2nd PHM World Assembly, held in Ecuador in 2005, an important group from Argentina actively participated and then began to hold talks and workshops in different spaces in order to raise awareness of the Movement, until in 2007, in the city of Rosario (Santa Fe), the official launching of the national circle of the PHM Argentina took place with the participation of different actors and civil society organizations, all advocates for the right to health. The event had the participation of Latin American delegates such as Colombia and Ecuador.

In 2008 the Argentine government, through the Ministry of Health, held a special celebration of the 30th anniversary of the Alma Ata Declaration and invited world personalities such as Halfdan Mahler and our colleague Ravi Narayan, also a PHM founder. At the end of the official activities both comrades participated in a day for local PHM activists, visiting health centers in marginal areas, sites of Memory and with a talk at the Faculty of Medicine.

Argentina has had an important representation in all of the PHM’s World Assemblies, with monetary contributions from the movement, but also with self-financed participation, as was the case of South Africa, where the comrades who participated self-financed their costs to guarantee their participation. Also with enthusiasm and self-financing the MSP AR, has participated in the two Latin American assemblies (Cuenca-Ecuador 2013 and Chimaltenango-Guatemala 2017), with a large Argentine delegation based primarily on self-management from each organization.

On the other hand, during the First Latin American Assembly, held in Cuenca, a new organizational structure was decided at the regional level, establishing four sub-regions and a collective coordination. In the southern sub-region Sandra Marín and Marcela Bobatto developed this mandate for five years, weaving new connections between organizations and institutions in Argentina, with articulation in Latin American and global spaces, a process that continues to be strengthened with the new coordination and is currently being extended to Chile, Uruguay and Paraguay.  During all these years the Argentine comrades did and continue doing militancy in the name and representation of their grassroots collectives and also of the PHM, in consonance and synchronicity. Carmen Báez, from Argentina, and Mariluz Martín, from Paraguay, are our acting coordinators.

Among the Argentinean organizations that are part of the PHM we can name the Association of General Medicine of the Province of Buenos Aires (AMGBA), the Argentinean Federation of General Medicine (FAMG), the National and Latin American Health Movement (LAICRIMPO), the Jarilla Network of Healthy Plants of Patagonia, Propuesta Tatu (Buenos Aires), Ramón Carrillo Forum, Hunger Museum, the Mental Health Association (ADESAM), colleagues from popular education organizations and other allied social movements, health officials and academics, among others. We have important allies such as the Latin American Association of Social Medicine and Collective Health (ALAMES), the network of Free Chairs of Food Sovereignty (CALISAS), the Network of Teachers against Agrotoxics of Entre Rios, the Latin American Agroecological Movement (MAELA), the Chair of Socio-environmental Health of the National University of Rosario.

For 33 years, the National and Latin American Health Movement (LAICRIMPO) has been holding annual three-day self-managed meetings, with the participation of between 400 to 1000 people, organizations and institutions from most of the Argentine provinces and some Latin American countries.

The Jarilla Network of Healthy Plants of Patagonia, born in 2003, has among its objectives the contribution to the sustainability and valuation of daily life from healthy eating habits and health care through plants and ancestral practices, in synchronicity with the proposals of Primary Health Care and different spaces of Public Health. It meets periodically every three months in delegates' meetings and, once a year, in a three-day meeting open to the community, with an average attendance of one hundred and fifty people and a pre-established program of activities to be developed in accordance with the existing social, political and/or environmental moment.

In the same way, the Association of General Medicine of the Province of Buenos Aires (AMGBA) and the Argentine Federation of General Medicine (FAMG), which congregate members of the health teams, organize congresses every year where between 1000 and 2000 people participate. Founding members of the Global PHM such as David Sanders, David Werner, Maria Hamling Zuñiga, Eduardo Espinoza and activists from Latin America such as Margarita Posada, Arturo Quishpe, among others, were invited and financed by our Congresses.

The generalist movement in Argentina was born with democracy with a government proposal close to Alma Ata that put Primary Health Care (PHC) into practice. One of the important characteristics is that it is the first discipline that proposed not to ally itself with laboratories or the pharmaceutical industry in the work of the scientific society, as sponsors of its congresses. It is a precursor of interdisciplinarity in health. For 30 years it has integrated psychologists, social workers, health promoters, nurses, health promoters, etc., participating in its events. And from the beginning there was a place for the communities in the central tables and workshops. It has always defended health as a right, associated with the fact that the core work is in the state, in public health.

The Hunger Museum is a space of encounter and struggle for Food Sovereignty that is part of the Network of Free Chairs of Food Sovereignty and Related Collectives (Red Calisas).

The Association for the Rights in Mental Health (ADESAM) was formed in 2005 with members of the field of Health and Law, being its purpose to fight for the full exercise of the rights of people with mental illness, for their inclusion in the community, which implies being part of the anti-mental health struggle consistent with that orientation.

Tatu Proposal is a Community Health Center, built by the population in a land taken, where volunteers from all disciplines and interests offer assistance and preventive care, which facilitates access to health in a comprehensive manner in the community. It was born with the Argentine doctors trained in the Latin American School of Medicine (ELAM) and therefore has a political position based on the Guevarist praxis of all its members. Several members of the MSP are militants in TATU.

These experiences are enough to visualize the character of resistance, re-existence and self-financing  that defines our sub-region. We are referring to forms of organization that include the creation of contents of interest, voluntary work (viditancia-militancia (activism for life)), fundraising for transportation, food and lodging. Due to this background, we are sure that we have the necessary resources, as well as the working groups to carry out the organization of ASP5.

The Movement is organized within the Southern Sub-region (Argentina, Paraguay, Chile and Uruguay) from a network of organizations, movements, networks, and since 2022 with the launching from the sub-region of strong thematic circles that have developed an interesting work with contents and proposals, which were extended and began to articulate with other Latin American regional coordinations, and with the regional and global team. These thematic circles are: Nutrition and Food Sovereignty, led by Marcela Bobatto and Marcos Filardi; Ancestral Knowledge, coordinated by Sandra Marín; and Mental Health, led by Susana Ratti. We actively participated in the campaign on the Transformation and Decolonization of Health Systems in Latin America and from that moment on we started to work in the Circle on that topic, facilitated by our colleague Mariluz Martin from Paraguay. The three regional thematic circles were extended to the rest of Latin America in the process of mobilization towards ASP5, to contribute with proposals in the program and resolutions of the same.

As mentioned, as the PHM gained strength in Argentina, representatives of different grassroots collectives and institutions participated in the different world and Latin American assemblies, which has strengthened the internal processes of struggle for health and a greater adhesion to this world organization. The PHM Argentina has participated in world campaigns, in the construction of the book "How to build a Health Movement" and in the elaboration of the book "Approximations to Good Living" compiling cosmovisions and experiences from all Latin America.

We can conclude that in these years there has been a qualitative and quantitative growth in Argentina that drives the participatory construction of the Movement not only in the sub-region but also at the Latin American level, with undeniable influence in the global space.

In the 4th PHM’s World Assembly held in Bangladesh 2018, the Argentinian  group proposed to host the the 5th Assembly, and from there began a work of consultation in all networks and organizations regarding this possibility, finding ourselves currently with massive support at national and regional level and the certainty of being able to carry it out. Likewise, we have the support of the Latin American regional and thematic circles that are working.

One of the public institutions supporting the 5th Assembly is the School of Medicine of Mar del Plata (Province of Buenos Aires). This School is part of a group of careers with an innovative curriculum profile, student-centered education. The program has a distinctive mark that was not taken into account in medical education, which includes: a strong presence in community environments from the first semester of study, work in communities and problematization of health, housing, water and quality of life issues in general. The program also includes learning processes, with group work and discussion, which is what is called case-based learning, problematizing reality among peers, and peer education. In addition to the classes with teachers and professors, the scenarios where medicine is taught are various, the hospital is replaced by other scenarios, like any place where health is problematized, any scenario is formative. It is integrated by teachers from more than 20 disciplines, it is an interdisciplinary education.

See you in Mar del Plata!