World Council of Churches

A worldwide fellowship of churches seeking unity, a common witness and Christian service

62nd World Health Assembly

Civil society organizations and social movements from across the globe met in Geneva, on 15-16 May, 2009, at a Forum on Equity, Justice and Health, organized by Peoples Health Movement, Third World Network, and the World Council of Churches to share concerns and recommend actions that civil society views as being of critical importance for advances in global Health and health equity. Based on the discussions they presented to the WHO and member countries participating in the 62nd World Health Assembly some overarching concerns as well as specific recommendations on the two resolutions on Primary Health Care and Social Determinants of Health.

16 May 2009

Civil society organizations and social movements from across the globe met in Geneva, on 15-16 May, 2009, at a Forum on Equity, Justice and Health, organized by Peoples Health Movement, Third World Network, and the World Council of Churches to share concerns and recommend actions that civil society views as being of critical importance for advances in global Health and health equity. Based on the discussions we present to the WHO and member countries participating in the 62nd World Health Assembly some overarching concerns as well as specific recommendations on the two resolutions on Primary Health Care and Social Determinants of Health. We urge member countries, civil society organizations and the WHO to take these into account in deliberations in the Assembly incorporate these in the resolutions to be discussed.

We urge Member States

In the area of Primary Health Care and Social Determinants to:

  • privilege the interests of people and public health, over commercial and corporate interests.

  • adopt a rights-based approach, including full ratification of the International Covenant on Economic, Social and Cultural Rights

  • establish a time-frame for achieving health for all, incorporating different strategies in local contexts

  • recognize the central role and responsibility of governments in ensuring universal access to health, while acknowledging the current role of community and faith-based organizations in PHC

  • recognize the capacities and capabilities of grassroots and community organizations and indigenous groups, as building blocks in the design and implementation of PHC

  • ensure that gender equity is a cross cutting concern in the implementation of PHC and in the addressing of social determinants of health

  • increase capacities of the public sector in health care provision, health research and health related industry (viz. pharmaceutical manufacturing), and strengthen national public health programs

More specifically in the areas of:

1. Governance, to:

  • ensure democratic and transparent decision making processes

  • establish mechanisms for accountability, including channels for civil society to monitor health budgets

  • enable empowerment of local populations to participate in the building of health care structures that are accountable to the needs of communities

2. Health Financing, to:

  • dedicate at least 5% of national income and 15% of national budgets to health services

  • ensure health care is free at the point of access for all, with a focus on equitable access for the poor

  • establish time-bound targets to achieve universal access that is free and equitable and ensure adequate resources to achieve them through sustainable financing mechanisms

  • avoid commercialization of health care and IP protection for health products, that unnecessarily increase the cost of health services without off-setting public health benefits

3. Trade and Health, to:

  • in the interim, incorporate full TRIPS flexibilities and avoid TRIPS-plus measures in national laws and in trade agreements, while working towards the re-negotiation of the TRIPS agreement to limit monopoly and promote access

  • ensure just/equitable licensing of IP produced by public funded research, and examine alternative mechanisms to IP to promote innovations

  • promote local manufacturing capacity for medicines, and strengthen public health systems’ ability to promote medicines access through use of price controls, rational drug use and use of generics

  • avoid liberalization, of health services, and promotion of medical tourism at the cost of public health

  • mainstream health concerns in all trade negotiations, and ensure trade agreements do not impinge on domestic regulation, and involve Health Ministries actively in trade negotiations

4. Food and Agriculture to:

  • promote and protect land, water,forest and employment rights of agricultural workers

  • restrict use of agricultural land for non-food purposes (viz. for biofuels, SEZs)

  • support local and traditional food and agricultural production

  • ensure equity in food distribution, promote food security, and ensure food safety norms that are also sensitive towards protection of livelihoods

5. In the area of Human Resources to:

  • develop and implement long-term human resource plans to meet health needs while also ensuring decent pay and working conditions of health care workers

  • involve health care workers, centrally, in health system planning processes

  • put in place policies and mechanisms to stop the flow of scarce health care workers away from developing countries, compensate governments for human resource losses and ensure ethical and transparent procedures where recruitment of external health care workers is unavoidable

  • adopt measures to retain, train/retrain and redeploy health professionals, and develop mechanisms for bringing unemployed HCW back into the HC system

  • address the problem of movement of the workers from the public to the private sector

  • dedicated long-term assistance for strengthening Human Resources in developing countries

We urge the World Health Organization to:

  • reclaim its leadership role in promoting and protecting of global health

  • move beyond operating in silos, and approach issues through the lens of equity, determinants and rights.

  • ensure that priorities and actions of the WHO recognize that health inequities are tied to global structural inequities, and that addressing these inequities will require reorienting the global economic and political architecture

  • mobilize resources for resource deficient countries to implement PHC approaches and actions to address social determinants of health

  • support member states to enact legislations and mechanisms to make health a fundamental right

More specifically in the areas of:

Human resources, to:

  • Give priority to addressing the acute shortage of human resources for health care in developing countries as a cross cutting issue for the WHO.

  • Recognize the urgency in this regard given the threat of reduction in jobs for health care workers in the context of the present global financial crisis.

Trade and Health, to:

  • build internal technical capacity to monitor and assess impact of global economic and trade policies on health equity

  • provide technical assistance to member states to make use of TRIPS flexibilities, and to examine all trade agreements – multilateral or bilateral – with a public health lens

  • be proactive in preventing TRIPS “plus” measures from being promoted

  • ensures the exclusion of pharmaceutical companies in all forms of participation, including covert or overt funding, in norm setting activities

  • take the lead in moving health services out of the General Agreement on Trade in Services (GATS).

Food and Agriculture, to:

  • promote food security, and sustainable agricultural practices sensitive to local cultures and needs.

  • coordinate monitoring and measurement of impacts of current financial, food, and agrarian crises on human nutrition.

We also urge member nations, in order to promote and protect global health equity, to ensure the following:

  • Multilateral Organizations, particularly the World Bank, the IMF and the WTO, should not act as spokesperson for global corporations.

  • The governance of the IMF and the WB be democratized through representative voting mechanisms, with much greater levels of transparency and accountability.

  • Multilateral agencies co-ordinate their activities to protect and promote biodiversity, and address the issue of climate change and its impact on health and health equity

  • Address the inherent inequity in the Agreement on Agriculture under the WTO, so as to mitigate and reverse its devastating impact on land rights and access to local resources, local agricultural practices and food security in many developing countries

  • WTO address need to protect agriculture from monopolies being conferred to agribusiness companies by IP protection.

  • That they apply health equity impact assessment for all national and global policies

  • In recognition of obligations of mutual assistance, establish mandatory mechanisms for global financing of national health systems in developing countries