Public Health Issues Out in the Cold

By Marwaan Macan-Markar

Public health activists like María Hamlin Zúniga, global coordinator of the International People’s Health Council (IPHC), are striving hard to get the World Social Forum (WSF) to incorporate public health issues into its mainstream agenda. If that is done, the global commitment to achieve health for all will be achievable, she says. Yet, as this year’s WSF reveals, public health concerns still hover on the margins of the debates.

Your movement has been trying to move public health issues to the centre of national and global policy, yet even at the WSF, your political agenda still appears to be on the sidelines. Why is that?

When people only have a medical view of health, it is hard for them to see the relationship between their issues and health issues. We don’t see it that way. We are trying to get people to understand that health covers all of our lives. We see the strengthening of health systems as one of our major demands. For example, how can we talk about conflict and not think of the lives and well being of the people affected by the threats of war.

So who has failed in getting that message across?

Perhaps it is the failure of people who are health activists. We need to bring that political consciousness of health to the whole movement – the people’s movement, the civil society movement. We need to make the connections between trade, the WTO (World Trade Organisation), the free trade agreements in the Americas – issues at the WSF -- and health.

How do you plan to do that?

We need to have a way to integrate certain actions that we want to pursue all over the world. At this WSF, for instance, we launched a Million Signature campaign to achieve the “Health For All” goals, since governments made a commitment back in 1978 to achieve that target by 2000, but it has not happened. We need to focus on that and ask why.

In that light, what themes or debates at the WSF can your movement identify as being relevant to your cause?

The impact of transnational corporations, of the (International Monetary) Fund, of the (World) Bank on societies troubles us. They have a lot to do with why we do not have health for all. And one of our demands has been that the World Health Organisation and the ministers of health take back the mandate. Bankers should not make decisions about health policy.

Are there many at the WSF who have to be convinced by that argument?

Nobody can say I am against health. It is very hard for people to say, “No I’m not in favour of health.” But we have to do more consciousness-raising with people at the WSF, because they will know that health is their issue. We are not using this signature campaign merely to get signatures; we are using it to get people to understand that health is an integrating issue with the other issues being discussed at the WSF.

In seeking a presence with the WSF it appears you also favour the flexible make-up of such a movement?

Yes, because in the people’s health movement, we do not want a hierarchy. And we have to be careful that it does not become hierarchical, since we have to be as just and fair as we are asking the world to be with the people.

Does such opposition to people’s movements gaining an institutional framework mean activists are searching for a new political order?

We have seen what hierarchical power structures are capable of doing, and that is why people are very cautious when it comes to setting up structures when you are talking about movements. Power, according to that saying, corrupts, and when people have a lot of power and money to go with it, then corruption sets in. We don’t want to see that in our social movements.

One glaring omission at the WSF, though, is the absences of voices from the other side of the political or economic divide at the debates. This, however, was not the case when you had the People’s Health Assembly in Bangladesh in 2000. Is that a problem?

Some people feel that the arguments of the Bank and the Fund are entirely bankrupt so why waste our time. I think it was important that we were able to have a dialogue with the World Bank at the assembly. In the end it was obvious that our arguments were much stronger than their arguments. I think it is important to have these dialogues, because if we are prepared with our documentation about what is happening there is nothing to be afraid of in this dialogue. We have reason on our side. It helps other people to understand when they hear two sides.