People's Democracy

(Weekly Organ of the Communist Party of India (Marxist)


No. 29

July 22, 2012


People’s Health

Cape Town Call to Action


(The Third People’s Health Assembly, organised by the People’s Health Movement, concluded in Cape Town, South Africa, on July 11. The assembly, attended by over 800 delegates from 90 countries, adopted a ‘Call to Action.’ We reproduce below an abridged version of the ‘Call.’)


The Global

Health Crisis

OUR health is threatened by the crisis of capitalism, manifested in food, ecological, financial, economic and political crises. These crises underpin the growing global health inequities within and between countries.


Health Crisis: Growing

Health Inequities

Underpinning the health crisis is the failure to address the social, political and environmental determinants of health resulting in:  the erosion of food sovereignty; inadequate income; and a lack of fair and equitable access to water, housing and sanitation, education, employment and universal and comprehensive health services.


Millions of families, particularly in low- and middle-income countries, are being denied access to comprehensive primary health care and universal health services by poverty and other institutional barriers. In high income countries, there has been a continuing campaign to reduce funding and support for the public sector and to replace public services with the market. Moving health care out of the public domain makes it easier for large capitalist enterprises (big pharma, big insurance and bio technology) to increase sales and profits, working in close partnership with those who make profits from the delivery of health services.


An emerging global trade and investment regime (driven by trade and investments agreements) is seriously undermining universal social entitlements and the powers of states to regulate activities’ of corporations and private financial institutions.


Access to affordable medicines has been compromised as a result of the WTO-TRIPS Agreement and the continuing pressure on developing countries to adopt TRIPS-plus standards through trade agreements and bogus anti-counterfeiting initiatives.


While we welcome the recent upsurge of interest in the concept of universal health coverage, we oppose the idea that this be achieved through the promotion of a minimalistic insurance model that would operate within a marketised system of healthcare, or worse still, be used as a context or excuse to dismantle or undermine public hospitals and promote corporate interests in health care delivery.


The Crises

of capitalism

The global health crisis is the result of the current capitalist crisis and the imposition of a neo-liberal political and economic model, which has several inter-related dimensions, among them: political, food, economic, financial and ecological. 


The political crisis is rooted in the lack of accountable, transparent and democratic decision-making. Globalisation has resulted in the immense concentration of power amongst a wealthy and corporate elite, who actively undermine democracy and social justice through the influence and corruption of national governments and international institutions. Even in countries with progressive governments, spaces for democratic participation are closing down and protest is being criminalised.


Imperialism has increased the use of its military might to maintain and expand its control over the political architecture as well as resources of the planet. The war industry, is deeply embedded within the capitalist economic system.


The financial crisis is rooted in the de-regulation of banks, that were allowed to become ‘too big to fail,’ Worse still, the response of national and international institutions to the financial crisis has been merely to restore the confidence of the same institutions and financial markets that had caused the crisis in the first place. Governments have swiftly enacted an ‘austerity agenda’ – cutting health and social spending --- effectively deepening and reinforcing the very neo-liberal economic model the crisis had so discredited, and handing even more power to the financial capitalist class.


The ecological crisis mirrors the rise in global inequalities as characterised by the obscene over-consumption of a small minority that is overstretching the capacity of the planet and a large majority of humanity who are denied even their basic needs. We all live on one planet – a fragile planet – that sustains the life of all. But the resources of this planet are being privatised and plundered in ways that are damaging and unjust.


Coercive population policies enacted in the name of climate protection are now violating women’s rights. Rich nations are passing on the burden of the ecological crisis onto the poor. Many of the effects of overproduction and consumption and climate change are felt by the world's indigenous communities, small-scale peasant farmers, the poor and the working classes.


The crisis of climate change is also clearly part of the crisis of capitalism. Although the planet is capable of providing for the needs of all its people, the current system of production and consumption only undermines the natural basis of life through a need for constant growth, while leaving billions of people in poverty.


The food crisis is manifested by the existence of a billion hungry people and two billion overweight or obese people. It is a manifestation of a much larger and more pervasive malaise, caused by the loss of food sovereignty and of control by communities and poor nations over their own resources. The food system is dominated by transnational corporations (big agribusiness and big food corporations) which has resulted in mono-cropping and the replacement of food crops with crops for bio-fuels; a huge increase in the speculative trading of food grains; unfair trade agreements; and oligopolies in the food retail sector. The food crisis is now being worsened by ‘land grabs,’ a new form of colonialism in which transnational corporations and sovereign wealth funds are acquiring large tracts of arable land in poor countries –displacing domestic food production systems as well as rural peoples from their lands. Meanwhile, hunger and malnutrition is being converted into a new market for processed ready-to-use foods (RUTF) and nutriceuticals.


Our Alternative


We seek a better world. We believe that transformative and radical change is required and can be achieved.


We need a new economics, which values every individual equally, not every dollar. It should be based on the objective of maximising benefits to people – their health, wellbeing, and quality of life – not total output or income. It should be based on collaboration, within and between communities and nations, not on competition. This is an economics that would be socially directed rather than market driven.


We also need new economic systems that would:

·                    ensure that everyone has enough, while discouraging over-consumption;

·                    encourage appropriate, equitable and sustainable consumption, with the least ecological and human impact, reflecting a commitment to future generations and harmony with the planet.

·                    replace existing global and regional trade and financial agreements with those that will eradicate food insecurity and malnutrition;

·                    be rooted in local communities and peoples’ lives within them, having an  obligation to local communities while being globally responsible;


We need a new system of global governance, including the international trade and finance systems, that places health, well-being, human rights and environmental sustainability at the centre of all policies, and genuine equality of influence at the heart of all decision-making, and which would fulfil the standards of democracy, accountability and transparency applicable at the national level.


We seek a world in which governments would:

·                    work multi-laterally to reach peaceful resolutions to international conflicts

·                    refrain from imposition of their own policies and interests on other sovereign nations, whether through force or by economic pressure; 

·                    be held accountable to the full implementation of the Universal Declaration of Human Rights and the Covenant on Economic, Social and Cultural Rights, including ensuring the systems for the provision of all dimensions of social and economic security

A new system of global and national governance would include regulatory structures that ensure:

·                    fair and progressive taxation regimes within and between countries that would enable equitable redistribution of resources and power

·                    effective closure of tax havens and democratic reform and regulation of the international banking system;

·                    A new and open regime for the production and management of knowledge and technology that protects findings essential for human and ecosystem health from private capture, and which promotes a new and open regime of knowledge sharing

Specifically, in the arena of global health governance, our vision would see a more coherent and accountable system of governance that would be free from corporate influence and the influence of unaccountable private actors. Multiple programmes and funds need to be replaced with new and more accountable mechanisms for the management and allocation of global public finance, working with and through UN institutions.



The World Health Oorganisation:

·                    must follow its constitutional mandate to act as the directing and coordinating authority for international and global health

·                    must be fully and adequately funded by assessed and untied contributions from sovereign nations

·                    be accountable to countries and the people of the world


Health systems should be:

·                    Universal, integrated and comprehensive, and also provide a platform for appropriate action on the social determinants of health;   

·                    based on accessible, effective, gender-sensitive, youth-friendly and free comprehensive primary health care, accountable and appropriate to people’s health needs;

·                    properly and adequately publicly financed with public expenditure representing the major share of total health expenditure and capable of protecting the population against the rising costs of health care;

·                    be capable of retaining local health workers within the national health system rather than losing them to international migration

The third PHA has celebrated the successes of the growing People’s Health Movement. In order to diminish the power of financial capital; democratize governance; and defeat neo-liberal economic policies, we will need to build a more effective and broad-based social movement. To this end, we will commit ourselves to building alliances with other movements and organisations who seek progressive and transformative change.